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Sweden and coronavirus

weltweit said:
That is true, but they have achieved what they have achieved without a lockdown / have tested some 270,000 people, at 20,000 a day. I am just trying to see what Germany have done right now, at first glance their health service does seem more prepared and better resourced than many other EU countries.
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Germany has various capacity advantages but I dont know quite how much of a difference maker that will actually be. Their testing regime was clearly different because they detected rather a large number of younger people (eg lots of people who had been skiing in the affected regions of Italy). But I dont actually know as any advantages they found in the early phase will carry through into the next phase in a way that meaningfully changes the picture there. It doesnt look like it will to me, but I should give it more time really.

South Korea has been different in many ways so far, but those gains will only last if they have really dodged the sort of epidemic growth we are now seeing in so many countries. Their testing, tracing and healthcare/hospital infection control advantages dont necessarily scale up, so they are on the list of countries with different outcomes so far that I am watching for signs that they still end up like everyone else eventually.
 
elbows said:
Germany has various capacity advantages but I dont know quite how much of a difference maker that will actually be. Their testing regime was clearly different because they detected rather a large number of younger people (eg lots of people who had been skiing in the affected regions of Italy).
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Yes, I have just posted about the skiing in Italy thing in a post on the world thread.
Some unique features of the German experience it seems.

elbows said:
But I dont actually know as any advantages they found in the early phase will carry through into the next phase in a way that meaningfully changes the picture there. It doesnt look like it will to me, but I should give it more time really.
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elbows said:
South Korea has been different in many ways so far, but those gains will only last if they have really dodged the sort of epidemic growth we are now seeing in so many countries. Their testing, tracing and healthcare/hospital infection control advantages dont necessarily scale up, so they are on the list of countries with different outcomes so far that I am watching for signs that they still end up like everyone else eventually.
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SK has been experiencing daily reductions in active cases for nearly two weeks now. They may well get a second outbreak, but this first one has been contained with minimal deaths. Their initial test-trace-isolate policy worked. I think we can safely say that now. Doesn't mean they are now immune to any fresh crisis, but does mean they have weathered an initial potential crisis.
 
littlebabyjesus said:
SK has been experiencing daily reductions in active cases for a week now. They may well get a second outbreak, but this first one has been contained with minimal deaths. Their initial test-trace-isolate policy worked. I think we can safely say that now. Doesn't mean they are now immune to any fresh crisis, but does mean they have weathered an initial potential crisis.
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I agree, thus far without lockdown their testing etc seems to have done very well, obviously it could still go tits up but I have a feeling that they have found a successful way. Does anyone know how many people are involved in their contact tracing enterprise, I have heard of massive numbers of tracers being needed to do it properly.
 
littlebabyjesus said:
SK has been experiencing daily reductions in active cases for nearly two weeks now. They may well get a second outbreak, but this first one has been contained with minimal deaths. Their initial test-trace-isolate policy worked. I think we can safely say that now. Doesn't mean they are now immune to any fresh crisis, but does mean they have weathered an initial potential crisis.
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I would not doubt the effectiveness of their testing & tracing. Especially when coupled with their approach to hospital infection control (maximum PPE, negative pressure rooms, dedicated Covid-19 hospitals), an aspect which is often overlooked.

As for the future, clearly I have my doubts, and I would not talk about their first wave as if it is beaten yet.
 
weltweit said:
I agree, thus far without lockdown their testing etc seems to have done very well, obviously it could still go tits up but I have a feeling that they have found a successful way. Does anyone know how many people are involved in their contact tracing enterprise, I have heard of massive numbers of tracers being needed to do it properly.
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Don't know about SK. I read a figure of 16,000 people in Hubei province alone at the height of China's outbreak.
 
elbows said:
I would not doubt the effectiveness of their testing & tracing. Especially when coupled with their approach to hospital infection control (maximum PPE, negative pressure rooms, dedicated Covid-19 hospitals), an aspect which is often overlooked.
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Test-trace-isolate, with each step crucial to the success of the process. That's surely the lesson here. East Asia had a head start because they've had these scares before and we haven't.
 
weltweit said:
More on SK here, from last night: Coronavirus - worldwide breaking news, discussion, stats, updates and more
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tbh I'm sure one of the reasons places like the UK didn't follow this model was the cost involved in setting up an effective trace and isolate system. Such a cost pales into insignificance compared to the costs now being incurred, of course. Also, SK's health care system is generally very good already, so they started from a good place. So spending money on your health system saves you money long-term. Whodathunk?
 
keybored said:
You'd hope so. It depends on whether cause of death in those with pre-existing conditions is marked as COVID-19 or the pre-existing condition.

Sorry, "hope" probably not the best word to use there.
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There also seems to be a question about how deaths outside hospital are being handled.
 
littlebabyjesus said:
Test-trace-isolate, with each step crucial to the success of the process. That's surely the lesson here. East Asia had a head start because they've had these scares before and we haven't.
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Yes we have been talking about that lesson for ages. It is not in dispute that it has had a major effect in the countries that stuck to it. I am disputing whether the advantages they gained are sustainable - I just dont know - I expect to find out over the next month or so.
 
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Yeah The Local is normally paywalled to 2 or 3 articles a month, but they’ve adopted the stance of having anything virus-related free to access, so should be no restrictions on that article or anything else concerning Coronavirus.

I’m staggered that there wasn’t a national ban on elderly care home visits in place before today. I had no idea, as my wife’s grandma is in a home here who banned visits 3 weeks ago, and I just assumed it applied everywhere. Surely that’s one of the first and most obvious things you do? I’m bewildered by the Swedes apparent lack of concern, or let’s say relative lack of concern compared to other countries.
 
I'm surprised they havent blinked yet, with an increase of 300 recorded deaths since this thread was started. Especially with the amount of international attention they have received for their stance.
 
Fuck it. I’m on holiday currently in Sweden. since my girlfriend can’t visit me in Copenhagen, I have escaped to her parents summerhouse in Öland with her.
if you’re gonna isolate, might as well as do it properly. Plus Netflix and chill with my flat mate is just awkward.
 
I still dont expect them to maintain their current stance much longer, based on stuff I've read in articles like this one.

Bccourier.com

www.bccourier.com www.bccourier.com

In an interview with the newspaper “Dagens Nyheter”, the social democrat says that the pandemic in Sweden is slower than in other countries does not mean that there will be fewer seriously ill and dead people. Sweden is pursuing the strategy of delaying the increase in infections in order not to overload the health system, said Löfven. “But that also means that we will have more seriously ill people who need intensive care, we will have significantly more deaths. We will face thousands of deaths. We should prepare for this. ”
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According to official information, Sweden has 4, 89 Beds for adults in intensive care units pro 100. 000 Inhabitants over in Europe comparatively very little capacity. In the country there are around 520 Intensive beds, of which 470 are occupied. Work is ongoing to increase the number. However, new intensive care units cannot be set up quickly, as government officials admit. In addition, qualified personnel must also be available.

As the tabloid “Aftonbladet” reported on Saturday, citing internal documents, the situation in the intensive care units in the Stockholm region is now dramatic. All beds could be occupied there this weekend, according to a letter from the University Clinic Karolinska, from which the sheet quotes. He would then have to prioritize which patients need the most intensive care treatment. “Our most important task now is to save everyone as many lives as we can together,” quotes the sheet at the end of the alarm letter.

Otherwise, work is being done to create more hospital beds. At the weekend, a field hospital for initially 19 open coronavirus patients, this could affect more than 600 beds will be increased, according to the authorities.
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On Thursday, Swedish media such as SVT or Sveriges Radio reported that the corona virus had already spread to several old people's homes in the capital, Stockholm.

A nursing service told the SVT that it is now in the homes he manages in the Stockholm region 250 Older people with a coronavirus Infection, including many with pre-existing conditions. So far 50 died, said the head of the “Familjeläkarna” service, Stefan Amér. Tegnell also reported on Thursday “more cases in retirement homes in Stockholm and other parts.”
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In the background, however, a course change is now also being prepared in Sweden. In order to limit the spread of the virus, the red-green minority government wants to get significantly more competencies and special powers, reports Sveriges Radio, citing the tabloid “Expressen”.

Accordingly, the Löfvens government addressed the opposition with a bill to secure their support for possible immediate measures such as curfews. The government wants to introduce the law as soon as possible, it should apply for three months. It should enable the government to take swift steps in the fight against the pandemic without first having to contact the Reichstag.
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“Among other things, it could be a limitation of meetings, closing of Shopping centers, bars, discotheques, fitness studios, cafes or sports facilities go ”, the station reports online. Furthermore, the law should allow transportation to be restricted and the government to have access to infrastructure facilities such as ports, airfields, bus and train stations. The Ministry of Social Affairs has confirmed to the Swedish news agency TT that preparations are underway for a corresponding bill.
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Asked my mate in Sweden about this on Friday. He said that basically the government has done what it can. In order to enforce lockdown they would need to give themselves a lot more powers than they currently have. He said that Swedish people are very civil minded and don't need to be forced to stay indoors at times like these.

Said it was hard to explain to people who aren't Swedish.
 
editor said:
To no one's surprise

www.theguardian.com

Sweden prepares for possible tighter coronavirus measures as deaths rise

Country has taken soft approach and its death rate is higher than its Nordic neighbours’
www.theguardian.com www.theguardian.com
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Ah so the Reichstag-bypassing measures being discussed in that previous article I found are off the table (see quote from your article below), lets hope that doesnt lead to too many further delays there. They've already lost so much time that we will unfortunately get to see, in Stockholm at least, what the consequences of doing too little are.

The state broadcaster SVT said on Sunday that after an outcry by opposition parties, the Social Democrat-led government had abandoned plans reported earlier in the weekend to rule by decree, bypassing MPs.

Under legislation to be tabled next week, the Riksdag, Sweden’s parliament, will now be consulted before the government takes any new emergency steps such as shutting airportsor train and bus stations, closing shops and restaurants, further limiting public gatherings or requisitioning medical equipment, according to SVT.
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Looking at Sweden's numbers on Worldometer, they don't appear drastically different from those of countries on lockdown, tbh. Early days still, but the first indicator of change, daily new cases, looks to have stopped growing and may now have peaked. Not been massively testing, but twice as many tests as the UK (low bar, admittedly). You wouldn't be able to pick Sweden out from a set of country stats and go 'clearly no lockdown here'.

The Dutch are using a comparison with Belgium's numbers to justify their continued 'smart lockdown' approach. Between the two of them, you wouldn't know from the numbers which one had the stricter lockdown. That still could change, of course, as neither is near peak yet.
 
A new bill which would allow the government to take measures -- such as closing schools, shopping malls, or restaurants -- without first getting parliamentary approval, now has enough support in parliament to be passed, following discussion with the main opposition parties.

The law is set to apply from April 18th to June 30th, and will only apply to measures related to the coronavirus crisis.

"We are now experiencing a historically difficult situation and we need opportunities to make difficult decisions if necessary," said Health Minister Lena Hallengren. "Even if parliament works fast, it can mean that we lose days. We are not prepared to take that risk."

Hallengren added that the government does not currently have concrete plans for any measures it would take under the new law.
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A total of 687 people have died with the coronavirus in Sweden, according to the Public Health Agency's latest update (presented at 2pm), and there have been 8,419 confirmed cases so far. A total of 678 people have so far been in intensive care, and around 469 patients are currently in intensive care. Sweden is currently seeing an average of around 45 deaths a day, said state epidemiologist Anders Tegnell.

Tegnell however told the press conference that there are signs that Sweden, or particularly Stockholm, may have reached "more of a plateau situation than before". "But we are starting to see an increase in other parts of the country," he said. He added that Stockholm is reaching a point where the basic reproduction number of the virus is 1.0, or in other words when one person infects on average only one other person.

However, infection in elderly care is a concern. In Stockholm, around 33 percent of all over-70s who have been infected with the coronavirus, and around 40 percent of all over-70s who have died, live in care homes for the elderly, according to the Public Health Agency. In the rest of Sweden the corresponding figure is only 5 percent and 4 percent.
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As for comparisons to other countries:

Norway on Monday stated they believed they had the coronavirus outbreak "under control".Eighty-three people have died after testing positive for the coronavirus in Norway. Asked at the press conference why Norway's death toll is so much lower than Sweden's, Tegnell responded:

"There are two reasons. Their infection has spread above all among much younger people than in Sweden. The other reason, for reasons we don't really know, is that the infection has spread much less in elderly care homes in Norway than in Sweden."

Tegnell said yesterday that the Public Health Agency was looking into why the coronavirus has spread to more elderly care homes in Sweden than in the other Nordic countries.
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Also of interest:

The department for thoracic surgery at Linköping University Hospital in Sweden tested all of its staff, around 50, for the coronavirus and found that around five to ten tested positive without obvious symptoms or with only very mild symptoms, such as a light headache or a slightly blocked nose.

A Public Health Agency survey is currently under way to investigate how many people in society may be carrying the coronavirus. But asked about the example from Linköping University Hospital, the agency's analyst Karin Tegmark Wisell told Swedish radio: "This underlines that paying attention to symptoms is not enough, but you have to observe social distancing to as great an extent as possible."

Public Health Agency state epidemiologist Anders Tegnell confirmed to Swedish radio's morning show P1-morgon that "the spread (of infection) in society is happening without us seeing it at all. It's been talked about that up to nine out of ten don't have particularly visible symptoms.

"But we don't know exactly because unfortunately no targeted studies have been possible. You would then have to go around randomly testing a fairly large group and see if they have antibodies. But that is in the pipeline, so perhaps we'll know soon," he said.
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All from https://www.thelocal.se/20200310/timeline-how-the-coronavirus-has-developed-in-sweden
 
A head doctor at a major hospital in Sweden says the current approach will “probably end in a historical massacre.” He says healthcare workers at his hospital who have tested positive for the virus but are asymptomatic have been advised to continue working. He asked to remain anonymous because “it is frowned upon to speak of the epidemic or to go against the official vision” but said he felt a need to speak out from an “ethical and medical point of view.”
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time.com

Sweden's Relaxed Approach to the Coronavirus Could Be Backfiring

The Nordic country has a much higher fatality rate than its neighbors
time.com time.com
 
I got back from Sweden this morning after an overnight visit. The comparison between DK and Sweden is so apparent. They are still going to restaurants and running around in Groups. The hospital on the Danish island of Bornholm has closed their corona virus dept due to lack of victims.
 
This is a rather awesome interview with the retired head of Sweden’s public health authority Prof John Giesecke, which should be essential viewing for anyone who wants to really understand the thinking behind Sweden’s distinctive approach to managing the epidemic. It’s half an hour, so not a short watch, but for anyone interested in understanding why Sweden thinks they have the right approach, I really recommend it. :thumbs:

If I try and summarise his words I’m sure to make a hash of it, but since most people won’t commit to watching a 30 min YouTube vid I’ll try. He’s saying basically he believes it’s mostly a very mild illness, and that the mortality rate is way over estimated, in other words many (perhaps most) have already had it without knowing. Also that the lockdowns in other countries are not based on any scientific evidence of effectiveness and will make little difference to the overall number of deaths and all countries will end up with similar death rates. Finally he dismisses Prof Neil Ferguson’s Imperial College paper which changed the UK approach as way too pessimistic and based on wrong assumptions.

He’s a very persuasive speaker and the interviewer asks smart questions and brings out a lot of info as a result. EDIT: Just to point out further, you can get most of the info from watching just the first twenty mins.

 
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I was talking to a friend last night. Her Dad lives in Stockholm and is elderly and quite frail. She's trying to persuade him to stay at home but he thinks she's overreacting as everything's still open. She's incredibly worried and pissed off about the Swedish response.
 
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