10 votes

‘Closing borders is ridiculous’: The epidemiologist behind Sweden’s controversial coronavirus strategy

9 comments

  1. [3]
    ohyran
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    There is A LOT to talk about with regards to Sweden - as a Swede we have been used a spitoon OR some kind of pedestal object by different political groups internationally for quite a while (trust...
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    There is A LOT to talk about with regards to Sweden - as a Swede we have been used a spitoon OR some kind of pedestal object by different political groups internationally for quite a while (trust me having someone tell me that "oh its heaven in Sweden", is as absurdly enraging as someone saying "Oh you all get gangraped and executed in Sweden". Sweden is just a rando place like anywhere else.

    BUT just like every single country found themselves forced in to their own take on what to do - so did we. What we also have is among other things: a very very strict set of base laws that practically BAN the government from regulations that would be required for a lockdown unless we are in an actual war. Changing the base laws isn't done easily (to be able to do some of the restrictions they already have, they have had to do some heavy work in parliament to push it through). Imagine for example someone in the US said "well no more guns for about a year", might be a good thing, might be bad - BUT it would be a punch-up of epic propertions forcing the country in to a stand still until the problem was sorted.

    So we need to rely on asking nicely and doing spot-fixes. (note here: the government recently pushed through a crisis law that allows them to temporarily sidestep the Riksdag - THIS is a scary move for many and it took way longer and will probably come back to haunt them in the next election)

    Second our system of State institutes is insanely a-political. For example, in the US the president can hire and fire the leaders of those institutes - here they are more or less banned from what is known as "political interference" of any form. If they comment too much on internal work, that is seen as a faux pas and can be directly "unconstitutional". In Norway their version of our Public Health Institute warned against closing schools - but as they are not in the same position they got overridden. For example (not saying "Norway Bad, Sweden Good" just as an example of the difference between the two countries)
    People working there are hired based on the expertize. The politicians simply don't have that form of control. If the Public Health Institute wants us to do something, well thats what is done no matter what the politicians think. It also means some pretty heavy hitting powernerds are thrust in to the limelight to handle journalists in times of crisis. Tegnell (the dude often referenced when it comes to "Swedens crazy risky method") is a guy with a CV as long as my arm concerning epidemiology, pandemics and field work but the man has NO media training. He looks, talks and communicates ideas like a substitute woodshop teacher. Since he's also in charge of the Public Health Institute - he has beyond his right now pretty insane schedule one large press meeting a day where he get pelted with odd questions from Swedish and more and more international journalists.
    Not gonna lie tho - as a nerd who hangs out with a lot of technically minded CS people - watching him do the technically correct but practically just strange answers of "Oh we don't know" and my favourite "yes we MAY all die tomorrow" replies is kind of joyous.

    Then its the counting of deaths and how they differ between countrys which will be an odd one for the future to figure out. I am trying to find this magazine article about the death toll numbers in comparison with earlier years where they are oddly stable for us, but can't since its the middle of the night and tired and tbh I don't actually understand the numbers - I just look at a a pretty graph that seems to fit my opinion - and that is also one of the problems. So lets skip that.

    Finally a few years back a playbook was created for how these things are ment to be handled in case of a pandemic. It's basically what is being followed now as best as everyone can based on what they can do.

    (for other institutional weirdness, ask why Sweden protested the suggested EU law for minimum wage and works to get through an exception for us - one of the arguments is "Our democracy wouldn't survive it" which is practically correct too - find out more in "Every country is slightly different and have its own oddities!")

    The issue is - everyone is doing what they can with what they have and it seems like most experts are on the same page internationally: "Aaaaah ok we need to stop this quick! Do what you can!". Looking at international experts all of them seem to be pretty chill in conversing about the difference as they understand the complexities but as describing us as either "A hellhole with only death and shariah law available" or "this magical unicorn stable where gold rains from the sky" seems to be part of an international political playbook since forever - here we are.

    (Edit: the weirdness of being a tiny little shithole country in the Nordics and being referenced on the sly every so often by the most powerful man in the world and often with direct lies (or oversimplifications that amount to the same thing) is really weird and has become this "new normal" almost in the news cycle.)

    11 votes
    1. [2]
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      1. ohyran
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        The thing is it is after a change to one of our fundamental power-controls AND one that until that point only required a check in with the Riksdag. Considering the fact that the Riksdag is fairly...

        The thing is it is after a change to one of our fundamental power-controls AND one that until that point only required a check in with the Riksdag. Considering the fact that the Riksdag is fairly much united at the moment in regards to control of large gatherings etc - the only difference this does it bring down the response time one working day - because as of yet not a single proposed fix as set in the examples have been voted down by the Riksdag.

        The reason this is problematic is the rushed state of the change and also the difference between voting after the fact and before and what those changes open up for in the future. Do we trust all future governments enough to remove one of the many checks and balances? Even if it is only a 3 month period of changes until the Riksdag votes on it, and even if that is under a state of duress defined by the Riksdag?
        (EDIT: what I mean is that this sets a precedence where in a future government can enact the same state of emergency like scenario and use the old change to push through the same thing a second time. Nothing exists in isolation and can be shut down and forgotten afterwards)

        It's like bugging and similar or the changes to gun laws concerning clips - the issue isn't current trust but all future trust.

        5 votes
    2. [2]
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      1. ohyran
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        Every place sounds like heaven when seen from a distance - its nice but so is everywhere else. There are people everywhere and people are awesome and the same everywhere. I have never met anyone...

        Every place sounds like heaven when seen from a distance - its nice but so is everywhere else. There are people everywhere and people are awesome and the same everywhere. I have never met anyone from anywhere who isn't just the same as me.

        Yeah most are following the guides BUT there is a problem: Spring.

        If you live in a place which is closed down, and dark half a year, spring is a big thing. Spring is when people flock outside. It's when people start doing things together actively. When people really get hammered outside in groups etc.
        We tend to be pretty good at staying indoors during Winter. If you know the Danish word "Hygge" - same cultural foundation. During the darker times people tend to stay in doors, tend to be good at self isolating and create a foundation of social interaction in that - during Spring that's when that gets it release. It's when most large festivals, social and cultural events happen etc etc.
        Summer is the time when the sun barely sets during night, a time for getting drunk and stay outside in the woods.

        It just became spring properly in Middle/Southern Sweden.

        Most are doing fine - a minority isn't, another minority is spending their time just fuming at the first minority and basically ensuring them ignoring the recommendations.


        Sidenote - I honestly believe, with all my heart, in humans. I love humans. I have never met a human that wasn't 99% awesome and brilliant and 1% asshole. It doesn't matter where people are from, Swedish, Ugandan, American, Taiwanese - just the same people with some teeny tiny differences based on culture and the vast majority of them being the same kind of person as everywhere and during times of crisis, like now, its one of those things that gets me calm.

        Sadly they had to shut down the International Summer football tournament here in Gothenburg for kids around the world which otherwise was on the one side annoying (kids cluttering up all the trams and buses) but on the other a hopeful message of "humans being humans". Some years ago I saw a Swedish girl trying to flirt HARD with this boy from (I think) South East Asia. They didn't seem to speak the same language but where making out next time I passed by them. If that isn't a pure message of hope in humanity I don't know what is.

        That idea, that you, me, everyone - are insanely more alike than we're different - that humans be humans, good and bad - fills me with joy currently.

        8 votes
  2. [2]
    unknown user
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    Sweden didn’t go into lockdown or impose strict social-distancing policies. Instead, it rolled out voluntary, ‘trust-based’ measures: it advised older people to avoid social contact and recommended that people work from home, wash their hands regularly and avoid non-essential travel. But borders and schools for under-16s remain open — as do many businesses, including restaurants and bars.

    The approach has sharp critics. Among them are 22 high-profile scientists who last week wrote in the Swedish newspaper Dagens Nyheter that the public-health authorities had failed, and urged politicians to step in with stricter measures. They point to the high number of coronavirus deaths in elder-care homes and Sweden’s overall fatality rate, which is higher than that of its Nordic neighbours — 131 per million people, compared with 55 per million in Denmark and 14 per million in Finland, which have adopted lockdowns.

    6 votes
    1. nacho
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      As additional context, Norway, which I'd argue is the country most similar to Sweden, closed down society. 193 dead for a population of a little over 5,4 million leads to a death rate of just...

      As additional context, Norway, which I'd argue is the country most similar to Sweden, closed down society. 193 dead for a population of a little over 5,4 million leads to a death rate of just about 35 per million.

      When society's closed down, the curve is flattened and elongated. The belief is that deaths will spread out more. Neither Norway nor Sweden have been close to maxing intensive unit or respirator capacity at any hospital during the epidemic thus far, so those dimensions of flattening the curve, which have been very real in other European countries doesn't factor in nearly as much.

      6 votes
  3. [4]
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    1. [3]
      Comment deleted by author
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      1. nacho
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        I think the idea of delay is both flattening the curve as one discovers more about the virus and what policies will be most effective, and to prevent the spread of the disease. Most countries have...

        I think the idea of delay is both flattening the curve as one discovers more about the virus and what policies will be most effective, and to prevent the spread of the disease.

        Most countries have desperately needed that time because they've been underprepared for a pandemic, and next to nothing's been known about the virus and possible effective treatments that may or may not have been available.

        All the large pandemics have come in several waves before they've been stopped, from Spanish flu to polio, measles, paratyphoid fever etc. To avoid that, we'd need effective medicinal treatment, like a vaccine or antiviral drugs that work on this corona-virus.

        Delay has value here, but whether it's worthwhile enough, we'll all need to move towards immunity as permanent treatment is illusive, time will show. There's a very real health cost to people being at home ad worsening economy too. Those calculations are very complex. I don't know how the math adds up.

        I think closing down society was smart, at least at first to try to get an overview and prepare for the situation. Opening up too early may be a mistake, staying closed down too first will be one as well.

        6 votes
      2. DanBC
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        You don't know that, because you're not testing people and you're only counting deaths of people who were tested positive for covid-19. The numbers you need to look at (in the absence of proper...

        We’re already over the peak here in Stockholm.

        You don't know that, because you're not testing people and you're only counting deaths of people who were tested positive for covid-19.

        The numbers you need to look at (in the absence of proper testing) is all cause mortality, and SCB hasn't released those yet.

        https://www.scb.se/en/About-us/news-and-press-releases/statistics-sweden-to-publish-preliminary-statistics-on-deaths-in-sweden/

        3 votes