Sweden: higher Covid-19 death rate while failing to collect on economic gains • Hacker News Board

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#371

Post by jessaustin » Wed, Jul 08, 2020, 2:58 AM UTC

pas wrote: post #239

gridlockd wrote: post #212

Earlier quoted context omitted.

Remember, the game plan that virologists came up with for COVID acknowledged that most people will get it eventually. The point of the lockdowns was not to eliminate spread, which is impossible, but to not overwhelm the system.

The plan is/was also to understand it, find effective protocols for managing it, etc. (And we also have pretty good chances of coming up with a vaccine in about 1 year.) It's not "just the same amount of death, but slower, so the crematoriums don't get overwhelmed".

...pretty good chances of coming up with a vaccine in about 1 year.

This is just wishful thinking. We've never had effective vaccines for this sort of virus. (The yearly flu vaccine is like 30% effective.) Sure lots of research groups are working on vaccines, but many of them are academics who have no particular duty to work on research likely to have an immediate payoff. The researchers who do have such a duty, i.e. those who work for private drug firms, are mostly developing treatments like the antiviral remdesivir. Effective treatments of various sorts are closer than any vaccine, for COVID-19. IMHO, the most likely eventual winner will be a scaled-up version of the convalescent plasma therapy, which unlike the current version will be able to produce effective antibodies without drawing blood from humans.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#372

Post by nradov » Wed, Jul 08, 2020, 3:04 AM UTC

stallmanite wrote: post #349

nradov wrote: post #172

Earlier quoted context omitted.

Ironically, medical researchers wouldn't have learned those mitigation techniques (like Dexamethasone) without a large population of patients to use as experimental subjects. In other words, if we succeed in slowing down the spread (which would be a good thing) then medical research into treatments and vaccines will also slow down.

Would work on a vaccine really slow down? There are many thousands of patients and how many does a vaccine study require in practice?

It would take longer to complete the vaccine phase 3 clinical trials. We need to see that the vaccinated group has a significantly lower risk of infection than the control group. But if the disease spread is already slow due to other measures then we need either more time to be sure whether the vaccine really works.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#373

Post by roca » Wed, Jul 08, 2020, 3:08 AM UTC

tomerico wrote: post #353

EdwardDiego wrote: post #236

Earlier quoted context omitted.

> It's pretty obvious at this point that a general lockdown is worthless as a replacement for locking down care homes specifically New Zealander here, our general lockdown went very well and enabled us to isolate clusters of transmission and prevent it becoming community transmission. While two of our clusters were rest homes, several others were not - a school, a St Patrick's Day celebration at a pub, and a wedding,…

New Zealand is a special case where it may be feasible to isolate yourself from the rest of the world and reach zero cases. With that said, it remains to be seen that it is possible to maintain zero community spread over the long term, and whether the economic impact of isolating yourself from the rest of the world is worth it.

We aren't economically isolated from the rest of the world. We're still exporting and importing. Exports in some industries are higher than ever. We're still bringing in workers in certain key roles. NZers can leave (though they'll probably need to pay for quarantine when they get back). The main things that are suspended are international student and tourist arrivals, and when the flood of NZers returning home abates, we'll probably be bringing them in through the quarantine system.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#374

Post by roca » Wed, Jul 08, 2020, 3:10 AM UTC

nl wrote: post #277

makomk wrote: post #61

Earlier quoted context omitted.

This. It's pretty obvious at this point that a general lockdown is worthless as a replacement for locking down care homes specifically - Spain had one of the strictest lockdowns in Europe but massively screwed up their handling of their care homes, and ended up with an even worse per-capital death toll than Sweden. Unfortunately, mainstream media publications have been spinning this instead as evidence that herd immu…

Australia had a very, very tight lock down on aged care homes, and yet very nearly 50% (62/106) of the COVID deaths in Australia were in these homes. It turns out to be pretty much impossible to keep out of aged care if there is community spread.

NZ ditto, except just about all our COVID deaths were in rest homes.

Not all elderly are in rest homes, either.

I don't know of anywhere with widescale community spread that has been really successful at protecting the elderly.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#375

Post by jessaustin » Wed, Jul 08, 2020, 3:11 AM UTC

b112 wrote: post #310

dvdplm wrote: post #184

Earlier quoted context omitted.

This is exactly what needed to be done, in Sweden and elsewhere. Pay staff triple and have them stay with the old folks and get everything delivered by externals with as little contact as possible. And no new admissions into the care homes.

Will you force them with a gun? To forgo all friends, family, comforts of home, and be literally trapped at work for months? Money doesn't just buy people. You'd essentially be drafting them.

GP said "pay staff triple". For 70% of nursing home workers in USA, that would be enough to get it done. The other 30% aren't rich enough to ignore tripled income, but rather they have family situations that would make it impossible. It's a pipe dream anyway, since our Congress is only capable of giving public money to rich people.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#376

Post by bhupy » Wed, Jul 08, 2020, 3:11 AM UTC

aazaa wrote: post #256

bhupy wrote: post #225

Earlier quoted context omitted.

> That's not the system in the US - or hasn't been. The Federal government maintains what, until recently, was the world's premier infectious disease-fighting organization - the CDC. The implication was that pandemic response occurs through this organization. In the past, this is exactly what happened. While you're right that the Federal government has the CDC, every single US States has its own infectious disease/he…

> While you're right that the Federal government has the CDC, every single US States has its own infectious disease/health agency[1]. Those appear to be general public heath agencies with names like: "Department of Health Services"; "Medicaid"; and "Department of Health and Environment". I don't see one mention of the word "infectious" to indicate specialty. None appear to be a unit with a mandate along the lines of…

> Those appear to be general public heath agencies with names like: "Department of Health Services"; "Medicaid"; and "Department of Health and Environment". I don't see one mention of the word "infectious" to indicate specialty.

Lmao what, that’s your argument? That’s just what the states call it. Take, for example, the Minnesota Department of Health. Among other things, its main charter is “disease control and prevention”[1]. This is true across the board. Every single US State has such an agency, whose staff are currently working full time on COVID. “I don’t see one word of the word infections”. Come on, really? THAT’S the best you got?

> "ECDC has approximately 300 staff and commands an annual budget of over €50 million."

What’s your point? The EU has funded their centralized agency less than the US, so? That doesn’t change the fact that the US has a federalized structure similar to the EU, where the States have a similar level of autonomy as their counterparts in the EU. The US State health agencies fall under the purviews of the State governments, which are wholly independent from the Federal government.

> "CDC's budget for fiscal year 2018 is $11.9 billion.”

Take this and also compare the budgets to the state government health agencies. The New York CITY Department of Health, whose responsibility includes infectious disease prevention has a budget of $1.6 billion, with 6,000 employees[2]. That’s just for the CITY of New York!

[1] https://en.wikipedia.org/wiki/Minnesota_Department_of_Health

[2] https://www1.nyc.gov/site/doh/about/about-doh.page

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#377

Post by kalleboo » Wed, Jul 08, 2020, 3:15 AM UTC

stallmanite wrote: post #349

nradov wrote: post #172

Earlier quoted context omitted.

Ironically, medical researchers wouldn't have learned those mitigation techniques (like Dexamethasone) without a large population of patients to use as experimental subjects. In other words, if we succeed in slowing down the spread (which would be a good thing) then medical research into treatments and vaccines will also slow down.

Would work on a vaccine really slow down? There are many thousands of patients and how many does a vaccine study require in practice?

https://news.sky.com/story/coronavirus-disappearing-so-fast-...

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#378

Post by bhupy » Wed, Jul 08, 2020, 3:15 AM UTC

triceratops wrote: post #303

bhupy wrote: post #231

Earlier quoted context omitted.

Not to mention that the US Federal government simply does not have the power to issue nationwide lockdowns.

The federal government doesn't need to order anyone to do anything. Fighting a pandemic is in everyone's best interests. It just needs to ensure there's a consistent strategy that everyone is executing.

It doesn’t need to do that at all, any more than the EU government needs to ensure there’s a consistent strategy among its member states that everyone is executing.

Different strategies apply for different states, because they have different elderly populations, different density characteristics, and different health system capacities.

Further, we still don’t know which approaches are the best, since we’re still learning about the disease. The fact that there are 50 separate approaches being tested affords us a wealth of data to operate on to shift strategies. As you said, fighting a pandemic is in everyone’s best interests, and states can and will change their strategies to minimize suffering.

An example: Governor Cuomo employed a fairly disastrous nursing home policy, which is largely what caused New York’s staggering death rate (at this moment, the highest in the Union). To be fair to him, he didn’t know that the virus would have this effect, and upon seeing the results from other states (FL, TX) which specifically protected nursing homes, course-corrected his own State’s strategy. This is a win for everyone, in the long run.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#379

Post by lostmyoldone » Wed, Jul 08, 2020, 3:17 AM UTC

jnwatson wrote: post #3

I don’t believe the article has addressed Sweden’s main argument for not shutting down: that herd immunity should be the prime driver. Essentially, that everyone is going to eventually have roughly the same death rate, so might as well get it over with. That remains to be seen; if Sweden’s peers can prevent flare-ups, it looks like Sweden was wrong.

One could claim that actually the main "argument", which isn't really much an argument, is that the government could not legally order a lockdown.

Or, well, they could still order it. But since it would have been illegal, it could not have been enforced in any way, as it would also be illegal to follow any order to enforce it.

Some politicians wanted a lockdown, but soon found out that Swedens crisis response laws are not triggered by disease, at least not unless it's a clear threat to the continuation of the state as such. Covid IS serious, but this far it doesn't look like a civilization ending disease.

Re: Sweden: higher Covid-19 death rate while failing to collect on economic gains

#380

Post by freyr » Wed, Jul 08, 2020, 3:18 AM UTC

arcticbull wrote: post #354

ncallaway wrote: post #110

Earlier quoted context omitted.

I would generally go for "as few as possible given the circumstances". Given how much higher they are over other nations—even taking into account excess deaths—I would say they have failed that metric.

You cannot know that until after the pandemic is over. The Swedes are betting that nobody in the world will be spared from COVID and therefore the delta in deaths is temporary. They are front-loading it while attempting to keep the economic impacts as low as possible. They anticipate the rest of the world will be contending with shutdowns, re-openings, shutdowns, re-openings, and when all is said and done, the death…

> The Swedes are betting that nobody in the world will be spared from COVID

It's also a bet that medical treatments won't improve and a vaccine won't be developed.