A Swedish doctor's perspective on Covid • Hacker News Board

Re: A Swedish doctor's perspective on Covid

#161

Post by xvilka » Sat, Aug 08, 2020, 1:26 AM UTC

bsder wrote: post #128

refurb wrote: post #42

Earlier quoted context omitted.

I think his point is you can't compare the impact of the flu because 1) it hits every year (versus a quick outbreak) and 2) many people are vaccinated. Don't forget the '17 flu seasons was 65k deaths in the US. So we're at a little under 3x right now. So yes, Covid is worse, but we don't bat an eye at 65k deaths due to the flu.

> So yes, Covid is worse, but we don't bat an eye at 65k deaths due to the flu. 1) Only as long as they are old people. The moment flu kills even a couple children, everybody goes apoplectic. 2) I suspect that one of the takeaways from Covid is going to be that viruses (even flu) cause a lot more long-term damage than we give them credit for. Nobody was funding brain or circulatory scans for flu patients--we're going…

They are not only bad. Viruses are also an important part of our evolution, way more important than bacteria. So it's bad and good at the same time.

Re: A Swedish doctor's perspective on Covid

#162

Post by torobos » Sat, Aug 08, 2020, 1:31 AM UTC

Just for information there is a next step for the locked down country and that is to test and then track down all those who potentialy has been infected. I heard the ipedimiology expert of Denmark tell that this would make it possible for even the most high risk groups to be free in society with out risk. So the lock down was not in order to eliminate the virus, but in order to get time to build up the capacity to test, track and trace. The reason for this is that in order to have a well functioning social contract in a welfarestate it’s neccessary that no part of the population is consodered expendable. So as a society we can not afford the kind of deaths that sweeden had. The high degree of trust that is necessary to work is created by everybody are taken care of and that everybody has value. It’s very different to a social contract like the one in us. And I am not stating that one is better than the other. Just different.

Re: A Swedish doctor's perspective on Covid

#163

Post by femto » Sat, Aug 08, 2020, 1:34 AM UTC

nopinsight wrote: post #131

tripletao wrote: post #119

Earlier quoted context omitted.

At $100k per quality-adjusted life-year and 10 QALY lost per death, those 5k deaths are $5B, about 1% of Sweden's GDP. So by the same math used to determine if medical treatments are cost-effective, it's breakeven if that GDP difference persists for about four months. We should also account for QALY lost due to people who get severely ill but recover, but I'd guess the net result is surprisingly close to breakeven. P…

Plausible long-term damage to the brain of a significant percentage of COVID patients, in both severe and non-severe cases—-according to a Lancet paper—should change the QALY-based calculation by a great deal. https://mobile.twitter.com/yaneerbaryam/status/1290916583137...

Perhaps the cost-benefit analysis should also include improvements in the technology to develop vaccines as a benefit? There's a good chance that the injection of resources into the development of COVID-19 vaccines will put us in a better position to respond to the next pandemic.

Re: A Swedish doctor's perspective on Covid

#164

Post by mcguire » Sat, Aug 08, 2020, 1:38 AM UTC

refurb wrote: post #88

supernova87a wrote: post #34

Earlier quoted context omitted.

Yes, I was noticing this too -- author doesn't state whether the country is locked down and social distancing/masks, etc. now. If so, they've only stabilized because they adopted the recommended measures finally.

First paragraph - "Unlike other countries, Sweden never went in to complete lockdown. Non-essential businesses have remained open, people have continued to go to cafés and restaurants, children have remained in school, and very few people have bothered with face masks in public."

Also in Sweden:

"Now, increasing numbers of workers are also coming forward to criticise regional healthcare authorities for protocols which they say discourage care home workers from sending residents into hospital, and prevent care home and nursing staff from administering oxygen without a doctor's approval, either as part of acute or palliative (end-of-life) services.

"'We were told not to send them in' "They told us that we shouldn't send anyone to the hospital, even if they may be 65 and have many years to live. We were told not to send them in," says Latifa Löfvenberg, a nurse who worked in several care homes around Gävle, north of Stockholm, at the beginning of the pandemic.

""Some can have a lot of years left to live with loved ones, but they don't have the chance... because they never make it to the hospital," she says. "They suffocate to death. And it's a lot of panic and it's very hard to just stand by and watch."" (https://www.bbc.com/news/world-europe-52704836)

My understanding is that Sweden avoided overcrowded hospitals by only offering palliative care (which doesn't include oxygen) to the elderly.

Re: A Swedish doctor's perspective on Covid

#165

Post by glofish » Sat, Aug 08, 2020, 1:41 AM UTC

ghj wrote: post #74

NYC is a good case study since it's one of the first place hit and is now more or less "done" with covid in the same sense used in this article (it had a peak and is now on the right tail). NYC is at 2716 cases per 100k and 281 deaths per 100k: https://www.cdc.gov/covid-data-tracker/#cases States with aggressive reopening policies like Florida/Louisana/Arizona etc had spikes recently but are also coming back down. Th…

Your numbers are way off.

25% percent of NYC was seropositive in May. So that works out to about 25k per 100k people.

The reported cases have always been just the tip of the iceberg. And we never knew how big the underwater part was. We still down't.

Take the current situation, is the disease penetration larger than that in March/April? Most likely not, not even close, yet the reported new cases are about 5x larger.

Re: A Swedish doctor's perspective on Covid

#166

Post by henrikschroder » Sat, Aug 08, 2020, 1:45 AM UTC

mcguire wrote: post #86

schemy wrote: post #49

Earlier quoted context omitted.

https://www.google.com/search?q=sweden+covid+deathrate&oq=sw... Sweden's death rate is down to zero today and has been trending down since mid April. Summer Holidays did not start until late May where deaths were already half of what they were in mid April. This post isn't aging, it's already aged.

Want to make any guesses as to what Sweden's all-cause mortality for 2020 will be? https://www.statista.com/statistics/525353/sweden-number-of-...

https://imgur.com/9NS5LFh

Worse than 2019, which was an exceptionally good year, but most probably below the ten-year average. Might even land below the five-year average.

Re: A Swedish doctor's perspective on Covid

#167

Post by henrikschroder » Sat, Aug 08, 2020, 1:49 AM UTC

rzwitserloot wrote: post #75

spirobel wrote: post #11

Earlier quoted context omitted.

the german gdp is down over 10 percent. A decade of growth is gone because of this failed policy. The young generation will suffer from this for a long time. Seems like the current politicians dont care about our future.

This is so callous. You're casually talking about the deaths of hundreds of thousands, maybe a million people. _Of course_ your government cares. They _also_ care about needless death. They're trying to walk the tightrope. If you want a look at a country that just goes: Eh, whatever - check out sweden, and the US. Which have at least as much economic damage, if not far more.

> If you want a look at a country that just goes: Eh, whatever - check out sweden

You couldn't be more wrong.

Re: A Swedish doctor's perspective on Covid

#168

Post by jhanschoo » Sat, Aug 08, 2020, 1:56 AM UTC

I'd note that the article doesn't address the issue of ER capacity at all. Most wealthy countries' citizens expect to be able to get treatment if they catch COVID, but if the US didn't implement lockdowns, that wouldn't be tenable. The author's thesis may still hold that this would still be a small proportion of deaths, but it would be a less popular decision than lockdowns.

Re: A Swedish doctor's perspective on Covid

#169

Post by mapgrep » Sat, Aug 08, 2020, 1:58 AM UTC

mcguire wrote: post #70

Udik wrote: post #39

Earlier quoted context omitted.

350k deaths sounds like a huge number, but it's important to take in account how many of those would have died anyway in the next two or three years. Dying at 80 is not the same as dying at 20.

Life expectancy at 80 in the US is about 9 years. You have a remarkably cavalier attitude.

The same argument is made by the Swedish ER doctor in the linked article:

“Considering that 70% of those who have died of covid are over 80 years old, quite a few of those 6,000 would have died this year anyway. That makes covid a mere blip in terms of its effect on mortality.”

It’s just empirically true that dying at 80 is different from dying at 20 if you’re assessing the impact of a pandemic. I guess it needs to be pointed out that “different” has a distinct meaning from “way less tragic.”

Re: A Swedish doctor's perspective on Covid

#170

Post by alyx » Sat, Aug 08, 2020, 2:01 AM UTC

refurb wrote: post #42

mcguire wrote: post #16

" Covid has at present killed less than 6000 in Sweden. It is very unlikely that the number of dead will go above 7,000. An average influenza year in Sweden, 700 people die of influenza. " The average number of people who die of influenza in the US is about 35,000. So we should expect 350,000 deaths and then we'll be all good?

I think his point is you can't compare the impact of the flu because 1) it hits every year (versus a quick outbreak) and 2) many people are vaccinated. Don't forget the '17 flu seasons was 65k deaths in the US. So we're at a little under 3x right now. So yes, Covid is worse, but we don't bat an eye at 65k deaths due to the flu.

Pull the flu/influenza death numbers from the CDC for the last decade. I dare you.

In the last ten years we (in the US) have lost +500,000 people to the flu.

For some reason the people that died from the flu must be lesser in value because nobody did anything about it.

You would think that a single year of 65k deaths would be enough for everybody to wear masks the following flu season. And yet?

No economic shutdowns. No masks. No restrictions on schools. Literally nothing other than vaccines that mostly don’t work.