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

Re: A Swedish doctor's perspective on Covid

#251

Post by DanBC » Sat, Aug 08, 2020, 9:34 AM UTC

alyx wrote: post #170

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.

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.…

You're counting flu and covid-19 deaths differently.

For flu you're using sophisticated statistical modelling of excess death combined with community surveillance of use of primary and secondary care. This will tend to overcount.

For covid-19 you're using "died after testing positive for covid, or with covid mentioned as the cause on the death certificate". This will tend to undercount (even when taking into account the slight overcount involved in people who die from other things after a +ve test).

Re: A Swedish doctor's perspective on Covid

#252

Post by olodus » Sat, Aug 08, 2020, 9:35 AM UTC

larsga wrote: post #244

"In total covid has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people." This is basically deliberate disinformation. In April and early May Sweden had 30-50% excess mortality. And this was despite actually stopping the virus through soft lockdown. What the full count would have been had they let the virus rage unchecked is hard to say, but he's compari…

I agree, though you need to wait to the end of the year to see if that excess death rate materialised in an actual increase in yearly mortality rate. That being said though, I agree that our numbers are high, plain and simple. Still imo when we review the strategy we need to really look at where we made the mistakes. Imo it is very clear that the main mistake we did was to not protect the elderly enough. When you look at the age curve of deaths compared to the age curve of people infected a lot of the death could have been avoided if only the older generation could have been protected while the rest of us seem to have managed the virus and built up our defences. My thinking is that a quicker move to protect elderly together with otherwise mostly the same strategy could hopefully have reached the same goal we have landed on currently, but without a large amount of the deaths. Maybe the government should have sent out masks to the old and vulnerable (though given it wasn't clear at the start if masks help against the virus).

Re: A Swedish doctor's perspective on Covid

#253

Post by throwaway202020 » Sat, Aug 08, 2020, 9:40 AM UTC

kybernetikos wrote: post #250

larsga wrote: post #244

"In total covid has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people." This is basically deliberate disinformation. In April and early May Sweden had 30-50% excess mortality. And this was despite actually stopping the virus through soft lockdown. What the full count would have been had they let the virus rage unchecked is hard to say, but he's compari…

Yes, the charts are pretty stark and show that Sweden has fared worse than the other nordic countries: https://ig.ft.com/coronavirus-chart/?areas=swe&areas=nor&are... or compare excess mortality between Sweden and other nordic countries in the charts halfway down https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386... I'm surprised the myth of Sweden doing well is still being bruited about.

Sweden chart is going downhill at the same rate as other countries with strict lockdown. There is a significant gap in mortality but I think the point is that people initially thought they would explode with COVID cases like early days in Wuhan (i.e. graph will go up, not down). Now it looks like they either have already hit zero new cases or going to hit them very soon. I think this is important fact worthy of studying deeply.

Re: A Swedish doctor's perspective on Covid

#254

Post by olodus » Sat, Aug 08, 2020, 9:47 AM UTC

kybernetikos wrote: post #250

larsga wrote: post #244

"In total covid has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people." This is basically deliberate disinformation. In April and early May Sweden had 30-50% excess mortality. And this was despite actually stopping the virus through soft lockdown. What the full count would have been had they let the virus rage unchecked is hard to say, but he's compari…

Yes, the charts are pretty stark and show that Sweden has fared worse than the other nordic countries: https://ig.ft.com/coronavirus-chart/?areas=swe&areas=nor&are... or compare excess mortality between Sweden and other nordic countries in the charts halfway down https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386... I'm surprised the myth of Sweden doing well is still being bruited about.

We are doing well. The chart you are showing shows a clear trend downward. The same can be seen if you look at the official charts of FOHM (Sweden's CDC). The current death rate is very low (some days at 0) and the number of infections are decreasing/at a stable low level.

That said the number of dead over the whole crisis are high, and that should not be overlooked. We need to change out strategy for future similar situations. Imo we should have protected the elderly better since that's were the large majority of deaths were (less than 100 of the deaths were among people younger than 50).

Re: A Swedish doctor's perspective on Covid

#255

Post by throwaway202020 » Sat, Aug 08, 2020, 9:49 AM UTC

larsga wrote: post #244

"In total covid has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people." This is basically deliberate disinformation. In April and early May Sweden had 30-50% excess mortality. And this was despite actually stopping the virus through soft lockdown. What the full count would have been had they let the virus rage unchecked is hard to say, but he's compari…

May be it's more fair to count for the months of COVID, March-July. So normal deaths would have been 42,000 during this period but COVID roughly added 10%. While this is still high and non-trivial amount, the fascinating thing is that almost everyone thought they will turn into Wuhan with dead bodies on roads and overflowing hospitals. For virus spread, soft lockdown was considered inconsequential back in March and any country doing nothing but hard lockdown was despised. In US, many people criticized for not having China style lockdown. In my view, Sweden has definitely done something that is worthy of study. I think it will be unfair to go back and say, yeah, soft down was all you needed in retrospect to devalue their achievement and what everyone thought was rather risky bet.

Re: A Swedish doctor's perspective on Covid

#256

Post by throwaway202020 » Sat, Aug 08, 2020, 9:52 AM UTC

gyger wrote: post #238

gorkempacaci wrote: post #135

Sweden didn’t go into total lockdown but still did a lot. In the grocery store the cashiers are in a plastic bubble. Wherever there is a line there are marks on the floor to show where to wait to keep distance. Nobody shakes hands for quite some time. Yes, people go to Cafes/restaurants but restaurants have been assessed and assigned covid-friendly seating layouts. There are many more things that clearly separate tod…

Also Stockholm in summer is empty. People leave the town and go on holiday, retract to the country side. I also don't understand when he says there is/was no social distancing. That is totally not my experience here, a lot of people were working from home and commuter trains were quite empty.

What about the photos of people happily seating in groups in restaurants and even attending sports events? I never seen anyone in those photos with masks. Also, I believe schools were kept open at least before summer vacations? I am not living there but very curious about how the life was during COVID period there.

Re: A Swedish doctor's perspective on Covid

#257

Post by kybernetikos » Sat, Aug 08, 2020, 9:54 AM UTC

throwaway202020 wrote: post #253

kybernetikos wrote: post #250

Earlier quoted context omitted.

Yes, the charts are pretty stark and show that Sweden has fared worse than the other nordic countries: https://ig.ft.com/coronavirus-chart/?areas=swe&areas=nor&are... or compare excess mortality between Sweden and other nordic countries in the charts halfway down https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386... I'm surprised the myth of Sweden doing well is still being bruited about.

Sweden chart is going downhill at the same rate as other countries with strict lockdown. There is a significant gap in mortality but I think the point is that people initially thought they would explode with COVID cases like early days in Wuhan (i.e. graph will go up, not down). Now it looks like they either have already hit zero new cases or going to hit them very soon. I think this is important fact worthy of study…

Check the charts I shared. They did explode initially, with far higher rates than similar countries, and they have taken much longer than similar countries to bring their death rates down. The earlier poster suggesting over 5000 more dead as a direct result of the policy is borne out by all cause mortality comparisons with similar countries.

Now possibly all these countries will be able to keep their low rates, but I'm concerned about the future: number of cases is on the rise again in Europe as a whole and increases in deaths will probably follow within the next month. I think we're still a way from being able to make a final reckoning.

The do-not-lock down case is mainly that we won't be able to control it until there's a vaccine, so lock down or no, total deaths will be similar. This isn't bourne out by the figures. Countries that allowed a larger spike initially have had much higher mortality rates (e.g. Compare the UK and Germany with now similar infection rates but very different mortality rates). Flattening the curve genuinely does seem to save lives.

The UK was keen to play the herd immunity game until they realised just how many people that would kill.

Re: A Swedish doctor's perspective on Covid

#258

Post by biolurker1 » Sat, Aug 08, 2020, 10:02 AM UTC

Long term consequences are where it's at. This article talks none of it. Let's hope that Sweden doesn't have heart failure and ground glass lungs for the next decades at high rates. Such a gamble from one doctor.

Re: A Swedish doctor's perspective on Covid

#259

Post by kybernetikos » Sat, Aug 08, 2020, 10:04 AM UTC

olodus wrote: post #254

kybernetikos wrote: post #250

Earlier quoted context omitted.

Yes, the charts are pretty stark and show that Sweden has fared worse than the other nordic countries: https://ig.ft.com/coronavirus-chart/?areas=swe&areas=nor&are... or compare excess mortality between Sweden and other nordic countries in the charts halfway down https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386... I'm surprised the myth of Sweden doing well is still being bruited about.

We are doing well. The chart you are showing shows a clear trend downward. The same can be seen if you look at the official charts of FOHM (Sweden's CDC). The current death rate is very low (some days at 0) and the number of infections are decreasing/at a stable low level. That said the number of dead over the whole crisis are high, and that should not be overlooked. We need to change out strategy for future similar…

What I see from the first chart I shared is that at 140 days Sweden still has not got its death rate down to the level the other nordics achieved at 80 days.

https://ig.ft.com/coronavirus-chart/?areas=swe&areas=nor&are...

Re: A Swedish doctor's perspective on Covid

#260

Post by olodus » Sat, Aug 08, 2020, 10:05 AM UTC

swang wrote: post #96

i don't know what is the actual truth and we probably won't know which way was the "correct" decision until well after this pandemic is over (assuming it ends). i think the biggest issue with the US response is the bad messaging and iffy attempts at lockdown and reopening. taiwan didn't go into lockdown but the country respects social distancing and masks and is very adamant about quarantining, tracing and cleaning.…

Yes you are correct during the worst part of corona my experience is not the same as the doctor from the article. Many people strictly kept away from places with large amount of people close together. A lot of employers changed to work from home. My employer says we will continue WFH until end of year. That said people still socialised, though outside and in smaller groups.

In the end our high mortality rate can't be overlooked. We need to change our strategy for future similar pandemics. That said, I think the most interesting stats to look at when deciding what we should have done differently is the breakdown of deaths per age-group. Less than 100 deaths are among people younger than 50. So almost all of our ~6000 deaths were among the elderly. That is what needs to change. Next time we need to be quicker at protecting the old. Otherwise our strategy could have worked, the rest seem to be able to build up their defences to the virus.