1) From the comments of the blog post: "todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
So one theory is that people are less likely to engage in risky behavior such as surgery this year. I am sure that people are driving less, flying less, working less, and in general, doing less that can increase the risk of death.
2) There are three types of lies: lies, damn lies and statistics. I am always wary of some totally random fact. "Least deadliest September on record." There's no implied causation there. Just a random fact. "Draw your own conclusions" is not helpful.
> There's no implied causation there. Just a random fact. "Draw your own conclusions" is not helpful.
Really? I can think of a narrative here about the virus being not as serious as people thought.
I can't relate to your complain at all. We want more straight fact not "helpful" opinions. If someone can't form an opinion on their own it's fine, just dont participate in the discussion. The last thing we want is some people joining some discussion just to magnify other people's thoughts.
"During the 15th week of the year, we saw the highest death rate in Sweden this millenium. " [0]
Statistics are just so hard to interpret and translate into a narrative that headlining a single data point is often misleading. I'm not interested enough to dive into this particular issue so I'm still not sure which claim is "true".
They aren't contradictory. 2019 had unusually few deaths, in part due to a mild flu season: https://www.icuregswe.org/globalassets/dokument/influenza-in.... So there were lots of vulnerable people who likely would have died in the next year, but COVID compressed many of those deaths into a few weeks.
The biggest misunderstanding for the media and politicians in this pandemic is that individual citizens are making their own response decisions rather than solely relying on government policy. So, Sweden was more lax from government policy perspective, but that doesn't mean Swedes were completely unafraid and behaving recklessly. They're not out recreating their own version of the Sturgis rally daily.
I have a few friends at Spotify working in Stockholm. Anecdotally, it seems that in general Swedes have never really shared the global concern for COVID. No masks, no real social distancing, still working in the office all summer, plenty of holiday fun with friends, and yet somewhat low hospitalizations anyway. Seeing how life has been there since the lockdown here in the USA I have been admittedly quite jealous.
I live in the outer suburbs of Stockholm and (normally) commute into town by train every day. Every year around midsummer (20 June), the trains start getting noticeably less crowded, as people start going on their summer holidays. Then it takes until late August before the rush-hour crowds are back to normal. Is seems an extraordinary coincidence that it was during this period that Covid-19 essentially petered out in Sweden. Since the beginning of September, the number of positive tests has been climbing again, more or less exponentially. The number of deaths is lagging behind, but there is a definite uptake the last couple of weeks. As usual, deaths seem to be going down during the last week because of lagging statistics. My guess is that the final number for friday 23 october will end around 7, and 30 October around 10 (but I hope I am wrong!). At least this seems to indicate that you do not need a full-blown lockdown to stamp out Covid-19 — "Swedish summer" is a sufficiently low level of activity!
Most likely this is due to a rapidly changing age distribution in Sweden.
It seems, probably mainly due to immigration, that the population of ages 20-60 have increased significantly since 2010, while the population of ages 60+ have increased less.
Early in the pandemic I wondered if all of the isolation would have the same effect here - fewer deaths due to driving, flying, flu, etc. But the CDC says we’ve had 300000 excess deaths this year: https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm...
Really makes one wonder about differences in the US and Swedish population, especially regarding widespread obesity and diabetes.
"One forgotten contribution could possibly be the large number of canceled surgeries.
The last number I saw was appx 30k canceled surgeries in Sweden since Mar -20. Historical data from Argentina, Israel and Denmark show significant reductions in death rates when doctors go on strike. The last strike was in the 1960's and I have been repeatedly promised (by doctors) that "..it is different now.."
We have also noted a quite dramatic reduction of cancer diagnoses because of reduced screening for breast- and gyn cancer. The common wisdom among "experts" is that there is a large number of undiscovered cases which will show up later and with much more severe and deadly cancer in the months and years ahead. I doubt this. I have read a couple of the research papers defining guidelines for interpretation of pathological finds and they state explicitly that it is better to "overdiagnose" by at least a factor of 10 (and in reality up to a factor of 50) in order to not miss any "real" cases of cancer. Better to cut nine healthy breasts or prostates than to have one undiagnosed case.
Well, in just a couple of years we will have clear and unambigous evidence for or against the efficency of the cancer screening programs. This is a form of full scale clinical trial happening in front of our eyes."
And
"Oh, todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
This is complete FUD. Overtreatment is a real concern that oncologists take seriously - for cancer precursors the recommended treatment now is often just "monitoring"
> defining guidelines for interpretation of pathological finds and they state explicitly that it is better to "overdiagnose"
Was it definitely after pathology reporting? It's normal to have a low threshold to send people to biopsy. From the number of developed cases you can get some idea about what ratio of "ok" results you should have as a referring doctor. (this is tracked) But once you do biopsy / further checks I haven't heard of overdiagnosis by a large factor - not the "you should have surgery" overdiagnosis anyway. "Wait, see how it develops, retest" seems more common.
The Economist graph shows "covid-19 excess deaths".
The article is about "September 2020 least deadly month ((...)) 2020 third least deadly year ever so far".
AFAIK there is no normalized way to count COVID-19-induced deaths.
If so there is no way to compare official "COVID-19-induced deaths", because a given case may be counted as such in a country and not in another one, or even in the same nation by a given doctor and not by another one.
The total amount of deaths seems more objective.
Moreover the pandemics is running, therefore any comparison offers only a peek on a fraction of the challenge. Isn't this "herd immunity" approach a sort of "let's endure more short-term deaths, then durably much less afterwards" bet? In such a case any accounting may be moot for years.
a) The spread of contagion before measures where imposed. Sweden was a few days later than the other Nordics in taking action, and may have been in a further advanced state to begin with.
b) Safety equipment. Sweden had no functioning central reserves for health care gear.
c) Failure to protect the vulnerable. The nursing homes are a mix of private and public, but all are administered at the municipal level. Proper care was not taken to protect the elderly, largely due to lack of local know how and incompetent central response.
I’ve been a staunch defender of the Swedish strategy, but it seems like there’s no avoiding the conclusion that the path taken by the other nordics may have been smarter in that it contained the spread until adequate supplies could be secured, good routines established and treatment options better understood. (To be fair to FHM that devised the strategy, b and c are certainly on other authorities.)
Significantly, although all the nordics now have a climbing number of cases, none has seen a sharp rise in the number of deaths. Mean time from hospitilization to death is around 18 days, so the resurgence has been ongoing for long enough that it’d have been noticeable by now.
It seems like the Swedish path may have two main benefits left:
1) Fewer vulnerable children were hurt by being sent home. Fewer women locked in with abusive partners. Nordic lock downs were less drastic, and may have avoided some of it, but at the global level it’s numbing to think of the suffering of children this year.
2) In terms of GDP growth, the indication is that Sweden didn’t do much better than the other nordics, but I think it’s still to early to gauge the long term economic benefits of a soft strategy. Maybe Sweden ended up taking on less debt per capita, for instance? I haven’t seen numbers on that, but school closings in particular are expensive, and so seems like reasonable speculation. Time will tell.
The economic benefits are probably not going to turn out to be compelling enough to justify the potentially avoidable deaths. From a utilitarian perspective, I think the first point may be though. The deaths have largely been people towards the end of their life. I think the constructive way to view it is that we should consider all years of a humans life equal. Is it worth sacrifying an 80 year old to save a 10 year old from being beaten up at home? If it hurts that kid for life in a tangible way, then yeah, that grim calculus may just work out.
The 20th century was the least deadly century ever, but we shouldn't conclude poison gas or misinformation are safe.
If you're summing all effects, you're looking at all data at once, and probably are doomed not to learn anything particularly actionable. Its in the breakdown that we kind find meaningful bits for future reference.
COVID-19 has at least 2 main solutions, which are mutually exclusive: (lockdown) or (no lockdown).
If there is no major other new pertinent factor, then when it comes to compare those solutions (deciding when to assess is a challenge) there are (proportionally) less deaths where the more efficient one is implemented.
It shows 2020 weekly deaths in comparison with a 2015-2019 average which is a good indication of the normal - precovid rate. You can see how there was a massive spike around week 12 to week 21, which is exactly when the initial covid outbreak hit and Sweden's disastrous "herd immunity" policy failed.
Now Swedes have been scared and changed their behavior and covid deaths are less. Furthermore, the defensive behavior of covid prevents other deaths. People, do not drive, do not party, do not engage in sports, do not take drugs, or over-drink or over-eat at parties, so that other causes of death go down.
So it is possible that covid isolation reduces death rate more than the deaths caused by the virus itself. But that is not a solution, people cannot live in covid isolation forever.
The excess deaths during the pandemic are not subtle in these graphs. If the data is accurate and the comparison with Sweden is valid, then it does tend to support the importance herd immunity to this virus.
Week 02 2017 France and neighbors had mortality of around 12 standard deviations above the baseline. I think number of standard deviations are a bad measure when the data is so chaotic, especially since the standard deviation can vary strongly from year to year and from country to country. Lets say that one country had a few lucky years with few abnormalizes, while another country faces catastrophes regularly. Then a minor catastrophe in the first country will look way worse than in the second.
It’s probably worth all of us with different views about lockdowns and restrictions bearing in mind that Sweden is not a control group for the rest of the world, and the rest of the world is not a control group for Sweden.
The Swedish authorities never suggested that lockdowns wouldn’t work in controlling the pandemic, in fact they acknowledged that they definitely would work in the short term; their core assertions were that the Swedish population would not be able to sustain involuntary restrictions until better treatments or a vaccine arrived, and that the harms caused by restrictions would be a net negative for their society. The jury is still out on those decisions, but they are rational.
In fact we’ll probably never know who chose the optimal policy mix to cope with the pandemic, and as a result we should give those with differing views an awful lot of slack as they try and negotiate it with limited resources and foresight (i.e. as humans).
For now, let’s just enjoy this good news about the people in Sweden at face value–we need it!
What is it about Sweden that makes people like cherry-picking facts from it? There's a whole right-wing conspiracy meme about muslim no-go areas that doesn't match the reality observed by Swedes.
Similarly, Sweden didn't have no restrictions in response to coronavirus.
Zones where it’s not safe and police must negotiate with criminal gangs of foreigners are real in my town Gothenburg, and certainly in Malmö, Uppsala, Stockholm etc. I’ve personally witnessed them shooting and burning cars outside of my apartment.
The image many foreigners have of Sweden is outdated due to mass immigration (HN PC may dislike it, but I call it population replacement) - that image is from when it was a homogenous country.
[+] [-] unreal37|5 years ago|reply
1) From the comments of the blog post: "todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
So one theory is that people are less likely to engage in risky behavior such as surgery this year. I am sure that people are driving less, flying less, working less, and in general, doing less that can increase the risk of death.
2) There are three types of lies: lies, damn lies and statistics. I am always wary of some totally random fact. "Least deadliest September on record." There's no implied causation there. Just a random fact. "Draw your own conclusions" is not helpful.
[+] [-] tomohawk|5 years ago|reply
https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
Note that countries have different ways of counting.
Here are the excess mortality statistics for some countries. This statistic takes a while to gather, so it lags 1-2 months, depending.
https://ourworldindata.org/grapher/excess-mortality-p-scores...
Sweden reached no excess mortality sometime in June, and is doing quite well.
[+] [-] nsonha|5 years ago|reply
Really? I can think of a narrative here about the virus being not as serious as people thought.
I can't relate to your complain at all. We want more straight fact not "helpful" opinions. If someone can't form an opinion on their own it's fine, just dont participate in the discussion. The last thing we want is some people joining some discussion just to magnify other people's thoughts.
[+] [-] tinus_hn|5 years ago|reply
[+] [-] mrfusion|5 years ago|reply
[deleted]
[+] [-] air7|5 years ago|reply
Statistics are just so hard to interpret and translate into a narrative that headlining a single data point is often misleading. I'm not interested enough to dive into this particular issue so I'm still not sure which claim is "true".
[0] https://emanuelkarlsten.se/number-of-deaths-in-sweden-during...
[+] [-] jonahrd|5 years ago|reply
[+] [-] playingchanges|5 years ago|reply
[+] [-] seppel|5 years ago|reply
[+] [-] chrisco255|5 years ago|reply
[+] [-] orangecat|5 years ago|reply
[+] [-] tims33|5 years ago|reply
[+] [-] hbosch|5 years ago|reply
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] mrfusion|5 years ago|reply
[+] [-] Pinus|5 years ago|reply
[+] [-] chinathrow|5 years ago|reply
We can't simply "stamp out" Covid-19, not even the swedes. Not even temporarily, they never had less than 150 cases per day since summer.
Source: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
[+] [-] zosima|5 years ago|reply
It seems, probably mainly due to immigration, that the population of ages 20-60 have increased significantly since 2010, while the population of ages 60+ have increased less.
http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE_...
This won't skew the average age very much, but will definitely reduce deaths per capita.
If mortality was calculated as a function of age distribution september would likely be average and april would have had a high excess mortality.
[+] [-] ytdytvhxgydvhh|5 years ago|reply
Really makes one wonder about differences in the US and Swedish population, especially regarding widespread obesity and diabetes.
[+] [-] mrfusion|5 years ago|reply
I’m not surprised at all that domestic deaths went up.
[+] [-] pelasaco|5 years ago|reply
"One forgotten contribution could possibly be the large number of canceled surgeries.
The last number I saw was appx 30k canceled surgeries in Sweden since Mar -20. Historical data from Argentina, Israel and Denmark show significant reductions in death rates when doctors go on strike. The last strike was in the 1960's and I have been repeatedly promised (by doctors) that "..it is different now.."
We have also noted a quite dramatic reduction of cancer diagnoses because of reduced screening for breast- and gyn cancer. The common wisdom among "experts" is that there is a large number of undiscovered cases which will show up later and with much more severe and deadly cancer in the months and years ahead. I doubt this. I have read a couple of the research papers defining guidelines for interpretation of pathological finds and they state explicitly that it is better to "overdiagnose" by at least a factor of 10 (and in reality up to a factor of 50) in order to not miss any "real" cases of cancer. Better to cut nine healthy breasts or prostates than to have one undiagnosed case.
Well, in just a couple of years we will have clear and unambigous evidence for or against the efficency of the cancer screening programs. This is a form of full scale clinical trial happening in front of our eyes."
And
"Oh, todays newspaper say it is 75k less surgeries in Sweden since Mar -20."
[+] [-] yread|5 years ago|reply
[+] [-] viraptor|5 years ago|reply
Was it definitely after pathology reporting? It's normal to have a low threshold to send people to biopsy. From the number of developed cases you can get some idea about what ratio of "ok" results you should have as a referring doctor. (this is tracked) But once you do biopsy / further checks I haven't heard of overdiagnosis by a large factor - not the "you should have surgery" overdiagnosis anyway. "Wait, see how it develops, retest" seems more common.
[+] [-] xenocratus|5 years ago|reply
[+] [-] natmaka|5 years ago|reply
The article is about "September 2020 least deadly month ((...)) 2020 third least deadly year ever so far".
AFAIK there is no normalized way to count COVID-19-induced deaths.
If so there is no way to compare official "COVID-19-induced deaths", because a given case may be counted as such in a country and not in another one, or even in the same nation by a given doctor and not by another one.
The total amount of deaths seems more objective.
Moreover the pandemics is running, therefore any comparison offers only a peek on a fraction of the challenge. Isn't this "herd immunity" approach a sort of "let's endure more short-term deaths, then durably much less afterwards" bet? In such a case any accounting may be moot for years.
[+] [-] oxymoron|5 years ago|reply
a) The spread of contagion before measures where imposed. Sweden was a few days later than the other Nordics in taking action, and may have been in a further advanced state to begin with. b) Safety equipment. Sweden had no functioning central reserves for health care gear. c) Failure to protect the vulnerable. The nursing homes are a mix of private and public, but all are administered at the municipal level. Proper care was not taken to protect the elderly, largely due to lack of local know how and incompetent central response.
I’ve been a staunch defender of the Swedish strategy, but it seems like there’s no avoiding the conclusion that the path taken by the other nordics may have been smarter in that it contained the spread until adequate supplies could be secured, good routines established and treatment options better understood. (To be fair to FHM that devised the strategy, b and c are certainly on other authorities.)
Significantly, although all the nordics now have a climbing number of cases, none has seen a sharp rise in the number of deaths. Mean time from hospitilization to death is around 18 days, so the resurgence has been ongoing for long enough that it’d have been noticeable by now.
It seems like the Swedish path may have two main benefits left:
1) Fewer vulnerable children were hurt by being sent home. Fewer women locked in with abusive partners. Nordic lock downs were less drastic, and may have avoided some of it, but at the global level it’s numbing to think of the suffering of children this year. 2) In terms of GDP growth, the indication is that Sweden didn’t do much better than the other nordics, but I think it’s still to early to gauge the long term economic benefits of a soft strategy. Maybe Sweden ended up taking on less debt per capita, for instance? I haven’t seen numbers on that, but school closings in particular are expensive, and so seems like reasonable speculation. Time will tell.
The economic benefits are probably not going to turn out to be compelling enough to justify the potentially avoidable deaths. From a utilitarian perspective, I think the first point may be though. The deaths have largely been people towards the end of their life. I think the constructive way to view it is that we should consider all years of a humans life equal. Is it worth sacrifying an 80 year old to save a 10 year old from being beaten up at home? If it hurts that kid for life in a tangible way, then yeah, that grim calculus may just work out.
[+] [-] brnt|5 years ago|reply
If you're summing all effects, you're looking at all data at once, and probably are doomed not to learn anything particularly actionable. Its in the breakdown that we kind find meaningful bits for future reference.
[+] [-] natmaka|5 years ago|reply
If there is no major other new pertinent factor, then when it comes to compare those solutions (deciding when to assess is a challenge) there are (proportionally) less deaths where the more efficient one is implemented.
Am I wrong?
[+] [-] raverbashing|5 years ago|reply
And I think it is related to the pandemic but in 2 ways:
- As people said, less activity in general and it was one of the better months in Europe in terms of deaths.
- The mortality in the initial months has probably anticipated possible deaths that would occur later in the year
[+] [-] Gwypaas|5 years ago|reply
For the year 2020 so far, ie January - September, the number of deaths per capita is the third lowest ever.
[+] [-] hristov|5 years ago|reply
https://www.statista.com/statistics/1115707/sweden-number-of...
It shows 2020 weekly deaths in comparison with a 2015-2019 average which is a good indication of the normal - precovid rate. You can see how there was a massive spike around week 12 to week 21, which is exactly when the initial covid outbreak hit and Sweden's disastrous "herd immunity" policy failed.
Now Swedes have been scared and changed their behavior and covid deaths are less. Furthermore, the defensive behavior of covid prevents other deaths. People, do not drive, do not party, do not engage in sports, do not take drugs, or over-drink or over-eat at parties, so that other causes of death go down.
So it is possible that covid isolation reduces death rate more than the deaths caused by the virus itself. But that is not a solution, people cannot live in covid isolation forever.
[+] [-] chmanie|5 years ago|reply
First thing I would do is to check whether they are lost some rows (or columns).
[+] [-] TooCreative|5 years ago|reply
Here is one for Germany:
https://www.destatis.de/DE/Themen/Querschnitt/Corona/Gesells...
[+] [-] hirundo|5 years ago|reply
https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
The excess deaths during the pandemic are not subtle in these graphs. If the data is accurate and the comparison with Sweden is valid, then it does tend to support the importance herd immunity to this virus.
[+] [-] Vinnl|5 years ago|reply
[+] [-] aaaxyz|5 years ago|reply
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] aflessner|5 years ago|reply
https://www.euromomo.eu/graphs-and-maps#excess-mortality
[+] [-] username90|5 years ago|reply
[+] [-] hyko|5 years ago|reply
The Swedish authorities never suggested that lockdowns wouldn’t work in controlling the pandemic, in fact they acknowledged that they definitely would work in the short term; their core assertions were that the Swedish population would not be able to sustain involuntary restrictions until better treatments or a vaccine arrived, and that the harms caused by restrictions would be a net negative for their society. The jury is still out on those decisions, but they are rational.
In fact we’ll probably never know who chose the optimal policy mix to cope with the pandemic, and as a result we should give those with differing views an awful lot of slack as they try and negotiate it with limited resources and foresight (i.e. as humans).
For now, let’s just enjoy this good news about the people in Sweden at face value–we need it!
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] pjc50|5 years ago|reply
Similarly, Sweden didn't have no restrictions in response to coronavirus.
[+] [-] jeofken|5 years ago|reply
The image many foreigners have of Sweden is outdated due to mass immigration (HN PC may dislike it, but I call it population replacement) - that image is from when it was a homogenous country.
[+] [-] rogerkirkness|5 years ago|reply
[+] [-] anovikov|5 years ago|reply