Sweden during the pandemic.....everything remained open

The United States' approach to the new coronavirus was in line with virtually the entire developed world—we attempted to limit the damage from the virus by “flattening the curve”, meaning preventing the virus from spreading as rapidly as it would have, were no action taken. This is a pretty simple concept to understand: A virus spreads at a certain rate, known as the RO factor (pronounced “R naught” factor, and that “O” is really a subscript “O”). It’s the basic reproduction ratio or basic reproductive rate, and it tells us how fast the virus spreads…at a high level it’s just how many people on average an infected person will infect. So if one sick person infects two other people (RO = 2), the disease will spread exponentially—two people infect four people, those four infect eight people, 16, 32, 64, 128, blastoff….it’s a pandemic. RO less than one, the disease dies out. 

That description of RO is at best simplistic. It’s actually a complex concept and difficult to compute. If you want to know more about it, here’s a scientific article that goes into detail. The complexity of computing RO is why so many projections by scientists were incorrect.

So we, and the rest of the developed world, tried to flatten the curve by closing businesses, enforcing social distancing, requiring masks, shutting schools, prohibiting gatherings, etc. Did it work? We don’t really know, but it probably did flatten the curve, at least temporarily. The big problem with our approach is that there wasn’t and isn’t an exit plan, and here we are today, worrying about a second wave of Covid-19.

Sweden, on the other hand, didn’t shut down its economy, didn’t prohibit gatherings, didn’t shut its schools, and basically left it up to its people to be responsible for themselves and safeguarding the people most vulnerable (like in rest homes). The result there was a higher death rate per capita than other surrounding Scandinavian countries, but a lesser rate (more than 50% less) than in Massachusetts, for instance. And now, if you look at the graph below, you can see that the number of deaths from this new coronavirus is declining dramatically in Sweden, much like in other countries hit hard by the virus, but with one HUGE difference. They don’t have to worry about a resurgence like we’re seeing in the US when the lockdown is eased, in phases, simply because they never locked down.

On the graph below, week 1 begins 3/12/2020, and week 14 ends 6/14/2020. The graph is weekly to compensate for inadequate reporting in Sweden on weekends, with resulting catchups on Mondays and Tuesdays.

 

As a concrete example:

 

Deaths

Population

Percent

Sweden

4891

10,230,000

0.05%

Massachusetts

7647

6,893,000

0.11%

 

Why is this the case? There are a lot of factors, so it's not necessarily that the Swedes simply handled it better than almost everyone else:

·        The Swedes trust their government more than we do here in the US, so they actually were careful and followed recommendations, and were aware that older people were more susceptible.

·        Both the Swedes and Massachusetts failed to adequately protect their nursing homes, driving up the mortality rate, although neither handled it as poorly as did Governor Cuomo in NY State, who actually forced nursing homes to accept Covid-19 patients, resulting in thousands of deaths.

·        Sweden vis-à-vis other Scandinavian states was the most welcoming of refugees fleeing Africa and the Middle East. The death rate in those communities is considerably higher than amongst native Swedes, for the same reasons that deaths are higher in the US in minority communities—denser populations, multigenerational households, less caution and social distancing, and more preexisting health issues.

 

So the Swedes ‘let it burn’, while doing their best to reduce the death toll, and ended up somewhere near ‘herd immunity”, while we and the rest of the world shut down our entire economies, had more deaths per capita in certain states and countries, and now are seeing second waves of contagion as areas reopen.

It’s very tough to compare, because Covid-19 is an unpredictable disease, and many, many factors contribute to its spread and resulting deaths--primarily how densely populated an area is, and the age and health of its population. However, the Swedes, going their own route, certainly have given us something to think about. Over there it’s almost over. Right here, we don’t know, but it looks to be starting over.