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Long Term, We’re All Swedes
There has been considerable debate regarding the validity of the Swedish approach to mitigating the effects of COVID-19. At National Review, John Fund and Joel Hay have written an excellent article detailing the successes of the Swedish “herd immunity” strategy. Next to it is Theodore Kupfer’s thoughtful response. The debate regarding the Swedish strategy vs. the US strategy will likely go on into the foreseeable future, with political, social, economic, and healthcare ramifications. Until all the data is in, we will most likely not know if Sweden’s gambit was worth the risk or if the path the US took was the right one. I think, though, that much of this debate misses out on an essential truth, one that we’ve turned a blind eye to, perhaps on purpose.
In the long term, we’re all Swedes.
Let me explain. One of the primary reasons that the Swedes went this route was that the other options simply were not sustainable. From the Fund/Hay article:
“We try to use evidence-based measurements,” Emma Frans, a doctor in epidemiology at Sweden’s Karolinska Institute, told Euronews. “We try to adjust everyday life. The Swedish plan is to implement measurements that you can practice for a long time.”
The problem with lockdowns is that “you tire the system out,” Anders Tegnell, Sweden’s chief epidemiologist, told the Guardian. “You can’t keep a lockdown going for months — it’s impossible.”
The Swedes where well-aware of the “shelter in place” option. But they also knew what many epidemiologists have all but admitted: COVID-19 is likely here to stay. This summer, the virus will die down in the northern hemisphere and flare-up in the southern hemisphere. This fall, it will make its way back to the northern hemisphere and will cause problems again, at least until we get a vaccine, which could be years away. Even the “flatten the curve” crowd admits that drawing out infections over time isn’t the same thing as reducing infections. Shelter-in-place orders are designed to spread the impact of the disease over time in order to reduce the strain on the health care system. The problem we have found is that lengthening the duration of the epidemic has its own set of risks (economic, social, and perhaps even greater numbers of “deaths of despair”). The Swedes looked at this scenario and decided that hiding from the virus was simply not a long-term solution and made the choice to fight the good fight now. They were well aware that they’d take their lumps, but they decided that it was better to go ahead and bite the bullet and get it over with.
In the US, we have made the decision to avoid the fight, to stretch the pandemic out for the foreseeable future. We have done so at great economic cost and perhaps even greater cost to our civil liberties. Indeed, the COVID crisis has given rise a set of authoritarian behaviors from governors and mayors that would have been unthinkable three months ago. And for what? To merely delay the inevitable reckoning? One day, maybe a month from now, maybe a year from now, we will have to come out of hiding and face the harsh light of day. We will reach the inevitable conclusion that countless civilizations have found over the course of history: the only way to conquer this menace is to face it head-on.
In short, we will become the Swedes.
The only variable left is “how long.” How long will we delay before arriving at this conclusion? How many lives will we destroy in the futile attempt to hide from the invisible terror? When do we face the light and move forward? The answers to those questions will be the ultimate test of our courage and resolve.
Published in Healthcare
The idea is to try and buy time.
Time to increase the medical infrastructure.
Time to start manufacturing PPE.
Time to find effective treatments.
Time to develop a vaccine.
I’m not a Swede and will never be one. And I’m not a libertarian and will never be one either.
There is a strategy at work here, as the post above indicates. You may not agree with the strategy, and I’m not sure that I do either as applied in specific instances. But blanket condemnation of certain courses of action in the name of an extremely limited notion of the role of government is a bridge too far, as is hyperbolic speculation about the future of civil liberties.
Shutting down the economy has a human cost also. Poverty and hopelessness also kill. I am not sure that I wouldn’t prefer the choices Sweden made. One advantage Sweden has over us, however, is a homogenous population made of Swedes.
Well, not exactly. Other than some influx of migrants from the Middle East and Southern Asia, Swedes are a very homogenous people. Not true for Americans. I also doubt that Sweden has anywhere near the diversity and density of our major metro areas, led by New York City. I don’t know about the general state of health of Swedes versus Americans, but I would bet on the average being better in Sweden. I recall a major issue in the big medical care costs debate of the last three decades being the high percentage of obesity, type 2 diabetes, cancer, and hypertension in the American population and that those were big contributors to the high costs of our maintaining a superior healthcare system.
My impression of the lockdown’s purpose is to avoid such a surge in cases and resulting deaths that we will have people dying at home and in the streets after the hospitals are filled to capacity. By ‘flattening the curve’ we moderate that to a more manageable and civilized level.
I think we must selectively restart our economic engine by the end of April. This will probably include recommendations that those in the most vulnerable categories take a range of precautions. By doing so, many of those will never experience this virus provided we develop a vaccine.
An interesting sidelight: Zeke Emanuel, President Obama’s healthcare system advisor, who has very openly said that he saw no reason for the elderly to live beyond 75 years and so didn’t think there should be exceptional provisions for their care, is now openly suggesting that the lockdown should stay in place for 12 to 18 months. Any approach resembling that is immediately identifiable as a statist strategy with no relationship to dealing with this virus.
I’m no expert in any of this, just trying to use my common sense. If I’m missing pieces or have facts wrong I welcome corrections.
Ten thousand Swedes ran through the weeds, chased by one Norwegian.
The dust from the weeds made snoose for the Swedes, at the battle of Copenhagen.
Politically, Trump had no choice but to go the current CDC recommended stay at home order route, and Trump is still getting ripped for implementing stay at home recommendation too late, or blamed for just about everything Covid-19 real or imagined.
If Trump went the Swedish carry on route every Covid-19 related death would be blamed on Trump.
The real political gambit coming soon is when to recommend going back to work … what industries, how many people, split shifts, etc.
The one certainty in the crisis is the Left will politicize everything for political gain, and with Biden as the (D) candidate it may be the only viable political strategy in their arsenal.
If it were done when ’tis done, then ’twere well
It were done quickly
In my life, I have found that it is generally better to rip the bandaid off than to slowly work around the edges. It’s better to give a harsh but definitive answer than to string someone along with false hope. But, here’s the kicker, do I always do those things? No. So I can understand why no politician in the US is willing to stand up and say: sorry, a lot of you are going to die now because we aren’t prepared. But we’ll be prepared for the next time so fewer of you will die then.
My guess is that Sweden will see some bad numbers and if you or your loved one is among them, you will be angry and unforgiving. But if the strategy is right, then next fall things may be better there than in the rest of the world.
Well, yeah, but I’m not sure how many people understand that. It seems like people think we really can make it go away, such that a second wave in the fall will seem like a failure. But there will be a second, and a third, and a fourth wave, and successive waves until it becomes just another seasonal thing. Are we going to shut back down for each of them?
Why would you ask that? Something in the previous discussion or in the public discussion that could make one believe that?
It’s a logical assertion.
If the current crisis poses such a threat that a near national shut down is needed, why would a second wave of infections do likewise?
That’s more or less my thesis: we can’t keep doing this over and over again. Eventually, we’ll adopt the Swedish model by sheer necessity.
You could kind of see Trump thinking aloud about a herd immunity strategy in one of his Rose Garden updates (I forget which one) where he said that some of his confidants said just “plow through” but then he noted how Fauci had convinced him of the countless deaths that would occur.
Oh, one other thing, haven’t we had to do this because we were not prepared? If we get prepared (whatever that entails) wouldn’t that mean avoiding the lockdown?
A large number of the deaths being recorded are among the elderly who in their daily lives have little effect on the areas that have been shut down. In other words, if measures are taken to isolate the vulnerable, that goes a long way in mitigation without shutting down the economy.
With luck we will have a vaccine or a good treatment.
Not if we get aggressively ahead of it like South Korea and Singapore did, with lots of testing, contact tracing and isolation of those infected and measures like masks in public, hopefully we won’t have too.
I’ve said for a month we didn’t have to be here.
If the CDC hadn’t beclowned themselves on the develop of a test, if they had aggressively stopped travel from infected areas, if they had done aggressive testing of high risk areas ( Chinatowns, cities with large Chinese populations, cities with direct flights from China etc, chants of racism be damned), if they had encouraged mask use by the public instead of the idiotic “it’s just the flu wash your damn hands campaign, we might not have been forced into the drastic action we had to take.
People keep going on about “the elderly”
Look at the NY data on deaths
4% are 40-49
11% are 50-59
19% are 60-69
Thats 1/3 of the deaths
How are you going to isolate those in their 50’s 60’s and 70’s and those younger with underlying medical conditions that put them at high risk from the rest of the public for extended periods of time?
Oh and 1/3 of all physicians in the US fall into the “high risk” age group.
How exactly would this work?
Months and months in house arrest with no contact with anyone outside of their household? You think that won’t have a negative effect on the economy?
Are you looking for perfection or some measures that mitigate? Everything in this process has an associated selectivity factor. Think not shaking hands.
A week ago, Sweden had 24.39 deaths per million. Today they have 66.51.
A week ago, the US had 14.39 deaths per million. Today it has 44.21.
The gap between the two countries keeps increasing. Seems to me they are going start considering lockdown pretty soon.
Purple cow?
Talk that we should stay shut down until a vaccine is developed – which may not be for another 18 months. The reaction to this go-round and talk about not wanting to lose even one life. Have we inoculated ourselves against that kind of thinking and talk for the next go-round? I hope so. I’d like to think so. But I’m not sure.
Singapore is going back of lockdown.
https://www.reuters.com/article/us-health-coronavirus-semiconductors-foc/with-singapore-lockdown-underway-essential-chipmakers-count-on-less-disruption-idUSKBN21Q042
https://www.wsj.com/articles/singapore-escalates-restrictions-as-it-faces-a-new-wave-of-infections-11585929290
It will be wave after wave until it becomes endemic or we somehow cauterize the country from the rest of the world forever.
Only if we keep the POTUS that we have now. Even better if we keep him and elect a Republican Congress.
The question that I have is: Given the facts that
(a) we can no longer hope to geographically isolate the bug (e.g., it is in every county in my home state of Maryland) and exposure is clearly vastly more widespread that first believed;
(b) the lockdown is highly porous—many (most) people still need to go places and do things, and
(c) treatment options have emerged since the commonly followed models were first unveiled,
what marginal benefits accrue from continuing the lockdown strategy that would be significantly better than Swedish model of individual prudence and precautions (e.g., mask & hygiene) along with an edict against large gatherings? Whatever that marginal benefit may be, it is expensive as hell.
Epidemiologically speaking, the Swedes do not appear to be paying a price for their approach whereas economically speaking, we are paying through the nose for ours.
I think it is perhaps premature to attempt to predict the long-term significance of this pathogen, given that we have a very poor sense of how many cases of it we actually have in the population. If it has already traveled widely with few serious symptoms, it seems reasonable that relatively minor changes to our public hygiene habits might render it far less alarming.
Grim scenarios are available in abundance, but what we need now is information.
I’m 81 and elderly but I might have to be an essential employee for the government of New Jersey.
https://josephsteinberg.com/covid-19-response-new-jersey-urgently-needs-cobol-programmers-yes-you-read-that-correctly/
As long as the healthcare system isn’t overwhelmed on a widespread basis, I think we’ve done the best we could.
In a country as big and diverse as ours, no one method is going to answer. Sweden is small and pretty dang homogeneous. Maybe it works in Sweden to isolate the vulnerable – how does that work in some of our ethnic communities, where multiple generations live together? What works for North Dakota might not work for New Jersey. I think it’s a waste of time to talk as if there’s one approach we all must or must not do.
The reason I think it is ridiculous to claim we are all Swedes, i.e. going to be inected with Wuhan virus, is polio and how public health officials fought it. Tactics are much the same. And believe it or not everyone came down with polio.
Besides the fact that we developed a vaccine, the vector for polio was contaminated food and water. The issue with CoronaVirus is that the disease is coming from inside the species, so to speak.