1. Sweden should be worse (at this point) than countries that enforced lockdown -> seems to be the case, compared to near neighbours anyway. If not, then it would suggest (with hindsight, though at the time still sensible, I think) that full lockdown was over-reaction.
2. With normal behaviour, things in Sweden should be pretty horrendous, according to what we think we understand (i.e life as normal R ~ 3). They're not.
3. This is probably due to Swedes not being stupid and changing behaviour more than the fairly minimal legal restrictions and so getting R somewhere close to 1 (transport data do show major changes in behaviour)
4. Raises the question, would we (UK) still have levelled off (if not declined) without the full lockdown? We don't know. Depends on discipline and we probably had more initial cases (more through travel for business etc) so would have levelled off at a higher level. Even if we had levelled off at 8 April rather than starting decline, the extra deaths in this wave would be in the tens of thousands.
5. If health services are not overwhelmed without a lockdown then lockdown alone just pushes deaths into the future by delaying infection. But those deaths might be avoided completely if there is a vaccine or effective treatment before they happen. So its too early to judge whether Sweden will have more deaths in the end than if full lockdown had been enforced.
I basically agree with all that (I'm not sure you're saying anything controversial)
In brief, it is too soon to tell with Sweden.
Yep, just replying to the 'big ouch' comment. It's not a big ouch unless you're expecting Sweden to have a big decline in cases or deaths at this point. They'll probably keep bobbing along at similar levels, unless behaviours change one way or another.
And, importantly, they`ll have significant herd immunity by now.
I thought it was only around 20%?
It`s a lot better than the approx 10% (maybe less) that we have got.
There are only two ways out of this: containment or herd immunity (vaccination is a form of herd immunity). I`ve always been in the latter camp and still am. We`ve got to learn to live with a new threat, which is going nowhere.
Interesting to see Foxy post this morning that he`s also beginning to think that the virus is endemic.
Both still a looooong way from what is required though. Agree that this thing is going to be around for the long-term without a vaccine.
Needs someone more mathmatically gifted than me to work this through - but if no herd immunity and R = 1 then 100 infections, go 100/100/100/100/100.
If 20% immune, then 100/80/64/51/41 etc
It's more like, with 20% immune and all else being equal, you can keep R bobbing along around 1 with slightly less severe measures / behaviours (and as Selebian says, in Sweden we are talking mainly about behaviours). It is not that at 59% you have no herd immunity then BANG at 60% you do.
Glad to see this post because it's been on my mind. I would (instinctively and therefore probably wrongly) say that if full mass immunity comes at 60%, then half of the effect comes at approx 45%. And a quarter at approx 30%. And below 15% very little.
If presenting it graphically helps....
Thanks. It's a leasehold through the looking glass!
There is a grim game going on in which the NHS are saints and government is the sinner.
How long will it be before Boris and Co capitalise on the fact that medical judgements are a matter for the saintly NHS, not wicked government officials?
Except that in this case that is not what appears to have happened.
There was an extremely strong directive from government (which I've quoted from and linked to above), issued on the 19th March, requiring the discharge of around 15,000 patients within a week.
The room for medical judgment was limited.
And Boris and Co. can hardly turn on an organisation they have canonised anyway.
It was the fault of our saintly doctors....
Particularly as it doesn't appear that it was.
This is Annex B: Every patient on every general ward should be reviewed on a twice daily board round to determine the following. If the answer to each question is ‘no’, active consideration for discharge to a less acute setting must be made. Requiring ITU or HDU care Requiring oxygen therapy/ NIV Requiring intravenous fluids NEWS2 less than 3 (clinical judgement required in patients with AF &/or chronic respiratory disease) Diminished level of consciousness where recovery realistic Acute functional impairment in excess of home/community care provision Last hours of life Requiring intravenous medication greater than b.d. (including analgesia) Undergone lower limb surgery within 48hrs Undergone thorax-abdominal/pelvic surgery with 72 hrs Within 24hrs of an invasive procedure (with attendant risk of acute life threatening deterioration)
"NEWS2 less than 3", as I understand it, refers to a score in the guidance about assessing Covid, or suspected Covid patients for deteriorating condition. The clear implication of this was that any such patients whose conditions were not deteriorating should be discharged.
Politicians wouldn’t make judgements about a medical scale
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