Sweden's liberal pandemic strategy questioned as Stockholm death toll mounts

[dann]

Saturday:
Coronavirus - countries (Worldometers, Oct. 31, 2020)
Deaths per million (Total deaths) New cases Serious/Critical
Sweden: 587 (5,938) 3,188* 59 *according to SVT.se No new numbers till Tuesday
Denmark: 124 (721) 1.126 19
Finland: 65 (358) 203 10
Norway: 52 (282) 269 10
Iceland: 38 (13) 68 4
Iceland has 979 active cases, Faroe Islands 14, New Zealand 75.
The Faroe Islands have 32 in quarantine, 0 hospitalized.

 

[dann]

An appeal to Australians and New Zealanders

Aussies and Kiwis, please do whatever you can to let the rest of the world know about the successful elimination of the virus in your countries.
Europeans know almost nothing about the elimination strategy.

Today, the Danish media had good news from Australia:
Australien oplever første dag uden nye smittede i 145 dage (TV2.dk, Nov. 1, 2020)
Australia has its first day in 145 days without new cases

But this is an exception and a very refreshing change from what the media are usually telling us about your corner of the world:
Virusramt delstat giver Australien kedelig dødsrekord (TV2.dk, Aug. 10, 2020)
Virus-impacted state gives Australia a sad record in deaths

Australien slår smitterekord på grund af udbrud i Melbourne (TV2.dk, July 27, 2020)
Austrlia beats contagion record due to outbreak in Melbourne

Virus er løs i Melbourne: Australien sætter smitterekord (DR.dk, July 27, 2020)
The virus is on the loose in Melbourne: Australia sets contagion record

Efter første coronatilfælde i over 100 dage: New Zealand lukker storby ned (DR.dk, Aug. 11, 2020)
After the first coronavirus case for more than 100 days: New Zealand locks down big city

I don't think it's because the media are deliberately misleading. I don't see the same confirmation bias at play here as I do in Swedish media. They just seem to be more focussed on Europe and the USA, so the news from Australia and New Zealand has to be dramatic to be mentioned, and curing a disease isn't as dramatic as getting it or dying of it.

So please inform the rest of the world - and in particular Europe and the USA since they tend to dismiss what they could have learned from countries like China, South Korea and Japan ('authoritarian', 'different mentality' (i.e. racism!)) - about your successful fight against the disease.
As readers of this thread, you are already aware of the prevailing ignorance about the rational way to cope with the virus and what we are up against, misinformation-wise.

 

[dann]

For Swedish authorities, and those elsewhere who will likely be watching closely, the question is whether an approach that calls on citizens to take responsibility themselves can work and reverse a negative trend like the one in Uppsala, which has seen hospitalizations from COVID-19 rise from 4 to 33 over the past two weeks.
Sweden’s hands-off approach to local lockdown - Uppsala goes into voluntary lockdown because of spike in coronavirus cases. (Politico, Oct. 24, 2020)

On Tuesday Scania county, which includes the southern city of Malmo, announced a voluntary lockdown, with residents urged to avoid shops, gyms, libraries, swimming pools, meetings, public transport and physical contact with people from outside their household.
“We need to press the emergency brake to stop this development now,” Eva Melander, the region’s medical director for infectious diseases, said.
Overall nearly 4 per cent of coronavirus tests yield a positive result, up from 1.2 per cent in early September.
Coronavirus: Sweden’s push for herd immunity immoral, says covid chief (TheAustralian, Oct. 29, 2020)

Lockdown, the strategy that dare not speak its name ... at least in Sweden.
And as so often before, Anders Tegnell is there to lie about it:

“But the curve is rising less steeply than elsewhere. So far the increase has not resulted in more people needing to be admitted to hospitals. All in all, we’re fairly satisfied.”
Coronavirus: Sweden’s push for herd immunity immoral, says covid chief (TheAustralian, Oct. 29, 2020)

Some people in Sweden don't understand why many Swedes don't seem to understand how serious the situation is. I don't find it very hard to grasp. At the press briefings with Anders Tegnell, he always begins with a description of how serious the situation is in the rest of Europe and the world before he moves on and starts to calm down his compatriots by telling them that Sweden is doing much better than everybody else.
I am pretty sure that he won't mention the Australian success story - ever!
If the Aussies want to get mentioned by Tegnell, they'll have to wait for the next outbreak.

 

[Arcade22]

Sweden is horrible because it's a ruthless dictatorship. If only we were as free as the Cuban people we would not have viruses. Please liberate us from our oppressors! Our capitalist slave drivers don't care how many die as long as we toil away in their sweatshops!

 

[lionking]

Sweden is horrible because it's a ruthless dictatorship. If only we were as free as the Cuban people we would not have viruses. Please liberate us from our oppressors! Our capitalist slave drivers don't care how many die as long as we toil away in their sweatshops!

Sweden’s response to covid has been a miserable and continuing failure. It’s leaders have become the laughing stock of the world.

 

[dann]

Sweden is horrible because it's a ruthless dictatorship. If only we were as free as the Cuban people we would not have viruses. Please liberate us from our oppressors! Our capitalist slave drivers don't care how many die as long as we toil away in their sweatshops!

Not quite true: So far, Cuba has had 128 Covid-19 deaths (Sweden +5,938), which is more than New Zealand, for instance, but very different from the majority of Latin American (or European) countries.
But what is more extraordinary is that they sent medical brigades to all corners of the world to fight the pandemic. They did the same thing when ebola had to be eliminated in Africa:

Belly of the Beast talks to doctors who served in Brazil, Bolivia and Italy, and of course the ones who held it down in Cuba during COVID-19. (Belly of the Beast/LatinoRebels, Oct. 30, 2020)

Danny Glover and Oliver Stone's The War on Cuba:

Worldometers: Coronavirus: Cuba (deaths per million: 11)

It is no wonder that so many people get upset about this, and I am not surprised that many Swedes (but far from all of them ) are infuriated, but I am pretty sure that Cuba would send a contingent of the Henry Reeve brigade to fight the virus in Stockholm, Uppsala or Malmö if you asked them.

And unlike the Swedish medical experts, the Cuban epidemiologists aren't busy lying to the world. I still can't get it into my head why you let your national epidemiologist get away with those lies. Unlike foreign journalists, you Swedes (and in particular Swedish journalists who read foreign news about Sweden's pandemic response) know that he is lying, and yet you let him carry on.

How can you let him get away with making claims like this one?
"So far the increase has not resulted in more people needing to be admitted to hospitals."

I don't know much about Swedish sweatshops - as far as Sweden is concerned, I have been focussed on the pandemic for the past seven months - but you could at least supply your sweatshop workers with face masks and do something about crowding on public transport.
Is that too much to ask?!

 

[dann]

Sunday:
Coronavirus - countries (Worldometers, Nov. 1, 2020)
Deaths per million (Total deaths) New cases Serious/Critical
Sweden: 587 (5,938) 3,188* 59 *according to SVT.se No new numbers till Tuesday
Denmark: 125 (723) 948 19
Finland: 65 (358) 178 10
Norway: 52 (282) 304 10
Iceland: 44 (15) 25 4
Iceland has 927 active cases, Faroe Islands 14, New Zealand 77.
The Faroe Islands have 32 in quarantine, 0 hospitalized.

 

[dann]

Lena - Läsarkommentar
Föreningen Vetenskap och Folkbildning (VoF) delar årligen ut priset till "Årets förvillare". Priset ges till en person eller organisation som motverkat vetenskap. Vilka kandidater tror du ligger bra till för att erhålla årets utmärkelse? Tegnell, kanske du själv eller någon annan?
Agnes Wold
Du får väl nominera! Fast du kanske måste gå med i föreningen först
Fråga Agnes Wold about the coronavirus (Expressen.se, Oct. 31, 2020 - 20:52)

Lena - Reader's comment
The association Science and Education of the People* (VoF) awards the annual prize to "The Misleader of the Year". The prize goes to a person or organization that has resisted science. Which candidates do you think are positioned to receive the recognition this year? Tegnell, maybe you yourself, or somebody else?
Agnes Wold
I guess you will have to nominate. But you may have to join the association first.
Ask Agnes Wold about the coronavirus

*What is folkbildning?

 

[dann]

Long-haulers and the experiences Covid-19 patients in ICUs

Överläkaren: Covidsjuka kan tappa förmågan att läsa eller köra bil (SVT.se, Nov. 1, 2020)
Chief physician: Covid-19 patients may lose the ability to read or drive a car

”Jag drömde att doktorn skulle skära av mina öron” (SVT.se, Oct. 31, 2020)
”I dreamt that the doctor was going to cut off my ears”

Mardrömmar och hallucinationer vanligt hos covidpatienter (SVT.se, Oct. 31, 2020)
Nightmares and hallucinations are common in Covid-19 patients

 

[Vixen]

<snip>

1) Sweden’s so-called health service was overwhelmed to the extent where hospitals stopped accepting new Covid-19 patients, practiced triage and simply let people receive palliative care, i.e. opioids, instead of treatment. People who should have had oxygen got drugged instead. This was practiced to the extent where Sweden actually had ”free intensive care beds,” i.e. Sweden let people die in their nursing homes despite available ICU beds!

What? That is seriously irresponsible as opioids suppress ease of breathing not alleviate it.

 

[dann]

How can you let him get away with making claims like this one?
"So far the increase has not resulted in more people needing to be admitted to hospitals."

Trots ökningen går det inte med säkerhet att säga att antalet fall vi nu ser kommer påverka vårdbehovet om några veckor, enligt Tegnell.
– Den där kopplingen tycker jag är svår, för det är liksom inte någon automatik i den. Vi har ju faktiskt levt med ganska stor smittspridning – jag menar vi har haft hyfsat höga tal under ganska många veckor nu – och det har inte gett något genomslag i vården på något dramatiskt sätt än så länge, säger han till tidningen.
Tegnell: Ökningen är värre än väntat (Expressen.se, Nov. 1, 2020)

In spite of the increase, it is not safe to say that the number of cases we have now will impact the need for health care in a couple of weeks, according to Tegnell.
– I think that it is difficult to make this connection because it is not something that happens automatically. We have actually lived with a very high level of contagion – I mean, we have had very high number of new cases for several weeks by now – and it hasn’t affected hospitals in any dramatic way so far, he tells the newspaper.
Tegnell: The increase is worse than expected

Weasel words from Anders Tegnell.
So the rising number of new cases have affected the number of hospitalizations after all – just not in any dramatic way.

 

[Samson]

I will shortly post audio of Stephen Franks.
This will surely fascinate you dann, he is a libertarian NZ politician and lawyer.

 

[dann]

What? That is seriously irresponsible as opioids suppress ease of breathing not alleviate it.

Let me be clear about this: I am not sure that opioids were the drug used for the Covid-19 patients receiving palliative care only. I no longer remember if the kind of drugs used was mentioned.
But one argument for palliative care was that the poor old people should be spared having to endure real treatment in ICUs. After that choice has been made, there is really no reason to prolong their suffering.

 

[dann]

I will shortly post audio of Stephen Franks.
This will surely fascinate you dann, he is a libertarian NZ politician and lawyer.

Do you mean this? (7:30-10:00)
The Panel with Stephen Franks and Pam Corkery - part 2 (RNZ, Nov. 2, 2020)

 

[Vixen]

Sorry, I know I asked, but housing, real estate and interest rates in New Zealand are too far removed from the theme I am interested in, i.e. the pandemic.
It sounds to me as if you don't really have any objections to Ardern's pandemic policies but are angry at her for other reasons, which makes you belittle what NZ has accomplished with her as the PM - corona-wise.

Nothing but the political will to do so prevents European countries from doing what Australia and New Zealand did. As for population density:
Denmark: 137 per km²Sweden: 25 per km²Finland: 18 per km²Norway: 15 per km² (like NZ)
Iceland: 3 per km² (like Australia)

It's a very far cry from Belgium's 383 or the Netherlands' 488 per km², countries that Sweden would prefer to be compared to in this question.
Population density can't be said to have complicated Sweden's pandemic response.

It is not enough to look at population density as a measure of no. people per sq km. Sweden and Finland have a large land mass but are something like 70 - 75% forest, lake or wetlands (swamps, marshes, bogs). Compare and contrast with the UK with only about 10% of its land as waterways. Whilst the UK and probably Denmark and NZ has the population evenly spread throughout the country, Australia - mostly outback - Sweden and Finland (ibid) have their populations concentrated around large metroplises/metropolii. Thus, it is misleading to quote Sweden as having a population density of 25/1 sq km, as the vast majority of its people live in massive urban communities, mostly along the coastlines. When you look at where people really live, you'll find that the majority live in cities that have population densities of something like 5,000/1 sq km. OK, not quite Belgium, Netherlands or England but you can see why there is such a high rate of infection in Sweden. Likewise in Finland's Helsinki region, where 25% of its population is concentrated. Also high is in the northwest, at the border with Sweden as there was until recently free movement of citizens, especially regarding healthcare workers, who brought covid19 into Finland with them.

 

[theprestige]

1) Sweden’s so-called health service was overwhelmed to the extent where hospitals stopped accepting new Covid-19 patients, practiced triage and simply let people receive palliative care, i.e. opioids, instead of treatment.

Let me be clear about this: I am not sure that opioids were the drug used for the Covid-19 patients receiving palliative care only. I no longer remember if the kind of drugs used was mentioned.

But one argument for palliative care was that the poor old people should be spared having to endure real treatment in ICUs. After that choice has been made, there is really no reason to prolong their suffering.

Is all of your analysis like this?

 

[Architect]

It is not enough to look at population density as a measure of no. people per sq km. Sweden and Finland have a large land mass but are something like 70 - 75% forest, lake or wetlands (swamps, marshes, bogs). Compare and contrast with the UK with only about 10% of its land as waterways. Whilst the UK and probably Denmark and NZ has the population evenly spread throughout the country, Australia - mostly outback - Sweden and Finland (ibid) have their populations concentrated around large metroplises/metropolii. Thus, it is misleading to quote Sweden as having a population density of 25/1 sq km, as the vast majority of its people live in massive urban communities, mostly along the coastlines. When you look at where people really live, you'll find that the majority live in cities that have population densities of something like 5,000/1 sq km. OK, not quite Belgium, Netherlands or England but you can see why there is such a high rate of infection in Sweden. Likewise in Finland's Helsinki region, where 25% of its population is concentrated. Also high is in the northwest, at the border with Sweden as there was until recently free movement of citizens, especially regarding healthcare workers, who brought covid19 into Finland with them.

In all fairness, the UK's population density is quite focussed too although I accept as a premise that Scotland will have a significantly lower overall density than our cousins south of the Border.

 

[dann]

Is all of your analysis like this?

I am not sure what you mean. If you are referring to my tendency to immediately admit that something I write is based on memory and therefore might be incorrect - before I look it up to make absolutely sure - then, yes, that is my typical MO.
You should take notice of this. It's never too late to learn.
Do you have any other snide remarks that you need to air before I go on?

 

[dann]

Is all of your analysis like this?

I guess I made it too obvious, so we can't expect theprestige to return for a comeback.

The health authorities have received many complaints about how elderly relatives were treated. A consistent theme is that nursing home residents with suspected Covid-19 were immediately placed on palliative care and given morphine and denied supplementary oxygen and intravenous fluids and nutrition. For many this was effectively a death sentence.
“People suffocated, it was horrible to watch. One patient asked me what I was giving him when I gave him the morphine injection, and I lied to him,” said Latifa Löfvenberg, a nurse. “Many died before their time. It was very, very difficult.”
(…)
“The ICU wards were comparatively empty,” said Dr Cecilia Söderberg-Nauclér, of Karolinska University Hospital. “Elderly people were not taken to hospitals—they are given sedatives but not oxygen or basic care.”
Yngve Gustafsson, a geriatrics specialist at Umea University, told the BMJ that the proportion of older people in respiratory care nationally was lower than at the same time a year before, even though people over 70 were the worst affected by Covid-19. He, too, was aghast at the practice of doctors prescribing a “palliative cocktail” for sick older people in care homes over the telephone.
“Older people are routinely being given morphine and midazolam, which are respiratory-inhibiting,” he told the Svenska Dagbladet newspaper, “It’s active euthanasia, to say the least.”
Questions raised about Sweden’s Covid-19 policy on nursing homes (BioEdge, June 20, 2020)

A little more from the same article, but not specifically about the use of opioids:

The problem seems to have been the guidelines issued by the National Board of Health and Welfare. At the start of the pandemic it suggested that doctors triage patients according to their so-called biological age, weighing overall health and the prospects for recovery, before making treatment decisions.
“Doctors overseeing nursing-home care were advised to keep their distance from residents because of infection risks and told to carefully weigh the condition of patients before referring them to hospitals, said Thomas Linden, chief medical officer of Sweden’s National Board of Health and Welfare.”
The idea was to keep hospital ICUs from being overwhelmed by older patients with a low chance of survival. However, the surge never happened. Instead, the elderly were denied access to unused facilities. “These guidelines have too often resulted in older patients being denied treatment, even when hospitals were operating below capacity,” according to critics who spoke to the WSJ. “Occupancy in the country’s intensive-care units, for instance, has yet to exceed 80%, according to government officials.”
“The ICU wards were comparatively empty,” said Dr Cecilia Söderberg-Nauclér, of Karolinska University Hospital. “Elderly people were not taken to hospitals—they are given sedatives but not oxygen or basic care.”

That was the reality of the Swedish situation that Tegnell and others brag about to the media outside of Sweden.

 

[dann]

A couple more, also not about the use of opioids:

In February and March 2020, most authorities focused on COVID‐19 in relation to hospitals. On March 26, the National Board of Health and Welfare issued national guidelines for palliative care drugs to relieve end‐of‐life symptoms. However, primary care recommendations for COVID‐19 were not issued until April 7. Early difficulties included how to manage large numbers of elderly people with COVID‐19 in their homes and how to establish well‐functioning collaboration between primary care, hospital care and ambulance and mobile health care. There was a lack of virus testing and COVID‐19 information adapted for primary care. Information on how to treat the elderly, and how to meet the need for oxygen in elderly care homes and nursing facilities that were often served by family doctors, was also lacking. Many doctors raised the alarm that there was a lack of palliative drugs and equipment to administer them. A lack of equipment also meant that virus tests could not be carried out on primary care patients at health centres. Primary care organisations have also had insufficient personnel, protective equipment and oxygen supplies.
(…)
On April 1, the Government banned prescriptions that exceeded three months’ supply. During spring 2020, several ICUs were short of the routine anaesthetics used to sedate patients on invasive mechanical ventilation. The distribution of medications was beyond the scope of this review.

The first eight months of Sweden’s COVID‐19 strategy and the key actions and actors that were involved (Sep. 20, 2020)

Asked by TT if more care home residents could have survived the virus if given hospital care, Lindén only said it was impossible to know until the review was completed.
"IVO's continued investigation will show this," he said.
However, Karolinska Institute professor Lars L Gustafsson, a specialist in elderly healthcare, said the reports were concerning. He emphasised the importance of individual assessments from a doctor – which IVO says were not always given – and believes care home residents did not receive sufficient hospital care.
Fact check: How many Covid-19 patients in Sweden's care homes received hospital treatment? (TheLocal.se, Aug. 7, 2020)

Some Swedish care home residents received insufficient healthcare: watchdog report (TheLocal.se, July 7, 2020)