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

[dann]

Mathematics professor Tom Britton miscalculated. In the spring, he calculated that Stockholm could achieve herd immunity against Covid-19 as early as in June, and the news went around the world. But he was actually wrong.
He openly admits this in an interview with Swedish Dagens Nyheter. And now that the spread of infection in Sweden is again at the same level as in the spring, the professor encourages Swedish national epidemiologist, Anders Tegnell, to also admit his mistakes. Because mistakes were made in the Swedish handling of the corona pandemic in the spring, says Tom Britton, professor of mathematical statistics at the University of Stockholm and, among other things, researcher on how infectious diseases spread in a population.
And this harms the Swedes' trust in the Public Health Agency, the Swedish equivalent of the (Danish) National Board of Health, if the errors are not acknowledged, Tom Britton adds: "The Public Health Agency and Anders Tegnell seem to have a hard time acknowledging mistakes, and others seem to think that, as a principle, everything the Public Health Agency does is wrong," Tom Britton told Dagens Nyheter.
Mathematics professor predicted Swedish herd immunity. Now he has sent more than 100 emails to Anders Tegnell (Berlingske.dk, Nov. 27, 2020)

Tom Britton also thinks that the Public Health Agency's attitude to face masks is a little cowardly.

Svenska Dagbladet today:

Han är matematikprofessorn som trollband många svenskar i våras med sina modeller. Men det blev fel. Och fel igen i somras. Nu har Tom Britton en ny uppfattning om när Sverige når flockimmunitet mot covid-19.
Tom Britton är kritisk till Folkhälsomyndigheten.
Myndigheten har varit för långsam och det tycks gå prestige i vissa frågor som de driver. Olyckligt, menar matematikprofessorn.
Britton efter felen – här är hans nya prognos (SvenskaDagbladet.se, Nov. 29, 2020)

He is the mathematics professor who spell bound many Swedes with his models this spring. But they were wrong. And wrong again this summer.
Now Tom Britton has a new view about when Sweden will reach herd immunity against Covid-19.
Tom Britton is critical of the Public Health Agency.
The Agency has been too slow – and some of the questions they are pursuing seem to become a matter of prestige. Unfortunate, the mathematics professor thinks.
Britton after the error – here is his new prognosis
It would be very interesting to see the prognosis, but it is behind a paywall.

 

[Vixen]

Yes, they're describing aerosol transmission indoors, and "long distances or times" is a relative term. True airborne transmission where the bloody thing blows on the wind and can be caught hundreds of metres away downwind in the open air is thankfully not an issue with this one.

I am sure I saw a study which shows the Covid virus can hang around in the air for a long time. For example, in a shop, when the person dispensing it has long left.

I don't think it necessarily means it has to 'blow around with the wind' hundreds of metres away outdoors. The risk would be indoors, where there is no wind to blow it away.

 

[dann]

I am sure I saw a study which shows the Covid virus can hang around in the air for a long time. For example, in a shop, when the person dispensing it has long left.

I don't think it necessarily means it has to 'blow around with the wind' hundreds of metres away outdoors. The risk would be indoors, where there is no wind to blow it away.

Yes, that seems to be the epidemiological consensus. In particular, if the ventilation system isn't very effective. However, in a shop (even in a bicycle repair shop), the doors are usually opened and closed all the time, which should contribute to some air circulation, and customers don't usually spend hours in a shop the way people do in churches, cinemas, bars and restaurants.

 

[Vixen]

The DAILY MAIL is claiming, yesterday, that Tegnell has been 'sidelined', presumably ont eh basis that Lofven's press conference overran thus, overlapping/clashing and blocking out Tegnell's scheduled after his.

Has Sweden's iconoclast public health expert been sidelined? Anders Tegnell is pushed off the airwaves amid 'split' within government as country's coronavirus deaths continue to rise
Swedish PM's briefing overran on Thursday, clashing with that of Anders Tegnell
Sweden has said it has seen no signs of herd immunity slowing spread of Covid
Tegnell once said country would fare better than others due to higher immunity
Total of 6,622 Covid-related deaths in Sweden and 5,841 new cases on Thursday

<snip>

Stricter restrictions were issued in 17 of 21 of Sweden's regions by the country's public health body and Dr Tegnell as well as a 10pm curfew on bars a pubs.

'It is a different situation than we had in the spring when it was more local. Now we have a community spread in many regions at the same time, which is partly a reason why we see such high numbers,' he said.

This would seem to suggest things are worse now than then.

 

[Vixen]

Yes, that seems to be the epidemiological consensus. In particular, if the ventilations system isn't very effective. However, in a shop (even in a bicycle repair shop), the doors are usually opened and closed all the time, which should contribute to some air circulation, and customers don't usually spend hours in a shop the way people do in churches, cinemas, bars and restaurants.

One really good piece of advice I saw is that if you enter a public place that seems really stuffy, then it's a good idea to not spend much time in there.

 

[dann]

This would seem to suggest things are worse now than then.

See post 2970.

 

[dann]

The DAILY MAIL is claiming, yesterday, that Tegnell has been 'sidelined', presumably on the basis that Lofven's press conference overran thus, overlapping/clashing and blocking out Tegnell's scheduled after his.

It was mentioned in the Swedish media as well. It may have been deliberate, but if not, it was at least an example of lack of coordination, which would be strange, all things considered.

More and more of Tegnell's former supporters seem to be leaving the sinking ship. Tom Britton is just the latest example. They all know that the only justification for the Swedish strategy was the expectation of herd immunity, which was somehow supposed to make the death toll in March, April, May and June a price worth paying. It was the one thing that was supposed to make Sweden able to sit back and relax while the pandemic caught up with Sweden's neighbors because ... well, it was just bound to do so, wasn't it?!

I do not doubt at all that Tegnell and Giesecke hate the other Nordic countries for not living up to their high hopes of a disastrous second wave in the other countries that could make Sweden's disaster seem to have served its delusional purpose.

At this point, all Tegnell has got going for his strategy is the claim that it is impossible to know why things turned out the way they did in Sweden, but the reason has become more and more obvious for everybody. I am hoping for a whistleblower in the Public Health Agency to step up and reveal what has been going on inside the agency for the past nine months. Then the others will try to distance themselves from him, and a new consensus will be established.

But so far, the Public Health Agency has seemed to work much like the Republican Party in the USA. Tegnell has been allowed to carry on as "corona czar" no matter how obvious it was that his strategy has been failing all the way.

Sweden is supposed to be one of the most enlightened countries in the world when it comes to whistleblowing, but I am not sure that this is actually true. To me, whistleblowing seems to go against the grain of Swedish nationalism and consensus culture.

 

[dann]

One really good piece of advice I saw is that if you enter a public place that seems really stuffy, then it's a good idea to not spend much time in there.

I avoid it entirely, but in the current situation it's a privilege, not an inalienable right, to be able to do so, unfortunately.

 

[Skeptic Ginger]

Yes, they're describing aerosol transmission indoors, and "long distances or times" is a relative term. True airborne transmission where the bloody thing blows on the wind and can be caught hundreds of metres away downwind in the open air is thankfully not an issue with this one.

That is simply not true. Tuberculosis is airborne yet you won't catch it outside in the wind. You have to breathe in a concentrated amount of droplet nuclei (not to be confused with droplets in droplet spread) in order for enough of the TB bacillus to make it to the alveoli which has the conditions it requires to start an infection.

The rest of my answer is in the COVID medicine thread.

 

[Skeptic Ginger]

I am sure I saw a study which shows the Covid virus can hang around in the air for a long time. For example, in a shop, when the person dispensing it has long left.

I don't think it necessarily means it has to 'blow around with the wind' hundreds of metres away outdoors. The risk would be indoors, where there is no wind to blow it away.

Exactly.

 

[Skeptic Ginger]

The DAILY MAIL is claiming, yesterday, that Tegnell has been 'sidelined', presumably ont eh basis that Lofven's press conference overran thus, overlapping/clashing and blocking out Tegnell's scheduled after his.

<snip>

This would seem to suggest things are worse now than then.

One thing that is different is it is clear that the herd immunity theory failed to provide any kind of protection greater than countries which went for various degrees of lock down.

 

[dann]

Sunday:
Coronavirus - countries (Worldometers, Nov. 29, 2020)
Deaths per million (Total deaths) New cases Serious/Critical
Sweden: 660 (6,681) 6,774* 219* **according to SVT.se No new numbers till Tuesday afternoon.
Denmark: 143 (829) 998* 43 *based on 54,691 tests, positive 1.82 %.. Fewer cases, but based on fewer tests.
Iceland: 76 (26) 10 2
Finland: 71 (393) 322 19
Norway: 60 (328) 282 36
Iceland has 187 active cases, Faroe Islands 4, New Zealand 69.
The Faroe Islands have 7 in quarantine, 0 hospitalized.

 

[dann]

One thing that is different is it is clear that the herd immunity theory failed to provide any kind of protection greater than countries which went for various degrees of lock down.

It is actually worse than that. As a theory, the herd immunity strategy managed to convince Swedish society, the government as well as the regions, politicians as well as epidemiologists and other infectious-disease experts, that there would be no second wave and that it would thus be unnecessary to use the respite of the summer months to get more PPE and testing capacity.

So even at this point, Sweden still is not testing as much as they should have been doing.

Anders Tegnell's legacy will be similar to Donald Trump's.

 

[Skeptic Ginger]

It is actually worse than that. As a theory, the herd immunity strategy managed to convince Swedish society, the government as well as the regions, politicians as well as epidemiologists and other infectious-disease experts, that there would be no second wave and that it would thus be unnecessary to use the respite of the summer months to get more PPE and testing capacity.
So even at this point, Sweden still is not testing as much as they should have been doing.

Anders Tegnell's legacy will be similar to Donald Trump's.

I can't believe we still don't have enough PPE for the hospitals here in WA State, especially for the nursing homes. And it looked like there would be enough testing capacity until people thought they might be able to get tests so they could safely have Thanksgiving dinner with family. But the health department told people not to get tested for that reason so people who might actually be infected could be tested.

 

[dann]

It makes sense to reserve testing capacity for people who need it the most, obviously, but that should have been a problem (and it was) only at the beginning of the pandemic and not at this point.

And it is the same with PPE. It made sense to tell people not to buy face masks when they were in short supply and needed at the hospitals and in nursing homes, but by now they have had plenty of time to stock face shields and face masks for all hospital and care workers.

 

[dann]

The DAILY MAIL is claiming, yesterday, that Tegnell has been 'sidelined', presumably on the basis that Lofven's press conference overran thus, overlapping/clashing and blocking out Tegnell's scheduled after his.

The general public is slowly losing confidence in him, but the level of confidence is still remarkably high:

When asked about their trust in Tegnell himself, 65 percent said they had a high level of confidence in the epidemiologist in November. That's down from 72 percent in November October? but still higher than the levels in June and August, 60 and 64 percent respectively.
Sweden's coronavirus strategy was built on public trust in authorities. Can they still count on that? (TheLocal.se, Nov. 27, 2020)

I guess the death toll was soon forgotten by most Swedes ...

Tegnell about the alleged rift between Löfven and himself:

"All rumours of a rift between the government and the agencies are completely false. We have a very strong dialogue and strong levels of trust between us," Tegnell said in response to one of his questions.

 

[jimbob]

That is simply not true. Tuberculosis is airborne yet you won't catch it outside in the wind. You have to breathe in a concentrated amount of droplet nuclei (not to be confused with droplets in droplet spread) in order for enough of the TB bacillus to make it to the alveoli which has the conditions it requires to start an infection.

The rest of my answer is in the COVID medicine thread.

I think you need more context.

Rolfe and I were discussing airborne viruses - the one that springs to mind is Foot and Mouth, which is airborne and the outbreaks can spread several *miles* downwind. At least that isn't the case with COVID-19.

 

[dann]

Another reason for Sweden’s shift, according to Rocklöv, is evidence that the more restrictive policies in neighbouring countries “worked better” and did not have deleterious economic effects as feared.

Debate over semantics remains. Johan Nöjd, head of infectious disease control for Uppsala—the first Swedish region to voluntarily impose harsher restrictions—defined their rules as a “local lockdown.” But the Public Health Authority of Sweden still refuses to call it that, insisting on labelling them “stricter guidelines.” This has led to a lot of confusion over the country’s strategy, says Rocklöv. “What it actually was, and if we actually changed, or not.”

Contributing to the confusion was an announcement from the public health authority on 22 October that some national restrictions were to be eased. This included the removal of special recommendations for over-70s and risk groups to stay at home and shield themselves, permitting visits to nursing homes, and allowing up to 300 people to attend cultural and sporting events as long as they were seated far apart.

“Even now when there has been a change, the media in Sweden probably will continue to report on the Swedish strategy as if it was constant,” Rocklöv says. “In fact, the strategy changed in the spring as well when the approach to testing and tracing was refined.” Sweden initially refused to increase testing levels but later relented, recently ramping up to 190 000 tests a week from 32 700 in May. However, on 10 November Reuters reported that several regions were struggling to keep up with rising demand, forcing authorities to restrict bookings.4 Swedish opposition parties are also claiming that testing is far from the level it should be.
Covid-19: What Sweden taught Scandinavia for the second wave (BMJ, Nov. 27, 2020)

I can recommend the whole article, but I have made the journalist aware that this is wrong:

Although total mortality is higher than in the rest of Scandinavia, Sweden’s current rates are relatively low, with an average of only three fatalities a day compared with 100 a day in early April.

Fler än 150 dödsfall har hittills rapporterats per vecka för de senaste tre veckorna. Notera att efterrapportering gör att antalet avlidna dessa veckor kommer att öka ytterligare.
Aktuell veckorapport om covid-19 (Public Health Agency, Nov. 27, 2020)

So far, more than 150 deaths a week have been reported for the most recent three weeks. Notice that delayed reporting means that the number of deceased for these weeks will be increasing.


The first (Swedish?) anti-masker has already objected to the article because of this:

“It is an extremely effective and inexpensive measure, while at the same time being simple, and the majority of studies have shown how effective it is,” he (Anders Vahlne, a professor of virology at the Karolinska Institute) told The BMJ. “It’s unclear why this measure shouldn’t be taken.”

 

[Vixen]

I think you need more context.

Rolfe and I were discussing airborne viruses - the one that springs to mind is Foot and Mouth, which is airborne and the outbreaks can spread several *miles* downwind. At least that isn't the case with COVID-19.

Rolfe is talking about 'true airborne' diseases, but of course livestock would be outside in a field so then, wind blown disease-carrying viruses/bacteria becomes relevant. However, of course, livestock are rarely indoors, except in their pens and stalls.

If Covid19 is not airborne, how would you explain mink populations across northern Europe carrying the '5-cluster' Covid19 mutation, and passing it on to at least a dozen human individuals?

 

[Vixen]

That is simply not true. Tuberculosis is airborne yet you won't catch it outside in the wind. You have to breathe in a concentrated amount of droplet nuclei (not to be confused with droplets in droplet spread) in order for enough of the TB bacillus to make it to the alveoli which has the conditions it requires to start an infection.

The rest of my answer is in the COVID medicine thread.

This. I was looking at some art gallery paintings recently and was struck by how many artists and their subjects were tublerculosis victims. Now TB is still within living memory of our grandparents - I even knew someone near my age whose father died of TB in a sanatorium - not to mention polio, which was rife especially in Denmark up to the early sixties, and will have also been in Sweden.

Given the relatively modern day scourges of TB and poliomyelitis, which swept across Europe, I struggle to understand how Tegnell can rationalise away his 'pandemic strategy' as being due to 'Covid19 being completely new and unprecedented'. It is just nonsense. They had the tools - previous dangerous contagious diseases, together with their medical studies thereof in order to qualify and specialise in that very topic - they had the know-how: they knew exactly what needs to be done to limit the spread of the disease. It is just infuriating to see experts adopt the 'do nothing' approach, even if the likes of Johnson, Bolsanaro (_sp?) and Trump could be forgiven (humph!) as being ignorant and uncaring self-serving politicians.