Saying it's too early for pats on back, while giving pats on back to Sweden
SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)
- Thread starter Don't Kill Bill
- Start date
Saying it's too early for pats on back, while giving pats on back to Sweden
Saying it's too early for pats on back, while giving pats on back to Sweden
Because I stated they have done well for the kids? Whilst saying they’ve let down the elderly and were shit at track/trace?
Sweden aren’t alone in doing well for the children, the other nordics and plenty of Asian countries have also done a good job and if kids were taken out of school/sport, I believe they were back in as quick as possible, but these countries were also better at those other aspects. It’s to be seen if Sweden can do as well as them in a more prepared second wave.
I worry for the children of hard lockdown countries. And social distancing in schools like in Denmark/Germany worries me for longterm psychological effects.
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I actually agree with a lot of your arguments about Sweden in your earlier post. As a Norwegian myself there is a lot of writing about their policy here. I also have a lot of family living in Sweden. It’s way to early saying their policy is a failure. Their main failure has been to protect their elderly at homes which is also acknowledged by Tegnell.
Yup, I’ve heard the argument that it’s the same with care homes in every country where they have a large spread; but the fact remains that they have found extremely horrific failures in 97 care homes in Sweden.
Care homes had people going to work even with symptoms because they are on an hourly (as required) salary that doesn’t get covered by sick pay.
They have also interviewed lots of Norwegian care home workers and Norway is just much better at it, having doctors on site that are trained in preventing virus spread etc which is missing in Sweden.
Norway, Iceland, Finland too were also much more on the ball of testing people who came home when the outbreaks happened in Italy in March. Apparently Sweden tracked everything from the alps (they can see which strains of virus remain in country and where they have been) and eradicated it looking at the virus that remains now, but didn’t test anyone coming from Iran, USA, UK obviously thinking there was no issue there... doh!
I’ll call failure on a country if they lockdown and a few months later have a runaway virus on their hands, which I’m certain is gonna happen in many many places. That would be failure. If you lockdown, you’ve surely got to be certain that you can test and trace else what was the fecking point of all that hardship?
Right now I’d say Sweden is somewhere in the middle of the failure/success league table.
Doing better than plenty of countries that locked down hard, marginally worse in deaths than some other countries that locked down hard (and have no ideas of the long term effects of that), insert Sweden here, and doing way worse than plenty of countries that locked down hard or soft or didn’t lock down but just were better at test/trace from the off.
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Worthwhile to remember a quote from the Deputy Health Minister in Italy about the second wave. Even if it comes, it should not be as bad as the first:
Obviously he’s far more qualified to his opinion than I am but I do wonder if he’s completely underestimating the lock down fatigue which seems to be prevalent in many countries.
It's not too bad in Italy, i think people would happily go back down that road for a month or two if it was necessary, but he is also referring to the treatment available now. In the early days equipment was in short supply and doctors were treating by trial and error. Now we know roughly what works and what doesn't.
A journalist did some investigation, it was shown on tv couple of weeks ago. Of the first 40 cases in Belgium, 28 came from the same hotel in Austria... It was a combination of bad luck and maybe acting too slow I think.
He probably just realises that Italy won’t need to go that far next time, that people in advance now know to be better with hand washing and distance, and that if cases start to rise, people will quickly be ok going back to being more vigilant with these things.
Lockdown shouldn’t be required because Italy “knows” it’s coming, rather than the quiet assassin it was in February.
Not just the treatment but to reach 1000 deaths per day, you need let several outbreaks fester which is now unlikely since we know that the virus is around and can target a certain community when cases arise by testing and isolating new cases relatively quickly.
Yup, countries had absolutely no idea how much virus was in their countries in Feb/March. Most countries will have a much clearer picture before a second wave.
Extrapolating back from the deaths in the UK, it's likely we had tens of thousands of cases before lockdown started, so I don't see that we would sleepwalk into another wave of that size. I think most of the population is very aware of the virus now, lots of organisations are still working from home, and testing and treatment is hugely improved on what we had in March/April. There will likely be further spikes along the way particularly with how we adapt through winter, but I would be very surprised if it was even close to the same as April.
Good post.
People were very quick to label Sweden's strategy as a failure within weeks of other countries going into lock down. In some senses it has "failed" - especially, as you say, in respect of its care homes. That however is an accusation that can be levelled at many countries, in Europe especially, the UK included. This is a virus which kills the elderly and the infirm. It's very easy and obvious say that it's a good idea to "keep it out of care homes" (and certain actions by the UK Government clearly fly in the face of that) but generally it is obvious that with a virus that spreads so rapidly it is very hard, if not impossible to do. My grandmother is in a care home. She is in her 80's, is brain damaged from a a botched operation in the 70's and has advanced dementia. It is essentially a prison, with the perfect basis for viral spread, having been "locked down" a few times to visitors numerous times since she's been in there for outbreaks of various things including Norovirus, which evidently can be fatal for the people in there.
One thing Sweden did get right, in my opinion was to consider what happens after a lock down and the difficulties you have exiting it. Likewise they considered the second order effects on the economy and the damage that can do. It will do huge damage here in the UK with millions already out of work as soon as the furlough scheme ends. My opinion is that some of the narrative here will change when that starts to bite people.
I have always been of the view that to compare strategies (and to hopefully learn something from them) the dust needs to settle over a significant period to allow that comparison.
This is a bit of a mega-thread to read but it details just how massively the government fecked this thing up.
That graph showing all those excess deaths of older people - shameful!
In other countries they would be dragging certain politicians from their offices and stringing them up in the street. I'm not actually advocating that...but certain politicians should watch their words carefully before shifting blame onto others!
That graph showing all those excess deaths of older people - shameful!
In other countries they would be dragging certain politicians from their offices and stringing them up in the street. I'm not actually advocating that...but certain politicians should watch their words carefully before shifting blame onto others!
I don’t think treatment has improved much at all. The mortality for severe cases is more or less the same as it ever was. We’re still just basically using supportive measures and hoping for the best. The only really solid evidence is behind dexamethasone and the benefits are marginal.
I do agree that we probably underestimated just how widespread the virus was in the community before the huge surge we saw earlier in the year. Which was combined with zero social distancing, of any kind.
Even though we’re seeing lots of photos/footage of people being much more reckless than we’re comfortable with we’re still living in a different world, when it comes to facilitating viral spread. A lot of people are being diligent about face coverings, handwashing, avoiding handshakes, hugs, kisses etc and a large % are avoiding crowded indoor spaces altogether. As compared to absolutely nobody taking these measures while the virus was first spreading.
All of which should mean we’re unlikely to get a similar surge all over again.
Absolutely, Europe is simply too interconnected.
I run a travel agency, built it for over a decade, now I haven’t earned a penny since March. Have an extra airport job, laid off a month back.
It’s a shit article though @Brwned because no-one here, absolutely no-one expected economic gains. We were warned immediately of the hardship ahead.
That said, many branches such as restaurants, hairdressers, chiropractors, cafes etc have done much better here than in other countries.
The article is made more shit by the fact that they cherry pick the countries in which to compare Sweden with; and as we see the situation unfolding in the United States now we can be fairly certain that they will soon have more deaths per capita. Increased mortality across the globe in many countries also tells a different story to the stats we are given (Holland a prime example), not for Sweden though.
As I mentioned earlier there are plenty of countries with a worse death rate per capita that locked down, which the article conveniently ignores.
Situations in many countries post lock down are deteriorating, once again, not here though, quite the opposite.
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Just to add to this, I think it’s unfair the way Sweden keeps getting accused of prioritising economy over lives.
A lot of the measures they took which differed from other countries, had feck all to do with the economy. Keeping schools open, allowing amateur sports to continue etc. No monetary gain whatsoever but an obvious benefit to the quality of life of the average Swede.
When people make this accusation they should also question how many Syrian refugees their countries took in per capita in comparison with the country that “cares more about the economy than lives”.
As you say, the strategy has been about finding the balance between saving those most at risk and taking care of children and the rest of society. They have always known the economy was going to get smashed.
Exactly this, the reality is to know how good a country has done will be to look at deaths caused by this pandemic, not just from Covid but from suicide, domestic violence caused by the struggles of lockdown, delayed cancer treatments etc (excess cancer deaths in the UK is rumoured to be 35k).
Imagine being one of those cancer patients, you've stayed at home to "save lives" but when it comes to saving yours "sorry mate, we're not running those vital services at the minute".
I still struggle to believe that story. Around here other services worked normally, the only issue is that there have been cases of patients delaying their appointments because they were wary of getting into hospitals which wasn't warranted since Covid-19 admittance were separated.
https://www.standard.co.uk/news/hea...us-outbreak-staff-boris-johnson-a4492066.html
Hillingdon Hospital has closed to A&E admissions due to an outbreak of covid amongst staff.
There has been a lot of disparaging of GPs in the news about why we've moved to a telephone triage model mainly with only face-to-face appts if needed but this is the reason, there are GP practices that can each serve up to 10s of thousands of patients at time and an outbreak there with subsequent closure would be disastrous for that local patient caseload under their care
Social distancing for NHS workers in work is nearly impossible.
Nosocomial spread of covid remains a huge worry and so the government voting against weekly testing of NHS staff and now the treasury saying that testing costs will have to be paid for by employees really is not just a kick in the teeth but also pretty dangerous for patient care
https://www.cityam.com/workers-forced-to-pay-extra-tax-for-coronavirus-tests/
Hillingdon Hospital has closed to A&E admissions due to an outbreak of covid amongst staff.
There has been a lot of disparaging of GPs in the news about why we've moved to a telephone triage model mainly with only face-to-face appts if needed but this is the reason, there are GP practices that can each serve up to 10s of thousands of patients at time and an outbreak there with subsequent closure would be disastrous for that local patient caseload under their care
Social distancing for NHS workers in work is nearly impossible.
Nosocomial spread of covid remains a huge worry and so the government voting against weekly testing of NHS staff and now the treasury saying that testing costs will have to be paid for by employees really is not just a kick in the teeth but also pretty dangerous for patient care
https://www.cityam.com/workers-forced-to-pay-extra-tax-for-coronavirus-tests/
They've u-turned on the employee testing tax thing this morning.
That’s not happening.
Besides, the whole point of the lockdown was to stop hospitals getting overwhelmed, so they could continue to provide essential services for people with other illnesses. Without that lockdown there would have been a hell of a lot more cancer patients denied treatments when hospitals start running out of beds and staff.
One interesting and overlooked place of interest with regards to how they've tackled the pandemic is Malta. I have a Maltese colleague and was asking him how they've done (as its a place I holidayed recently and absolutely adored). They have a very densely populated (highest in EU and one of the highest in the world) country. Only a population of around 500 thousands but only 9 deaths and 673 cases is pretty impressive for a country in Europe with close proximity to Italy.
Cases were mainly between March and April, strategy seemed to be quarantine strictly and heavy fines for breaking, travel bans on some places, strict self-isolating for returnees. And they've relaxed things since early May and have done well with sporadic cases on a daily bases but mostly from returning foreigners.
Cases were mainly between March and April, strategy seemed to be quarantine strictly and heavy fines for breaking, travel bans on some places, strict self-isolating for returnees. And they've relaxed things since early May and have done well with sporadic cases on a daily bases but mostly from returning foreigners.
I'm not sure what point you're trying to make. Clearly a global pandemic is going to have an economic impact. The question is whether than impact has been mitigated by the measures taken. I would hazard a guess that in countries under a hard lockdown the economic impact will be worse, although I wouldn't pretend to have the expertise to engage with that point in detail.
I am not suggesting that Sweden's course of action is (or was) the "right one" (whatever you might consider that to be based on numerous metrics) but simply that they have clearly considered other issues when making their decision including the impact of second order effects which will, undoubtedly cause deaths through direct means (suicides, cancers not picked up at early stages) and where a recession bites, lowering of life expectancy generally.
It has prevented people getting routine testing though, many of which pick up early signs of cancer which then proves treatable.
The lockdown didn’t prevent anything. Hospitals reallocating resources to prepare for a surge caused those knock on effects you’re referring to. Without the lockdown those resources (and more) would have all been needed to treat covid patients. As it stands, the interruption to non-covid care has been fairly brief. It could easily have been a lot worse.
I actually don’t know what sort of reallocation of hospital resources went on in Sweden but would be surprised if it was any less than anywhere else. Especially with them experiencing a higher mortality than many other countries.
I'm even surprised that there's been interruptions at all. I don't think that I have heard about an area where all hospitals and clinics were overrun to the point where they only had Covid-19 patients. In France the reason some patients were moved to other hospitals and regions was to allow all services to work normally. I know that there was an article about it in the UK but surely the NHS is robust enough to not have to interrupt non-covid cares?
Routine cancer screening has been controversial due to its lack of evidence base in reducing cancer mortality
https://www.cochrane.org/CD004720/PROSTATE_screening-for-prostate-cancer
https://www.who.int/cancer/detection/en/
But I agree with Pogue that cancer outcomes would have been substantially worse with a worse covid outbreak
Treatment is happening still, blood transfusion is happening still, cancer MDTs are still happening, surgical intervention is still happening for obstructed patients. There is a triage process to identify who to prioritise, there is still inpatient stays for the ones who need close monitoring on intensive chemo regimens. On the whole we have aimed to prevent the whole system from crashing which would have been the outcome if covid was allowed to be unchecked and that would have been far worse for cancer-related mortality both short and long term.
Addendum: I agree though that there will be an effect in terms of underdiagnosing and probably worse prognostic outcomes for some of those ones and its not at all ideal and there has to be more done to get people coming to docs with symptoms, get the screenings underway for the more evidence-based things, and reduce stigma of going to hospital
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All emergency or urgent care went ahead. It was only elective procedures or screening services that took a hit.
Elective procedures were pushed out to reduce demand on beds/ventilators and screening services were delayed to keep people out of hospitals unless absolutely necessary. A few months delay for a screening test means very little anyway. These things are often done only once every few years anyway.
There is definitely a worry that people have been avoiding going to doctors and getting ominous symptoms checked out. Hopefully the message is getting out that GP’s are still open for business. There’s been a big public education push about this in recent weeks.
Lots Pogue, huge surgery waiting list now.
It’s somewhat unfair to compare the Swedish economy’s fallout with the Danish without looking at the export of the two countries. Sweden is exporting very cyclical items as heavy machinery and cars whereas Denmark is exporting medicine and bacon. So the Danish export will be much less hit than Sweden.
Privately owned and operated Care Homes with 100% patients who are paying privately, will turn a profit and still be 'fit for purpose'. Privately owned and operated Care Homes with patients primarily funded via the state, cannot make a realistic profit and be at all times and in all conditions fit for purpose, even when the staff operating in these homes are working their socks off and being paid peanuts.
Covid-19 has proved this beyond doubt and if Boris is going to do some 'levelling up' this is the place to start Prime Minister!
Covid-19 has proved this beyond doubt and if Boris is going to do some 'levelling up' this is the place to start Prime Minister!
Small island states like Malta will always fare well. It's not like mainland Europe where you have no idea who is coming in and from where, with millions crossing borders daily. Malta knows exactly who comes and goes, and what flight/ship they were on, and within a couple of days of the first case all travel in or out was effectively shut down.
The cancer line is a load of bs. I've got a friend who has been diagnosed and started her chemotherapy treatment since lockdown has started, and just hit cycle 5 on her treatment. The vital services are running, however that doesn't make good news stories.
I think that issue on care homes is not a new one, and existed well before covid (should of been dealt with a long time ago). What fecked it was the policy of discharging 15,000 patients from hospital into care homes and not routinely testing those patients. That alone would have saved ten's of thousand's of lives.
You said the lockdown would cause millions of people to go unemployed when furlough ends in the UK. It was a direct causal explanation: the lockdown caused this unemployment. The reality is that millions were going to go unemployed irrespective of the lockdown, as evidenced by Sweden already having a significant increase in unemployment (up 2%) by May. The spending patterns during March and April provide some indication for why:
The reality is the virus was the dominant factor in the economic outcomes. The role lockdown played in it depends largely on how successfully it contained the virus. For example, Norway are expecting to have a quicker recovery than Sweden in part because their lockdown worked so well.
Every government considered the second order effects. The reason the UK held off on lockdown was because they were completely aware of the effect it would have on the economy, wellbeing and a whole host of other features of daily life. They didn't follow a public health strategy while overlooking the economic outcomes, they forecasted that if the virus hit as badly as predicted - and given how badly it hit with the lockdown, we have every reason to expect it would have caused mayhem in hospitals all over - then the economic outomes would be even worse too. Regardless of the strategies imposed, there is very little evidence that limiting the economic collapse that came with the pandemic was remotely possible.
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I know someone who has had a routine test postponed because of lock down. I personally have had a non-urgent appointment for serious eye condition in October postponed weeks ago with no clarity on when it'll be re-scheduled. I'm not worrying about it since there's not much I can do about it.
I am clearly not suggesting that all emergency surgeries, or chemotherapy or treatment for cancer has been postponed or delayed. My point, basically as that some cancers (bowel and cervical being two specifically) are picked up by routine testing and treated quickly giving people more of a chance of survival. If some of those routine services have been postponed (which I understand is the case) then it is reasonable to assume that it will have a negative impact for some.
I don't know about Sweden. That wasn't my point.