Friday, April 10, 2020

UPDATED: Are The Wheels Coming Off The Swedish Model?

Sweden continues to be touted by COVID shutdown deniers--those who dispute the need for strict social distancing rules to fight the Wuhan pandemic, albeit at the cost of serious economic damage. Sweden has, unlike most other countries--including its culturally close Scandinavian neighbors Norway and Denmark--adopted a laissez faire approach to the pandemic. Social distancing is optional in Sweden. That's pretty much all they've done.

Shutdown deniers have held up Sweden's approach as a model response that will spare economic damage, but signs are emerging that the Swedish model may have been a bad idea. For example:

Sweden Resorts To Storing Bodies At Ice-Rinks As COVID-19 Deaths Soar

When was the last "regular flu season" you recall during which bodies of the deceased were stored at ... ice rinks? The reason for this is that flu deaths occur over a period of 7-8 months, while COVID pandemic deaths are occuring over a matter of weeks in many countries--including the US, of course. I imagine the presence of dead bodies in ice rinks must be rather inconvenient--not to say disconcerting--for non-social distancing Swedish skating enthusiasts! Watch out for Granny when you come out of that spin! And, by the way, that's happening in Stockholm, the capital, not in some country town:

On Thursday, Sweden reported another rise in the daily death rate, with the virus now killing at least 100 people for the second day in a row, raising the total number of dead to 792. Total cases in the country now exceed 9,100, with the hospital system in Stockholm overwhelmed with patients and dead bodies.  
Swedish authorities have resorted to storing bodies in "refrigerated shipping containers, ice rinks, and canteen fridges," reported RT News.  
The massive influx of virus-related deaths has overflowed morgues with bodies, and crematoriums cannot keep up.  
Hospital systems in Gothenburg and Stockholm are renting out ice rinks, refrigerated containers, and cold storage facilities to house bodies in April.  
"The big bottleneck is our mortuary that is not designed for such a large city that we are in. It is then important for relatives to arrange the funerals so that the deceased become coffin-bound and thus can come over to the cemetery administration," said Katarina Evenseth, the funeral director in Gothenburg.

Could you please arrange the funeral ASAP so we can get your dearly departed the hell out of the ice rink?

What's going on? I think an examination of stats at Worldometer may tell the story. In the tables that follow, remember that Sweden's total population is pretty much equal to the combined population of Norway and Denmark--which instituted strict social distancing some time ago.

So, first of all, let's look at

                 Total Cases  New Cases  Total Deaths  New Deaths  Serious-Critical
Sweden:      9,685       +544             870         +77      749
Norway:       6,298         +79             112           +4          70
Denmark:    5,819       +184             247         +10      113

What should jump out from this table is that Sweden, with about 2.5K fewer cases, has twice the new cases, well over twice the deaths, well over five times the new deaths, and over four times the number of serious/critical cases. By any measure Sweden is doing far worse than Norway and Denmark combined: lots more deaths, lots more new cases, and lots more critical care cases--all with significantly fewer total cases. And this is a relatively recent development, which is the way pandemics develop--in the blink of an eye.

But the question is, how to explain these discrepancies? Why do fewer cases in Sweden yield more deaths, more critical cases, and an accelerating case count? Given roughly equal quality of healthcare, shouldn't the numbers be about the same?

The answer is in the testing. Relative to other countries, Sweden hasn't bothered to do much testing. In a pandemic, testing is a bit like taking the pulse of your country. If you do a fair amount of testing you have a fair idea of the progress of the disease through the population. You'll be aware of trends. On the other hand, if you don't bother doing much testing you'll become aware of the disease's progress through your population when--all of a sudden--you end up using ice rinks to store dead bodies. You don't see the trend until it smacks you upside the head. That's what's happening in Sweden now.

We can see this from Worldometer's tests per million figures--Norway and Denmark, whose combined populations equal that of Sweden, have done over five times as many tests:

                Tests per 1M Popoulation
Sweden:            5,416
Norway:           22,720
Denmark:        11,176

What's going on here, I think, is that Sweden tests only those people who are very obviously ill. The reality, I suspect, is far different: Sweden probably has many, many more instances of COVID infection, which is being spread by people with only minor symptoms, than its total case number indicates. But spreaders with minor symptoms leads to a greater pool of infected persons, that can lead to serious illness and death in that larger pool of infected persons. That's why you want to prevent spread of infection in a pandemic, even when the mortality rate is relatively low--if it happens fast enough, it leads to a collapse of healthcare. And that explains the suddenly worsening stats, accelerating in an alarming way, in Sweden.

Hey, maybe I'm wrong. If so, anyone who wants can say they told me so.

UPDATE: I don't like number crunching, and that's what it would take to compare Sweden to the US. However, a quick glance at a sort of bottom line state does lead one to believe that the US is doing substantially better than Sweden. That bottom line stat is--Deaths Per 1M Population: US - 56, Sweden - 86.

In fairness, both Sweden and the US are doing quite a bit better than many Western European countries, including in no particular order: Italy, Spain, France, UK, Belgium, Netherlands, and Switzerland. Still, the US was late to the pandemic and it's likely--in my opinion--that Sweden was, too. A comparison of Sweden and the US when all is said and done may tell us something about the wisest approach.


  1. I have a hard enough time understanding what is going on in the US, much less Sweden.

    Questions I have about Sweden:

    1. Are certain ethnic groups being affected more? If do, why... third hand possibly Somali immigrants are more affected, perhaps social distancing?

    2. Is the goal more deaths now, vs even more deaths over the long haul?

    3. Is the reason using ice rinks instead of regular mortuaries due to fear of contagion?

    4. Are the schools shut?

    5. Are masks required?

    6. What’s the strategy behind so little testing? Seems it’s accepting community spreading, without tracing.

    7. Why the reduction in prescribing quinine?

    8. Is the wearing of masks required?

    1. I try to present a moving target.

    2. I also have a question about the ice rinks. The number of deaths does not suggest a situation exists where you need to use ice rinks. If I was to guess, I would guess that bodies are taking longer to bury because the government wants them tested for coronavirus before releasing them to the family, creating a bureaucratic delay.

  2. Sailer today writes, with words from an iSteve commenter:
    "In Austria, there have been *two random studies* conducted so far (sample size about 1500 each).
    Austria is the first country in continental Europe, to come out with such a study (Iceland is the famous other country in Europe).
    One sample focused on professions assumed to be at high risk of infection (health care, supermarket employees), whereas the other aimed at getting a representative sample for the entire country....

    The virus seems to have binary properties: not very contageous under most circumstances, but *highly* contagious in others.
    I am no expert on this, but believe, that solving the *superspreader* issue is key to understanding this thing. I am surprised, that no modeller has tried to come up with an “adjusted R0”, adjusted for superspreaders, that is – what if we find out, that eliminating superspreaders (or events) reduces R0 to close to 1?
    I am also surprised, that not *more random studies* have been conducted around the world, in order to better get a final grip on the data."

    1. I read that first thing this morning and have been thinking about doing a post using that as one point of reference. The talk of "superspreaders" is, I'm beginning to think, somewhat deceptive. Here's what I mean.

      There are now a wide variety of anecdotal accounts about how outbreaks of COVID have begun. Usually they come down to one to a handful of infected persons showing up at large gatherings to mass events that are characterized by close contact over a prolonged period. The top health official in my area put it this way: infection usually comes from exposure to an infected person within 6 ft., and for at least 10 minutes. She added that mostly what we're seeing--and we rank in the top ten always--is family spread: someone is infected, goes home, and infects their family. IOW, you're not that likely to be infected by incidental contact with a stranger--like going to the grocery store, etc.

      Now, the anecdotal stuff falls into line with Gottlieb's idea--overall, 5% of the population, but up to 10% in special sectors.

      So, funerals, weddings, sporting events, pre-Lent festivals (Mardi Gras), nursing homes, and now the carrier USS TR (10%, btw, in a very close quarter situation, similar to first responders and medical personnel). The point is, if just one infected person gets into situations as described, they can begin an infection process that spreads rapidly. They're not really "superspreaders"--it's really simply that the situation facilitates the spread in ways that ordinary daily life outside the family doesn't. Close contact, packed together in crowds, hugging and kissing, etc.

      Social distancing is supposed to break up that close, prolonged contact that COVID needs more than more virulent viruses. The rationale for social distancing in the COVID case is that once loosed it has a higher Case Fatality Rate than flu. So this year so far we have about 20K flu deaths since Oct. But we now have the same 20K COVID deaths in just a month and a half or so.

      The trick would be to really educate people re what situations to avoid and to get them to observe precautions. IMO, Americans have actually been very good like that, far better than medical professionals expected.

  3. Indeed, we've been "FAR better than medical professionals expected."
    So, maybe they're not as expert as the MSM would have us believe.
    They *may* know much, about the details of how a virus effects the organs of a person, but they don't know nearly enough about anything else, to justify their being given a shot, at the Machtergreifung that they've pulled off here.

    They were empowered to use a sledgehammer, instead of letting us try a claw-hammer.
    Shades of Diocletian.

    If DJT doesn't end this lockdown soon, or if he lets Fauci etc. push him to reimpose it months later, I'll fear that (one way or the other) they've got him by the stones.

    1. I maintain that in the circs Trump had no choice, because he knew things were getting out of control via NYC and a few other hot spots. He is not being manipulated by Fauci--Trump is in charge--not Fauci--and he's listening to a wide range of advice. I'm sure his biggest concern is for the fall. Can we prevent a renewed outburst in the fall, or can we prepare for it so that we won't have to take the same measures.

  4. "he's listening to a wide range of advice."
    The fate of the republic likely hinges on that, and on if Barr actually has the stones to give the D.S. guys "their due".
    Book it, they'll pull out all stops, to try to intimidate Barr into the tall grass.

    1. Barr knows that. Does he seem intimidated to you?

    2. Not so far.
      But, I can only hope, that he can anticipate/ neutralize all of the possible ploys in their arsenal, incl. a massive onslaught of terrorism.

  5. At risk of repeating myself, I see all this to be, as Churchill wrote about the launching of the Schlieffen Plan, "a drama never surpassed".
    It's a helluva time to be alive, and a helluva privilege, to be able to interact about all this, with such knowledgeable folks as those who post here.

  6. CTH just posted the news, that Louisville judge J.R. Walker (appointed by DJT) blocked the city brass, from their bid to block Easter Worship.
    What if DJT is implementing his vintage trolling method, by enticing his foes to expose their derangement, for all sane folks to see?

  7. Agree with the close proximity for a couple of minutes.

    But, there also seems to be contaminated places. A hall used for weddings on Korea was a spreader vector I read.

    Masks seem to help, but are having most impact when?

    1. It's real detective work. For example, you'd have to try to find out how many infected people were at the wedding and consider the likelihood of how many surfaces they contaminated and so forth.

      But the bottom line seems to be that the rate of infection is relatively low for the total population--relative to the flu.

  8. Isolation proposals are useful only in certain circumstances. A variety of diseases were contained mainly when pretty much anyone who had the disease could be quarantined.

    A big problem with large scale lockdown models like this is that they are fine in theory (remember what Feynman said about theory) but over a large and varied population plenty of leaks will occur. Absolutely. And in a realistic situation not a damned thing can be done about it (even the totalitarian Chinese failed). The vast majority of the population will survive, lockdown or not, and destroying civilization for a hopeless quest is not a good approach.

    Governments have gotten into a sort of cytokine storm of their own (disturbingly parallel to how COVID kills its victims), becoming so obsessed with attacking the disease that they are destroying their countries.

    1. Sorry, that's not historically correct. Read the history of the 1918 Flu Pandemic. The record appears to show that the "lockdown" measures that were put into effect were effective in limiting the effect, as compared to localities that didn't take such measures. Lots more could be said about that, but that appears to be the fact. Those measures were not taken to quarantine those who already had the disease but rather to prevent the spread of the disease through the general population, same as today.

      As for destroying "civilization," the American people-- and most Western countries--have been hard at work destroying the true heritage of their civilization for many years.

  9. "most Western countries--have been hard at work destroying...."

    A fair amount of truth to that, but it's been done mostly at a slow pace, enough so that, there was/ is time to work to turn the ship around.
    By contrast, the worldwide damage inflicted by these recent policies, dwarfs all prior episodes in modern history, save maybe for the Thirty Years War, Napoleon's wars, and the World Wars.

    Incl. in this damage is, the knowledge politicians, scientists, etc. now have, that most of the public is quite supine, and will stand for a massive lockdown campaign, akin to selling truckloads of snowballs to eskimos.

    If the brass pay no real price, for reimposing lockdowns later this year, this will vindicate Wm. Pfaff's fears expressed decades ago, that our leaders will tell us anything, and we will believe anything.

    At least we can thank our lucky stars, that DJT is calling many shots.
    Had Hillary been in power now, we'd have seen an Orwellian state by c. 2034 (50 years after 1984).

    1. "A fair amount of truth to that"

      A LOT more than a fair amount of truth to that. :-)

      "dwarfs all prior episodes in modern history, save maybe for the Thirty Years War, Napoleon's wars, and the World Wars."

      I count, conservatively, four episodes there. But why confine ourselves to modern history? All history is connected, and you've skipped over important episodes of moderns history as well. Why not include the 100 Years War, the Protestant Revolt, the French Revolution (without which no Napoleon), the Russian Revolution, the Communist takeover of China? Now we're up to nine, without really trying. And all of these were *spiritual* crises--which are much more damaging than physical plagues.

      "the worldwide damage inflicted by these recent policies, dwarfs all prior episodes"

      I think you're exaggerating, and especially because we're only a month and a half into this.

      "it's been done mostly at a slow pace, enough so that, there was/ is time to work to turn the ship around."

      In my reading of history the process has largely been inexorably in one direction, with no turning back.

    2. "Why not include the 100 Years War", etc.?
      Most of the episode on your list were, so I understand it, less likely to spur much fear in other key places (e.g. in world markets, such as they were), than would've been spurred by, say Bonaparte's rampages *across* Europe.

      (I'll bet that, when he sold us Louisiana Territory, it raised many eyebrows, seeing as Robespierre hadn't bothered.)

      "much more damaging than physical plagues."
      In the long run, probably quite so.
      I'm talking about the much shorter run.
      Really major wars of the sort I listed (e.g. WWII) can bring mass privation across whole continents, and outright starvation in major cities (e.g. Leningrad).

  10. As for 1918, the world (esp. Western Civ.) was in far more resilient shape then, despite having been clobbered by a World War and a Bolshevik Revolution.
    Thus, it could endure lockdowns far more easliy, than the current JIT economy.
    The world debt load (relative to Gross Product) was a fraction of its current level.
    The world was nowhere near to scraping the bottom of the vital OIL "barrel", and thus high (economy-breaking) oil prices were nothing, like the threat that they have been in recent decades.

    Almost all of the key components (e.g. oil, spare parts) of our industrial machinery were a train-car ride from the key installations (incl. TX & OK), for reliable delivery to key destinations.
    Whereas now, we depend on so much of this stuff coming from the other side of the globe, much of it from unstable countries.
    At least we can thank our lucky stars, that DJT is working
    to rectify this danger.

    1. "As for 1918, the world (esp. Western Civ.) was in far more resilient shape then, despite having been clobbered by a World War and a Bolshevik Revolution."

      A World War and a Bolshevik? Aren't you leaving out the influenza pandemic?

      I absolutely could not disagree more. Western Europe NEVER recovered from the "Great" War. The demographic, social, cultural, and political effects are still being played out. Not only internally in Europe but around the world.

      I notice, too, that you've left out the Great--and worldwide--Depression, which lasted ... how long was that?

    2. None of the above refutes my main thesis, that in those years, the world (esp. Western Civ.) was in far more *resilient* shape then, partly because its peoples were of far more virile character, than is the current crop of Snowflakes.

      Then, a brutal Depression led to rise of evil mov'ts (e.g. the NSDAP), but other lands muddled thru.
      Nowadays, when these Snowflakes are "traumatized" by a Micro Aggression, they declare Cold Civil War vs. the White Patriarchy.

      Very good discussion, but family responsibilities now preclude me sticking around, to do justice to *all* of your arguments.
      So, I trust that you're having a fine Easter!

    3. "None of the above refutes my main thesis"

      Sorry, your main thesis doesn't hold water. We wouldn't be where we are today without those prior "resilient" periods in our history.

  11. Back to key components:
    Failure to replace a bad gasket in 1918 might get an ammo plant to blow up a neighboring block, but if such a failure now melts down a Three Mile Island, or a Chernoble, it could devastate whole provinces or countries.

    Dr Tim Morgan, among others, fears that the complexity of the current system is thus far less resilient, than ever before in world history.
    See :

    "The modern industrial economy is not only enormous by historic standards, but is extraordinarily complex as well.
    Scale and complexity make the modern economy *high-maintenance* in energy terms.
    Output grew rapidly in the period (roughly between 1945 and 1965) when trend ECoEs were at their historic nadir, but has struggled since then, as ECoEs have risen...."
    (ECoE = energy cost of extracting energy.)