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Thursday, July 16, 2020

UPDATED: The Swedish Model V. The New York Model

Here's a long interesting article, comparing the "Swedish Model" with what happened in New York--carnage among the elderly:

Why Sweden Succeeded in “Flattening the Curve” and New York Failed
The reason New York failed to "flatten the curve" and Sweden succeeded probably has little to do with lockdowns.

The author isn't naive. He understands that Sweden's record isn't great compared to the other Scandinavian countries. That's largely because the Swedes--like most others--failed to realize early on where the real danger lay: in the nursing homes. In that sense you could say that their model ended up being successful in some respects more by chance than by planning. Nevertheless, there are important lessons to be learned. Lessons that we in America seem determined to ignore.

Here's the heart of the article:

If flattening the curve was the primary goal of policymakers, Sweden was largely a success. New York, on the other hand, was not, despite widespread closures and strict enforcement of social distancing policies. 
The reason New York failed and Sweden succeeded probably has relatively little to do with the fact that bars and restaurants were open in Sweden. Or that New York’s schools were closed while Sweden’s were open. As Weiss explains, the difference probably isn’t related to lockdowns at all. It probably has much more to do with the fact that New York failed to protect the most at-risk populations: the elderly and infirm. 
“Here’s the good news: You can shut down businesses or keep them open. Close schools or stay in session. Wear masks or not,” says Weiss, a graduate of Harvard Business School. “The virus will make its way through in either case, [but] if we protect the elderly then deaths will be spared.”

UPDATE: Here's what I mean. There was really no way to know, at the time the pandemic started, that the elderly and infirm would be at grossly disproportionate risk as compared to every other demographic category. After all, for all we knew, this could have turned out to be another 1918, in which the young and healthy were the most at risk. But we did find out. The problem is, that reality was basically hidden from the public for months. Sweden adjusted, we didn't and still haven't in important respects.

8 comments:

  1. I read the FEE article and I'm honestly not sure what to make of it. Please take the following with a grain of salt. I'm no expert and I come here because of the discussion of 'Obamagate'. I'm just trying to puzzle my way through to some kind of understanding of what's going on with the corona.

    It seems to me that NY is the true outlier because its policies with respect to the elderly, esp the elderly in group living situations, were deeply flawed. The lockdown was irrelevant to the elderly because, essentially, they weren't locked down. I also have to wonder whether the elderly population at highest risk in NY wasn't in substantially worse health than in other places.

    Sweden didn't lock down and suffered fatality rates similar to (or better than) some countries which did lock down. But, as the author (and Mark) notes, Sweden's fatality rate is remarkably higher than Denmark, Norway and Finland, which did lock down. Sweden's death rate (554/1m) so far is far higher than Denmark's (105/1m), Norway's (47/1m) and Finland's (59/1m). Of all countries with over 1000 cases, Sweden ranks 5th in the world in fatalities per million.

    Was Sweden's economic result sufficiently better than its neighbors to justify the additional fatalities? I don't think we yet know the answer to this question.

    And if Sweden did suffer greater fatalities than its neighbors by not locking down, will it do better than its neighbors in the future because it has exposed a greater proportion of its population to the virus? I don't think we yet know the answer to this question.

    Will Sweden do better than NY, which did lock down? I don't think we yet know the answer to this question.

    And Weiss says: “The virus will make its way through in either case [lock down or not], [but] if we protect the elderly then deaths will be spared.” I don't think we know the answer to this either. If "locking down" the elderly saves lives, so it may save the lives of those with co-morbid conditions if they are treated like the elderly. Do we yet know?

    And even if we lock down the elderly why won't the virus "make its way through" to the elderly anyway, as Weiss says it inevitably does. Can the elderly be protected indefinitely?

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    1. I think Weiss is simply wrong--what he's saying doesn't make sense. Obviously if deaths will be "spared" then there has to be some sort of a "lockdown"--a lockdown re screening all who access nursing homes. That's where Sweden failed--big time. My guess would be that the other Scandinavian countries ended up being lucky in that regard (my guess)--their lockdown policies ended up shielding the elderly and infirm, even if they didn't initially understand how crucial that would be.

      If the Swedes had taken that step--and accounts from within Sweden that I've read suggest that they were pretty laissez faire in that regard--then they might well have been a shining example.

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    2. My guess is that the lockdowns in themselves made almost no difference in the incidence of Covid-19, though they did catastrophic damage in other areas including public health.

      The media are hyping "cases" to keep the fear going, but the weekly deaths curve looks the same as other epidemics in which there were no lockdowns.

      Nobody wants to admit that they did so much harm to achieve little or no benefit, and Party members don't want to admit that for them, it's always been about crushing the peasants' revolt and getting rid of the Bad Orange Man.

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  2. "a lockdown re screening all who access nursing homes" is a far cry from locking down everything.
    If DJT fails to draw that distinction, he may well get smoked in Nov., unless Durham makes huge busts before then.

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    1. The DoJ Spokesgal says they expect action "by the end of the summer."

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  3. Hmm...
    Hypothesis: Restrictions on Hydroxychloroquine Contribute to the COVID-19 Cases Surge Watts Up With That

    Due to the FDA Memo of June 15th.

    Multiple members of AAPS have communicated to AAPS their inability to prescribe hydroxychloroquine (HCQ) for a full regimen to treat or prevent COVID-19, including but not limited to physicians in Western Michigan, Georgia, New Jersey, Arizona, and Texas.

    I found this while trying to see if the difference in death rate in the Nordic Countries was due to HCQ use.

    Sweden has Industrial Sized Assisted Living Facilities, that probably made the situation worse.

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