COVID-19 UPDATE: Regenexx is committed to the health and safety of our patients. You may now be seen in clinic or via telemedicine for virtual/online or phone visits.
LEARN MORE
Our physicians are available via telemedicine to continue to give you the care you need during this difficult time. Learn more.

Sweden: COVID Disaster or Valuable Data?

By /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

By submitting the form, you are agreeing that you read and consent to our Privacy Policy. We may also contact you via email, phone, and other electronic means to communicate information about our products and services. We do not sell, or share your information to third party vendors.

This week there were several COVID media narratives. One took aim at Sweden for bucking the shutdown trend. Some of these stories were based all or in part on a new study out of the University of Virginia. So let’s dive into that new research and see what it found. We’ll also examine what’s been happening with Corona rebel Sweden. Let’s dig in.

Sweden and Corona 101

When the rest of the world was shutting down in March, Sweden took a different tack. They kept schools, bars, restaurants, and businesses largely open and asked their population to self-isolate. This really pissed off many in the media so the narrative became that Sweden was on a course to kill a good chunk of its citizens. That’s back when the media was reporting a crude fatality rate of 3-4% for COVID-19. That fatality rate, of course, turned out to be fiction, as the COVID-19 infection fatality rate has since been revised to a high of 1 in 200 to a low of 1 in 2,000 (0.5%-0.05%).

Sweden’s Curious Steep Drop in Daily Deaths

Given that Sweden is an irresponsible and awful country for not toeing the COVID party line, we would expect that the pandemic would be raging out of control there right now. That packed ICU wards would result in ever-increasing deaths and general daily armageddon. However, what’s really happening?

One of these countries above is Sweden and one is the UK (which I chose randomly) (3). The UK aggressively shut down, but Sweden didn’t. The drop in deaths per day as the spring became the summer looks pretty similar. (Tip: on the left is Sweden and on the right is the UK).

The New Research on Sweden

Researchers from the University of Virginia looked at the data out of Sweden through May 15th (1). First, let’s start with their conclusion:

The Swedish COVID-19 strategy has thus far yielded a striking result: mild mandates overlaid with voluntary measures can achieve results highly similar to late-onset stringent mandates. However, this policy causes more healthcare demand and mortality than early stringent control and depends on continued public will.”

Huh? That’s far from a NY Times headline this week: “Sweden Has Become the World’s Cautionary Tale” (4). So let’s dig deeper.

What Else Did the Researchers Find?

Sweden’s ICU capacity was expected to be overloaded but wasn’t. The researchers thought that this could have been due to lower than expected death rates and the concept that Sweden prioritized ICU beds for the young and sick, and didn’t focus on providing ICU care for the infirmed and elderly, who were already institutionalized in nursing homes.

More Deaths

As I have written before, there is little doubt that Sweden had more death per capita than it’s regional neighbors. However, that’s because they exposed more people with the idea of building herd immunity. In the meantime, it’s death rate has been lower than other countries who decided to lock down like Great Britain (3).

Sweden is also unique in that 7 out of 10 deaths have been in the elderly over 70 years of age (6). In fact, 54% have been in people over age 80. Those numbers skew more heavily towards the elderly than most other countries.

The Financial Narrative

The 2nd quarter GDP data isn’t out yet and we won’t get our first glimpse of that number for about a month. However, the Organisation for Economic Co-operation and Development (OECD) makes predictions (2). Let’s dive in.

The second narrative of the week is focused on Sweden’s economic results which the NYT piece claimed were as bad as everyone else’s. I already reviewed that they beat the pants off the US in the first quarter. If we look at the OECD website, how well is Sweeden predicted to do in the 2nd quarter versus other EU countries?

Sweden (the yellow dot) is expected to do much better than the average of 17 Eurozone countries (blue line pointing to the red diamond to the left) and similar to its region (same as Denmark, better than Finland). That makes sense, as you can’t remove a small country of 10 million people from the regional economy in Scandanavia and the EU.

For example, 69% of the major EU countries that imported goods into Sweden were shut down in the second quarter (7). See the graph below for those countries (yellow squares) and their percentages of Sweden’s imports:

Hence, you don’t need to be a Nobel winning economist to understand why Sweden, the lone man out among EU countries, would be economically hamstrung by both a lack of imports and exports.

The REAL Story

The most interesting story here is why did Sweden do so well? The new research paper above used the term “striking”. Why? There should have been way more deaths and an out of control pandemic. Those deaths should be blowing through the roof right now, far outpacing, on a per capita basis, the countries that locked down. However, as you can see above, Sweden’s deaths per day metric is falling off a cliff just like the countries that locked down.

From a public health standpoint, the obvious question that needs to be asked is whether Sweden’s relative success calls into question the efficacy of lockdowns. The scientists in the paper are hinting at that conclusion, but it’s so against the grain that the question rarely gets asked. In fact, just asking it can paint a big target on your back.

Fattening the Curve and Deaths Caused by Shutdowns

Remember, when this Pandemic hit us in March, we were all told that the purpose of a shutdown was to “flatten the curve”. That meant that the same number of people would die, but that we would avoid health system overload by pushing those cases down the road. That was the prevailing media narrative the the spring.

Now the media has changed the narrative to shaming anyone who doesn’t agree that shuttering the economy longterm to preserve lives is the best plan. Of course, there is no mention of the 150K people that the American Academy of Family Physicians estimates will die due to deaths of despair because of more shutdowns (5). There is also no mention of the hundreds of thousands more who will likely die due to missed or late diagnoses of treatable medical problems. Why? That doesn’t agree with the narrative.

The upshot? So is Sweden an awful country that doesn’t care about its citizens or is it the most interesting data point to date in the pandemic? Public health officials need to pay attention to what happened in Sweden, not as a cautionary tale, but as a result that doesn’t agree with the idea that our large country shutdowns saved lives.

___________________________

References:

(1) Shina C L Kamerlin et al, Managing COVID-19 spread with voluntary public-health measures: Sweden as a case study for pandemic control, Clinical Infectious Diseases (2020). DOI: 10.1093/cid/ciaa864

(2) OECD Nominal GDP Forecast. https://data.oecd.org/gdp/nominal-gdp-forecast.htm#indicator-chart Accessed 7/8/20.

(3) Coronavirus Worldmeter. https://www.worldometers.info/coronavirus/ Accessed 7/8/20.

(4) New York Times. Sweden has become the World’s Cautionary Tale. https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html Accessed 7/8/20

(5) The Well Being Trust and the Robert Grahm Center (American Academy of Family Physicians). PROJECTED
DEATHS OF DESPAIR from COVID-19. https://wellbeingtrust.org/wp-content/uploads/2020/05/WBT_Deaths-of-Despair_COVID-19-FINAL-FINAL.pdf Accessed 5/8/20.

(6) Statistica. Number of coronavirus (COVID-19) deaths in Sweden in 2020, by age groups(as of July 8, 2020). Accessed 7/8/20.

(7) Trading Economics. Sweden Imports By Country. https://tradingeconomics.com/sweden/imports-by-country. Accessed 7/8/20.

Category: Coronavirus

Leave a Reply

Your email address will not be published. Required fields are marked *

7 thoughts on “Sweden: COVID Disaster or Valuable Data?

  1. Joy

    They had leadership who requested the public social distance, sacrifice and follow other guidelines and we didn’t. Our leadership has pretty much given up, and given their preference for dividing us we are starting to revisit the shutdowns (and now more likely bankruptcy) of restaurants, bars, gyms etc. Leadership, by turning this pandemic into a political fight of ‘us vs. them’ has now put our reopening of schools next month in jeopardy. The upshot? More pain to come.

  2. Heather

    Anders Tegnell the top epidemiologist in Sweden has stated that their approach resulted in too many deaths. Sweden now has the 5th highest per capita death rate in the world.
    On July 2nd the Prime Minister called for an inquiry into the no lockdown policy.
    Ok to let the elderly die? No idea how old you are, but FYI, people in their 60’s don’t consider themselves elderly.
    I subscribed to this site for information on orthopaedics.
    I am unsubscribing.

    1. Chris Centeno, MD Post author

      Heather, I would imagine that the Swedes are under immense pressure, so the fact that any public official has had to bow to the media narrative is not surprising. On your statement that Sweden has the 5th highest death rate in the world, on deaths per 100,000 they’re 7th: https://coronavirus.jhu.edu/data/mortality However, that metric is also not a firm comparison as it is different if you count deaths differently. For example, Belgium has decided to add in all suspected and not confirmed deaths, making it look like it has one of the highest numbers of deaths per 100,000 in the world: https://www.bbc.com/news/world-europe-52491210
      On being upset about a factual article with multiple references, I can’t help you there. If you have a specific item that I discussed that you believe is wrong, please bring that issue up. For example, is my assessment that Sweeden’s drop in deaths per day is similar to many other countries’ wrong? If so, why? Is my assessment that Sweden’s economy likely did better than the Eurozone wrong and why?

  3. Peter Salvatori

    I’ve been following Sweden for some time now and was puzzled by your response to Heather. Sweden does have the 5th highest deaths per capita (excluding San Marino and Andorra) as indicated by the table in the JHU link.

    1. Chris Centeno, MD Post author

      Peter, Sweden is 7th in that table. I was commenting between patients quickly, so see my revised comment above now that I have had a chance to sit at my desktop.

  4. Pat

    Heather said “Anders Tegnell the top epidemiologist in Sweden has stated that their approach resulted in too many deaths”. Yes, he said that. But if you read more, and in Swedish, he said his mistake was he assumed the elderly care homes would have understood masks/handwashing, but they didn’t as they normally did not do this, so they carried on with their normal practices. Next time around, he will not “assume”. Of course, this clarification never seems to get picked up by the Western press, only thing you see is headlines like “Anders Tegnell admits to making a mistake”. Dr Centeno makes is brutally obvious that if not for that mistake, Sweden would actually be way down the charts on fatalities when he states “Sweden is also unique in that 7 out of 10 deaths have been in the elderly over 70 years of age (6). In fact, 54% have been in people over age 80. Those numbers skew more heavily towards the elderly than most other countries.”. Sweden would have been the superstar if it had protected the elderly better, and most likely would have had half the death rate.

    1. Chris Centeno, MD Post author

      Thanks, Pat for the translation!

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

CONTACT US

9035 Wadsworth Pkwy #1000
Westminster, CO 80021
888-525-3005

FOLLOW US

Copyright © Regenexx 2020. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

Subscribe here!

For more coronavirus updates and hard facts by Dr. Centeno.

You have Successfully Subscribed!

LinkedIn
Email