What really happened with Sweden and COVID-19? The story is a little more complicated than you usually hear, but you don't have to get too deep in the weeds to see that something interesting happened there.
Start off in 2020, when the pandemic begins and Sweden adopts the most hands-off policy of any peer nation. There are no lockdowns, no school closings, no restaurant closings, and no masking. Here's how they did:
Even in those early days, Sweden's death toll was fairly low, and it would have been even lower if not for their catastrophically bad handling of nursing homes. If they had even matched the performance of other countries in their protection of the elderly, their excess mortality rate would have been down around 5%.
Still, the pandemic continued to rage and Sweden's death rate was higher than other Scandinavian countries. So in late 2020 they cracked down a bit. Large groups were prohibited, schools were allowed to close if they wanted, and the government gave itself authority to shut down shops.
Importantly, though, these changes were modest and mostly voluntary. In practice, almost nothing changed. Restaurants, bars, shops and gyms all stayed open, and although schools were allowed to close, few did.
In one sense then, the "Swedish model" changed when the COVID death rate stubbornly stayed too high. But it was a very modest U-turn, and Sweden remained far more open than most other countries. Its model was basically intact, and it eventually produced this:
Over time, Sweden has had one of the best excess mortality rates among advanced countries despite having one of the worst vaccination rates:
One reason for Sweden's success is that although government recommendations were just those—recommendations—Swedes generally took them seriously:
In a survey by Sweden’s Public Health Agency from the spring of 2020, more than 80% of Swedes reported they had adjusted their behaviour, for example by practising social distancing, avoiding crowds and public transport, and working from home. Aggregated mobile data confirmed that Swedes reduced their travel and mobility during the pandemic.
Swedes were not forced to take action against the spread of the virus, but they did so anyway. This voluntary approach might not have worked everywhere, but Sweden has a history of high trust in authorities, and people tend to comply with public health recommendations.
Would this work elsewhere? One may doubt. But it worked in Sweden and the results were manifold. Restaurants stayed open and people continued to eat in them. Businesses mostly stayed open and people continued to work. Schools stayed open and kids continued to learn. All this happened with fairly minimal intrusion into people's lives and no panic or constantly shifting guidance. There's a lesson to be learned here.
There's a lesson to be learned here.
Yes. If you have a relatively homogenous and well educated society in which trust in authorities and one’s neighbors is high, it’s entirely possible to keep everything open and also have everyone act in ways that don't excessively undermine other people’s attempts to maintain good health. For example, shopping in fully open stores with everyone respectfully staying 6ft apart, wearing masks as much as possible, covering one’s face when coughing, and staying home at the first sign of illness.
This world of mutual respect and responsibility is decidedly not the one that present day Americans find themselves in. So whatever the lessons are of Sweden, they likely are not replicable here.
"This world of mutual respect and responsibility is decidedly not the one that present day Americans find themselves in."
What evidence do you have for this? America remains a high trust society by global norms. Crime is not especially high, again by global norms. Americans tend to form lines and behave sensibly in crowd conditions. etc etc.
Basically what I see in your statement (and many others below) is precisely the point of the "The Republican apocalypse" story -- people desperately want to make claims about the US that are borderline crazy -- but go unchallenged within certain bubbles...
The real dividing line, it seems to me, is that
- some people, in the face of a problem, care more that something, anything be done than that it be the correct or optimal response. We see in diet recommendations and we saw this in covid recommendations. Demands for action even though it's not at all clear quite what the correct action should be.
- a subset of the above are obsessed with the idea that ANYONE might refuse to follow the rules, and insist on moving from not just guidelines or recommendations to laws (ideally with serious penalties)
- meanwhile a different group of people have zero patience with recommendations that are not well founded
- and a subset of those have even less patience with laws that are not well founded.
The response across every country (and in the US each state) was basically a tussle between each of these groups. Plenty in the US (and I saw this repeatedly) were utterly mendacious in how they portrayed the other side; for example repeatedly calling "vaccine deniers" or "mask deniers" people who said they personally would use masks or get vaccinated, but did not feel it should be legally compulsory.
In other words I don't think there's any reason to claim that the US is any less willing to engage in "mutual respect and responsibility" than comparable countries, like Sweden. In both countries most people are willing to engage in that, and to go along with what look like reasonable recommendations. In both countries some people disagree with something or other and (a much smaller fraction) will make a big deal about it. And in both countries a different group of people are utterly OBSESSED with the idea that someone, anyone, anywhere is "getting away" with disagreeing with everyone else.
And Sweden is hardly as perfect as so many Americans (clueless as to the actual details) believe. It looks to me like sports hooliganism (a fine example of "mutual respect and responsibility") is rather worse than in the US, and rape is substantially worse and still rising...
And Sweden is hardly as perfect as so many Americans (clueless as to the actual details) believe.
No one thinks Sweden or any other country is “perfect.” The rest of your comment is comprised of similar straw man arguments.
The lesson is Sweden is an actual Country, whereas the US is a nation formed by immigrants from other countries.
If US history tells us anything, it tells us that the number of situations where US citizens will voluntarily sacrifice anything, even anything as ridiculously simple as wearing a mask, which is almost as close nothing as you can get, is so small as compared with other countries which actually share a culture that comparisons based on what “Swedes would voluntarily do” is laughable.
Well, laughable if we were not talking about refusing to take minimal precautions to protect others lives.
The unwillingness of the US population to voluntarily take these precautions is something to be ashamed of.
Another example: Gun ownership per capita in Scandinavia is pretty high, and yet Scandinavians have very low murder rates. “There’s a lesson to be learned” there too, but America is decidedly not going to be learning anything from anywhere else on earth with regards to guns any time soon.
Gun ownership per capita in Scandinavia is pretty high,
Pretty high by global standards and pretty high by Texas standards are too very different animals. Also, the Nordic states do impose very stringent rules with respect to firearms. It's definitely not just a matter of peer pressure:
https://www.vox.com/2016/8/8/12351824/gun-control-sweden-solution#:~:text=Sweden%20licenses%20guns%20in%20much,a%20written%20and%20shooting%20test.
(For my money, the single most frustrating aspect of the gun violence debate in the US is the notion that strong, sensible gun regulations equate to "banning" private firearms ownership. That's complete BS: we'll never enact gun prohibition in the US, but there's no reason we can't treat gun ownership like car ownership.)
Gun laws and ownership in Sweden are not, in any way, comparable with the United States. Start with the fact that "pretty high" means that about 8% of the Swedish population owns a gun, and there are a total of 23 guns per hundred Swedes. The comparable numbers in the U.S. are 50% and 110.
In Sweden, you must apply to be able to own a gun. This includes having a valid reason for gun ownership. The two main valid reasons, each with a separate license, are hunting, in which case you may only own rifles, or for sport, in which case, you may only own pistols.
You must be a member of a shooting club for at least six months, or go through a hunting course. Only hunting rifles and single shot shotguns are legal for hunting, and there are strict limits on the number of rounds a semiautomatic rifle may hold, usually 5.
Guns must be stored in a safe. If they are being transported, they must be unloaded. They may not be concealed.
The laws on self defense with a firearm are extremely strict, and it is largely not allowed.
So, there's really no comparison.
The Swiss have "high" gun ownership, more so than the Swedes--though still smaller than US.
This is almost entirely due to a now obsolete tradition: Swiss soldiers store their personal military equipment at home, including their rifles. The idea was that this improves readiness and allows for quick mobilization in case of attack (they need to be fast as the country is so small that any attack gets all across in very short order...). This was probably still valid in WW2. Now there is so much materiel involved that can not possibly stored at home that this is nostalgia (and as fas as I know optional; you can leave your gun with the army if you prefer).
Also: Switzerland does not look too good on gun violence (eliminate the US from the data and Switzerland is among the worst with no active war going on).
I kind of think the real story here is Denmark.
To the point where I wonder about the projections being used in that first chart - that Denmark (along with Norway and Germany) could have had no or negative excess deaths doesn't pass the sniff test.
Part of a post I made elsewhere that you may like to read if you have time:
And here's another one: claiming that Sweden had a low excess death rate and more or less claiming as due to Sweden's failure to implement lockdowns. But here's a thing about Sweden's "excess death rate": "The date associated with a death might refer to when the death occurred or to when it was registered. This varies by country. Death counts by date of registration can vary significantly irrespectively of any actual variation in deaths, such as from registration delays or the closure of registration offices on weekends and holidays. It can also happen that deaths are registered, but the date of death is unknown — this is the case for Sweden."
You can find that quote here:
https://ourworldindata.org/excess-mortality-covid
where you will also find a very comprehensive coverage of the topic (and I really do mean comprehensive).
It's not wise to assume that other places - and especially Sweden - do things the same way we do.
That might move a reported death from one month to another, but it's not going to change cumulative excess deaths.
No, of course. Which is why Sweden actually shows a small negative count for excess deaths. In other words, Sweden is just one of those states where the Covid epidemic called new lives into existence rather than causing actual deaths.
But read the ourworldindata article, don't just make up your own preferred "facts".
In the US, we did not a "flu" season with Covid precautions in place. The same most places, so deaths went down because of that. Covid deaths more than made up for lives not lost to the flu, so excess deaths typically went up. Deaths from travel also went down, though up in per mile traveled, if I recall correctly--also due to Covid restrictions.
One reason for Sweden's success is that although government recommendations were just those—recommendations—Swedes generally took them seriously
In other words strong social distancing works.
Ideally, a society doesn't need to actually impose rules to achieve this. The most effective overall policies in reducing covid deaths (Taiwan, Australia, China) probably featured both rules and a population that generally follows government orders. Sweden falls into a second category (along with Japan), which eschews rules but gets the comparable results. US, Britain, etc fall into a third category (managing the population during a health crisis is like herding cats).
I don’t have the excess death rate for California but according to Worldometers California has a death rate from COVID of 2612 per million. Sweden has 2401.
So pretty similar. And considering that California has 40 million population and Sweden has 10 million, and that 6 million Californians voted for Trump, I’d say it might be wise to learn lessons from California.
At this point "deaths from Covid" is a complete shit statistics. You really do need to go with "excess mortality" because otherwise you're relying on the ability of various and sundry governments to correctly identify and categorize deaths caused by SARS-CoV-2.
I have no doubt California did better than many American states, but that's a pretty low bar.
Whereas 'excess death' counts are totally accurate and wholly believable, yes ?
Deaths are typically accurate. Cause listed might be suspect. As for "excess deaths"--that involves past counts and statistics. It typically bounces around depending on how bad (or good) the flu season is.
For reasons I would hope would be obvious, yes, the tracking of “deaths” in general is almost always more statistically reliable than the tracking of cause of death.
Excess mortality makes less sense as a metric when Covid deaths drop below the "noise" of excess mortality. It makes more sense in years like 2020 when Covid had a major impact.
To illustrate, some Scandinavian countries had periods where cumulative excess death dipped well below zero. We can either assume efforts to prevent Covid death saved people from death by other causes, or the measurement is in the "noise" range.
"noise" in quotes, because it's not real noise, just variation from causes that are related to Covid or Covid prevention.
There’s very little doubt that a number of countries (those who enjoyed success in minimizing Covid illness via strong NPIs ) indeed saw a reduction in overall deaths below the 2019 norm, because of a significant decline in activities that are conducive to accidents or the spread of disease.
There's no doubt that 5% swings in excess mortality were normal before the pandemic for Sweden.
The tales of Sweden during Covid are mostly myth, told by people who really want to push a narrative and use Sweden to make up whatever stories they want.
In reality, Sweden enforced shutdowns on large events, sporting events, alcohol sales, cinemas/theaters, high schools, universities. Many elementary and middle schools closed for 6 to 12 months.
Sweden tried to ignore Covid during the first several months of the pandemic and they were late in enacting shutdowns. However, the idea that they never enacted or enforced shutdowns later in 2020 and throughout 2021 is false.
Kevin is pushing a myth. There were lots of government enforced closures/lockdowns. Schools were not completely open. Swedish society did not magically pull together because they are a 'homogenous' people who all get along.
The lesson to be learned appears to be that people are desperate for myths that reinforce what they wish to be true. Actually learning from the past is difficult if you are unwilling to see what happened in the past.
Just like the covid deniers see 2020-2022 as proof of their worldview, the Sweden promoters see what they want to see....no matter what actually happened in Sweden.
Both you and Kevin are wrong about schools. Sweden never closed schools for those in elementary school and junior high but did close high schools and universities.
Kevin is also wrong to say Sweden "cracked down a bit" in late 2020. The changes were smaller than trivial. Alcohol sales ended at 9 pm instead of 10 pm and a few government buildings closed for a few weeks in a nation of 10 million people.
A johns Hopkins meta study showed last year that lockdowns prevented zero Covid deaths and of course the harms around the world. Of course, being on the Left means you can never admit you are wrong. Never.
Kevin is kind enough to allow links in this comment section. I would be curious to see the Johns Hopkins meta study.
There are a bunch of things I'd like to see normalized before concluding that Sweden did a good job. Population age, smoking, obesity come to mind. Also, hospital beds per capita. In the US, restrictions were added when it appeared that overflowing hospital beds might happen, and restrictions were relaxed when there were more hospital beds. Did Sweden have fewer excess deaths because they didn't overflow their hospitals?
Almost no hospitals "over flowed" in the U.S. out of the 5,000.
It should be noted that the idea that Sweden is a mostly white, homogenous society is also wrong. It has among the highest foreign-born populations, by percentage, in the world, something like 20%. By comparison, the US's foreign-born population is around 13-15% (depending on if you're counting documented vs. undocumented, etc.)
jdubs is right -- early on in the pandemic, Sweden tried a herd-immunity approach and kept things open, but particularly as Covid started sweeping through the elderly population, it overwhelmed the health care system and they realized they had to take a different approach, so they started imposing a lot of restrictions. But in the end they couldn't really unshit the bed and ended up having the highest Covid mortality of any Scandinavian country. Oh, and their economy didn't do any better, either.
LA Times columnist Michael Hilzik has a far less sanguine view of Sweden's Covid policy here: https://www.latimes.com/business/story/2022-03-31/sweden-covid-policy-was-a-disaster
Church attendance in Sweden is about 5%; in the US, during Covid, it was about 30%. Also, much of the resistance to masking and public gathering restrictions centered on churches in the US, with a culture-wars split about it that went to the SCOTUS, which fell in line with the evangelicals in its decision.
Also, in Sweden, I expect there is much higher trust in government than the US, which explains why government advisories were followed. If the US had followed its original plans for an outbreak, things might have been different, but you will always have the religious right in the US weighting its freedom to worship higher than almost anything -- except perhaps the right to own and carry a gun.
30% of Americans did not attend church during Covid - not even close.
The US CDC plan for an outbreak was clear: no lockdowns. The WHO stated the same thing in 2009 and again in the fall of 2019.
When you try to shut down churches (including outdoor services) but keep casinos open and allow political rallies that you agree with you will not get cooperation from most religious people or acquiescence from the courts.
One factor I've never seen Kevin mention is that Sweden has a very high percentage of one-person households. Most Covid transmission happens within a household, but when there's no one else in the household, there's no transmission.
There are so many variables to consider
The Nordic countries along with GB France and Italy lie along the same lattitude line as most of our northern states Germany Norway Sweden and Finland for that matter would be in northern Canada if they were superimposed over north America.
Our problem is that individual states were given way too much leeway in addressing COVID and as such some governors pointed to those Nordic countries and tried to do the same thing and they they adjusted THEIR stats to prove the Nordic countries right.
The United States is far different than most countries. Our population is greater, it is a melting pot of various groups and we "live" further south than those countries that tried a different way of addressing COVID than we did. DeSantis massaged his figures, because that was the only way to make his stats look like Nordic countries whereas the governor or Wyoming did not because his population density is 5.7 people per sq mile !!!
Personally I have no problem with either masking or vaccination or both AND making that decision myself because I will look out for those around me. It was only the folks who wanted no regulations, at all, who bristled at just the thought of regulation anything for everybody.
WE are weird in that regard
Three missing points here.
First, there were other first world countries with much better success. If we want better models we need to look at those, like Canada or S Korea or Taiwan. Heck some of our individual states were better than Sweden while we also had states with death rates that would have placed them among th worst in the world.
Second, Sweden had a very high percentage of single person households. Since spread was mostly among families they had a natural advantage.
Third, other sources give Sweden higher vaccination rates. Regardless, what is noticeable is that essentially every "state" within the country had the same vaccination rate. There were no hot spots like we had in the US and some countries in Europe.(Link)
We should also remember what really happened in the US. The places that didnt believe in lockdowns, masks, etc just didnt adhere and not much happened to them for that. I worked at two hospitals 40 miles apart. Stores in the more urban area had signs saying you needed to wear a mask. Signs at the stores in the more rural area had sings saying no masks were allowed.
https://covid19dataportal.se/dashboards/vaccines/
Steve
If you want to see real differences in mortality rates you must consider Asian countries, including Australia and New Zealand. These countries probably show what can be accomplished with real concerted action.
Kevin has consistently ignored these more successful countries. Why look at the smaller differences between less-successful countries?
We may have been lucky in several ways with Covid - the next pandemic could be more fatal and/or transmissible. It should certainly be possible to have better vaccine development and distribution among other things. Concentrating on how Sweden differed from similar countries will probably not be very useful.
Australia and NZ are islands. Much easier.
The destruction of trust during COVID will kill many people if we have a worse pandemic in the future.
o Insane overreaction to what turns out to have been a disease that is mostly harmless to all but the aged, the already sick, and the hopelessly neurotic (https://www.google.com/amp/s/amp.theguardian.com/society/2022/sep/07/study-finds-link-between-poor-mental-health-and-long-covid)
o Absolute lack of concern for the education and care of children whose parents were not in the keyboard class
o Politicians like Nancy Pelosi and Gavin Newsom demanding that businesses shut down but then violating the rules because their hair or their dinner parties were IMPORTANT (https://www.google.com/amp/s/news.yahoo.com/amphtml/biden-caught-video-violating-d-120303957.html)
o The use of masks as a class marker. Remember the Met Gala with makes staff and unmasked celebrities? Apparently if you are red carpet material you can't spread COVID? Why should any of us allow our "betters" to lord it over us?
The good news is that between vaccines, the evolution to a mostly non lethal disease, and widespread infection, we came out ok. Given the economic, political, and societal costs of our actual policy response, I don’t think it was worth it. Hindsight being 20/20 and all. Oh well. Life goes on.
Sweden and Norway are very similar countries (although they would disagree).
Sweden's population = 10.48 million and they had 25,436 covid deaths
Norway's population = 5.408 million and they had 5,560 covid deaths
Adjusting for population (doubling Norway's deaths) and taking the difference, then Sweden had ~14,000 more deaths than a similar country did by following stricter procedures.
And this is...what exactly Kevin? A win for something, something?
Norway has small boutique type nursing homes whereas Sweden has very large nursing homes. The Norwegian health department stated in May 2020 that its lockdown did not slow the coronavirus at all but harmed children.
Places that were hit early and hard were caught flat footed. We weren't the first to have an outbreak outside of China and were caught flat footed too. Some of this has to do with population density, whether or not kids were in school (or went to spring break), local customs, etc. Once a major outbreak hits, you basically have to lock everything down--and that's done to keep the hospitals from completely collapsing.
The speed of the spread and the fact that it was spreading while people were asymptomatic was completely unexpected. And people were in denial. Spring Break should have been cancelled that first year--it was a super spreader event that seeded outbreaks across the country. And there was the conference in Boston, etc.
The covid out break needs to be studied and lessons need to be learned. Cursory examinations do not tell us much. Sweden had outbreaks in nursing homes--which was bad. But did they have super spreader events? I don't know.
Flattening the peak made sense.
Long term lock downs and mask mandates were madness. Long term school closures was criminal neglect of our children.
When one-third of the nation had to be savagely put down in a war they started—just to prevent them from enslaving other humans as livestock in the basis of skin color—and they fought to preserve that status for another century—there isn’t much hope that they’ll do anything that isn’t selfish and destructive.
Excepting Norway, Sweden has a far lower population density than all the countries listed -- roughly a third lower than the US even. I suspect that at least a part of Sweden's "success" while imposing fewer mandates was simply due to the fact that its lower population density made such mandates less necessary.
Be interesting to use things like cell phone data (as in your Church study) to see how much voluntary distancing there was in Sweden.