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Sweden eschewed lockdowns. Itís (still) too early to be certain it was wrong.

By Andreas Ortmann - posted Tuesday, 24 November 2020


The case of Sweden has attracted considerable attention, and opinionated - but often poorly informed - commentary (e.g., hereherehere, and here). We have been told that Sweden has become a cautionary tale and does not qualify as a model that Australia ought to pay attention to, nevermind follow.

The circumstances of the two countries (e.g., Australia's insular status against the more integrated Scandinavian situation Sweden finds itself in, different population densities, different willingness of the people here and there to follow public-health advice voluntarily, etc.), and the strategies they have chosen to battle the pandemic caused by SARS-COV-2 (orders versus recommendations, heavy fiscal stimuli vs moderate ones), are quite dissimilar. Still … it is useful to understand the facts as they pertain to the Swedish patient. When everything is said and done, a couple of years down the road at the minimum, it is likely to be a useful reference point for an overall assessment of the consequences of various health, economic, and other interventions and lessons to be learned for future pandemics.

Commentators typically make much of the relatively high death rate per capita that Sweden has run up. And indeed, as of the publication of the earlier version of this article on August 1, worldometer suggested that Sweden had done poorly on this count and trailed only Belgium, the UK, Spain, Italy, and Peru, ahead of then-attention grabbers such as the USA, Brazil, Chile, and Mexico, and way ahead of countries such as Germany (then 110 deaths per million of population), Austria (then 80), and Czechia (then 36), which at that point were considered examplars of sorts.

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What a difference a couple of months make!

I predicted in the Conversation piece that Sweden would, by the end of this year, have dropped out of the Top Twenty of that particular league table (deaths per millon of population). As of the writing of the present version, two months before the end of the year, Sweden has dropped out of the worldometer Top Fifteen (trailing the USA, the UK, France, Belgium, Spain, Italy, and several Middle - and South American countries, not counting Andorra, San Marino, and Vatican City) and is well on its way to verify my prediction although it reports as covid-19 deaths those dying with the virus, not those that die of the virus.

The same commentators that routinely dismissed the Swedish approach, often with moralizing arguments clearly designed to derail the public discourse, argue(d) also that these high losses in human life cannot be justified by better economic performance. A key piece of evidence, also used by Duckett & Mackey, is a study by researchers from the University of Copenhagen that suggests that aggregate spending dropped by around 25 percent in Sweden and by an additional 4 percent points in Denmark only. Many commentators suggest that these economic gains, if they exist, are not worth the pain that current lost lives impose. One of my colleagues has made a similar argument. As have other Aussie economists that in essence have denied that intertemporal trade-offs exist.

There are obvious responses to these arguments:

First, we are most likely still in the early stages of the pandemic, even though in Victoria, most US states, and many countries (prominently, in Europe see also here) second or third waves stronger than the first waves are well under way - at least in terms of diagnosed cases (but maybe not in terms of deaths). It therefore simply does not make sense to compare at this stage death rates without controlling for the stage in which a particular state or country is in, its (socio-)demographic idiosycracies, and its policy responses. Arguments that rely on a snapshot of a moment in the past such as the second quarter or even earlier windows, strike me as silly, misleading, and in fact outright irresponsible. Sweden for example has currently very few deaths and the evidence suggests that there haven't been excess deaths for months. It is possible that the number of deaths for the year will be in the norm (see here and here, see excess in z-scores for the latter) even with the dramatic increase in cases it has seen since late September.

While cases have increased in Sweden, the number of "covid-19 deaths" has stayed, for now, at very low levels. While they are bound to go up - it typically takes 3–5 weeks for diagnosed cases to turn to death and ICU numbers have crept up - there is currently no indication the numbers will take the dramatic turn they have taken in the Melbourne outbreak, or a large number of US states. That's because infections in Sweden currently seem to afflict mostly those in the 20–60 years range for which probability of fatality has been known for a long time to be substantially reduced. (I understand that Sweden has currently 10 new ICU cases daily. This will result in up to 3 deaths daily with a lag of a couple of weeks. When it peaked in the April/May it was around 50 ICU cases and later 15 deaths from ICUs per day. The big unknown currently is what happens in the old-folks homes.) Clearly though, the Swedish authorities have not taken the second wave lightly since they have imposed localized restrictions that are often tougher (albeit more confusing and hence inducing less compliance) than those during the first wave.

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As mentioned, as of the writing of this version (November 5), Sweden has dropped out of the Top Fifteen deaths-per-million-of-population league table.

Around the same time I published the original version of this article, Anders Tegnell, the chief epidemiologist at Sweden's public health agency, was quoted as saying,

"In many ways the voluntary measures we put in place in Sweden have been just as effective as complete lockdowns in other countries." He added:

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This article was first published on Medium. It is an expanded version of an article published on The Conversation



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About the Author

Andreas Ortmann is Professor of Experimental and Behavioural Economics in the School of Economics, UNSW Business School.

Creative Commons LicenseThis work is licensed under a Creative Commons License.

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