Northern Europe during Pandemic -- Summers 2020 & 2021 & onwards

[Dockhead]

Originally Posted by Recy

Swedish epidemiologists´ thoughts about the lockdown.

https://unherd.com/thepost/coming-up...of2YDemk9qL7d8

Fascinating. Thanks for this, which I have sent to a number of friends. The main points, as asserted [with my own comments in square brackets]:


1. The measures taken around the world are not evidence-based and are strongly politically driven, as politicians address fear in their populations by implementing measures which appear bold and decisive, without any evidence that they are necessary or appropriate.



2. The disease appears to have a real fatality rate within the same order of magnitude as a bad flu epidemic -- maybe double but not 10x. A bad year for the ordinary flu kills 2,000 people in Sweden. So far 1,319 people have been killed by COVID in Sweden, and the death rate is falling. The final result will not be in a different order of magnitude from the ordinary flu, and the final result will be more or less the same all over the world.


3. Death rates fall as much from the early deaths of vulnerable people, as from developing immunity or the results of social distancing. [This is supported by what we saw in Lombardy, with death rates already falling before the lockdown even started.]



4. Widespread testing will show that over 50% of people in Sweden and in the UK have already had the disease.



5. Sweden, which more than other Nordic countries has very large nursing homes, failed to take adequate measures to protect people in nursing homes, where a majority of the deaths have occurred.


6. South Korea has failed to contain the disease at a low level and starts to give up trying. The disease is not really stoppable; it can only be slowed down, and that simply delays the development of the epidemic.


7. Lockdowns once implemented cannot be suddenly released, because a surge of pent-up cases will result which may overwhelm health systems. Yet one other bad result from lockdowns is that they can only be released in gradual steps [prolonging the social and economic damage].


8. The much-cited Royal College study [I linked to it in these pages myself, the day it was published] is not peer reviewed and is deeply flawed, painting a picture of the pandemic which we already see now is not accurate. Just one of many flaws is the assumption that hospital capacities are static, when in fact they are being expanded all around the world. ICU beds have been tripled in Sweden for example [which means Sweden is not using even 1/3 of available ICU beds, with hospitalizations already falling].



9. There will not be an effective and widely distributed vaccine before the end of 2021, if even then. It is not possible in democracies to maintain lockdowns until then (it might be in China where you can just weld people's doors shut), therefore, the disease will sooner or later progress through every country.


10. Health authorities in Sweden are satisfied with the numbers and are recommending further loosening of the measures, starting with opening of the rest of schools in Sweden, which the politicians apparently are implementing.


11. Policies in Denmark and Norway converge with Sweden's as measures there are lifted step by step. Finland never got the epidemic in the first place [which means Finland is vulnerable?]





I don't have knowledge in the field of epidemiology and can't say whether he's talking nonsense or not, but it sounds awfully persuasive. I find particularly interesting the political aspects. The political ability of Nordic governments to avoid lockdowns may be a sign of social maturity and social trust -- Nordic governments do not feel compelled to take bold-looking measures just for politics' sake when it is contrary to good judgement and contrary to the advice of health authorities, unlike elsewhere. Opposition parties don't use the pandemic to score political points, a striking fact for those of us not native to the Nordics.

[B23iL23]

Dockhead.

When was the last time 10,000 people died in New York from the flu in an 8 week period? When was the last time 10,000 people died from the flu in the UK in an 8 week period? Or 22,000 deaths in Italy in the same period.

It has never happened (not since Spanish flu)

You can have all the statements you want on either side of the argument, you can say this is just another virus and not really that different from say the flu. You can say politicians are all over reacting. You can say that we're underestimating the number of infections by 50/100/200%.

So What. Fact is this virus kills a lot more people, especially those with underlying conditions.

[conachair]

Originally Posted by Dockhead

I don't have knowledge in the field of epidemiology and can't say whether he's talking nonsense or not, but it sounds awfully persuasive.

It would be much more so if it was awash with links to published science. Bias is such a fundamental part of human judgement, science knows this. We hear what we want to hear..... one voice among a mass drowns out the bits we don't want to hear.
Still wishing the best though, but just sounds too much of an outlier saying things we want to hear to latch on to without a lot of skepticism.

[GordMay]

When modeling studies lead to catastrophic predictions of what could happen, if nothing is done; governments and people generally take actions to mitigate those predicted outcomes.
The more successful those mitigating actions are, the less valid those predictions appear, in hindsight, to the casual inexpert observer.
It appears to become a self-defeating exercise.
It's not. The prediction, that didn't come to pass, helped prevent the disastrous outcome.

[CatNewBee]

Originally Posted by B23iL23

Dockhead.

When was the last time 10,000 people died in New York from the flu in an 8 week period? When was the last time 10,000 people died from the flu in the UK in an 8 week period? Or 22,000 deaths in Italy in the same period.

It has never happened (not since Spanish flu)

You can have all the statements you want on either side of the argument, you can say this is just another virus and not really that different from say the flu. You can say politicians are all over reacting. You can say that we're underestimating the number of infections by 50/100/200%.

So What. Fact is this virus kills a lot more people, especially those with underlying conditions.

Population of NY is 8.400.000 person, assuming a person gets 75 yo, and will die if not shot down earlier, that means 1/75 of the population dies each year, or 112.000 people per year, divided by 12, there are pretty much 10.000 people per month dying on a regular base, as probably another 10.000 are born. Nothing really scary so far.

[Dockhead]

Originally Posted by GordMay

When modeling studies lead to catastrophic predictions of what could happen, if nothing is done; governments and people generally take actions to mitigate those predicted outcomes.
The more successful those mitigating actions are, the less valid those predictions appear, in hindsight, to the casual inexpert observer.
It appears to become a self-defeating exercise.
It's not. The prediction, that didn't come to pass, helped prevent the disastrous outcome.

Yes, when you think there MIGHT be a catastrophe, it is bloody hard to do nothing, or to appear to do something which is insufficiently bold.


It is hard from different points of view, and one of those is the political.


However, you cannot say that the right policy in every such case of a possible but not certain catastrophe, is to take action no matter what, and all the more, to take the boldest possible action, although that might be the politically most expedient thing. Taking action which is too much or wrong can be as bad as taking no action or too little, when taking action has its own costs or other negative aspects. In this case, economic damage from lockdowns can be so profound as to cause deaths in its own right, and for years to come. Ordering people to stay home is immensely costly and economically and socially destructive. In some cases it might be the right thing to do despite the cost and the destruction, but it's not a decision which should be made on the basis of logic like "better safe than sorry" or "just to be sure".



There are simply no easy answers to such questions. You have to use the best science you can get your hands on, weigh the risks, and be as logical and fact-based and evidence-based as it is possible to be, and take your best shot.


I said it before and I'll say it again -- I would not like to be in charge of making policy at a time like this. Whatever decision you make, the chances of getting it wrong are very great, and you will be sure to be blamed for it.


I am however increasingly skeptical about the value of severe lockdowns; what this guy says rings true to me. But do I know anything for sure? No, and I don't think anyone knows anything for sure. I think we won't know for sure for a year or more.


Sweden's experience doesn't necessarily prove anything with regard to the rest of the world, because every country has its own specific demographics, climate, health care system, etc etc etc. Sweden's experience is just a data point.



But the short term results, at least of Sweden's policies, are looking better and better as time goes on. Despite the tragic mistake made in Sweden with the failure to protect people in nursing homes, the deaths have still not reached the level of a bad flu year, and hospitals are not stressed, as hospitalization rates and rates of cases going to intensive care continue stable or falling.





https://www.icuregswe.org/en/data--r...ntensive-care/


There are about 500 ICU beds in use, with about 1500 available, and the demand is not increasing. A month ago there was considerable internal debate about the Swedish policy; today already not so much, and the Danes and Norwegians will soon have the same policies. We shall see, of course.

[Dockhead]

Originally Posted by CatNewBee

Population of NY is 8.400.000 person, assuming a person gets 75 yo, and will die if not shot down earlier, that means 1/75 of the population dies each year, or 112.000 people per year, divided by 12, there are pretty much 10.000 people per month dying on a regular base, as probably another 10.000 are born. Nothing really scary so far.

4,881 people died in New York state from the flu in 2015. 10,000 deaths is in the same order of magnitude, just as the doctor suggested. This doesn't mean that coronavirus is nothing, or that it's "just like the flu" -- it's not. It's different from the flu in several ways and requires different policies. New York is terribly hard hit compared to almost any other place on earth. Whether New York needs such a radical measure as ordering people to stay home, however, I don't know.

[letsgetsailing3]

Originally Posted by Dockhead

4,881 people died in New York state from the flu in 2015. 10,000 deaths is in the same order of magnitude, just as the doctor suggested. This doesn't mean that coronavirus is nothing, or that it's "just like the flu" -- it's not. It's different from the flu in several ways and requires different policies. New York is terribly hard hit compared to almost any other place on earth. Whether New York needs such a radical measure as ordering people to stay home, however, I don't know.

Six weeks ago we had the first confirmed case of coronavirus in New York.

That death count is in spite of the fact that we've closed down our society in New York, that society is social-distancing, and that we've bascially put the whole of government into fighting it.

This is a bit different from a seasonal flu.

[Dockhead]

Originally Posted by B23iL23

Dockhead.

When was the last time . . . 22,000 deaths in Italy in the same period.

It has never happened (not since Spanish flu)

Not true! 24,981 people died in Italy during the 2016/7 flu outbreak. See: https://www.sciencedirect.com/scienc...01971219303285


Italy is way past the peak, of this wave anyway, so it would be surprising if total deaths amount to much more than 30,000 or so, at least this year.


I totally agree that the coronavirus is NOT "just like the flu" -- as the doctor in the linked video also says. But we are not seeing prospects of an order of magnitude of difference in mortality compared to a bad flu year.

[Dockhead]

Originally Posted by letsgetsailing3

Six weeks we've had the coronavirus, with every precaution we've taken, it's a bit different from a seasonal flu.

I agree. And no non-stupid person says that the coronavirus is "just like the flu". The coronavirus pandemic is clearly quite a bit more severe than a flu pandemic. But the question of whether it is double or triple as bad, on the one hand, or 10x or 100x as bad, on the other, is crucially important, in weighing the right policies to deal with it.


"Freak out and take every possible measure, the bolder the better, regardless of cost", as a policy, thus melting down the world economy and impoverishing a generation, might be the right thing to do with a pandemic which threatens the existence of the human race. But something which is within an order of magnitude of a normal flu season? Better be more careful with policy, and forget easy answers.

[letsgetsailing3]

Originally Posted by Dockhead

I agree. And no non-stupid person says that the coronavirus is "just like the flu". The coronavirus pandemic is clearly quite a bit more severe than a flu pandemic. But the question of whether it is double or triple as bad or 10x or 100x as bad, is crucially important, in weighing the right policies to deal with it.


"Freak out and take every possible measure, the bolder the better, regardless of cost", as a policy, thus melting down the world economy and impoverishing a generation, might be the right thing to do with a pandemic which threatens the existence of the human race. Something which is within an order of magnitude of a normal flu season? Better be more careful with policy, and forget easy answers.

OK, I agree with you to some degree. But I've yet to hear a reasonable alternative.

The alternative, of course, would be to "let her rip", but then you're going to get a LOT of finger pointing from the media, as they blame politicians for crazy amounts of deaths. By the way, people would shut down society on their own, as they'd get a bit upset when grandpa and cousin Eddie dies from this.

See Italy for what that strategy looks like for most of the world. The Nordic countries may be able to get away with it, as they are already somewhat set up for selective social distancing, and may be a bit healthier and more affluent to begin with.

Our health care system and society are set up to prevent all preventable deaths. Yes, that's a costly policy.

[Dockhead]

Originally Posted by letsgetsailing3

OK, I agree with you to some degree. But I've yet to hear a reasonable alternative.

The alternative, of course, would be to "let her rip", but then you're going to get a LOT of finger pointing from the media, as they blame politicians for crazy amounts of deaths. By the way, people would shut down society on their own, as they'd get a bit upset when grandpa and cousin Eddie dies from this.

It is important to note that there are more possible approaches to the problem than the extremes of locking a country down, on the one hand, or "letting her rip", on the other. This is, as we say, a false dichotomy.


No country that I know of has just "let her rip". Sweden took serious voluntary social distancing measures which profoundly changed the way people live in Sweden, and which will cause economic damage. The other Nordic countries also relied primarily on voluntary social distancing without closing businesses other than restaurants, hairdressers, tattoo salons, etc., in most cases, without ordering people to stay home, without restricting internal travel, without limiting social interaction, at least up to a certain group size.

That is not "letting her rip", not in any of those countries. There are an array of different measures which can be taken in different combinations.

Originally Posted by letsgetsailing3

See Italy for what that strategy looks like for most of the world. The Nordic countries may be able to get away with it, as they are already somewhat set up for selective social distancing, and may be a bit healthier and more affluent to begin with.

Italy didn't do anything at all until the pandemic was far advanced. Not necessarily blaming them -- they were the first after China and no one had much of an idea how to respond at the time. That was NOT what Sweden did at all. Sweden closed high schools and universities, banned large gatherings, and introduced extensive voluntary social distancing rules EARLY in the development of the pandemic. Sweden did extensive education of the population EARLY in the game and provided extensive and effective information. Not saying that the Swedes are brilliant and the Italians stupid -- just that the Swedes were lucky to have a bit more time to think about it, and they were smart enough not to waste that time.

Originally Posted by letsgetsailing3

. . . Our health care system and society are set up to prevent all preventable deaths. Yes, that's a costly policy.

Here I disagree with you. Because resources are inherently limited, it is impossible to prevent "every preventable death" even in the wealthiest countries, and so we don't, and we don't try, and we accept a certain number of deaths from causes which could be prevented if we had unlimited resources to spend preventing them. So we try to prevent those deaths that we can afford to prevent, which is all you can do. We don't even track how many people die from the flu in the U.S. other than children; in Italy it is something like 25,000 per year. Just about every one of those deaths is a "preventable death" if we are willing to bear the cost of locking down the whole world every time there is an outbreak of flu, but we don't do that.

If every life had infinite value, then we could prevent every single death from infectious diseases by making every person live in permanent social isolation in a sterile bubble. But we don't do that, because infectious diseases, including a certain number of deaths, is one of the costs of living in societies were people have real life interactions with each other, and we accept that cost, mitigating the cost as much as we can by investing in medical research, vaccinations, etc etc etc., but not eliminating it, or even close.

So you cannot approach this pandemic from the point of view of every life's having infinite value; that will lead to disastrously wrong policy decisions. We have to prevent those deaths that we can reasonably prevent, just like we do with all other public health challenges, using the most efficient policies we can come up with, weighed against what we can afford, including how much economic destruction we can afford, and weighed also against the cost of degradation of life which is caused by the measures we take, which is also far from a trivial matter.

The last thing is something which hardly anyone mentions. Everyone dies. Our days are numbered -- "Man who is born of woman is few of days and full of trouble." Why is a day less precious than a life? A certain number of days is of course equal to a life -- that's all a life is, that is, a certain number of days. It is possible to put math to that. Every measure we take to save a life has a cost not just in money terms, but in terms of degradation of the quality of life for a certain number of people. Impoverishing people degrades the quality of life of people just like locking them up at home so that can't sail or see people they love or do the things they love.

Suppose a certain set of measures to prevent COVID deaths requires locking the whole population up for 3 months, and causes economic harm which puts an additional 10% of the population into poverty. How many deaths would you have to prevent, for that to be worth while? I'm not sure it's obvious that preventing the deaths of even 0.1% of the population, say 330,000 people in the U.S., is worth even one lockup, even ignoring the economic consequences -- reducing the quality of life of 99% by say 50% over 25% of a year. If the average life remaining of the population is say 35 years, that is roughly like killing (P * 99% * 50% * 25%)/35, or say 0.35% of the population.


And that is assuming that lockdowns even save lives at all -- in many cases, they may not, as explained by the good doctor in the linked video. So the calculus may not be impairing lives equivalent to killing off 0.35% of the population against saving 0.1% of the population -- it might very well be against "saving maybe 0.1% of the population, or maybe 0.01%, or maybe none at all -- we don't know so we just do it for good measure."


I think it is profoundly ignorant to ignore these very serious costs of our policies, just taking bold as possible action for good measure and just "to be sure". There has been a lot of ridicule poured on people worried about sailing this year when people are dying, but it's an absolutely reasonable thing to think about -- how many more summers does any of us have left for sailing? What part of the remaining value of my life is represented by this one summer? I have 8 more summers left in this decade of my life; my days are numbered like everyone else's. Back to the original topic of this thread -- I sure as hell plan to be out there.

[TigerPaws]

Thousands of cars line up at San Antonio food bank from before dawn as millions file for unemployment across the country

• The San Antonio Food Bank served 12,000 families who all showed up in their cars to receive food packages on Friday during a mega distribution in the city of 1.5 million people
• The pictures which show a parking lot full of waiting vehicles serve as a stark reminder of the economic crisis
• Last week, the San Antonio Food Bank fed about 10,000 households in a single day — the largest distribution day in the organization's history, but today it served another 2,000 on top of that number
  

https://www.dailymail.co.uk/news/art...mployment.html

Is the cure worse than the disease? 12,000 families, 48,000 to 50,000 men, women and children looking for food in just 1 city in the U.S.

This is happening all over, is this destruction of the economy and the resulting suffering worth it?

[letsgetsailing3]

Originally Posted by Dockhead

It is important to note that there are more possible approaches to the problem than the extremes of locking a country down, on the one hand, or "letting her rip", on the other. This is, as we say, a false dichotomy.


No country that I know of has just "let her rip". Sweden took serious voluntary social distancing measures which profoundly changed the way people live in Sweden, and which will cause economic damage. The other Nordic countries also relied primarily on voluntary social distancing without closing businesses other than restaurants, hairdressers, tattoo salons, etc., in most cases, without ordering people to stay home, without restricting internal travel, without limiting social interaction, at least up to a certain group size.

That is not "letting her rip", not in any of those countries. There are an array of different measures which can be taken in different combinations.



Italy didn't do anything at all until the pandemic was far advanced. Not necessarily blaming them -- they were the first after China and no one had much of an idea how to respond at the time. That was NOT what Sweden did at all. Sweden closed high schools and universities, banned large gatherings, and introduced extensive voluntary social distancing rules EARLY in the development of the pandemic. Sweden did extensive education of the population EARLY in the game and provided extensive and effective information. Not saying that the Swedes are brilliant and the Italians stupid -- just that the Swedes were lucky to have a bit more time to think about it, and they were smart enough not to waste that time.



Here I disagree with you. Because resources are inherently limited, it is impossible to prevent "every preventable death" even in the wealthiest countries, and so we don't, and we don't try, and we accept a certain number of deaths from causes which could be prevented if we had unlimited resources to spend preventing them. So we try to prevent those deaths that we can afford to prevent, which is all you can do. We don't even track how many people die from the flu in the U.S. other than children; in Italy it is something like 25,000 per year. Just about every one of those deaths is a "preventable death" if we are willing to bear the cost of locking down the whole world every time there is an outbreak of flu, but we don't do that.

If every life had infinite value, then we could prevent every single death from infectious diseases by making every person live in permanent social isolation in a sterile bubble. But we don't do that, because infectious diseases, including a certain number of deaths, is one of the costs of living in societies were people have real life interactions with each other, and we accept that cost, mitigating the cost as much as we can by investing in medical research, vaccinations, etc etc etc., but not eliminating it, or even close.

So you cannot approach this pandemic from the point of view of every life's having infinite value; that will lead to disastrously wrong policy decisions. We have to prevent those deaths that we can reasonably prevent, just like we do with all other public health challenges, using the most efficient policies we can come up with, weighed against what we can afford, including how much economic destruction we can afford, and weighed also against the cost of degradation of life which is caused by the measures we take, which is also far from a trivial matter.

The last thing is something which hardly anyone mentions. Everyone dies. Our days are numbered -- "Man who is born of woman is few of days and full of trouble." Why is a day less precious than a life? A certain number of days is of course equal to a life -- that's all a life is, that is, a certain number of days. It is possible to put math to that. Every measure we take to save a life has a cost not just in money terms, but in terms of degradation of the quality of life for a certain number of people. Impoverishing people degrades the quality of life of people just like locking them up at home so that can't sail or see people they love or do the things they love.

Suppose a certain set of measures to prevent COVID deaths requires locking the whole population up for 3 months, and causes economic harm which puts an additional 10% of the population into poverty. How many deaths would you have to prevent, for that to be worth while? I'm not sure it's obvious that preventing the deaths of even 0.1% of the population, say 330,000 people in the U.S., is worth even one lockup, even ignoring the economic consequences -- reducing the quality of life of 99% by say 50% over 25% of a year. If the average life remaining of the population is say 35 years, that is roughly like killing (P * 99% * 50% * 25%)/35, or say 0.35% of the population.


And that is assuming that lockdowns even save lives at all -- in many cases, they may not, as explained by the good doctor in the linked video. So the calculus may not be impairing lives equivalent to killing off 0.35% of the population against saving 0.1% of the population -- it might very well be against "saving maybe 0.1% of the population, or maybe 0.01%, or maybe none at all -- we don't know so we just do it for good measure."


I think it is profoundly ignorant to ignore these very serious costs of our policies, just taking bold as possible action for good measure and just "to be sure". There has been a lot of ridicule poured on people worried about sailing this year when people are dying, but it's an absolutely reasonable thing to think about -- how many more summers does any of us have left for sailing? What part of the remaining value of my life is represented by this one summer? I have 8 more summers left in this decade of my life; my days are numbered like everyone else's. Back to the original topic of this thread -- I sure as hell plan to be out there.

I'm sorry, but too long, didn't read.

If you said anything other than "politicians are attempting to come up with the best compromise between saving lives and the economy", you wasted your breath.

I did catch this nugget, though: " I have 8 more summers left in this decade of my life; my days are numbered like everyone else's."

I'm sure I don't know what your point is. But rest assured that the guidelines most countries are putting out are designed to save your life, as well as those of anyone you know.

My parents likely have fewer years left than you. But fewer still if they aren't very careful. I like my parents. So I'm kind of OK making the meager sacrifices being asked of us at this point.

My grandfather was asked to go to world war II. My dad was asked to go to Vietnam. We're being asked to stay home and watch Netflix for a couple of months. Poor, poor us. But I'm certainly willing to do that if it raises the odds a bit for a generation who did their part when it was their turn.

Better be careful with that "everyman for himself" philosophy. Because that only really works until you need/want something. So little is being asked. It's incredible how much more whining people do when not much is really being asked. Our generation has had maybe the best run of any generation in the history of the world. And the biggest result of that is to create a bunch of whiners.


"Oh, my cruising plans might get interrupted this year." Wow. Just wow.

[TigerPaws]

Originally Posted by letsgetsailing3

I'm sorry, but too long, didn't read.

If you said anything other than "politicians are attempting to come up with the best compromise between saving lives and the economy", you wasted your breath.

I did catch this nugget, though: " I have 8 more summers left in this decade of my life; my days are numbered like everyone else's."

I'm sure I don't know what your point is. But rest assured that the guidelines most countries are putting out are designed to save your life, as well as those of anyone you know.

My parents have fewer years left than you. But fewer still if they aren't very careful. I like my parents. So I'm kind of OK making the meager sacrifices being asked of us at this point.

My grandfather was asked to go to world war II. My dad was asked to go to Vietnam. We're being asked to stay home and watch Netflix for a couple of months. Poor, poor us.

While you are OK with the way things are what about the 25 or so million Americans without a job today? What about those facing eviction because they cannot pay the rent? What about the people who have poured their blood, sweat, tears and life savings into a business that has been forced by gov edict into bankruptcy? There are untold hundreds of thousands suffering because of gov edicts to save a few?

Are you willing to tell those families who are about to become homeless and relying on what they are given by a food bank that they need to suffer because of your fears.

I agree the most venerable are at the most risk, accommodations can be made for them not the public at large? Locking up an entire city because a small percentage of the population might be affected is insane.

If someone is at risk they can stay home and let the rest of the population get on with their lives.