The Virus - Are You Affected?

[Jokodo]

What? Denmark and Sweden has the same strategy. The countries look demographically different, which is why government policies vary. But they have the same end goal.






The administrative staff that report the numbers are free on weekends? But numbers are unreliable everywhere. There's a shortage of tests and testing capacity. If there's a queue to a testing lab they're going to wait with the already dead patients. Triage patients have priority. Lab staff are already over-worked everywhere. It's a bottle neck.

The link doesn't say what you want to conclude from it. Denmark isn't easing some restrictions because they've achieved widespread immunity, they are (tentatively and with a foot on the brake) easing some restrictions because they believe that they have stomped hard enough that they can do so and still keep R(eff) below 1.0 with those restrictions that remain in place. Nothing about Sweden follows from that.

I thought that was what I said? Both Sweden and Denmark is very far from herd immunity still.

You said that you expect Sweden to peak earlier because they have laxer measures. That makes sense if Denmark and Sweden both flatten the curve, with Denmark doing more of it, but both eventually reaching the same number of cumulative infections. It does not make sense if Denmark and Sweden both try to suppress the outbreak without getting a high number of infections, and Denmark taking a more radical approach in doing so. In the latter case, the eventual total number of infections is expected to be lower, and the peak crucially earlier, in Denmark.

Here is, literally, what you said: "[Sweden] had less restrictions so should have had it a couple of days earlier." This does not make sense when both aim at stomping out the outbreak before it reaches high numbers, but it does make sense if both merely flatten the curve.

Denmark was aiming for peak deaths 12/4. Sweden 10/4.

If that's what Sweden aimed for, they failed. Deaths are still rising if you look at weekday figures.

And then a trailing tail downwards. They were both wrong. Both countries stopped infection rates more than what was desireable if the goal is to minimally disrupt society.

The official numbers of new daily confirmed infections are uniformative - they depend more on who is tested than on who is infected, especially when testing equipment is a scarce resource.

If you look at deaths rather than infections, it's not so pretty. https://platz.se/coronavirus/ reports 136 new deaths yesterday (https://www.worldometers.info/coronavirus/country/sweden/ has 170, but I suspect these included some belatedly reported deaths from the Easter weekend). Sweden has 10 million people, Italy 60 million. Relative to its population, there have only been 3 days on which Italy reported more deaths than that using the lower figure of 136, all of them back in March. Using the higher figure, only Spain and Belgium and maybe UK and France (they report inconsistently, adding deaths outside hospitals in batches on some days) ever exceeded Sweden's numbers (among major countries, I'm ignoring San Marino and Andorra). Among major countries (not counting San Marino, Andorra, St. Marteen), Sweden now is #8 globally in deaths per capita. Unlike most of the countries ahead of it, however, Sweden's numbers are still trending up. Sure, deaths trail infections by something like two weeks, so the deaths still rising is compatible with infections having slowed down in recent days, but I haven't seen anything to indicate that this is actually so. We just don't have good enough data to tell either way.

For Denmark I know it in detail because I'm friends with somebody who is in charge of organising one of the shifts in the Corona ward of the second biggest hospital. She's told exactly, in detail, what Sundhedsstyrelsen's (Danish CDC) strategy is in the goal behind it.

At this point nobody knows why Italy went so out of control and Scandinavia didn't. To quote the guys at This week in virology podcast, "this is something we're going to study for many years to come".

There is no "Scandinavia" in this story. Sweden has 4 times Norway's and twice Denmark's deaths per million inhabitants (that already accounts for its larger population) and it's the only one where that number still points upward.

I also saw an encourging article about Africa. Due to the continents relationship with infectious diseases they already have cultures well adapted to minimse damage from diseases. So we might be overly concerned by how things will turn out there.

https://www.bbc.com/news/world-africa-52268320

Right now there's many unknowns.

Your last sentence is correct.

 

[DrZoidberg]

Denmark was aiming for peak deaths 12/4. Sweden 10/4.

If that's what Sweden aimed for, they failed. Deaths are still rising if you look at weekday figures.

I don't think you understand the strategy. The peak is coming in the future yes. They wanted it to come earlier, but it didn't. With this strategy deaths aren't going to stop.

The whole point with flattening the curve is to take pressure off the medical services. But Sweden and Denmark took so much pressure off the medical services that they now have loads of empty beds. Because they cancelled all non-critical operations they are now in a situation where they never have had more empty beds. To put it bluntly Denmark and Sweden want more people to be dying daily from this than now. The spread now is so slow that herd immunity won't be reached for months.

This is bad. Because it means that Denmark and Sweden are fucking up their economies more than what is necessary. And it'll take us longer to get out of this.

And then a trailing tail downwards. They were both wrong. Both countries stopped infection rates more than what was desireable if the goal is to minimally disrupt society.

The official numbers of new daily confirmed infections are uniformative - they depend more on who is tested than on who is infected, especially when testing equipment is a scarce resource.

If you look at deaths rather than infections, it's not so pretty. https://platz.se/coronavirus/ reports 136 new deaths yesterday (https://www.worldometers.info/coronavirus/country/sweden/ has 170, but I suspect these included some belatedly reported deaths from the Easter weekend). Sweden has 10 million people, Italy 60 million. Relative to its population, there have only been 3 days on which Italy reported more deaths than that using the lower figure of 136, all of them back in March. Using the higher figure, only Spain and Belgium and maybe UK and France (they report inconsistently, adding deaths outside hospitals in batches on some days) ever exceeded Sweden's numbers (among major countries, I'm ignoring San Marino and Andorra). Among major countries (not counting San Marino, Andorra, St. Marteen), Sweden now is #8 globally in deaths per capita. Unlike most of the countries ahead of it, however, Sweden's numbers are still trending up. Sure, deaths trail infections by something like two weeks, so the deaths still rising is compatible with infections having slowed down in recent days, but I haven't seen anything to indicate that this is actually so. We just don't have good enough data to tell either way.

There's many moving parts. You're comparing numbers that can't be compared. Access to ventilators and staff to operate them is critical. As well as an ability to isolate the sick. Sweden and Denmark are high tech countries. It turns out that it was not a problem for large numbers of them to work from home. This is going to be different in a country where people don't have that option. How the economy looks matters.

There is no "Scandinavia" in this story. Sweden has 4 times Norway's and twice Denmark's deaths per million inhabitants (that already accounts for its larger population) and it's the only one where that number still points upward.

All of Scandinavia has the same problem. The social isolation has been too effective. Of the three countries Sweden turned out to have had the best strategy. But all of them restricted spread too much.

What I think might be tripping you up is number of deaths in absolute numbers? It's not a situation where less deaths are necessarily better. If somebody gets Corona, gets a bed in an isolation ward with a ventilator and dies anyway, that's fine. That's God doing what God does best. It's only a tragedy if two, young fit but sick people show up at the hospital, but there's only one ventilator available. Ie what happened in Milano and Wuhan.

But you are correct, that in general, less death is a good sign. But you're using that metric indiscriminately.

 

[Jokodo]

I don't think you understand the strategy. The peak is coming in the future yes. They wanted it to come earlier, but it didn't. With this strategy deaths aren't going to stop.

The whole point with flattening the curve is to take pressure off the medical services. But Sweden and Denmark took so much pressure off the medical services that they now have loads of empty beds. Because they cancelled all non-critical operations they are now in a situation where they never have had more empty beds. To put it bluntly Denmark and Sweden want more people to be dying daily from this than now. The spread now is so slow that herd immunity won't be reached for months.

This is bad. Because it means that Denmark and Sweden are fucking up their economies more than what is necessary. And it'll take us longer to get out of this.

And then a trailing tail downwards. They were both wrong. Both countries stopped infection rates more than what was desireable if the goal is to minimally disrupt society.

The official numbers of new daily confirmed infections are uniformative - they depend more on who is tested than on who is infected, especially when testing equipment is a scarce resource.

If you look at deaths rather than infections, it's not so pretty. https://platz.se/coronavirus/ reports 136 new deaths yesterday (https://www.worldometers.info/coronavirus/country/sweden/ has 170, but I suspect these included some belatedly reported deaths from the Easter weekend). Sweden has 10 million people, Italy 60 million. Relative to its population, there have only been 3 days on which Italy reported more deaths than that using the lower figure of 136, all of them back in March. Using the higher figure, only Spain and Belgium and maybe UK and France (they report inconsistently, adding deaths outside hospitals in batches on some days) ever exceeded Sweden's numbers (among major countries, I'm ignoring San Marino and Andorra). Among major countries (not counting San Marino, Andorra, St. Marteen), Sweden now is #8 globally in deaths per capita. Unlike most of the countries ahead of it, however, Sweden's numbers are still trending up. Sure, deaths trail infections by something like two weeks, so the deaths still rising is compatible with infections having slowed down in recent days, but I haven't seen anything to indicate that this is actually so. We just don't have good enough data to tell either way.

There's many moving parts. You're comparing numbers that can't be compared. Access to ventilators and staff to operate them is critical. As well as an ability to isolate the sick. Sweden and Denmark are high tech countries. It turns out that it was not a problem for large numbers of them to work from home. This is going to be different in a country where people don't have that option. How the economy looks matters.

There is no "Scandinavia" in this story. Sweden has 4 times Norway's and twice Denmark's deaths per million inhabitants (that already accounts for its larger population) and it's the only one where that number still points upward.

All of Scandinavia has the same problem. The social isolation has been too effective. Of the three countries Sweden turned out to have had the best strategy. But all of them restricted spread too much.

What I think might be tripping you up is number of deaths in absolute numbers? It's not a situation where less deaths are necessarily better. If somebody gets Corona, gets a bed in an isolation ward with a ventilator and dies anyway, that's fine. That's God doing what God does best. It's only a tragedy if two, young fit but sick people show up at the hospital, but there's only one ventilator available. Ie what happened in Milano and Wuhan.

But you are correct, that in general, less death is a good sign. But you're using that metric indiscriminately.

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

 

[DrZoidberg]

I don't think you understand the strategy. The peak is coming in the future yes. They wanted it to come earlier, but it didn't. With this strategy deaths aren't going to stop.

The whole point with flattening the curve is to take pressure off the medical services. But Sweden and Denmark took so much pressure off the medical services that they now have loads of empty beds. Because they cancelled all non-critical operations they are now in a situation where they never have had more empty beds. To put it bluntly Denmark and Sweden want more people to be dying daily from this than now. The spread now is so slow that herd immunity won't be reached for months.

This is bad. Because it means that Denmark and Sweden are fucking up their economies more than what is necessary. And it'll take us longer to get out of this.



There's many moving parts. You're comparing numbers that can't be compared. Access to ventilators and staff to operate them is critical. As well as an ability to isolate the sick. Sweden and Denmark are high tech countries. It turns out that it was not a problem for large numbers of them to work from home. This is going to be different in a country where people don't have that option. How the economy looks matters.

There is no "Scandinavia" in this story. Sweden has 4 times Norway's and twice Denmark's deaths per million inhabitants (that already accounts for its larger population) and it's the only one where that number still points upward.

All of Scandinavia has the same problem. The social isolation has been too effective. Of the three countries Sweden turned out to have had the best strategy. But all of them restricted spread too much.

What I think might be tripping you up is number of deaths in absolute numbers? It's not a situation where less deaths are necessarily better. If somebody gets Corona, gets a bed in an isolation ward with a ventilator and dies anyway, that's fine. That's God doing what God does best. It's only a tragedy if two, young fit but sick people show up at the hospital, but there's only one ventilator available. Ie what happened in Milano and Wuhan.

But you are correct, that in general, less death is a good sign. But you're using that metric indiscriminately.

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

No. The goal is to minise the number of dead... overall. We want to put all the at risk people to be in the 30% who never are exposed to the virus. That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out. That's herd immunity. Exposing people in a controlled manner is letting Covid-19 rip through society at a pace where the ICU's and access to ventilators can keep up. We want Covid-19 to spread as quickly as our access to hospital beds allow. That's the strategy the world is now pursuing.

From now on Covid-19 will always be with us. We'll get a resurgence every 10 years or so. But with the heard immunity already among the general population, future epidemics won't be as bad. We want to get to herd immunity ASAP. That will mean letting people die.

 

[Loren Pechtel]

The whole point with flattening the curve is to take pressure off the medical services. But Sweden and Denmark took so much pressure off the medical services that they now have loads of empty beds. Because they cancelled all non-critical operations they are now in a situation where they never have had more empty beds. To put it bluntly Denmark and Sweden want more people to be dying daily from this than now. The spread now is so slow that herd immunity won't be reached for months.

There are more reasons to cancel the non-critical stuff:

1) Shortage of PPE.

2) Going to a hospital for any reason is dangerous these days, especially if you're going to weaken yourself by letting the doctors chop away at you. Most things are better postponed for patient safety.

 

[bilby]

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

No. The goal is to minise the number of dead... overall. We want to put all the at risk people to be in the 30% who never are exposed to the virus. That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out. That's herd immunity. Exposing people in a controlled manner is letting Covid-19 rip through society at a pace where the ICU's and access to ventilators can keep up. We want Covid-19 to spread as quickly as our access to hospital beds allow. That's the strategy the world is now pursuing.

From now on Covid-19 will always be with us. We'll get a resurgence every 10 years or so. But with the heard immunity already among the general population, future epidemics won't be as bad. We want to get to herd immunity ASAP. That will mean letting people die.

Immunity for those who have had the disease is an assumption.

It's not yet been shown to be a fact, and there's some evidence that it's possible to have the disease twice, which if true blows that assumption out of the water.

It would be very stupid indeed to base policy on the belief that immunity can reliably be acquired by merely surviving exposure to the disease.

It's also becoming increasingly clear that those not in "at risk" groups nonetheless have a non-zero fatality rate - making the 'herd immunity' strategy (even if immunity actually is acquired by exposure) effectively asking people to bet their lives at long odds. The odds are long, sure. But the stake is huge, and the prize is poorly defined. No sensible person would take that bet.

 

[Jimmy Higgins]

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

No. The goal is to minise the number of dead... overall. We want to put all the at risk people to be in the 30% who never are exposed to the virus. That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out. That's herd immunity. Exposing people in a controlled manner is letting Covid-19 rip through society at a pace where the ICU's and access to ventilators can keep up. We want Covid-19 to spread as quickly as our access to hospital beds allow. That's the strategy the world is now pursuing.

From now on Covid-19 will always be with us. We'll get a resurgence every 10 years or so. But with the heard immunity already among the general population, future epidemics won't be as bad. We want to get to herd immunity ASAP. That will mean letting people die.

Immunity for those who have had the disease is an assumption.

It's not yet been shown to be a fact, and there's some evidence that it's possible to have the disease twice, which if true blows that assumption out of the water.

It would be very stupid indeed to base policy on the belief that immunity can reliably be acquired by merely surviving exposure to the disease.

It's also becoming increasingly clear that those not in "at risk" groups nonetheless have a non-zero fatality rate - making the 'herd immunity' strategy (even if immunity actually is acquired by exposure) effectively asking people to bet their lives at long odds. The odds are long, sure. But the stake is huge, and the prize is poorly defined. No sensible person would take that bet.

America is suffering from a severe shortage of sensible.

 

[ZiprHead]

 

[Emily Lake]

Please be kind to your software support people – they are doing the best they can under very trying circumstances. None of this is their fault.

we've always been kind to IT.
But on the gripping hand, i do have to tell management if i didn't finish a task because one of seven computers and servers between me and Pensacola are singing Daisy. Not saying anyone's at fault, but i cannot charge the 'fix government curricula' contract if a different government branch's computer isn't prepared for the load.

Point of order, sir! You can't have a "gripping hand" comment without having already gone through one hand and the other.

 

[Jokodo]

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

No. The goal is to minise the number of dead... overall. We want to put all the at risk people to be in the 30% who never are exposed to the virus.

I don't know Swedish demographics all that well, but I'm pretty sure that in Austria, people who are over 60 OR have asthma OR diabetes OR hypertension OR are overweight make up significantly more than 30%.

That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out.

The pandemic dies out when the new infections are fewer than the currently infected for long enough. Whether that is achieved through more and more people being immune, or through fewer interactions, doesn't matter to the virus and neither to us. Except for the following reasons it should matter to us:

1) we don't know that surviving the virus grants immunity. It might grant immunity in close to 100% of survivors (even measles doesn't reach 100% straight) for the rest of their life, or for a few years, or months; or it might grant immunity to 70% of survivors, and make the second infection worse than the first for the other 30%. What we do know about similar viruses tells us that probably most people achieve immunity for a relatively long time at least. But that's a lot of maybes to bet 10,000-50,000 lives on (in a small country like Sweden).
2) More young and fit people being infected at the same time also means more possibilities for the elderly and those with pre-existing conditions to get infected. It's simply not realistic to park everyone known to be susceptible to developing a severe case on Mars. And it's not like a SARS-CoV-2 infection is reliably detected within no more than hours of becoming contagious.
3) Have you looked at actual numbers? After - what? - a month into the first wave, Sweden has 12,500 official cases. Assume that there are 20 times as many actual infections, that's still only 500,000. Herd immunity requires a high double digit percentage of people having undergone the infection. So it might be true that, given current rates of new infections, Sweden will achieve herd immunity earlier than Denmark each keeping up their current regime: Sweden in late 2021, and Denmark in early 2024.

I for one hope that we have a vaccine before that. I don't know that this will be the case, but I'm not willing to bet 5-digit numbers of dead for 7-digit or very low 8-digit population countries (like Austria or Sweden) on the assumption that we never may.

 

[DrZoidberg]

So an overweight 70 year old with diabetes who would otherwise have lived to see his 90th birthday dies, that's ok? It's only a tragedy if young and fit people die?

No. The goal is to minise the number of dead... overall. We want to put all the at risk people to be in the 30% who never are exposed to the virus. That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out. That's herd immunity. Exposing people in a controlled manner is letting Covid-19 rip through society at a pace where the ICU's and access to ventilators can keep up. We want Covid-19 to spread as quickly as our access to hospital beds allow. That's the strategy the world is now pursuing.

From now on Covid-19 will always be with us. We'll get a resurgence every 10 years or so. But with the heard immunity already among the general population, future epidemics won't be as bad. We want to get to herd immunity ASAP. That will mean letting people die.

Immunity for those who have had the disease is an assumption.

It's not yet been shown to be a fact, and there's some evidence that it's possible to have the disease twice, which if true blows that assumption out of the water.

It would be very stupid indeed to base policy on the belief that immunity can reliably be acquired by merely surviving exposure to the disease.

I listen to TWIV. They have world leading experts on the show. The last episode (602) the interviewed Stanley Perlman who is an immunologist and the world's leading expert on Coronaviruses. He's studied this specifically... his entire life. He's an old geezer.

https://www.microbe.tv/twiv/

They do discuss the myth that people can be re-infected and why people think this. It's just from misunderstanding test results. Many people have been tested positive. Then negative and then positive again. From this a myth has spread about re-infection, that the press happily has spun into a story. But it's got more to do with the technicalities of testing.

They're not saying in the show that it's impossible for re-infection. But they think it's unlikely.

It's also becoming increasingly clear that those not in "at risk" groups nonetheless have a non-zero fatality rate - making the 'herd immunity' strategy (even if immunity actually is acquired by exposure) effectively asking people to bet their lives at long odds. The odds are long, sure. But the stake is huge, and the prize is poorly defined. No sensible person would take that bet.

The experts weren't surprised. They knew this all along. But everybody surviving is not on the menu. The experts and those in charge had to pick a strategy, and this one is the least painful one. But yes, people are going to be dropping like flies. Even people not at risk. This would be true regardless of strategy. The qustion is just how many will drop like flies. And having everybody perpetually staying indoors is also not a viable option.

 

[DrZoidberg]

I don't know Swedish demographics all that well, but I'm pretty sure that in Austria, people who are over 60 OR have asthma OR diabetes OR hypertension OR are overweight make up significantly more than 30%.

When we have between 60 to 80 % of people having had the disease and recovered the virus will naturally stop it's spread. That's what herd immunity means. That's how viruses work. There's no committee that decided this. Nobody agreed to this. This is nature. Yes, it's going to suck for anybody at risk and many of them will die. Yes, I'm sure it'll be impossible to protect everybody at risk.

I'm sharing a house with a woman with late stage lungcancer. Yesterday her doctor told her not to worry about the virus. To go out and live her life. What's left of it. Because she's fucked to keep safe from the virus. She'll get it and when she does she will die. They asked her if she really wants to spend her last days stuck in her room isolated from everybody she loves. This is somebody close to me. It hurt to hear. But it's reality.

That requires the other 70% of the population to be exposed... in a controlled manner. They become immune. Then the pandemic dies out.

The pandemic dies out when the new infections are fewer than the currently infected for long enough. Whether that is achieved through more and more people being immune, or through fewer interactions, doesn't matter to the virus and neither to us. Except for the following reasons it should matter to us:

1) we don't know that surviving the virus grants immunity. It might grant immunity in close to 100% of survivors (even measles doesn't reach 100% straight) for the rest of their life, or for a few years, or months; or it might grant immunity to 70% of survivors, and make the second infection worse than the first for the other 30%. What we do know about similar viruses tells us that probably most people achieve immunity for a relatively long time at least. But that's a lot of maybes to bet 10,000-50,000 lives on (in a small country like Sweden).
2) More young and fit people being infected at the same time also means more possibilities for the elderly and those with pre-existing conditions to get infected. It's simply not realistic to park everyone known to be susceptible to developing a severe case on Mars. And it's not like a SARS-CoV-2 infection is reliably detected within no more than hours of becoming contagious.
3) Have you looked at actual numbers? After - what? - a month into the first wave, Sweden has 12,500 official cases. Assume that there are 20 times as many actual infections, that's still only 500,000. Herd immunity requires a high double digit percentage of people having undergone the infection. So it might be true that, given current rates of new infections, Sweden will achieve herd immunity earlier than Denmark each keeping up their current regime: Sweden in late 2021, and Denmark in early 2024.

I for one hope that we have a vaccine before that. I don't know that this will be the case, but I'm not willing to bet 5-digit numbers of dead for 7-digit or very low 8-digit population countries (like Austria or Sweden) on the assumption that we never may.

A vaccine will be another year at least. We can't keep everybody indoors for a year. Our only two available options is to either;

1) do nothing. Let it run it's course and take a short sharp shock and bury many dead.

Or

2) do what we're doing now which is slowing the spread in a controlled manner.

I'm not sure what strategy you are proposing? You haven't presented a realistic alternative.

 

[Jokodo]

When we have between 60 to 80 % of people having had the disease and recovered the virus will naturally stop it's spread. That's what herd immunity means. That's how viruses work. There's no committee that decided this. Nobody agreed to this. This is nature. Yes, it's going to suck for anybody at risk and many of them will die. Yes, I'm sure it'll be impossible to protect everybody at risk.

I'm sharing a house with a woman with late stage lungcancer. Yesterday her doctor told her not to worry about the virus. To go out and live her life. What's left of it. Because she's fucked to keep safe from the virus. She'll get it and when she does she will die. They asked her if she really wants to spend her last days stuck in her room isolated from everybody she loves. This is somebody close to me. It hurt to hear. But it's reality.

The pandemic dies out when the new infections are fewer than the currently infected for long enough. Whether that is achieved through more and more people being immune, or through fewer interactions, doesn't matter to the virus and neither to us. Except for the following reasons it should matter to us:

1) we don't know that surviving the virus grants immunity. It might grant immunity in close to 100% of survivors (even measles doesn't reach 100% straight) for the rest of their life, or for a few years, or months; or it might grant immunity to 70% of survivors, and make the second infection worse than the first for the other 30%. What we do know about similar viruses tells us that probably most people achieve immunity for a relatively long time at least. But that's a lot of maybes to bet 10,000-50,000 lives on (in a small country like Sweden).
2) More young and fit people being infected at the same time also means more possibilities for the elderly and those with pre-existing conditions to get infected. It's simply not realistic to park everyone known to be susceptible to developing a severe case on Mars. And it's not like a SARS-CoV-2 infection is reliably detected within no more than hours of becoming contagious.
3) Have you looked at actual numbers? After - what? - a month into the first wave, Sweden has 12,500 official cases. Assume that there are 20 times as many actual infections, that's still only 500,000. Herd immunity requires a high double digit percentage of people having undergone the infection. So it might be true that, given current rates of new infections, Sweden will achieve herd immunity earlier than Denmark each keeping up their current regime: Sweden in late 2021, and Denmark in early 2024.

I for one hope that we have a vaccine before that. I don't know that this will be the case, but I'm not willing to bet 5-digit numbers of dead for 7-digit or very low 8-digit population countries (like Austria or Sweden) on the assumption that we never may.

A vaccine will be another year at least. We can't keep everybody indoors for a year. Our only two available options is to either;

1) do nothing. Let it run it's course and take a short sharp shock and bury many dead.

Or

2) do what we're doing now which is slowing the spread in a controlled manner.

I'm not sure what strategy you are proposing? You haven't presented a realistic alternative.

3) Stomp on it hard so that the reproduction rate drops to significantly below 1.0 and the number of active cases is actually declining. Simultaneously expand testing infrastructure. When active cases have dropped to the hundreds (and undetected active cases have become insignificant), open up but with the handbrakes on, i.e. refrain from mass events for pretty much the rest of the year and open up the borders for e.g. family/friend visits with health checks in place but no mass tourism. If you have a very good idea who has it, it is enough to reduce the movements of those who have it. As long as you have no real idea who has it, reducing everyone's movements is the only safe bet.

If we stomp hard on it during the first wave, and if we make sure we have enough testing capacity to keep the numbers low once we've driven them down, by minimizing undetected infections to the 10s or 100s per month, then (and only then) can we return to a kind of normal that is economically viable for months or years (unless you're in tourism - tough luck!). A normal where schools operate in two shifts, a morning and an afternoon shift, to reduce class size, where the borders are open but mass tourism disencouraged, where working from home will be the default for most office jobs when no meeting is scheduled, use your imagination - but where production is up and running and you won't be scorned for visiting your friends.

The problem with your number (2) is that it sounds nice in theory, until you plug in actual numbers, like how long "doing what we do now" would have to be maintained, or how many people die along the road. When you do that, you quickly find it's simply not feasible. Sweden now has around 10,000 registered active cases. Let's assume that cases remain active for an average of 3 weeks, that the real number of cases is 10 times the official number, and that herd immunity is reached at 60%. In that case, it would take 60 3-week periods to get to herd immunity by "slowing the spread in a controlled manner". That's more than 3 years! More than three years with moderate restriction in place (they'd have to be somewhat stricter than what Sweden currently has, as the active cases are still growing), and possibly three years with 3-digit (or close) daily death counts. This. Does. Not. Work.

Stomp on it hard and test everyone with any chance of having contracted it when the numbers of active infections have become manageable works. It's what China did, and other countries seem to be on the right track: Australia, Thailand, New Zealand, Austria, maybe Czechia and Denmark.

 

[DrZoidberg]

When we have between 60 to 80 % of people having had the disease and recovered the virus will naturally stop it's spread. That's what herd immunity means. That's how viruses work. There's no committee that decided this. Nobody agreed to this. This is nature. Yes, it's going to suck for anybody at risk and many of them will die. Yes, I'm sure it'll be impossible to protect everybody at risk.

I'm sharing a house with a woman with late stage lungcancer. Yesterday her doctor told her not to worry about the virus. To go out and live her life. What's left of it. Because she's fucked to keep safe from the virus. She'll get it and when she does she will die. They asked her if she really wants to spend her last days stuck in her room isolated from everybody she loves. This is somebody close to me. It hurt to hear. But it's reality.

The pandemic dies out when the new infections are fewer than the currently infected for long enough. Whether that is achieved through more and more people being immune, or through fewer interactions, doesn't matter to the virus and neither to us. Except for the following reasons it should matter to us:

1) we don't know that surviving the virus grants immunity. It might grant immunity in close to 100% of survivors (even measles doesn't reach 100% straight) for the rest of their life, or for a few years, or months; or it might grant immunity to 70% of survivors, and make the second infection worse than the first for the other 30%. What we do know about similar viruses tells us that probably most people achieve immunity for a relatively long time at least. But that's a lot of maybes to bet 10,000-50,000 lives on (in a small country like Sweden).
2) More young and fit people being infected at the same time also means more possibilities for the elderly and those with pre-existing conditions to get infected. It's simply not realistic to park everyone known to be susceptible to developing a severe case on Mars. And it's not like a SARS-CoV-2 infection is reliably detected within no more than hours of becoming contagious.
3) Have you looked at actual numbers? After - what? - a month into the first wave, Sweden has 12,500 official cases. Assume that there are 20 times as many actual infections, that's still only 500,000. Herd immunity requires a high double digit percentage of people having undergone the infection. So it might be true that, given current rates of new infections, Sweden will achieve herd immunity earlier than Denmark each keeping up their current regime: Sweden in late 2021, and Denmark in early 2024.

I for one hope that we have a vaccine before that. I don't know that this will be the case, but I'm not willing to bet 5-digit numbers of dead for 7-digit or very low 8-digit population countries (like Austria or Sweden) on the assumption that we never may.

A vaccine will be another year at least. We can't keep everybody indoors for a year. Our only two available options is to either;

1) do nothing. Let it run it's course and take a short sharp shock and bury many dead.

Or

2) do what we're doing now which is slowing the spread in a controlled manner.

I'm not sure what strategy you are proposing? You haven't presented a realistic alternative.

3) Stomp on it hard so that the reproduction rate drops to significantly below 1.0 and the number of active cases is actually declining. Simultaneously expand testing infrastructure. When active cases have dropped to the hundreds (and undetected active cases have become insignificant), open up but with the handbrakes on, i.e. refrain from mass events for pretty much the rest of the year and open up the borders for e.g. family/friend visits with health checks in place but no mass tourism. If you have a very good idea who has it, it is enough to reduce the movements of those who have it. As long as you have no real idea who has it, reducing everyone's movements is the only safe bet.

If we stomp hard on it during the first wave, and if we make sure we have enough testing capacity to keep the numbers low once we've driven them down, by minimizing undetected infections to the 10s or 100s per month, then (and only then) can we return to a kind of normal that is economically viable for months or years (unless you're in tourism - tough luck!). A normal where schools operate in two shifts, a morning and an afternoon shift, to reduce class size, where the borders are open but mass tourism disencouraged, where working from home will be the default for most office jobs when no meeting is scheduled, use your imagination - but where production is up and running and you won't be scorned for visiting your friends.

The problem with your number (2) is that it sounds nice in theory, until you plug in actual numbers, like how long "doing what we do now" would have to be maintained, or how many people die along the road. When you do that, you quickly find it's simply not feasible. Sweden now has around 10,000 registered active cases. Let's assume that cases remain active for an average of 3 weeks, that the real number of cases is 10 times the official number, and that herd immunity is reached at 60%. In that case, it would take 60 3-week periods to get to herd immunity by "slowing the spread in a controlled manner". That's more than 3 years! More than three years with moderate restriction in place (they'd have to be somewhat stricter than what Sweden currently has, as the active cases are still growing), and possibly three years with 3-digit (or close) daily death counts. This. Does. Not. Work.

Stomp on it hard and test everyone with any chance of having contracted it when the numbers of active infections have become manageable works. It's what China did, and other countries seem to be on the right track: Australia, Thailand, New Zealand, Austria, maybe Czechia and Denmark.

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Stomping hard has only worked in China, South Korea and Taiwan. Why? Because they were the ONLY countries in the world who had prepared for a possible SARS like outbreak. Without adequate preparation we're fucked for stomping hard.

There's also cultural problems. China, South Korea and Taiwan are all Confucian cultures were figures of authority are respected. People are obedient and they work together. Northern Europe is similar. So we have also managed to contain the spread quite well. But we were not prepared for this. Not at all. Sweden was bizarrely unprepared, thanks to two decades of mismanagement and budget cuts to disaster preparedness. So stomping hard was not an option.

The Catholic countries don't give a fuck about what figures of authority says. They just do their own thing. The English speaking part of the world are fiercly indipendent. They're not going to obey anyone no matter what. In India the poor can't afford to obey the social distancing rules. In Africa they're doing so little testing that we have no idea what's going on. It probably isn't great. It's the same deal in the Middle-East. Syrians have other things to worry about. Russia is probably not being honest about the extent of the spread of this. China is also probably lying about numbers.

USA has a special culture of small government and trusting people to take care of themselves. That's awesome for the economy when things are nice and stable. But an absolute disaster when there's a disaster.... like now. USA is fucked. I'm sorry to say. They have the worst culture possible for tackling this. They also have the most obese people in the world. Obesity puts you at an extreme risk for the Corona virus. That's not great. So yeah... it's not going to be a good time for USA.

And not to be a hippie about this... but we're all in this together. If there's any one country in the world that doesn't play ball and manages to stomp hard then it's a wasted effort for any other country. China... a totalitarian state with a closed border, is now constantly getting new cases from people with Covid-19 travelling in from abroad. If they can't even stop it nobody will.

edit:

also, don't look at the number of active cases. There's so much variation in how the tests are done. Only look at the number of people dead from Corona. But that isn't reliable any longer. Because in many places they've stopped testing the dead.... like France. But it's still a much better metric than active cases

 

[Jokodo]

3) Stomp on it hard so that the reproduction rate drops to significantly below 1.0 and the number of active cases is actually declining. Simultaneously expand testing infrastructure. When active cases have dropped to the hundreds (and undetected active cases have become insignificant), open up but with the handbrakes on, i.e. refrain from mass events for pretty much the rest of the year and open up the borders for e.g. family/friend visits with health checks in place but no mass tourism. If you have a very good idea who has it, it is enough to reduce the movements of those who have it. As long as you have no real idea who has it, reducing everyone's movements is the only safe bet.

If we stomp hard on it during the first wave, and if we make sure we have enough testing capacity to keep the numbers low once we've driven them down, by minimizing undetected infections to the 10s or 100s per month, then (and only then) can we return to a kind of normal that is economically viable for months or years (unless you're in tourism - tough luck!). A normal where schools operate in two shifts, a morning and an afternoon shift, to reduce class size, where the borders are open but mass tourism disencouraged, where working from home will be the default for most office jobs when no meeting is scheduled, use your imagination - but where production is up and running and you won't be scorned for visiting your friends.

The problem with your number (2) is that it sounds nice in theory, until you plug in actual numbers, like how long "doing what we do now" would have to be maintained, or how many people die along the road. When you do that, you quickly find it's simply not feasible. Sweden now has around 10,000 registered active cases. Let's assume that cases remain active for an average of 3 weeks, that the real number of cases is 10 times the official number, and that herd immunity is reached at 60%. In that case, it would take 60 3-week periods to get to herd immunity by "slowing the spread in a controlled manner". That's more than 3 years! More than three years with moderate restriction in place (they'd have to be somewhat stricter than what Sweden currently has, as the active cases are still growing), and possibly three years with 3-digit (or close) daily death counts. This. Does. Not. Work.

Stomp on it hard and test everyone with any chance of having contracted it when the numbers of active infections have become manageable works. It's what China did, and other countries seem to be on the right track: Australia, Thailand, New Zealand, Austria, maybe Czechia and Denmark.

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Stomping hard has only worked in China, South Korea and Taiwan. Why? Because they were the ONLY countries in the world who had prepared for a possible SARS like outbreak. Without adequate preparation we're fucked for stomping hard.

There's also cultural problems.

Your preference for cultural essentialist explanations and the notion that we cannot copy what they did because reasons notwithstanding, the curve for Taiwan looks almost exactly the same as the curve for Austria, Australia or New Zealand (Thailand too but I'm leaving them out because I have no idea how much testing they do) - and so does the curve for South Korea considering they are several weeks ahead in time.

Reality is under no obligation to conform to your prejudices.

If there's any one country in the world that doesn't play ball and manages to stomp hard then it's a wasted effort for any other country.

therefore, let Sweden be the country that doesn't play ball?

 

[Jokodo]

And you didn't actually respond to anything in my last post...

 

[DrZoidberg]

Your preference for cultural essentialist explanations and the notion that we cannot copy what they did because reasons notwithstanding, the curve for Taiwan looks almost exactly the same as the curve for Austria, Australia or New Zealand (Thailand too but I'm leaving them out because I have no idea how much testing they do) - and so does the curve for South Korea considering they are several weeks ahead in time.

Reality is under no obligation to conform to your prejudices.

I don't think differences in culture are necessarily essentialist. If it's essentialist, then it can't be changed. But cultures are fluid and people who move to another culture adapt to it, which is the opposite of what essentialism means. So I'm not sure what you're trying to gain from associating me with essentialism? I think you're using the word wrong. I also don't think it's prejudice. We're seeing it in the statistics. In the north of Sweden they've been social distancing in accordance with the Covid-19 regulations for centuries. It's their culture. Guess what? No problems with Covid-19. It's culture. I think it's just stupid to deny it. People in warm cultures get out more and socialise more. Because houses are hot and sweaty and it's just nice to be outdoors. People in cold countries stay indoors more. Is this essentialism?

I don't know about Australia or New Zeeland. But Austria is very limitted in who they test. They had the Austrian based Valeria Cagno on TWIV talking about the situation there. They pretty much have the Italian situation. They don't even test all who have died. They only test people if it's questionable if they have been infected. The obvious ones are not tested so don't end up in the statistic.

As far as I can tell the number of confirmed cases going up now is only analagous to somebody fixing the access to testing facilities. I know it's still an absolute disaster for USA. They've had to change the law in order to fix bottle necks. Until just a few weeks ago all tests had to be sent to CDC for verification. They've stopped that now. Now many labs can confrm Civid-19. This caused an explosion in verified cases without necessarily it meaning that more people are infected. Covid-19 was quite likely ripping through USA in February unchecked. Hardly anybody was testing then.

If there's any one country in the world that doesn't play ball and manages to stomp hard then it's a wasted effort for any other country.

therefore, let Sweden be the country that doesn't play ball?

Sweden hasn't imposed any rules because they haven't had to. Swedes are very obedient. The governement has issues recommendations which the the people has followed. All they've done is banned large festivals. But Swedes are still working from home. Schools are not closed. People still have taken their kids out of school to home-school them.

For a non-Swede this can be hard to grasp. But right now the social pressure to obey the recomendations are immense. People are staying home and social distancing, because they're afraid to be shamed by their neighbours. Not because of any laws. Denmark has imposed strict restrictions. Sweden has not. The cultures are very similar. But in both countries people are behaving pretty much the same.

Also worth noting... Sweden is a sparsely populated country. Social distancing is easy in Sweden. It's very well adapted to social distance. Swedes hate being too close to one another. Again... it's a cultural trait. Which leads to less of a need to put laws in place.

Sweden's main problem isn't the obedience of it's people. But that their preparedness for this sucks balls. They have very little capacity to treat large number of people with ARDS. That's why I think their numbers are more shit than Denmark.

 

[Jokodo]

I don't think differences in culture are necessarily essentialist. If it's essentialist, then it can't be changed. But cultures are fluid and people who move to another culture adapt to it, which is the opposite of what essentialism means. So I'm not sure what you're trying to gain from associating me with essentialism? I think you're using the word wrong. I also don't think it's prejudice. We're seeing it in the statistics. In the north of Sweden they've been social distancing in accordance with the Covid-19 regulations for centuries. It's their culture. Guess what? No problems with Covid-19. It's culture. I think it's just stupid to deny it. People in warm cultures get out more and socialise more. Because houses are hot and sweaty and it's just nice to be outdoors. People in cold countries stay indoors more. Is this essentialism?

I don't know about Australia or New Zeeland. But Austria is very limitted in who they test. They had the Austrian based Valeria Cagno on TWIV talking about the situation there.

Would that be the Valeria Cagno from the University of Geneva featured in this episode? https://www.microbe.tv/twiv/twiv-special-sars-cov-2/

Geneva is in Switzerland and the only place Austria is even mentioned (you can search the transcript here: https://www.microbe.tv/twiv/twiv-special-coronavirus-sars-cov-2-and-covid-19-update-transcript/) is the list of countries travellers from which Israel recently starting to put into quarantine.

They pretty much have the Italian situation. They don't even test all who have died. They only test people if it's questionable if they have been infected. The obvious ones are not tested so don't end up in the statistic.

Austria does too little testing like pretty much every other place, but you shouldn't get your ideas of the situation on the ground from someone talking about Switzerland more than a month ago...

As far as I can tell the number of confirmed cases going up now is only analagous to somebody fixing the access to testing facilities. I know it's still an absolute disaster for USA. They've had to change the law in order to fix bottle necks. Until just a few weeks ago all tests had to be sent to CDC for verification. They've stopped that now. Now many labs can confrm Civid-19. This caused an explosion in verified cases without necessarily it meaning that more people are infected. Covid-19 was quite likely ripping through USA in February unchecked. Hardly anybody was testing then.

therefore, let Sweden be the country that doesn't play ball?

Sweden hasn't imposed any rules because they haven't had to. Swedes are very obedient. The governement has issues recommendations which the the people has followed. All they've done is banned large festivals. But Swedes are still working from home. Schools are not closed. People still have taken their kids out of school to home-school them.

For a non-Swede this can be hard to grasp. But right now the social pressure to obey the recomendations are immense. People are staying home and social distancing, because they're afraid to be shamed by their neighbours. Not because of any laws. Denmark has imposed strict restrictions. Sweden has not. The cultures are very similar. But in both countries people are behaving pretty much the same.

Also worth noting... Sweden is a sparsely populated country. Social distancing is easy in Sweden. It's very well adapted to social distance. Swedes hate being too close to one another. Again... it's a cultural trait. Which leads to less of a need to put laws in place.

Sweden's main problem isn't the obedience of it's people. But that their preparedness for this sucks balls. They have very little capacity to treat large number of people with ARDS. That's why I think their numbers are more shit than Denmark.

All the more damning for the policy if the situation is as bad as it is despite a population unusually willing to follow recommendations and a sparse population.

 

[DrZoidberg]

All the more damning for the policy if the situation is as bad as it is despite a population unusually willing to follow recommendations and a sparse population.

I think you're being absurdly simplistic. You're looking at singular numbers drawing sweeping conclusions. Here's what I think. It looks like every country has acted in the best possible way they could, given the available information and their available options. I haven't seen any country fucking it up. Not even USA, with a complete moron on charge. Countries have done what they could. And the stuff they haven't done they haven't done earlier for good reason. USA has not been well prepared for this. That's why it's shitty there now. Just the way they organise society to allow them to be home to cook more food for themselves has been lacking. So they eat out more and are fatter, which puts them at risk from dying from Covid-19. Like I said... there's many factors here. We can't look at it simplistically. Sweden hasn't put laws in place to enforce social distancing because they don't have to. Italy does, so they have.

This time around I've been pretty impressed by how governments have handled it. It seems like the experts have been listened to... for once.

 

[Jokodo]

All the more damning for the policy if the situation is as bad as it is despite a population unusually willing to follow recommendations and a sparse population.

I think you're being absurdly simplistic. You're looking at singular numbers drawing sweeping conclusions.

Not at all. I'm looking at the numbers in context. Sweden is testing half as much as Denmark and less than a third as much as Norway (per million), yet it has twice/four times as many deaths. Little testing means that almost certainly, not only cases but also deaths go unreported in more significant numbers. I am explicitly *not* looking at Sweden's number in isolation and explaiming that they're huge, I'm comparing them with other countries.

Sweden is number 8 globally in deaths per million population (not counting small states and territories below 100k inhabitants), despite its low population density and despite a populace happy to obey recommendations, as you claim. And unlike other countries ahead on this list, it's not clear that deaths in Sweden have plateaued. I find I'm having a hard time being impressed by how they handled it.