Swedes #persist in refusing to overwhelm ICU capacity (Massachusetts has a higher overall death rate)

Today’s numbers are out. From my big tracking post:

4/17 comment: Sweden at 613 cases/130 deaths; Denmark at 321/12; Massachusetts at 2,221/159. It is getting tougher to argue that the Danish shutdown was ineffective (but maybe Denmark will suffer its infections starting in a few weeks; kids in Denmark went back to school on Wednesday). And it is getting tougher to argue that the Massachusetts shutdown was effective (but maybe we won’t have a second wave since we were so incompetent at slowing down the first wave?). Sweden has had 1,333 total deaths without shutting down. Massachusetts shut down and has had 1,404 deaths (1.5X the rate).

American journalists and the Facebook righteous are sure that, just as it was in March, disaster is just around the corner for Sweden. The hospitals will be overwhelmed. People who could be trivially saved with a ventilator will drop dead in the street. (Example from fivethirtyeight.com hero Nate Silver.)

How is that going? The Swedes make their hospital situation public: https://www.icuregswe.org/en/data–results/covid-19-in-swedish-intensive-care/. It looks as though they have roughly 500 people in the ICU, up from 450 on April 8:

About 50 COVID-19 patients go into the ICU every day, but, if we interpreted the above chart correctly, nearly 50 are also coming out (unfortunately quite a few will be dead when they emerge, since there is no cure for COVID-19).

How do Americans maintain their faith in the face of these data. And in the refusal of God to smite the Swedes with a full ICU or a higher-than-Massachusetts death rate? One professor (of computer science, not epidemiology) simply asserted his sincerely held belief that Sweden would suffer an explosion of disease and ICU demand in the next week. Therefore, we had obviously saved lives by shutting down. Couldn’t Massachusetts have saved a lot more lives by continuing to operate our economy, maybe with a few more COVID-19 patients that had to be shuffled to a mostly-empty hospital, and sending the extra few $billion of wealth created (by the open economy) to Africa for clean water projects? No! Without a shutdown, the death toll in Massachusetts would have been staggering.


15 thoughts on “Swedes #persist in refusing to overwhelm ICU capacity (Massachusetts has a higher overall death rate)

  1. Even if Sweden’s ICU wards don’t get overwhelmed, losing more lives to Covid-19 than the rest of Scandinavia combined isn’t a good look.

    • See other posts. Comparing the five Nordic nations is not relevant. Most of the influx to Sweden/Stockholm came from visitors to the Alps. Norwegians and Danes do not travel to the Alps in the same extent. Danes fall, on their skies, in Swedish hills, Norwgians fall while skiing in the Scandes – the mountains that seperate Sweden and Norway. During the winterseason Swedes tend to BOTH travel to the Alps and the Scandes… Almost ALL of the (death-) victims,in the firsts fase, are related to Stockholm and/or the Alps.
      1 The Baltic countries registrer deaths in different way.
      2 If I die tomorrow – will it be registred as Corona or the last day of my cancer?
      3 In Sweden most cases are going unawere…¨
      4 It is too soon to se conclusions.

    • “Scandinavia” is just Sweden, Denmark, and Norway. The Swedish population is actually roughly the same size as “the rest of Scandinavia combined.” (if you want to add Finland in then “the rest” is 1.5X larger. As Professor Giesecke reminds us, let’s check back in a year from now and see if those other countries prevented deaths by hiding in bunkers or merely delayed them.

      So far Sweden hasn’t lost more citizens to COVID-19 than two years worth of taxpayer-funded opioid deaths in just a single county within Ohio: https://www.nbc4i.com/news/montgomery-county-ohio-tops-in-u-s-for-overdose-deaths/

  2. A couple of things stand out to me with all of this:

    In all of the reported/recorded deaths, is anyone keeping track, in a rigorous and standardized way, of the associated cormorbidities? We know that certain risk factors (obesity, hypertension, diabetes, age/frailty, smoking) are associated with elevated risk, but has it been codified for each death in a standardized way so that, given 1400 deaths in a state, we could look at those deaths by CCS (COVID-19 Comorbidity Score) and have a real picture of who this thing kills, and thus, how many others are potentially at risk?

    Also, which comorbidities are associated with better/worse outcomes? Is diabetes twice as bad as obesity for someone’s prognosis? If you had the flu seven years out of the past 10, does that make you more likely to die?

    Finally, has anyone figured out why some people are virtually impervious to the virus while other seemingly healthy people wind up on death’s door? Why, for example, was Boris Johnson nearly pushing up daisies while George Stephanopoulos is reportedly virtually symptom-free? How does someone who is 90 years old and wheezing every day manage to survive while a 21 year old cheerleader in perfect health wind up dead? In other words, is there some genetic component to COVID-19 resistance that we could identify?

    I keep thinking of that project you worked on that would have allowed every person to carry with them a comprehensive medical history that could be plugged into every hospital system in the developed world. Wouldn’t it be great if we could look at everyone who has died in New York City and say: “It’s not so much the density of the population or the ethnicity. Most people who required ventilation and subsequently died had a CCS of 7 out of 10 or above, and we know there are 36,329 other people with scores that high in the New York Metropolitan area, and we know exactly where they are. We’re going to send them a postcard, because without a vaccine, all those people are goners whether we open the restaurants 1 month from now or 12 months from now.”

    Finally finally: has there been any attempt to figure out if the people who died testing positive for COVID-19 also had the regular flu at the same time?

    • Superbug: Yes, the medical record system is a mess. Since there is no integration with prior records, the hospital will presumably do the smart thing and write down “COVID-19” and “unknown pre-existing conditions”.

  3. This is great stuff, Phil, keep it up — for about six weeks you seem to have had about the most sober view of what is going on. It is starting to look like yet another episode in the madness of crowds that may well take its place among Tulipmania, the South Sea Bubble, the Salem Witch Trials and so on.

    • Jack: Thanks for the kind words. I can’t say that I had anything figured out any faster than anyone else. And I have been mostly cowering in fear here at home (since there isn’t anywhere to go, though I guess I could have boldly volunteered to work at one of the handful of hospitals that are busy and that need help from someone completely unskilled). I did try to look for numbers that seemed inconsistent and, of course, asking even that level of question will earn one a title as a covid denier!

    • @Jack: Ha! One of the casualties of the South Sea Bubble was James Puckle’s joint-stock company, which was all set to manufacture his eponymous Gun in large quantities, but wound up with just one customer. For its time, it was an advanced weapon capable of firing around 9 shots per minute (with a kind of flintlock mechanism!) The most interesting quirk? Puckle designed it to fire conventional round projectiles, of course, but he also wanted it to shoot **square** bullets, which were thought to tumble and cause more pain and damage. The square bullets were to be fired only at the Ottoman Turks — Christian enemies were supposed to be targeted exclusively with more merciful, round projectiles.

      Patent number 418 in 1718. Here’s a fascinating video featuring an example assembled from spare parts remaining from the two original, complete guns. Amazing engineering, craftsmanship and metalworking for the early 1700s.


  4. Comparing reported COVID-19 deaths per capita:

    – BC is at 77 deaths, 15 deaths per million. Public health officials are starting to talk about lifting restrictions – see page 34 of today’s slides. Superbug: 36% of cases had at least one chronic condition.
    – Canada as a whole is doing worse than BC: 1310 deaths, 35 deaths per million. Quebec in particular is doing badly, perhaps because of the Florida effect – Quebec’s spring break was earlier than the rest of Canada.
    – The US is doing worse than Canada: 36589 deaths, 111 deaths per million.
    – Sweden is doing worse than the US as a whole: 1400 deaths, 137 deaths per million.
    – Massachusetts is doing worse than Sweden: 1108 deaths, 161 deaths per million.
    – Italy is at 22745 deaths, 377 deaths per million.
    – New York state is at 8893 deaths, 457 deaths per million.

    • Per the post above, current Massachusetts total deaths are 1,404. BC shouldn’t let anyone from MA come to Whistler!

  5. This is more of a madness of elites thing since they are the ones shutting everything down. If you are an ordinary person, you stay at home because there is no place to go to. The only decision you are allowed to make is whether or not to wear the mask when you leave. Owners of small businesses do have some choice in whether they want to defy the shutdown.

  6. Mattias,

    Denmark, Norway, Sweden, Iceland all imported Corona from Austria

    It appears that more danes than swedes visit Austria in a typical year

    Denmark and Norway went – your guess is as good as mine – 65% shutdown on march 13th. Sweden went 52% shutdown on march 17th.

    The three countries all expect to have a GDP that is 4-11% smaller next year.

    Things are more similar than most people think.

    • Steven:
      If I may (and I already now beg all Danes reading this for forgiveness) paraphrase the movie Apocalypse Now: Danes don’t ski!
      In the south of Sweden and in Denmark, one of the most popular forms of tourism is going by bus to the Alps. This is during summer… And mostly for 65+.
      Many busrides – even for Swedes, starts in Copenhagen (Denmark) and they are registrered as Danes in the statistics.
      Anyway – the Danes I have met/know about, going to the Alps for a skiingvacation in Austria, are about as many Americans working for the UN I came across, as a child growing up in Southern Africa: None.

      Sweden had its first case 30th of January. But Stockholm had winterholidays (for schools) the same weeks as the build-up and game (Champions League) between Atalanta and Valencia. So Sweden got ITS spread way ahead of the spread from Austria. And (“Danes don’t ski’) Norwegians tend to ski in their own/Swedish mountains.

      So Austria – especially when people that were sent into isolation, is partly a non-issue. The Italian spread – which did not influence Danes and Norwegians the same way – is the important spread for partly Sweden – but mostly Stockholm.

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