Department of Lies, Damned lies, and Statistics: “In Sweden, Will Voluntary Self-Isolation Work Better Than State-Enforced Lockdowns in the Long Run?” (Reason).
As noted previously in this blog, despite having access to schools, restaurants, gyms, and offices, Swedes have been dying at a lower rate than residents of shut-down Massachusetts (latest). But there are some European countries in shutdown that have yet lower official COVID-19 death rates. Almost nobody in Germany or Norway dies from COVID-19. Are they exceptionally lucky, doing something better, or using a different standard to attribute death to the evil coronavirus?
(Summary: Swedes automatically count anyone who has tested positive for COVID-19 as a COVID-19 death; the Norwegians require that a doctor assess that an ancient person has specifically died because of COVID-19, rather than one of 3 pre-existing conditions, and then take time from his/her/zer/their day to report that to the authorities.)
From the article:
There are also reasons to think that Sweden is doing better than these comparisons suggest. Many countries don’t count COVID-19 deaths outside of hospitals. When people die at home, in nursing homes, or in prisons, they don’t show up in the coronavirus death count.
In the Stockholm region of Sweden, 42 percent of deaths took place in nursing homes for the elderly. In many countries, and some U.S. states, those deaths would not show up in the data.
According to Johns Hopkins University, Belgium has twice as many COVID-19 deaths per capita as the Netherlands. But in Belgium, almost half of those deaths are from nursing homes, while testing is more rare in Dutch nursing homes so fewer deaths there are attributed to the disease.
After France started to include nursing homes in the statistics, the total number of French COVID-19 deaths jumped by almost a third.
During the present pandemic, Sweden systematically checks the list of people who have tested positive for the virus against the population register. Every time the government discovers that someone who had the virus has died, that person is registered as a COVID-19 death if it happened within 30 days of the diagnosis—even if the cause of death was cancer or a heart attack.
It means that Sweden reports the number of people who die with COVID-19, not of COVID-19.
Even in a culturally and geographically similar country like Norway—celebrated for its low death rate—they do things differently. The Norwegians only count something as a COVID-19 death if a doctor concludes that someone was killed by the disease and decides to report it to the country’s public health authority.
The article confirms what I posted earlier, i.e., that Swedes are not running out of ICU capacity:
The Swedes who have died from the coronavirus did not die due to lack of hospital beds or ventilators. Thanks to a rapid increase in intensive care unit capacity, 20 percent of Sweden’s ICUs are unoccupied. Stockholm has built a new field hospital, already equipped to receive hundreds of COVID-19 patients, including 30 ICU beds. So far it has not had to open. The average age of the dead has been 81, which is close to our average life expectancy.
Why didn’t Swedes drop dead like the models said they would?
For example, the influential Imperial College model estimates a higher reproduction rate of the disease in Sweden than in other countries, “not because the mortality trends are significantly different from any other country, but as an artefact of our model…because no full lockdown has been ordered.”
In other words, the model could only handle two scenarios: an enforced national lockdown or zero change in behavior. It had no way of computing Swedes who decided to socially distance voluntarily.
[Believers in the Church of Shutdown, of course, will say that Swedes are completely different from Americans (note that 25 percent of people living in Sweden have no genetic, cultural, or linguistic connection to stuff we might consider “Swedish”; one quarter of the population was born somewhere else or has two parents born somewhere other than Sweden; Swedish 15-year-olds actually scored slightly lower than Americans in the science section of the PISA test (though they did a lot better in math)). Had at-risk Americans not been able to tap into strong leadership (from epidemiology professor Donald Trump in the White House!), they would have read media reports of mass deaths and not changed their behavior in any way. No American would have switched to work-from-home. No American would have decided to cook at home rather than spend an hour in a jammed restaurant. No American would have invested in a mask or Clorox wipes. Due to universal stupidity among Americans (or at least the nearly half who voted for Donald Trump), a Swedish approach of shutting down mass gatherings and trying to isolate the vulnerable could never have changed behavior or epidemic velocity in the U.S.]
Of course, we probably won’t be able to evaluate the success or failure of any country’s policy until early 2021 (otherwise we risk celebrating a country for preventing deaths when all that happened was that the country either postponed the death or classified it differently). But I think it is interesting that already we’re getting a glimpse into why apparently similar countries should have such different death rates.
- “Sweden Says Controversial Covid-19 Strategy Is Proving Effective” (Bloomberg; Swedish church priests say that their religion is true)
- “Sweden grapples with high death toll after controversially refusing to lock down” (New York Post; members of the Church of Shutdown say that the Swedish religion is false)