[JoeAltmaier]

Well, Sweden's 4:10000 death rate is alarming. In only a few months. And their confident approach (doing very little) in the face of scant information was bold. With lives at stake, its natural to be alarmed/scandalized at their lack of effort to control a pandemic.

[sojournerc]

A pandemic cannot be controlled, only mitigated. That's what one part of the definition of epidemic vs. pandemic.

What's alarming is that there isn't sympathy or discussion of the way lockdowns are putting lives at stake, when control of the virus is an illusion.

It's natural to be alarmed at overly authoritarian responses, the justifications of which are diminishing as we get more information.

Sweden, as far as I understand, is doing very little authoritarian intervention, but are providing thre public information so they can make their own choices with respect to risks they want to take.

[graeme]

But several countries have basically eliminated the virus. SARS-COV-2 spreads in clusters. Tracing these clusters, testing people, and isolating patients seems to work.

Neighboring Denmark is down to ~30 cases a day. Is it impossible to believe that with border control and testing they’ll basically have it eliminated on their territory?

Countries which have basically eliminated it: Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China

Also the Canadian provinces of new brunswick, nova scotia, newfoundland, PEI, Saskatchewan, Manitoba

I’m sure I’m forgetting some. What do the countries in that list have in common? Yes some are islands but not all. Yes some are small but not all.

For the most part, they took action early, and used contact tracing, testing, isolation, and border control systems.

According to this article the small, poor country of Belize has outdone the province of Quebec, where I live. Belize developed a software based contact tracing system. Quebec still does it by fax. It is not a surprise which jurisdiction has better results.

What’s your theory for how the systems built in these countries will inevitably fail? The virus is contagious but it isn’t magical. It has to spread from person to person. If you test people, isolate the infected, trace their contacts, the virus has nowhere to go.

Most of the west is still not isolating the infected, instead sending them home to their families, and in many cases free to leave home if they decide to break quarantine.

https://www.vancourier.com/living/government-of-belize-credi...

[ApolloFortyNine]

The only virus ever to be eliminated globally is smallpox, and it took a vaccine to do so.

Unless Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China plan on never reopening to the World, the virus will spread again. It's already been proven you can go from 1 case to full pandemic in 4 months.

[graeme]

> It's already been proven you can go from 1 case to full pandemic in 4 months.

When nobody was testing, and nobody was expecting it. Testing and tracing infrastructure will only get better, not worse. You won’t see cases in Hong Kong suddenly go from zero to thousands.

> Unless Vietnam, Cambodia, Thailand, Australia, New Zealand, iceland, luxembourg, monaco, Taiwan, Hong Kong, Belize, China plan on never reopening to the World, the virus will spread again.

I suspect they'll reopen with mandatory testing and isolation of travelers. Many of those countries already have varying versions of this.

This will go until a vaccine exists. Then once a vaccine exists you’ll need proof of vaccination to enter.

Tourism is nice for economies, but not being in lockdown and not paying the costs of an outbreak is even better.

Why exactly will it be impossible for those countries to use this system for 1-2 years until a vaccine is ready? The alternative on offer in countries with outbreaks is hardly compelling.

Perhaps we’ll discover a treatment in between that will make this unnecessary, but barring that the world may divide into cold zones and hot zones.

[dredds]

Indeed. NZ & Aus exchange about 20% of each other's tourism in a regular year. Sometime in July we should see open borders across the ditch, saving a good number of jobs in travel and tourism sectors. Job subsidies have been timed to maximize this 'bounce back' economy as well.

China, Singapore, and Qatar seem to have less-lethal strains if their recent numbers are to be believed. Perhaps in lieu of an early vaccine we might see weaker asymptomatic strains as providing a safer path to herd immunity. Someone here from these countries might be able to explain their low death rates in more detail.

[graeme]

Good point about tourism amongst clean zones. There will also be less domestic money that leaks out to foreign tourism: much will be spent domestically instead. Tourism is mostly a wash.

The bigger loss will likely be from whatever business/scientific travel is truly necessary. If that gets harder you may see some long run economic harm.

As for China, not obvious they have a lower fatality rate? Their official stats show a 5% CFR.

Singapore and Qatar have their cases amongst the mostly young migrant workers, which should have a much lower fatality rate due to age. I’m skeptical that any countries have a much less lethal strain. Unless we see nursing homes with widespread infections but few deaths.

https://www.bloomberg.com/news/articles/2020-05-05/as-virus-...

[JoeAltmaier]

Of course there's discussion. All over.

And the point of lockdown was, time. Time to understand what to do next. Now that's happening.

The concern is all the idealism and absolutism thrown about, instead of measured intelligent discussion, IMO.

[alkonaut]

> With lives at stake,

I think we must remember that "lives at stake" aren't just Covid infected. People will die in 10 years from budget cuts coming from things we do now. This isn't about counting bodies in the spring of 2020 (only).

[tharne]

That's pure speculation and not very informative to the debate. Basically you're saying, "In a decade the government will spend less money on a number of unspecified things and those cuts are going to kill people in some unspecified way".

You could just as easy make a number of different equally speculative arguments, such as:

"This will force drastic cuts in spending, including military budgets, leading to fewer deaths from war".

"This will kill a lot of the elderly and chronically ill, drastically reducing government costs for things like healthcare, socially security and pensions, freeing up money for other things".

"This will leads to more people moving to suburbs, increasing carbon emissions."

"This will lead to more people working remotely, decreasing carbon emissions."

What this pandemic has taught us so far is that we're really bad at predicting the future. In the meantime, we should try to minimize the death toll in the here and now.

[alkonaut]

> What this pandemic has taught us so far is that we're really bad at predicting the future. In the meantime, we should try to minimize the death toll in the here and now.

While I agree that it’s hard and speculative, I don’t agree with this. We have to minimize total suffering and lives lost and in the long term even if it means using very difficult predictions.

[heracles]

I certainly don't like the death rate either. Unfortunately lots of countries are in the same ballpark, 3-4/10000, but with wildly varying stragies. "Only a few months" happens to be the same timeframe for almost everyone else, so not sure why that is relevant. We aren't "doing very little", lots of restrictions on behaviour and travel, but certainly less strict than many other places. "Effort" isn't a good proxy for effective in these circumstances.

I think there is at least two things going on: - The long-run approach being taken makes it seem like nothing is going on, since there isn't much action. Slow and steady easily registers and stillness. - Tons of misreporting, in all directions. I get newsclips from friends in the UK that are just out wrongwrongwrong, and they are wrong in different ways and directions!

With this being said, I hope that Sweden's approach is in't the best! Why? Well, that would mean that large parts of the rest of the world is doing something better (if we simplify it into "lockdown" vs "limited restrictions"). That would cost us here in Sweden 1000's of unnecessary death, but perhaps spare millions in the rest of the world.

[matz1]

With only 4:10000, its not worth being alarmed. I like their approach.

[cwhiz]

That rate is in line with the US and most European countries. The US lost 40 million jobs and spent $4 trillion dollars to achieve the same outcome as Sweden.

And now the US is reopening and attempting a similar approach to Sweden. You can’t shut the world down for months and months waiting for a vaccine.

[MagnumOpus]

You compare two of the worst approaches in the world and present a false fallacy of "shut down the world" when in fact the countries with stricter quarantine/tracing/tracking approaches had far better outcomes:

Germany, and Japan, and Korea, and Taiwan lost far fewer jobs, killed far fewer people per capita and nearly eradicated the pandemic while it is still rampant in the US and Sweden.

[tlear]

Japan is an interesting one. They did next to nothing.

Life is almost back to what it was before atm. How did Tokyo not have a massive outbreak is an absolute mystery. But it did not.

Was it that 99% of people when told to started wearing masks and people do not hug or shake hands? We have no idea, no tracing, very small amount of testing, no house arrests of any kind.

[claudeganon]

They didn’t do “next to nothing.” They used a cluster-based approach through their public health center network, that was put in place to combat TB in the 30s. Turns out, that was pretty effective at combatting COVID.

> In 1935, with funding from the Rockefeller Foundation, Japan opened its first public health centre (PHC) in Tokyo. The country then put in place a programme that led to the building of another 187 nationwide. They survived the war and the occupation. But the thing of note is that before and after the war, their priority, says Taniguchi, was always to “stay watchful all the time” for the emergence of TB cases. If one was found, they were tasked with rushing to the patient's residence, checking for clusters and sterilising the house Seventy-five years on, 469 PHCs are in operation across the country, with each manned, on average, by 64 medical professionals, including one to two licensed doctors. They still locate clusters, track links and conduct tests. It is this “accumulated wealth of expertise, rarely found elsewhere” that has made the difference. Japan has not had to rely on mass testing strategies because it’s health care history had already left a cluster-crushing strategy embedded in its system

https://moneyweek.com/economy/global-economy/601264/cluster-...

[ardy42]

> They didn’t do “next to nothing.” They used a cluster-based approach through their public health center network, that was put in place to combat TB in the 30s. Turns out, that was pretty effective at combatting COVID.

Also, IIRC, their culture is naturally more socially distanced than western ones (e.g. mask wearing was already common in some situations, bowing instead of hand shaking, etc.).

[claudeganon]

Mask wearing, yes. I’m not sure about the other parts. Unmarried people live with their parents well into adulthood. There are less children, so maybe that’s a factor. But most stores, restaurants, and other venues in Japan would seem cramped and overcapacity by Western standards.

[JoeAltmaier]

America's rate was kept under control ever since the lockdown. As planned.

[supportlocal4h]

By definition a pandemic is not eradicated if it is still rampant.

Without a vaccine, Germany, Japan, Korea, Taiwan, and anyone else are still at the same risk they were five months ago.

[riffraff]

not really: in five months we (humans) have gathered ideas on how to treat the disease; we've ramped up the production of masks, ventilators, tests, an so on; we've educated the population on how to be safer; we've set up special paths to manage infected people in hospitals so we can avoid contamination; we've increased IC beds; we've learned how to identify the disease earlier rather than just consider it a flu; and many other things.

Everyone is still at risk but the risk today is lower than 5 months ago.

[cwhiz]

Worst approaches? In what way? Certainly not in outcome. Just in your mind?

[JoeAltmaier]

It is a doubling or tripling of other places. 5% of all deaths due to a single infection.

The US lockdown had concrete effect, limiting cases to what the hospitals could manage. Further, we understand more now (1000's of studies and papers published in a few months).

To compare blindly ignoring the disease and crossing fingers (Sweden's approach) vs wait-measure-respond, I know which way I prefer.

[cwhiz]

Doubling or tripling? Belgium 8.2, UK 5.8, Spain 5.8, Italy 5.5, France 4.4, Netherlands 3.5, Ireland 3.3, US 3.3.

The US lockdown may not have had any impact. Mobility trends are disconnected from government orders. The people more likely stemmed the tide in the US more than any government action.

Sweden is just marginally worse off against Covid overall than the US. And they didn’t have to spend $4 trillion or lose 40 million jobs to achieve that.

[useerup]

> Sweden is just marginally worse off against Covid overall than the US. And they didn’t have to spend $4 trillion or lose 40 million jobs to achieve that.

Sweden took less drastic action than the US. Sweden did take some action early, encouraging social distancing, increased hand hygiene etc. Then again, in Sweden you can take sick leave with full pay. More people will stay home if they feel sick.

Parts of the US took more drastic actions, but very, very late (during a pandemic where number of cases double every 4-5 days, one week is late, several weeks is very late). Shutting down borders to foreigners doesn't cut it when the virus is already spreading in the communities.

While they ended up in almost the same place, you really cannot compare them. The Swedish circumstances are so different from those of the US, that you cannot expect the Swedish same strategy to work the same way in the US.

And before you claim that the Swedish strategy is a success, consider how Sweden compares to its Nordic neighbors, where you can compare the circumstances.

Per 1,000,000 inhabitants:

    Sweden  4042 cases, 450 deaths
    Denmark 2040 cases, 101 deaths
    Finland 1247 cases,  58 deaths
    Norway  1567 cases,  44 deaths

[mikem170]

But yet Norway's prime minister thinks they overreacted with their lockdown:

>Leaders in some European countries have suggested enforcing tough lockdown measures early in the COVID-19 outbreak may not have been entirely necessary.

>Norway’s prime minister Erna Solberg said during a television interview last week with state broadcaster NRK that its approach had been over cautious.

>“I probably took many of the decisions out of fear. Worst case scenarios became controlling,” Ms Solberg explained.

>She assured viewers that strict restrictions were imposed based on the international state of the disease at the time, but said that on reflection perhaps they were misguided.

[0] https://au.news.yahoo.com/coronavirus-norway-pm-regrets-not-...

[kspacewalk2]

Why are we cherry-picking Nordic neighbours? Because they happen to back one of several competing narratives? We can find plenty of other countries that have implemented stringent lockdowns and have similar or higher cases and deaths per capita.

That's the beautiful thing about these almost meaningless cross-country comparisons - the data is so low-quality and heterogenous that you can pick a pair of countries and validate pretty much every hypothesis with it.

[BlackNitrogen]

The comparisons aren't meaningless, cause they are very similar. People who want to defend Sweden don't like how terrible Sweden looks. Because of idealogical reasons around locking down a lot of people want Sweden's strategy to work, and they torture themselves into weak arguments to justify killing a lot more people. If you can't compare them for some reason, then you basically can't do any comparisons because you ruled out their nearest neighbors.

[claudeganon]

Again, as someone else up thread pointed out, you’re just comparing various notches on the “bad response” scale. Your calculus doesn’t work if you compare Sweden to Taiwan or the US to South Korea, even with adjustments to population.

If your argument is that “it doesn’t make that much of a difference choosing between doing nothing and pursuing a bungled, haphazard response,” then sure, a lot would probably agree with you. But these are not the only choices any of these countries had.

The economic damage is part and parcel of the overall mismanagement, which is why Taiwan and South Korea are doing better with both handling the pandemic and the state of their economies.

[cwhiz]

I specifically said Europe. You all are the ones who continue to move the goalposts.

In context of the European response Sweden is doing just fine. Japan and Korea have a different culture around surveillance than people in America or Europe. What worked in those two countries isn't relevant because Europeans and Americans reject that kind of surveillance.

Sweden has done about as well as any other western country in regard to the coronavirus and they did it without ruining their economy.

Sometimes I think people here on HN are just hoping the economy will tank.

[claudeganon]

I honestly hope the economy gets back to normal, I just think you need to have a rational and thorough response, like South Korea and Taiwan in order to do that. Otherwise, you’re talking about the possibility of regionally endemic disease with sporadic flare-ups that’s constantly throwing things off course.

You also can’t really shift goal posts comparing Taiwan to Sweden because we’re talking about a global pandemic that originated in China. It honestly doesn’t matter who’s doing best in Europe if people are better off in SE Asia, both in terms of economic damage and that caused by disease. Hand-waiving at “cultural differences” seems mostly an excuse because there is as much difference in culture between the high-performing countries in Asia as there is between the low-performing ones in Europe.

[cygx]

If "doing just fine" is code for "5-10 times worse than their nearest neighbours" (in terms of deaths per capita), sure.

[thu2111]

You're cherry picking data points. JP Morgan amongst others have studied all the data and found no correlation or even declines in infection rates before and after lockdowns:

https://dailycaller.com/2020/05/20/jp-morgan-infection-rates...

Sweden is about middle of the pack. Most of that is because of the virus getting into care homes, which a lockdown can't prevent anyway given the staff have to come and go, and blocking the elderly from all visits forever is deeply inhumane. Given their age many of them would rather catch the virus than live longer but always be alone, and have said so.

So far it appears lockdowns didn't affect the virus much at all. However, they are definitely killing people if you look at the changes in suicide rates, the backlogs for cancer treatment that have built up and so on.

The problem with believing that Taiwan and South Korea are doing better for fundamental reasons is that it may simply be random. Japan did very little or nothing, probably due to trying to avoid the Olympics getting cancelled, and had similarly good results. The differences in testing levels and definitions between countries alone make comparisons based on reported infection and death rates meaningless.

[matthewdgreen]

"JP Morgan amongst others have studied all the data and found no correlation or even declines in infection rates before and after lockdowns"

This claim doesn't pass the sniff test, doesn't match a clear signal that anyone can see on graphs of data from Wuhan, NYC and Italy as well as other US states, and doesn't comport with our basic understanding of how infectious disease spreads. The fact that it's featured in a political website that uses the words "research... allegedly found" in its first sentence is just the cherry on top.

[claudeganon]

I can’t really parse this “article,” which appears to be from a right-wing opinion site, mostly linking tweets from a CNBC anchor.

Taiwan and South Korea being random seems a spurious claim. Taiwan’s Vice President is an epidemiologist invested with a great deal of executive authority in dealing with public health crises and has guided the country’s response from the outset. South Korea was trending in a quite bad direction with the church outbreaks and quashed them through massive interventions in testing and mobile hospital capacity. And neither country has mass-scale lockdowns like the west (because they didn’t need them).

[blaser-waffle]

A vaccine which might never come. Or which may come in a year or more. Or which has side effects.

[JoeAltmaier]

Just the beginning of it. There are antibody treatments, new knowledge about ventilators vs oxygen, triage and testing advances. All because we took the time for that.

[mayama]

Here are the deaths per 1M for few countries around Sweden's death number. Even ignoring Italy which was affected first, all other countries deaths per million are within 2% of each other. What is alarming about Sweden's numbers?

* UK 585

* Spain 580

* Italy 556

* Sweden 450

* France 445

* Netherlands 350

* USA 330

[cygx]

Here are the deaths per 1M for few countries around Sweden's death number.

Why that restriction? Let's expand your list a bit more, shall we:

* Portugal 142

* Germany 103

* Denmark 100

* Austria 75

* Finland 58

* Norway 44

* Czechia 30

* Poland 29

* Greece 17

The contrast between Sweden and its nearest neighbors Denmark, Finland, Norway is kind of glaring...

[geoffreymcgill]

A chart to help visualize some of those countries...

https://i.imgur.com/WrYORJL.png