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Sweden is being hailed by some as a model of Scandinavian Pragmatism and by others as a Dangerous Game of Russian Roulette with People’s Lives

 

 The Swedish approach is best summed up in comments made by the country’s Chief Epidemiologist, Anders Tegnell. “We think we’ve already taken the most important measures,” he said last week.

“Stay home if you feel ill; work from home if you can; and ensure that we protect our older fellow citizens.

 “You could alter other rules, such as those governing trips to the restaurant or gatherings, but you get the best effect when everyone simply sticks to the basic code of conduct.” That ‘bests effect’ may not be realised – Sweden has now recorded the most coronavirus deaths in Europe per capita (rolling seven-day average 12th – 19th May), according to data published by the University of Oxford on 19th May.

Sweden has never enforced a strict lockdown, with cafes and restaurants remaining open. Instead, the government advised citizens to use their common sense and stay home if sick and maintain social distancing when they go outside or to public places. Unlike almost every other European nation, Sweden saw its death rate increase to 6.25 per million inhabitants between 12th – 19th May. By contrast, the UK’s fell to 5.75, Belgium averaged 4.6, France 3.49 and Italy registered 3 per million. On the face of it, it seems that the sooner and harder a country enforced a lockdown, the sooner they flattened the curve.

But, is there a correlation between the speed and severity of countries’ lockdowns? Clearly at this stage there are so many known that drawing conclusions is a fool’s game? What we can do, however, is try to understand the data. Up to date statistics on May 20th 2020 – from the trusted source statista.com – raises valid questions over whether or not the kind of strict Spanish and Italian style lockdowns might prove, in the long run, to be any more effective at bringing down mortality rates than the Swedish model. The table below shows the tally so far of deaths per million:


Coronavirus (COVID-19) deaths worldwide per one million
Population as of May 20th 2020, by country (www.statista.com)

So far, the data shows us that Spain and Italy have – so far – suffered many more deaths per million population than the UK and Sweden – two countries considered to have taken a softer approach. There may, of course, be other factors, such as the average age of the population and levels of obesity, which are known factors in mortality. There are also differences in how different countries classify what a COVID-19 death actually is and where fatalities happened.

Statista says this:

‘Based on a comparison of coronavirus deaths in over 170 countries relative to their population, Belgium had the most losses to COVID-19 up until May 20, 2020. As of the same date, the virus had infected over 4.9 million people worldwide, and the number of deaths had totalled more than 323,000.

Note, however, that COVID-19 test rates can vary per country. Additionally, big differences show up between countries when combining the number of deaths against confirmed COVID-19 cases.’

It is becoming increasingly obvious that one of the UK’s strategic errors may have been to send old people back to their care homes after they have recovered or simply deemed too well to warrant taking up a valuable bed space in hospital. This perhaps explains why such a large proportion of UK deaths have been in care homes. BBC Policy Editor Lewis Goodall revealed leaked statistics from County Durham County Council that showed that 45 percent of all of their COVID-19 deaths so far have come from care homes, while only 55 percent have been recorded in hospitals.

Making sense of so many variables, behaviours and policy approaches is for statisticians and experts. Until then, none of us truly knows whether or not the Swedish model is something to adopt, and whether its comparatively unscathed economy makes it all worth it in the end. Those countries that have adopted the strictest lockdown regimes are paying the heaviest economic price – and the costs to mental health are yet to be seen. Italy’s extremely long and draconian lockdown has, reportedly (and in many, many publications) had a devastating effect on mental health, particularly amongst those who live alone: which is, ironically, disproportionately the elderly.

One thing that it may be fair to predict is this: whatever the approach, whatever the variables, COVID-19 will prove to be a zero-sum game.

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