Hi Gianluigi, I have not done any updates in a while, but it is nice to see that we are seeing the effects of the vaccine across Europe and (parts of) the World now.

The Economist has made nice graphs of the excess deaths in different European countries, and here is what it looks like (with Sweden marked in yellow).

As all EU countries (as well as a few others) have very similar vaccination rates I would expect similar case fatality rates at least if testing was similar in different countries, but this is how it looks like since vaccination started:

Honestly it surprises me a bit that Sweden's rate is so low, considering that I believe that we are testing less then others (I have never done an official test for instance, just one home test when I was part of organizing an event).

Pictures taken from Jacob Gudiol's twitter.

(BTW, Last two weeks I was on vacation in Sicily and Naples, really nice.)

Another thing that I missed mentioning, and that is really important too is which type of government support businesses and consumers have been provided, and how that affects e.g. the national dept. There's a lot of things to consider...

Niko, The overall efficiency should be measured by its "output" performance in terms of "infected per tests", or "infected per capita", or "deaths per capita" from the start, up to now. Sweden has done it much worse than the other nordic countries and even compared to many countries in Europe (including our own country, Greece). The Swedes are rather happy and proud these days because having around 250 infected daily is "success", while similar numbers in Greece (with almost same population) is "terrible". If Sweden is going to be a success story with so far almost 90,000 infected, compared to roughly 15,000 in Greece, the greek cases must be three times higher per day over many months to come... We will see. To argue that "these people would die because they were sick and/or old", is a bad excuse for the failure. Every country can argue like that! Euthanasia is not allowed in Sweden and the authorities should do their best to save lives, period!

In addition, if one takes into consideration the very low density of population per square km in Sweden, compared to almost all countries in Europe, "social distance" should have worked much better here, but it did not! Stockholm with less than 1.5 million has much less intensity than Athens, Paris, London, Brussels, Milano etc...

There will be different opinions there, but for me a death caused by e.g. cancer is just as important as one by Covid.

I have a hard time seeing that many people would draw the conclusion that no one has died from Covid in e.g. Norway, so I don't see that as a problem. Instead it poses an interesting question. It looks like the measures taken by Norway, Iceland, and Denmark led them to have lower mortality then normal. How come? Probably less people then normal died from e.g. the flu (as those lives are extended with similar measures) . Then the question is, why are they not doing that every year, i.e. were the measures a bit too drastic this time or should they (and others) learn to take these type of measures on a regular basis, e.g. every flu season? Why/Why not?

This is a trade off that is always done in every society and every hospital and there is no given answer on what's right.

Great work (+1). Economically it seems that so far the Swedish experiment has not brought tremendous advantages: [Pandemic, Shutdown and Consumer Spending: Lessons from Scandinavian Policy Responses to COVID-19][1]?

Attachments:

2005.04630.pdf

There something wrong in your model. If we assume an R0 of 3.84 (which I guess you mean with initial R), then herd immunity is easy to calculate and you would reach it when 1/R0 are susceptible, i.e. 26% of the population is susceptible. To get down to only 2% susceptible you need either a much higher R0 or that you run towards the herd immunity, so the herd immunity does not have enough tome to slow down the growth. Considering that you talk about a time frame for this fall/winter then we are apparently not running towards the herd immunity.

See herd immunity here: https://en.wikipedia.org/wiki/Herd_immunity

Btw, your number of 16,000 in itself is quite reasonable. Reasonable numbers is easy to calculate by just multiplying fatality rate (0.2 - 2% perhaps) with number of infected (50 - 90% perhaps) giving between 10,000 to 180,000 deaths depending in which figures apply. Of course, the fatality rate is the most important factor here (I think they believe it's around 0.2% in Stockholm to date). That's why it is so important to protect risk groups.

Anyways, the number in itself is not that strange, but the parameter settings you have in your model simply don't add up with the current development, so the trajectory will most likely not be as in your simulation while the end result might be the same.

So far, the Swedish open society experiment has not been very successful compared to the majority of European countries that have applied much restrictive lockdown policies. For instance, if the Swedish Song Contest for Eurovision that took place on March 19 in front of 30000 people at Friends Arena in Stockholm was without public, precisely as in Denmark, it could have reduced the number of infections and deaths.

Attachments:

lockdown.nb

The first relevant antibody tests for Sweden came just a couple of days ago. As expected the largest proportion of positive antibody tests are found in Stockholm. A total of 7.3 percent of the blood samples from people in Stockholm were positive. For the southern region of Skåne (that borders to Denmark), the proportion of positive samples was 4.2 percent and for Västra Götaland, where the second largest city, Gothenburg is located, the figure was 3.7 percent.

The analyzes also show that there is a big difference between age groups. Antibodies were most common in people aged 20-64, a total of 6.7 percent of the samples in the group were positive. In the 65-70 age group, the proportion of infected persons was less, 2.7 percent. This indicates that protection of elderly has worked to some extent at least.

The tests were taken end of April, so more people will have antibodies by now. It is my understanding that it can take a few weeks after an infection before you have built antibodies. If that is the case, it means that means that even more people have been sick at this point. Does someone know? @Robert Nachbar perhaps?

Jan, By the day the Euro- Song contest took place in Stockholm, there were at least 1500 infected in Sweden (tested positive) and 12 people were already dead. No other measures had been taken until March 19 and Stockholm was (and still is) the main source of epidemy in Sweden. Anders Tegnell did not think it was necessary to use its power to close the doors to Friends Arena. When he limited the number of people in gatherings to 500 a few days later, he found it sufficient and "restrictive" enough. When he was questioned by the SVT if 500 is not a very high number compared to 10 that was the average number in Europe, he answered that it does not make a big difference... Personally, I was in accordance with the Health authorities to keep the schoolls open, and against the total lockdown. We see if the Swedish strategy was right.

By the way, many countries in Europe do not want tourists from Sweden this year. If Anders Tegnell and the government were consistent with their recommendations to not travel abroad (not even within the country for more than 2 hours), they should be happy if the Norwegians, Danes, Greeks and Cypriots do not like the Swedes this summer...

Thanks Nicholas. I think it's still too early to say if we did it right or not, but it is for sure not obvious that we did it wrong at least. In a sense nobody will have made it right (there will always be one sort of mistake or the other). In another sense two countries with completely different strategies might end up having done most things right, considering there situation.

(If my simulations from early April are right Sweden will have a small increase in October when the seasonal effect is over, but if we relax just a tidy bit too much then we might very well have a second wave coming. The simulations should be taken with a pinch of salt though, as there are a lt of unknowns and simplifications in them)

Agreed, one thing I would like to add though is that there is likely a short term and a long term economical impact from Corona itself and the restrictions. Things like closing restaurants will have an immediate impact of course, just as sick leave will. Naturally, if you had a lot of people being sick, then that will have a negative effect on economy. To me, this effect is likely to be a short term effect. This part of the economic downfall should be relatively easy to come back from, while e.g. consequences of missed school or unemployment will have a more lasting impact.

Hi Jan, I am not persuaded that this new method "excess deaths per 100,000" is a better measure than the reported COVID19 fatalities, as the authors of that study argue. To see how "absurd" that measure is, let us take Denmark and especially Norway which are to the left of their "normal" deaths. The -15/100,000 in Norway, means that no-one has died of COVID19! If one adds the approximated 1,500 deaths of COVID19 in Norway into "normal" ones, it should be positive, i.e. to the right. If it is still -15/100,000, which for Norway is about - 650 persons, adding the "wrong" deaths (according to this method), it would be plus and not minus. Or, does it mean that no-one has died in Norway from other reasons and the "wrong" 1,500 reported are wrong and should had died to fit with their normal death-ratio? Or, does it mean that Norway could "afford" more than 3,000 deaths, "wrongly reported as COVID19" in order to be on its normal line?

Thanks Christos. It all depends on how many that have actually been infected this far (with this one could to a good estimate of the Swedish fatality rate) and how many are needed for herd immunity (with this one can estimate how many that will actually get infected eventually).

Just by looking at your graph comparing estimated with observed deaths it is quite obvious that your model is not correctly tuned. Does this mean that your total in September will be wrong? Not necessarily, but I would say it will quite likely be wrong.

You are using a very high beta resulting in 3.6 infected per infected person, while data shows that Sweden has been just above 1 for most of the time, and now has had an R value below 1 for at least a week (I don't remember exactly for how long).

Thanks Jan! I hope I am very wrong and my death estimates are too high! But I am very worried with the Swedish strategy. By the way, my initial R is about 3.84 = (0.275/0.0715) solvS[t] /. solv, if t = 0, i.e. if S[0] = 1. Today, when t = 84, the R-ratio is about 1.23 since the susceptible is about 32%, and in 4 days, it will fall to 0.99. By the end of September it will fall to less than 0.08, since the model predicts that there will be about 2% of the population as potential susceptible during the fall/winter.

Of course countries that have very different levels of infection at a given moment might not want people to travel between them. Clusters were you are allowed to travel e.g. between Sweden, UK, France, and Italy, or e.g. Denmark, Norway, Cyprus, and Germany respectively are not unreasonable. The big problem is if there are intersecting clusters, then the clusters become pretty pointless.

As far as I know there is no reliable and comparable information on infected per capita. Where did you find that?

All data that I see is number of known cases, and as test strategies vary so much they are not really comparable.

That said I really hope that we have more infected per capita than most other countries. If we don't then for sure our strategy has failed. For instance, the comparison that could be made with Denmark after both countries published their first antibody studies, suggested that Sweden has had a lower death rate per infected. However, I prefer not to draw any conclusions from that yet. I just don't think the data on that is anywhere as reliable as it should do do this.

Jan. check the following official site where you can find the number of tests and tests/capita etc. Many European countries publish it every day, others (like Sweden) once per week. At the same site you find the number of infected and Infected/capita. Then, you can simply find infected/tests. Sweden has a low rate (tests/capita) and a high rate (infected/capita), therefore a rather high ratio infected/tests, while Italy much lower. https://ourworldindata.org/coronavirus-testing

Yes, "Black Lives Matter" demonstrations can have a positive impact on infected numbers, but such demonstrations have taken place everywhere in Europe recently and not only in Stockholm. Yesterday, they tested 46,882 people in Italy and found 210 positive cases (the accumulated values are 237,500 out of 4.7 million tests). The number of positive cases in Sweden yesterday was 940, and given the fact that they do not test more than 8,000 per day, that is a rather big ratio. You say that " I really hope that we have more infected per capita than most other countries" and I respect your honest statement (altough I prefer as few as possible). Perhaps Anders Tegnell's goal was also to get higher infected/capita in Sweden and in that case he has succeeded ... But, since deaths are strongly positive related to infected cases, he (and everyone who has been rensponsible for health care) has failed. Shouldn't had been better to have had 2,500 (deaths) / 25,000 (infected), instead of the currect ratio 4,891 (deaths) / 53,323 (infected), even if the first ratio is higher?

Ok, Jan! It is meaningless to use Wolfram to debatte about Sweden. Here is my last comment.

If the current statistics are not that favourable for Sweden, one can be happy with the Swedish strategy because (i) the statistics can't be compared and (ii) it is too early to rely on these (misleading) statistics.

Regarding argument (ii), it is frequently used in Sweden to calm the people now and as we say in football, "spark the boll at the public". Arguing like that one "hopes" that other countries, like Denmark, Norway, Finland, Greece, Poland etc will be soon hit by much higher death and infected ratios, while the Swedish ratios will suddenly improve significantly and, by Christmas or Easter next year we will be better off...

Regarding argument (i), that will remain for ever in Sweden, because it would be almost impossible for other countries to adjust their sampling and measurements of "deaths" and "infected" to the Swedish one. I find it rather strange when Sweden, a country that has promised so many tests before and never managed to do that, shifts its position and argues that testing is not that important now (which is true, since the more we test the more infected we get and many of them continued to work with old people without knowing that they were infected...). Perhaps the Italian sampling (almost 8% of its population) is biased while the Swedish (about 3.5%) is statistically correct. But the possible bias in sampling is impossible to explain the much higher infected/tested ratios in Sweden. By the way, right now we got the daily statistics, worse than yesterday, 102 deaths and 1239 infected....

I have added a new section to the post, with a short updated from the last few months, including some comparison between genders, age groups, and regions.

The fact that the graph points move on their own. While we just entered the number on each day. This coding is absolutely amazing.

Jan, I agree with you. My question had to do with the selected methodology of "excess deaths" which can give absurd numbers, i.e. below the normal. When in an average year there are say 10,000 "normal deaths" and in the COVID19 year you observe 9,500, there are many "naive" who would question if there were COVID19 deaths. Personally I believe that in Norway there were around 1,000 deaths and if in that year the selected method finds 9,500, there should be 1,500 less deaths from other sources. And as you say, that might happened, i.e. deaths from other sources might had been lower. But that method can't figure out the "true" number attributed to COVID19.