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I agree with your conclusions, but some nitpicks.

  • Sweden's top epidomologists have their main experience from Ebola in Western Africa, or at least that is true for state epidemlogist Tegnell.

  • Sweden's original plan was to copy the Korean plan with track and trace. It failed early on, because of to little testing capacity. Then - mid-March - it became to decrease the spread without lockdowns - mainly by paying people to stay home. In large part it is because Sweden doesn't have legislation that really allows for a lockdown outside of war, and constitutional safeguards against fast-tracking such legislation. Such legislation is in the works but not expected until next year.

Otherwise, Sweden's experience is similar to other West European nations that was hard hit during the spring. Likely Sweden had already in mid-March a much larger spread then surrounding countries, so the Swedish strategy is better compared to France, Netherlands etc then surrounding countries. And the main difference against these other hard hit Western European countries so far is getting the second wave later, but it is clearly here now.
by fjallstrom on Mon Nov 16th, 2020 at 09:23:52 PM EST
Your second point gives me pause because it makes it seem like they stumbled into a set of measures due to outside constraints and then they called it a strategy. The reasonings were delivered afterwards. At least the technical constraints could have been overcome. Was there any interest to do so?

The style of communication is weird and makes things more difficult than they have to be. They said public contacts are limited to eight. Tegnell says you can go to cinemas but the interior ministry says no. Then the health authority sends in their lawyers?!

From FOIA requests and public pronouncements it seems like herd immunity vacillates from the center of the strategy to 'nice side effect'. Then there is this weird aversion to using masks. Finally, why do they have to go out on a limb and make those very bold and very wrong predictions? While coming up with excuses why their direct neighbors have much fewer deaths and infections. From the outside looking in it's very confusing.

I'd prefer the politicians to stay mostly out of it but the technocracy is not unpolitical. Politicians at least have to legislate to provide the resources that have been sorely lacking. And they can't escape the responsibility of setting the objectives of the civil service. If the civil service says "we just want to ride this out" then that is an inherently political decision.

Schengen is toast!

by epochepoque on Wed Nov 18th, 2020 at 02:58:02 PM EST
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There has been a tendency everywhere to allow technical/political constraints to dictate "strategy".  In Ireland these were:

  1. Lack of testing capacity early on, particularly shortage of reagent
  2. Inability/unwillingness to close N. Ireland border
  3. Lack of quick testing facilities at ports/airports
  4. Mistaken belief that aerosol infection wasn't significant and reluctance to mandate facemasks early on because of fear people wouldn't change/dispose of them safely
  5. Need to keep "essential services" open
  6. Track and trace too slow
  7. Lockdown fatigue
  8. Hospitality and travel industry lobbying

All of these factors made a "Zero Covid" strategy difficult, and so they settled for a "manage covid within hospital and intensive care capacity" strategy instead - which has ended up being no less difficult.


Index of Frank's Diaries

by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Wed Nov 18th, 2020 at 04:50:21 PM EST
[ Parent ]
I just found this:

The Long Shadow Of The Future

The progression of the initial outbreak in different countries followed three main patterns. Countries like Singapore and Taiwan represented Pattern A, where (despite many connections to the original source of the outbreak in China) vigilant government action effectively cut off community transmission, keeping total cases and deaths low. China and South Korea represented Pattern B: an initial uncontrolled outbreak followed by draconian government interventions that succeeded in getting at least the first wave of the outbreak under control.

Pattern C is represented by countries like Italy and Iran, where waiting too long to lock down populations led to a short-term exponential growth of new cases that overwhelmed the healthcare system and resulted in a large number of deaths.

A Tale Of Two Pandemics - The Nordic response to COVID-19 reveals a dark side of consensus politics.

This tale of these two Nordic approaches to COVID-19 shows how similar countries can make dramatically different choices about how to balance the tradeoff between liberty and security. In a paradoxical way, however, the radically different approaches taken by the Swedish and Danish governments reflect a deeper underlying similarity: These are countries whose populations are among the most trusting in the world. They display an unusual confidence in the state and its institutions. Social cohesion and trust run so deep that the Swedish and Danish governments might well have swapped their very different COVID strategies and still retained public support.

Schengen is toast!
by epochepoque on Wed Nov 18th, 2020 at 06:35:45 PM EST
[ Parent ]
"Social cohesion and trust run so deep that the Swedish and Danish governments might well have swapped their very different COVID strategies and still retained public support."

This is very true. Or as a friend put it: If we have experts who model these strategies, then we expect to follow those stratgies at crunch time. And if different experts come to different conclusions we expect our expert authority to come down on a strategy and then we follow that one.

by fjallstrom on Thu Nov 19th, 2020 at 02:46:37 PM EST
[ Parent ]
To a certain extent, yes strategy was determined in part by outside measures. Or rather, any response to a pandemic is determined by the structures you have going in. Which underlines your point about the importance now to set the EU-structures for the next pandemic.

Another part of the Swedish government structure is somewhat independent government authorities. The legislature legislates the laws they follow, the cabinet details the tasks in fomral letters and appoints the head of the authority. That is it. The minister of health is forbidden to issue any another orders to the authority, that would be ministerstyre, which is grounds for impeachment.

So on the press conference where the eight person rule was announced, the prime minister and the health mininster were (if you speak Swedish legalese) very clear that in all rules the cabinet can directly decide it will be eight people. And they expect all relevant authorities to come to the same conclusion. In effect, there are a lot of rules where the cabinet does not have power, and it would take to long to change the rules, in particular when you are a minority government. However, Sweden has a heavy layer of consensus culture on top of the structures so usually people go along.

Why make faulty predictions? Well, most predicitions turn out wrong, but there still needs to be predictions. There was a large and hidden spread in early March, which created a lot of faulty inputs. The actions taken mid-March did break the growth in spread, ICU admittances peaked two weeks later and deaths four weeks later, but at much higher levels then expected due to the hidden nature of the early spread. When the main crisis was over for the hospitals, testing was expanded in June, creating a false impression of an increase. That increase in tested cases was the tail end of the first wave.

Comparing Sweden with neighbouring countries is in my opinion not illuminating. Sweden had much more cases then Finland, and Finland had a lockdown. But France had also much more cases then Finland and they both had lockdowns. Is Sweden better compared with Finland then France? My view is, that if effective measures are taken, the main factor is the amounts of real cases when action is taken. And since that was largely hidden there was a fair amount of bad luck involved.

To demonstrate the importance of luck: Sweden's densest populated county - Stockholm - had half the deaths in Sweden during the spring, while the second densest populated county - Skåne - had a fraction of that. Under the same rules. I think it is obvious that Stockholm had a much larger outbreak before action was taken. If the rest of Sweden had looked like Skåne the story would be about how the Nordic countries managed to avoid the pandemic (until they didn't). My personal theory on why Stockholm had such a large outbreak is the Swedish sport break. That break is in different weeks in different locations, and Stockholm probably managed to hit the worst week and probably had more people going skiing in the Alps.

by fjallstrom on Thu Nov 19th, 2020 at 02:07:09 PM EST
[ Parent ]


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