Sunday 27 September 2020

Well, yes and no.

From The Guardian:

It’s not true that Sweden offers an escape from the public health catastrophe.

Whether you count the March-April death spike as a 'public health catastrophe' or not is up to you, but whatever you call it, Sweden seems to be out of the woods and back to normal, with an average of about 3 covid-19 related deaths per day since the end of July, that's not even a bad 'flu season. What's done is done.

I only wish it did. But, and this is when conservative commentators, politicians and conspiracy theorists look away, Sweden offers an escape from the social catastrophe now engulfing us.

And why do we have a 'social catastrophe'? In the short term, it is because of the lock down, that's clearly an economic catastrophe, which has led to a social catastrophe.

You never hear the Telegraph or the Mail say that we need Swedish levels of sickness benefit to ensure that carriers stay at home and quarantine. Or Swedish levels of housing benefit to ensure that they aren’t evicted from those same homes.

The knights of the suburbs do not insist that the hundreds of thousands who will be thrown on the dole in the coming months need Swedish levels of unemployment benefit and an interventionist Scandinavian state to retrain them.

That's circular logic. If Sweden had done full lock down, they simply wouldn't have been able to afford their high levels of unemployment benefit and retraining programmes. They can only maintain this because so few people lost their jobs. The UK did full lock down, lost hundreds of billions in economic output, with related loss of tax revenues, put a million people out of work and wasted tens of billions in Furlough Scheme payments and other welfare payments. Conversely, if the UK had done a much softer Swedish style lock down, very few people would have lost their livelihood, so there would be little need for retraining programmes, and we could have afforded a more generous welfare system (like a UBI).
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It's also a diagonal comparison. It's the Guardian's job to slag off anything vaguely right-wing, fair enough, but what the nominally Conservative government is doing is pretty much the opposite of what the right-wing press are calling for. And the article doesn't bother addressing the actual topic in hand, whether Sweden was right to do a very soft lock down.

It's not a left-vs-right thing either, I commend Prof. Sunetra Gupta's article in The Evening Standard. She always looked at this from a scientific stand-point and said that lock downs were pointless back in April or May:

Professor Sunetra Gupta, who has been a leading critic of the cost of lockdown, says she welcomes the return of schools as children “if anything... would benefit from being exposed to this and other seasonal coronaviruses”.

Gupta, who is a professor of theoretical epidemiology at Oxford, told The Londoner that alongside huge social and educational benefits, the “evidence is mounting that early exposure to these various coronaviruses is what enables people to survive them”.

She rejected being bracketed with libertarian lockdown sceptics, saying her opposition came from the left. “I personally think that only thinking along the lines of eliminating coronavirus, without giving heed to the consequences on the disadvantaged young and globally, is a dereliction of our duties as global citizens”.
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Finally, there's this:

By not locking down in the spring, Sweden had a more protracted outbreak with far more deaths per capita than its neighbours. Admittedly, its death rate was not as bad as Britain’s. But then no European country had a death rate as bad as Britain’s because no other European country put the village idiot in charge.

Yes, we have the village idiots in charge, but the UK does not have the worst death rate. We are third-worst behind Belgium and Spain and only slightly worse than Italy or Sweden (ignoring micro-states).

26 comments:

Bayard said...

It's time to start a new series "killer arguments against Sweden getting it right over lockdown, not". I can see it being a long series.

Mark Wadsworth said...

B, this isn't up to mere mortals like you or me to decide. It's people like Gupta v people like Ferguson, who are at opposite ends of the debate. Half of them are completely wrong, but which half? (Ferguson, obviously).

benj said...

In the end, it will boil down to what the real infection fatality rate is, matched to how the virus effects different age groups.

That will give any policy intervention a measure of Quality-Adjusted Life Years Saved.

Based on Ferguson, the government believes it has saved upto 1.5 million lives.

That gives an IFR of nearly 3%, based on the fact the NHS would be swamped.

That gives 6-10 million QUALYs lost.

The assumption is though, the IFR is 0.9%, mitigated (every who want NHS treatment gets it)

That gives 2.5 million QUALYs lost.

However, given the likely economic cost of covid is going to be £350bn and a life is valued at £8million, the "breakeven" QUALY's lost is 3.5 million.

So even at a IFR of 0.9% and >500K covid deaths, its not worth the projected costs.

Now imagine that a) the IFR isn't 0.9% b) this need not have cost anywhere near £350bn in order to have got similar IFR (as the Swedes appear to show).

For those interested https://tinyurl.com/y4xh5dy8

Sobers said...

If you ask me the measures taken by governments have had little to no effect whatsoever on the impact covid has had on a population. I suspect that eventually proper scientific research (not thinly disguised political dogma) will show that the main driver of the variance between countries is factors such as population age structure, population ethnic makeup, population overall level of health and population smoking percentage, population density and also the way in which statistics are arrived at in each country. There may also be some genetic variations between populations as well, with some being more prone to infection than others.

Its noticeable that poor countries have done better than rich ones which is counter intuitive, and suggests that it is not the actions of government that makes any difference, but the basic nature of each population group that is the main driving factor. Thus rich countries with good healthcare facilities have more elderly people with multiple health issues still alive, who thus can catch the virus and die from/with it, whereas poor ones have younger populations and less elderly as they've already died at younger ages from other causes. Similarly poorer countries tend to have less immigrants, and its also obvious that non-Caucasians suffer more from covid than European natives do. Poorer countries tend to smoke more, and their data collection may be less rigorous than the richer ones, and they do not have as many people living in massive urban areas either.

L fairfax said...

What is really important is not the number of people killed by Covid but total death numbers.
Are they worse in Sweden than previous years?
If not then is Covid the problem?

Mark Wadsworth said...

Benj, did you really read all 188 pages of that?

S, "If you ask me the measures taken by governments have had little to no effect whatsoever"

There are plenty of scientists who say the same thing (and I tend to agree). But the politicians are listening to the scientists who say the opposite (and the media seem to agree with them).

As to rich-v-poor countries, apparently this is probably because the flu/coronavirus season in colder countries is in Feb-April and is usually quite bad, and in warmer countries (which tend to be poorer, heck knows why), the flu/coronavirus season is in July - September and is usually not so bad. (I'm not sure why you don't add on 6 months for southern hemisphere).

As discussed, population density is irrelevant. What matters is the number of people an average person comes into close contact with each day.

LF, again, apparently, the flu deaths were very low in 2019, meaning there was an excess of vulnerable people waiting to be knocked off their perch in 2020. If you add 2019 and 2020 flu deaths together, they are pretty much average for any two normal years.

L fairfax said...

"apparently, the flu deaths were very low in 2019, meaning there was an excess of vulnerable people waiting to be knocked off their perch in 2020. If you add 2019 and 2020 flu deaths together, they are pretty much average for any two normal years."
That would convince me - although I would like to see the figures.
I don't think people who support lockdown would be convinced though.

Mark Wadsworth said...

LF, unfortunately, all these scientists have their own prejudices and cherry pick data.

Jack C in the comments to an earlier post left a link to this video, which taken in isolation seems very plausible to me, that's where I got it from. Either those things are true or they aren't.

Warning - it's half an hour long.

Lola said...

Benj. That is the first COBA I have seen for all this. Well done.

Sobers said...

"population density is irrelevant. What matters is the number of people an average person comes into close contact with each day."

Which must be related at least to population density, no? Its obvious that the mega-cities are far more contagious, so the more a country has densely populated areas, the more cases it will have. Its not so much the density overall, but the density where people actually live that matters.

benj said...

@MW

Just skimmed for relevant points.

@ Lola

The Imperial report and the one I linked to are, I assume, what is driving policy.

But it seems there are are a ton of assumptions each make, usually the absolute worse case senerio, that could significantly(understatement) skew the results. No wonder the politcans and public are shitting themselves.

If you read the report I linked to, the QUALYs are based on 10.5 average years lost. But they admit themsselves there are a number of assumptions they make that could have made that figure way too high.

Such as, the deaths are evenly spread across age ranges! It's there, read it.

This is important. If those QUALYs saved aren't 2.5million but say half, then the cost of lockdown/supression is a monumental cluster-fuck of a mistake.

Did we get anywhere near overwhelming our NHS? No we did not. Would we if we lifted all suppression measures except strictest quanitine of most vunerable (which we are much better prepared to do now) for 3 months?

I don't think so.

Mark Wadsworth said...

S, yes, large towns have larger offices, bigger supermarkets, more cinemas and more people use public transport etc. So inevitably you come into close contact with more people.

But if you live in an idealised sparsely populated rural economy, you might still go to a farmers market once a week where you meet thousands of people to even things out.

Mark Wadsworth said...

Benj, being cynical, yes, we have to ascribe an arbitrary £ value to a life saved or extended by one year for cost-benefit analysis purposes.

But should we also factor in that if an OAP dies five years earlier, that saves £40,000 in state pension costs and maybe £30,000 in average cost of NHS treatment for a year?

30,000 OAPs have died, so that makes £2.1 billion future costs saved.

George Carty said...

Sobers, aren't early and severe restrictions of international travel (usually banning outright everyone but citizens and permanent residents, with even those subjected to two weeks of enforced quarantine) the one government policy that did make a big difference?

It looks like all the real Covid success stories had that in common: Taiwan, South Korea, New Zealand, Iceland, Australia (minus Victoria)...

benj said...

"If those QUALYs saved aren't 2.5million". Lost, not saved. Ooops.

@MW

£2.1bn is a drop in the bucket at the moment. But answer to your question, yes.

I don't think this is cynical. Just hard headed. Which is the pont of having QUALYs.

Of course its even more complex. You have to consider loss of welfare. Long term economic impact of children not going to school. Loss of QUALYs due to economic/welfare impacts (address in that report).

On the other hand, you've also got loss of life due to people not getting diagnosis/treatment of not covid illnesses.

If Cohen could persuade me those QUALYs lost really were 2.5 million or over, I could just about cut the government a break.

But I don't think they would be (with the right policies). Remember, 2.5 million equates to 500K direct covid deaths.

Lola said...

Benj MW. I recall that the price of a life assumed by government is £60,000 per annum. I have read that average age of the covid (sorry allegedly covid) victims is 79.5 years. men live to about 80 women to about 84 (both from memory...

George Carty said...

Plus of course almost all the success stories are islands (or a de facto island in South Korea's case, as its only land border is a miles-wide literal minefield)...

Sobers said...

" aren't early and severe restrictions of international travel (usually banning outright everyone but citizens and permanent residents, with even those subjected to two weeks of enforced quarantine) the one government policy that did make a big difference?

It looks like all the real Covid success stories had that in common: Taiwan, South Korea, New Zealand, Iceland, Australia (minus Victoria)..."

Could be. Did Germany ban incoming flights though? I assume not, as the land borders were not closed. And Germany has had a 'good war' against Covid, so the travel ban doesn't explain that.

Of course at the beginning of all this, the very same people now berating Boris and Co for his mishandling of the crisis were also shouting that to close the borders would be racist, and we should all be hugging a Chinaman...........

Lola said...

https://www.telegraph.co.uk/news/2020/09/29/coronavirus-deaths-hit-one-million-many-lives-will-claim/ (paywall.

The commenters are with us!

Global death rate ~ 0.0014%...

Lola said...

Sorry - 0.0135%. But that's known by even professional statisticians by the technical language 'bugger all'.

Mark Wadsworth said...

GC, you say "island", Sobers counters with "Germany". So that's inconclusive at best. Slovakia did even better, also not an island.

L, yes, it's increased global deaths by about 2% for six months. Not bugger all, but not a global catastrophe either.

George Carty said...

AIUI Germany didn't do that much better than most of Europe where infection rates were concerned, but had fewer deaths (but still a lot more than the real success stories previously mentioned) because of its high-quality health care system (and because they did a good job keeping the virus out of their care homes).

Slovakia and the rest of Eastern Europe (like Vietnam) may have been protected by their relatively low numbers of international travellers.

benj said...

@Lola

If a life is valued at £4.8M rather than my £8M, that raises the "breakeven" point substanially, makes things even more inexplicable.

Mark Wadsworth said...

GC, yes agreed, all those things are factors and may push things one way or another. But for every example there is a counter-example. I suspect that the better outcomes in east Asia is because they are more immune to these types of diseases.

But the one thing that makes f--- all difference is whether you had a lock down or not.

George Carty said...

How much of the COVID19 deaths in Western Europe were a result of austerity policies which led to PPE stockpiles being run down, in the (false) belief that they could be rapidly replenished if needed?

(Which was of course impossible because they were relying on China to supply their PPE: the very country that was ground zero for the pandemic.)

Mark Wadsworth said...

GC, that is a politically loaded question. You can't plan for everything.

By the way, PR China claims to have only had 4,000 or so covid-19 deaths in total.