People have to stop this delusion that the Swedish approach is somehow successful because it got worse or equally bad in the UK, France, Spain and Italy.
That is an apples to oranges comparison. You have to compare similar countries to each other. Everywhere we look at Corona outbreaks, it is without exception high density areas that get hit worse all other things being equal.
We can see this in both Europe and the US. The high density areas are worse hit than those less dense. We can see this between countries and as well as internally. Inside Sweden more dense areas like Stockholm got hit harder than less dense countryside.
Exactly the same pattern in Norway. Oslo where I live got hit harder than less dense areas.
We see the same in Europe. Higher density countries such as the Netherlands, Italy, Spain and the UK got hit harder than low density countries such as the Nordics.
Within the US, dense cities and states such as New York and New Jersey got hit harder than low density ones like North Dakota, Iowa etc.
The second issue is culture, and when you responded. Italy e.g. was not just high density but also a society organized in unfavorable ways. Old people living together in larger families. A culture where touching, kissing etc is more normal. Nordic people e.g. lives more alone. Elderly are in retirement homes or live alone etc. And Nordic people are not very touchy and naturally tend to stand quite far apart from each other when talking.
Sweden Must be Compared to Other Nordic Countries
Hence you cannot cherry pick countries to fit a narrative, such as picking Sweden and say Italy to make the Swedish approach look sane. Those countries are not directly comparable. You need to compare similar countries. The most similar countries to Sweden is Norway and Finland.
Sweden has 12x the death rate of Norway. There is no clearer proof of how terrible the Swedish strategy was. All countries have most people dying in retirement homes, so this is not really an excuse for Sweden. More people died in retirement homes in Sweden because the disease spread more all over society. When the virus is all over, care workers at retirement homes are also more likely to pick it up while traveling to work.
That Norway did better is not some fluke. Every single other Nordic country which followed another strategy from Sweden had much better outcomes.
Why Did the UK, France and Spain Have Bad Outcomes?
Sweden had warning of virus as early as Norway. In fact Sweden was better prepared than Norway as Norway got hit worse first. Hence a Norwegian comparison is fair.
With the other large European countries it is different. Italy was ground zero. We did at this point now know how bad it could get in Europe. Hence they did not have the ability to lock down as early. Other European countries where able to learn from Italian mistakes and lockdown earlier.
The UK cannot be held up as an example of a country which failed despite a lockdown. The UK failed for much the same reason as Sweden. They waited far too long before instructing a lockdown. Norway and Denmark e.g. had lockdowns before anybody was dead. Far earlier.
The UK also suffered from poor testing and tracing. Compare with e.g. Germany with a much better testing and tracing and earlier lockdown and you see much better results. Due to its size an density, Germany is sensible to compare with the UK. It shows those with early lockdowns and good testing and tracing did better.
France is much the same story. They may have locked down earlier but they did in fact not really know when to lock down. They where driving blind because their testing and tracing was not as good as Germany.
We Know the Recipe for Success Now!
COVID19 spread has now happened in so many countries over sufficient time to be able to draw conclusions. The conclusions are clear. This is what is most important:
- Testing and tracing. Countries which where good at this, such as South Korea, Taiwan, Singapore and Vietnam got much fewer cases. We have seen similar experience in several other developing countries which put in a lot of effort on tracing. Sweden totally ignored this approach.
- Early lockdowns when needed. Countries which where good at testing and tracing where able to determine better where and when lockdowns where needed. Many Asian countries succeeded quite well with localized lockdowns. If you don’t do this you cannot localize your lockdown.
- Full national lockdown is the last solution if you don’t have tracing under control. Countries doing this early before any deaths, where able to drastically shorten their lockdown period and reduce deaths.
Countries that did not focus on testing and tracing and which implemented lockdown late, pretty much all ended up with terrible results.
The hammer and dance approach works. The “flatten the curve” approach didn’t work. Sweden is using flatten the curve under the assumption that “hammer and dance” would be too hard to achieve. However it was not hard to achieve.
Speaking from experience in Norway, nobody was particularly good at social distancing here. All you need to do to get the R number way down was to close down schools, hair cutters, bars, sports arrangements and things where a lot of people got together and reduce use of public transport. E.g. by having more people work home.
Other than that life actually carried on quite normally in Norway during “lockdown.” People walked to the store as normal. Took a stroll with their dogs or met friends. Yes we cut down on large groups of friends. But all through this period I saw many teenagers continue to hang out in fairly large groups. That was not enough to make the lockdown fail.
We pulled this all off without even using face masks.
In other words, this is not rocket science. Any country can pull this off. A lockdown does not need to be hard. You don’t need police going around chasing people. You don’t need to weld shut doors or anything crazy like that.
Just cut down on on the large gathering and life can in fact go on fairly normal. The key is to do this early. Don’t wait until you have made the problem 10x harder to deal with.