Sweden

Our Ministers Didn’t “Do Okay” Against the Coronavirus

Matthew Syed’s latest article in the Sunday Times is titled “Now we know our ministers did OK against Covid, but I hear no apologies”. And while Syed may not have chosen the title (that was probably his editor), he did write this: “The truth is that on the whole, and with only a few exceptions, ministers did their best in unenviable circumstances.”

Syed’s basic argument is as follows. The recent WHO report reveals that, in terms of excess deaths, Britain “is roughly in the middle of the bunch when compared with similar nations”. Therefore, those who slammed the Government for its handling of the pandemic were wrong, and really ought to apologise.

The article isn’t all bad. For example, Syed skewers those unhinged left-wing commentators who accused the Government of pursuing ‘eugenics’ for not locking down sooner, and chides his fellow journalists for asking ‘gotcha’ questions, rather than trying to get useful information out of politicians.

Yet for every swipe he takes at those who say the Government didn’t do enough, he also takes a swipe at those who say the Government did too much. And his basic argument – the one I outlined above – doesn’t work.

The WHO Figures on Sweden’s Excess Deaths Must Radically Change the Terms of the Covid Inquiry

Lockdown sceptics Robert Dingwall, Professor of Sociology at Nottingham Trent University, has written a barnstorming piece for today’s Sunday Telegraph arguing that Sweden’s below-average number of excess deaths for 2020 and 2021 – in the league table compiled by the World Health Organisation – should change the terms of the official Covid inquiry.

“Judge me in a year,” said Anders Tegnell, Sweden’s State Epidemiologist, in July 2020, when his country was being attacked for sticking to its pandemic plan rather than adopting the novel intervention of lockdown. The latest World Health Organisation figures add to the evidence that has been accumulating since summer 2021. Sweden managed the pandemic more successfully than most, with much less disruption of everyday life and economic activity.

The WHO has published estimates of excess deaths globally for 2020 and 2021. This approach covers all deaths from Covid, whether formally diagnosed or not, together with collateral damage in deaths from other conditions that went untreated. Looking at Europe, where official data are usually robust, Sweden had half the excess death rate of the UK, Germany or Spain – and a quarter of that of many Eastern European nations.

In turn, the U.K. tends to be mid-table, in line with other large Western European countries, while Eastern European countries have had much worse experiences. There is a widely-circulated view that the UK has had a uniquely bad pandemic. The data simply do not support this.

Nor do they support the view that the outcomes have much to do with the restrictions adopted by different governments, how soon they began, or the stringency of enforcement. The question, then, is how governments came to adopt highly restrictive policies in the first place. This must be the starting point for any national inquiry. Why was the experience of emergency planners, and two decades of pandemic preparation, abandoned everywhere except Sweden?

Worth reading in full.

Covid Vaccines Increase Risk of Severe Heart Inflammation Up to 120-Fold, Major Study Finds

Covid vaccination increases the risk of severe heart inflammation up to 120-fold, a major study from Scandinavia published in the Journal of the American Medical Association (JAMA) has found.

The study looked at over 23 million patient records covering the over-12s populations of Denmark, Finland, Norway and Sweden from the start of the vaccine rollout in December 2020 to October 5th 2021.

For young males aged 16-24 years within 28 days of a second dose the study found severe myocarditis (requiring inpatient hospital admission) around five times more common after Pfizer and 14 times more common after Moderna. This corresponded to six events per 100,000 people after Pfizer and 18 events per 100,000 after Moderna. A second dose of Moderna given after a first dose of Pfizer came with even higher risk: a 36-fold increased risk, corresponding to 27 events per 100,000 people. The Moderna vaccine has three times the dose of mRNA of the Pfizer vaccine, which the authors suggest lies behind the increased risk.

Sweden Saw Second Smallest Increase in National Debt Out of All EU Countries

In 2020, the first year of the pandemic, almost every country in the world had a major recession. As this map from the IMF shows, most countries in Europe saw GDP decline by more than 3%, the only exception being Ireland (which in any case has an unusual way of counting GDP).

Despite this, unemployment in the EU only increased by a modest 1.2 percentage points, rising from 6.6% to 7.8% by the third quarter of 2020. One reason why unemployment didn’t rise more during months of lockdown is that governments spent unprecedented sums of money on furlough and other wage-support schemes.

The Countries That, Like the U.K., Have Ditched Covid Travel Rules

As the U.K. ends its remaining Covid travel rules and restrictions, the Telegraph takes a look at other countries that got there first and to where U.K. citizens can now travel in the normal pre-pandemic way (just be sure to pick an airline and airport without mask requirements).

The U.K. and its airlines are not alone in peeling back the layers of Covid bureaucracy. While the vast majority of countries have some form of Covid red tape in place, from outright border closures (China, Japan) to vaccine certificates (Italy, Greece) to tests the day before travel (USA), there are five nations – all within a three-and-a-half hour flight from London – which have scrapped all Covid measures.

The first to do so was Norway. On February 12th this year, our Nordic neighbours lifted all Covid restrictions (although some do remain in the Arctic exclave of Svalbard). Since British Airways operates flights to Oslo from London Heathrow, this means that an entirely restriction- and mask-free holiday is possible. If you test positive while in Norway, you will be advised to stay at home, although as in the U.K., this is a recommendation and not the law.

Further north, Iceland has also dropped all of its restrictions. On February 25th, Iceland announced that all visitors are welcome regardless of vaccination status, with no obligation to take a PCR test to board a plane there, and no locator forms. British Airways operates flights from London Heathrow to Reykjavik, and maskless Jet2 run services to Iceland from U.K. airports, too, some of which (like Manchester) do not have mandatory mask rules in place.

Closer to home, Ireland dropped almost all of its legal Covid restrictions on February 28th. However, the Irish public health bodies still recommend people wear face masks on public transport, so you might see some remnants of the pandemic while out and about. Again, British Airways operates flights from Heathrow to Dublin, paving the way for an entirely hassle-free holiday.

On the Continent, there are two countries that have dropped all Covid restrictions. Hungary dropped its vaccination requirement, Covid certificates and face mask rules on March 7th. You can fly in from Heathrow with British Airways, meaning an entirely mask-free holiday. You can also fly to Budapest with Jet2, although these are via Leeds Bradford which still demands a face covering to enter the airport, though this could change by the time you fly. Romania, too, has dropped all Covid requirements on March 9th, and British Airways operates direct flights from London Heathrow.

Some destinations are close to making the cut for the restriction-free league of nations. As of February 9th, Sweden has been without any domestic Covid rules, as it was for much of the pandemic, although it still has a vaccination entry requirement in place. Slovenia also dropped most Covid regulations on February 21st, although you still need to wear face masks in some public spaces and complete a Passenger Locator Form on entry. Mexico, too, has no vaccination or testing requirements, but you must register your arrival on the Mexico Vuela Seguro Platform. Our list of the 22 countries that unvaccinated people can visit is a good starting point, if you are looking for a hassle-free holiday.

Worth reading in full.

Age-Adjusted Excess Mortality During the Pandemic in Sweden

One of the most startling facts of the pandemic is that, between January of 2020 and June of 2021, Sweden had negative excess mortality – the country’s age-standardised mortality rate was below the five-year average.

Despite all the warnings about “disaster” and “folly”, Sweden actually saw fewer deaths than usual over this eighteen month period. (The ONS data on which this conclusion is based only go up to June of 2021. But it’s a good bet the picture hasn’t changed much since then.)   

Even lockdown sceptics might find this difficult to believe. Sure, Sweden didn’t turn out to be the disaster that lockdown proponents claimed it would be. But can it really be true that there were fewer deaths than usual? What about those reports of Swedish hospitals “filling up with patients” in the winter of 2020?

It can really be true. And those reports are easy to reconcile with the mortality data. You just have to remember two phenomena: the ‘dry tinder’ effect, and mortality displacement.

For those who’ve forgotten, here’s a brief reminder. The ‘dry tinder’ effect refers to the tendency for mortality to increase following a period of unusually low mortality, due to the presence of large numbers of very frail elderly people, who ended up living longer than expected.

Mortality displacement is just the opposite. It refers to the tendency for mortality to decrease following a period of unusually high mortality – for deaths to be ‘brought forward’ by some deadly event, such as a pandemic, heat wave or unusually cold winter.

Once you’re familiar with these two phenomena, you realise it’s perfectly possible for hospitals to fill up temporarily without the mortality rate going up at all in the medium term (over a period of several months or a year, say.)

Anders Tegnell Lands Job at WHO

Anders Tegnell is leaving his post as Chief Epidemiologist of Sweden to take up a role at the World Health Organisation. Reuters has the story.

The man who became the face of Sweden’s no-lockdown pandemic policy, Anders Tegnell, is stepping down as chief epidemiologist to take up a role at the World Health Organisation (WHO), the Swedish Health Agency said on Wednesday.

Tegnell, whose almost daily news conferences had Swedes glued to their screens for much of the pandemic, will become a senior expert at a WHO group tasked with coordinating the Covid vaccine response between health and vaccine organisations.

Tegnell proved a polarising figure at the Health Agency. He was forced to have police protection after he and his family received death threats but his face has also featured on T-shirts with the slogan “In Tegnell we trust”. Some people even got Tegnell tatoos…

When much of the world scrambled to lock down as the coronavirus spread like wildfire in winter and spring 2020, Sweden stood out by opting for mild and voluntary measures. It kept schools open while most restaurants, bars and other businesses never shut. Mask were never recommended.

Tegnell, 65, argued that lockdowns were not sustainable and that voluntary measures could achieve the same results without damaging the trust between authorities and the public.

I hope he wasn’t pushed out in Sweden following the official inquiry, which while affirming his general no-lockdown approach, also criticised the lack of earlier action on masks, shops and restaurants and, pointedly, criticised the Government for following his advice too closely.

Sweden has recommended against Covid vaccines for children under 11, so perhaps Tegnell will take some of that scepticism about the safety profile of these vaccines to his new role. We might also hope he will be a sceptical influence in any development of future pandemic guidance to avoid lockdowns and other draconian measures being normalised.

Worth reading in full.

Sweden Was Right to Avoid Lockdowns But Wrong Not to Impose Restrictions and Masks Sooner, Inquiry Concludes

Sweden’s official inquiry into its handling of the pandemic is a mixed bag. On the one hand, it comes out firmly against lockdowns – understood as stay-at-home orders – and affirms the decision not to close schools. On the other hand, it criticises the Government for not being quicker to restrict indoor meeting spaces such as shops and restaurants, to bring in masks, and for relying too much on the advice of its Public Health Agency, including Anders Tegnell, the State Epidemiologist – despite it being his advice to swim against the flow and resist lockdown. The Telegraph has the story.

Recurring lockdowns imposed across Europe to curb COVID-19 were neither “necessary” nor “defensible”, Sweden’s official inquiry into its handling of the pandemic has concluded.

In its final report, the country’s Coronavirus Commission strongly supported Sweden’s pandemic strategy, concluding that the decision to rely primarily on “advice and recommendations which people were expected to follow voluntarily” had been “fundamentally correct”.

The decision not to impose mandatory restrictions meant that Swedes “retained more of their personal freedom than in many other countries,” the report concludes.

In addition, the commission writes that it is “not convinced that extended or recurring mandatory lockdowns, as introduced in other countries, are a necessary element in the response to a new, serious epidemic outbreak”.

Several countries which did impose lockdowns, it notes, had “significantly worse outcomes” than Sweden, while the restriction of individual freedom was “hardly defensible other than in the face of very extreme threats”.

So far so good. But it goes on to say that measures were “too few and should have come sooner”.

Why Are Deaths in Highly-Vaccinated Denmark Approaching a Record High?

Denmark has become a standout sceptical hero of late, having lifted all restrictions at the start of the month and reclassified Covid as no longer “an infection critical to society”. The Government has even put out a fact check to counter misinformation about its approach – the right kind of fact check, countering actual misinformation.

The Danish shift in strategy was all the more remarkable in that it came at a time when reported infections and deaths in the country were at or close to an all-time high. Infections have since plateaued, underlining that it was the right move. However, given that the near-record deaths have come two years in and despite high levels of vaccination, it is worth digging into the data to see if there’s anything more they can tell us.

U.K. and Denmark (OWID)

The first thing that stands out is how high hospital admissions are, though as the Government says, many of these will be incidental admissions or mild cases. In addition, while hospital admissions are much higher in Denmark than the U.K., the number of patients in hospital is around the same (see below, plus the admissions (above) appear to be peaking), which presumably reflects mild cases with short stays.

Norway Ends Covid Restrictions Including Self-Isolation Requirement Despite Omicron Surge

Norway scrapped almost all remaining COVID-19 restrictions on Saturday morning, doing away with its self-isolation and face mask requirements, ending social distancing, and limiting testing to those with symptoms, despite being in the middle of its Omicron surge, which has not yet begun to fall. The Local has the story.

“The one-metre rule is disappearing. We are taking away the recommendation on social distancing,” Prime Minister Jonas Gahr Støre told reporters at a press conference.

“Now we can now socialise like we did before, in nightlife, at cultural events and other social occasions. And on the way to and from work on buses, trains and ferries,” he said.

Norway’s decision to lift restrictions comes four days after Sweden lifted its restrictions on Wednesday, and twelve days after Denmark did on February 1st. 

Støre put the change in restrictions to the shift in infections towards the milder Omicron variant of the COVID-19 virus. 

“We can ease the restrictions because Omicron does not cause as serious disease as previous variants. Even though the infection rate is rising, the proportion who end up in hospital is low. We are well protected with the vaccine,” he said. “We can treat COVID-19 like other diseases.” 

Among the changes, which apply from 10am on Saturday morning, are:  

• The one-metre rule is abolished 
• The requirement to wear face masks is abolished 
• Only adults with symptoms are now advised to get tested for COVID-19 
• The requirement to self-isolate for four days has been downgraded to a recommendation
• Kindergarten children and school pupils should stay home if ill, but can return after one fever-free day 
• All remaining requirements to show a negative test on arrival at the Norwegian border have been scrapped

Those who are unable or unwilling to get vaccinated and those in vulnerable groups are still recommended to wear face masks. 

Under the new testing requirements, those who test positive using an antigen or lateral flow test at home are asked to register the positive test in their local municipality’s infection tracking system. 

Gahr Støre stressed however that “the pandemic is not over”, and advised unvaccinated people and those in risk groups to continue practising social distancing and wear masks where social distancing is not possible.

The Norwegian Institute of Public Health (FHI) said the country had yet to see the peak of the Omicron surge, but it was expected soon.

The agency’s director Camilla Stoltenberg told reporters the number of Covid hospitalisations had risen by 40% in the past week.