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Comment by geysersam | Hacker News Reader

Sweden did not have a good response to the COVID pandemic. More people died than in many comparable countries, we can agree on these facts. But that the response was poor because authorities did not "listen to scientists" is a difficult claim to swallow.

Before 2020 the concept "national lockdown in response to a virus outbreak" simply did not exist. There were no consensus in the scientific world that a lockdown would be an effective measure to improve peoples health, all things considered.

If anything I think the Swedish weak response was an effect of listening too much to expert opinions and politicians not taking initiatives and making their own judgements.

Early in the pandemic there were many predictions made on number of deaths etc by some scientists. These models often overestimated the number of deaths/cases. Science is important but it's messy and it takes time.

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> Sweden did not have a good response to the COVID pandemic

Austria (with several complete lockdowns) overtook Sweden in Covid deaths per capita in December 2021[0]

Aren't Sweden's excess mortality figures since the start of Covid actually pretty good compared with the rest of Europe? [1]

[0] https://www.kleinezeitung.at/international/6078837/Relativ-z...

[1] https://ec.europa.eu/eurostat/statistics-explained/index.php...

Yeah but I do think there is merit in comparing Sweden to neighboring countries such as Denmark.

However, luck is also a factor that shouldn't be disregarded. If anything was learnt from the attempts of modeling the development of the pandemic it should be that the virus does not diffuse through the population in some idealized fashion. It's extremely messy and depends on local circumstances and sheer chance.

This can easily be confirmed by comparing different regions of countries. Despite similar regulations the variation is enormous.

Only if you ignore other factors like demographics and population density of population / population-weighted density.

Countries should be evaluated based on performance relative to doing nothing not relative to other counties in very different situations. Niger has a median age of 15.4, Italy has a median age of 45.5 they simply have vastly different ratios of the elderly etc.

Population density (on a national scale) is not relevant. Sweden is an urbanized country, like most (all?) of the western world. More than 85% of Swedes live in urban environments: https://www.statista.com/statistics/455935/urbanization-in-s...

“Urban” Sweden is much different from other countries. For example, someone else urged us to compare Sweden to France. Yet Paris has a population density of 20000/km^2 versus Stockholm’s 4000/km^2. I’ve lived in places with both densities and one is considerably more “urban” than the other.

If you draw the border of Paris further and further out, I’m sure you can get the density as low as you want. Meaning: the density figure of a city says very little of how dense it is and says more about how far out into sparsely populated farmland the official city limit ends.

Go look at a Google street view of the far ends of Stockholm metro area…

Paris has a population density of 9,800/sq mi across 1,101.7 sq mi and an inner core of 53,000/sq mi across 40.7 sq mi.

Stockholm’s urban area of 11,000/sq mi across 147.35 sq mi, is comparable to Paris, but it’s inner core 73 sq mi is a much lower density 13,000/sq mi. Even if you assumed all those people lived in a 40 square mile “inner inner” core you still don’t get close to 53,000/sq mi.

Is that land area or area including water?

For disease transmission it’s the average population density of the population not the country. Effectively the population density of each area * population in that area divided by total population.

So, assuming 3 areas 1,000 square miles with 2,000 people, 100 square miles with 4,000 people and 10 square miles with 8,000 people you do : (2,000^2/1,000 + 4,000^2/100 + 8,000^2/10) / (2,000 + 4,000 + 8,000) = 468.8 people per square mile, not (2,000 + 4,000 + 8,000) / (1,000 + 100 + 10) = 12.6 people per square mile.

The reason is adding a huge area that nobody lived in (ex: 1 person across 1 million square miles) doesn’t change the calculation. (1^2/1,000,000 + 2,000^2/1,000 + 4,000^2/100 + 8,000^2/10) / (1+2,000 + 4,000 + 8,000) = 468.8 people per square mile

Population density is indeed important, but averaging over whole countries gives the wrong impressions.

Covid was deadlier in urban areas. Compare rural regions, such as the ones bordering Norway and Sweden, and the mortality is pretty much comparable across the border. Slightly on the Swedish side, but well within what can be ascribed to random variability. That doesn't make the border closings look especially effective in retrospect. The virus doesn't care about borders.

A different calculation of density works fine: https://news.ycombinator.com/item?id=30812118

We care about the population density of population, not the population density of land. It’s sometimes call the population-weighted density.

> Sweden did not have a good response to the COVID pandemic. More people died than in many comparable countries, we can agree on these facts.

I do not agree. And you don’t provide any evidence to support your claim. This paper doesn’t either; it uses Norway as a single comparable country, and their reasoning is that it’s another Nordic country. As others have pointed out in this thread it’s quite dissimilar in many ways.

National lockdowns where a common strategy for outbreaks before 2020.

Spanish flu: “Social distancing measures were introduced, for example closing schools, theatres, and places of worship, limiting public transportation, and banning mass gatherings.”

“Maritime quarantines were declared on islands such as Iceland, Australia, and American Samoa” https://en.wikipedia.org/wiki/Spanish_flu

And just to show how little had changed: “Wearing face masks became common in some places, such as Japan, though there were debates over their efficacy.[173] There was also some resistance to their use, as exemplified by the Anti-Mask League of San Francisco.“ https://en.wikipedia.org/wiki/Anti-Mask_League_of_San_Franci...

That's interesting. Thanks for the link.

However, social distancing and quarantine was recommended by the Swedish health authority in the early stages of the pandemic. I refered to the society wide lockdowns, those kinds of measures were not applied (could not have been applied) in 1918.

What specific difference are you thinking of? The US had plenty of local lockdowns in 1918, including such things as school by phone. Mask mandates, closing or minimum 20 foot separation between tables at restaurants etc.

I agree it was a more local response, some locations closed bookstores others kept them open etc. But we only created the CDC in response to the Spanish flu, there simply wasn’t a national organization developed to handle pandemic response.

I don't believe there were enough telephone infrastructure to have school over phone for more than a very marginal part of the population in 1918. I'd like to be proven wrong.

I'm talking about lockdowns. https://en.m.wikipedia.org/wiki/COVID-19_lockdowns

> there simply wasn’t a national organization developed to handle pandemic response.

Exactly. But not only that, our technical and economic capability to implement such lockdowns widely eclipse the society of 1918. These are enormous differences.

I think you have it largely backwards, 1918 had more extreme lockdowns. Even though they where not uniform nationwide.

They had actual fines and up to 10 says of prison time for failing to follow mask mandate in SF. This was then copied by other cities in California and other states across the US.

In most places they just shut down schools without any remote learning whatsoever.

That said, the city vs country decide was much stronger before cars. We had less than 1/3 of todays population and large chunk of that was still living on single family farms.

Please provide support for your claim that large parts of society were under lockdown in wide areas of the US and the world during the 1918 pandemic. I can find no support for that myself.

This article from the university of Michigan describes the pandemic regulations in SF: https://www.influenzaarchive.org/cities/city-sanfrancisco.ht...

From what I understand: 1. There were no wide lockdowns. Theaters, dancehalls and schools closed temporarily. But there were nothing like the mandatory and enforced lockdowns we've seen across the globe the last couple of years (China, Spain, France, Belgium, Netherlands, etc). The state did not pay people money to stay at home from work, which we've seen in many countries the last couple of years. Closing dancehalls is not a lockdown. 2. Breaking the mask mandate did not lead to prison time like you insinuate. The article says most infringements lead to "a stern warning". 3. Despite the relatively harsh restrictions SF did not fare particularly well counting the number of deaths from the illness.

I maintain my claim that it was *not* the scientific consensus before 2020 that wide swats of the population should be made to stay at home and not work as a response to an influenza pandemic.

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