There’s an interesting experiment going on, on the other side of the planet. Our furniture-making, meatball-eating, hockey-dazzling friends in Sweden’s approach to managing this crisis is a lot different than what’s going on around here. We’ve seen a few examples around the world how not to do things. How a few days here and there can have a drastic effect. How not taking it seriously can have big implications. The Globe & Mail wrote about Sweden last week. CNN picked up on it yesterday. Sweden, not a culture that I would associate with recklessness, is taking a huge gamble. If I were a betting man (and I assure you, by any definition of that expression, I am), even I wouldn’t rolling the dice the way they’re doing it.
I will summarize the articles, add a few comments… and something they left out.
To summarize, their schools are open, their pubs are open and there’s no lockdown. Gatherings of more than 50 people are banned, but everything else is left up to the honour system. Trust that others will do the right thing. Recommendations, not orders. Their PM calls it a “common sense” approach. Their chief epidemiologist is saying that it’s working “reasonably well” so far, and that they’ve had “not very much” spread into elderly homes and “almost no” spread into hospitals. In other words, it is, at best, working ok, but it’s in the elderly homes and it’s in hospitals. So basically, it’s everywhere.
Not everyone has bought into the plan… a letter from 2,000 doctors and public-health experts went out, urging the government to get a reality check. But for now… many Swedes get it, and are isolating and maintaining social/physical distancing. But also, many are hosting big family Easter celebrations this weekend. How will it all play out? The articles suggest we’ll know “next month”. I think we’ll know a lot sooner.
A quick look at numbers shows a sharp increase yesterday… like, double the number of new cases from the previous day… a 12% increase, implying a TTD of 6 days… so if that rate remains constant, their 9,000 cases will be 18,000 next week and 36,000 the following week. I will say that the growth rates before that were lower, and as I said yesterday, one day doesn’t make a trend. But the whole thing makes me very uneasy.
Some other numbers that are troubling and not mentioned… once you become infected and are verified by a test, you become a statistic. Your statistic will get modified as time goes on… symptoms or no symptoms, hospitalization or not, ICU or not and so on. The final statistic you will have attached to you is in the “Resolved” category, and it can go one of two ways: Recovered or Deceased. To be clear, this doesn’t include anyone who may presently have it, symptoms or no symptoms… this is exclusively those who definitely had it, and now definitely don’t. At last tally, Sweden had 1,251 resolved cases.
Here are the numbers, for comparison… for all known resolved cases, these are the percentages of those who fully recovered:
South Korea: 97.2%
Canada: 91.3%
Italy: 61.8%
USA: 59.5%
And while we’re here… BC: 94.1% — and that number would be higher were it not for the type of clusters (like long-term care homes) that we’ve experienced here.
And Sweden…? 30.5%.
Out of 10 people in Sweden who’ve had this thing and it’s run it course, 7 have died. Which seriously brings to question how deeply they have their heads buried in the sand. That is a staggering number for a first-world country that claims to have things under control. I hope they come to their senses soon.
Closer to home…
There seems to be some confusion when it comes to physical distancing. Stay home or go out in the sun but don’t get together with others and jog, but away from other people and bike, but not where others do, so bike lanes are sort of not ok, so what’s the deal…
Here’s the deal. You can go out if you pretend the following… pretend that you’re carrying this virus… you’re very fortunate that you have no symptoms, but you’re very infectious… and, if you give this to someone else, the moment you do, a lightning bolt will shoot out of the sky and strike you dead, instantly. Just like that.
So… what do you need do to avoid that? A mask or mouth covering helps… a lot. It doesn’t help you as much as it helps others, but like that parable where everyone’s arms are frozen straight out and everyone fears they’ll starve to death because they can’t feed themselves… well, duh, just feed each other. Everyone wins when you do your part.
When you cough or sneeze, you eject particles into the air…. little droplets within which the virus is carried… and those droplets can hang around, suspended in the air. Not for hours, but for several seconds. While the virus itself is small enough to penetrate most fabrics, water droplets are comparatively much bigger… so wearing a mask is like coughing or sneezing into your elbow or a handkerchief.
Assuming no masks, if you’re walking single file outside with other people (Arbutus corridor, seawall, sidewalks…), maintain a distance of 4 to 5 meters. If the guy in front of you coughs or sneezes, it’s unlikely to reach you. If you’re jogging or slow biking, 10 meters. And normal biking, 20 meters. And if you’re heading towards each other — well, you’re in the wrong place. As much as I enjoy cycling, not there, not now. Someone else just breathing hard, let alone coughing/sneezing — within 20 meters of us approaching each other — I would be breathing his exhaust. I don’t want to do that.
The numbers across the country look good. Flat, or lower… let’s keep at it… and hope that the people who decided to ignore what Dr. Henry and Mr. Dix said about 100 times this week…. “This is not the time to…”, and jammed up the ferry line-ups this morning, and swarmed Victoria and the Gulf Islands — don’t wreck things for all of us.
Sweden, cruise ships etc are cruel medical experiments. We’ll learn from the data but the cost is ridiculous.
You talked about a number that is concerning me a lot in some places — the CFR or “case fatality rate”. It’s the number of cases that close by fatality divided by the number of total closed cases (it’s the complement of the numbers you’ve posted there). So fo the US it’s around 40% and Sweden was close to 80% yesterday. Canada is just over 8%. This number is very sensitive to reporting errors (since if you only get tested if you’re in the hospital and are very sick, then you’ll get counted and people not as sick won’t). But still worrying. Thanks for pointing it out HK!
Thank you for your continuing insightful columns… Much appreciated.
Thank you very much for your work. I too read with interest Sweden’s approach. What struck me is that they are sending their young out ostensibly to get infected and to develop herd immunity. But at what sacrifice? We already know it can hit the younger too. So how many of them will ultimately get ill and possibly die while increasing their societies immunity?
As you say, it is all one big science experiment and all we can do is wait and see what the results are…
For interests sake, perhaps you could add the data from that country, to which you are already collecting? Will be very interesting to see what type of exponential increase they see.
Rafael HirschRafael
What is TTD?. I tried to look it up but nothing came up that made sense.
Pernilla Ridell stay safe friend ????????????????
Thank you. Stay safe.
It’s the long term care facilities and group homes I’m worried about in BC. Out of Ontario: https://toronto.ctvnews.ca/staff-at-ontario-facility-for-vulnerable-adults-walks-out-following-covid-19-outbreak-1.4891552
Our officials are doing a great job here in BC. However IMO they should have had government officials at ferry line ups and Sea to Sky Hwy etc asking where are you going and why. If the answers don’t add up they are denied and need to turn around. So many of us want our routines back. If society would have been forced into a hard stop some 4-5 weeks ago we would be further on the way to bending curve. A small percentage are unfortunately irresponsible and hope the RCMP enforces and fines them fully
Jennifer Pejic
Care to speculate on when restrictions get lifted, or whether we might see them lifted before the rest of Canada?
I was going to ask you to comment on Sweden! Nice
Meatballs and hockey. Best news I’ve heard in weeks.
Wow. Great take on Sweden. Thanks.
RE: “Out of 10 people in Sweden who’ve had this thing and it’s run it course, 7 have died… a staggering number for a first-world country”
I was alarmed by that as well. I suspect it’s due to (I believe term is) ‘lead time bias’, due to their slowness in reacting and rolling out tests, the first patients who get ‘confirmed’ will be those that die or are near death (‘the most serious’). I guess we will know in the coming weeks, there are almost 9000 current cases…
What is frustrating in trying to compare and project different countries (and even areas within countries) is the fact that the ‘tests administered per capita’ figure is so different so we don’t really know the true spread or mortality (i.e. look at North Korea’s shining proactive steps & glorious medical system – 0 cases & deaths! Less testing=less confirmed cases). Even the speed and accuracy of the tests can affect figures (i.e. a test that takes 3 days to call one ‘confirmed positive’ vs. a test that takes hours, means a multiple day delay in reporting that again, skews figures)…
Thank you for your intelligent insights!
Thank you for this. It makes the Sweden situation much clearer for me. Do you mind if I share this?
Thank you Horatio Kemeny – you are a solid predictable sane voice, in the world of unpredictability and a sprinkle of insanity. Thank you for who you are to us, and to those we love and impact.
I wish I could see a summary of Israel.
The information about distancing when walking or biking is most useful. Thanks.
Am lovin your daily analysis. It’s the first thing I look at in the morning. If only the UK media would take note and produce something similar
I read about this.
I have been following your excellent analysis every day. But as I have friends in Sweden who are home with the virus, I can tell you that the ONLY time you can get tested is upon admission to the hospital in case of emergency. That means that the official number of cases is artificially low, but also why the fatality rate would be significantly higher (or the number of resolved cases so much lower).