Tuesday, May 19, 2020

Sweden's Experiment: Focus On Immunity


Whitney: In The Race For Immunity, Sweden Leads The Pack





In a pandemic, there is no substitute for immunity, because immunity provides the best protection against reinfection. That’s why Sweden set its sights on immunity from the very beginning. They crafted a policy that was designed to protect the old and vulnerable, prevent the public health system from being overwhelmed, and, most important, allow younger, low-risk people to interact freely so they’d contract the virus and develop the antibodies they’d need to fight future infections. That was the plan and it worked like a charm. Now Sweden is just weeks away from achieving herd immunity (which means that future outbreaks will not be nearly as severe) while the lockdown nations– that are just now easing restrictions– face an excruciating uphill slog that may or may not succeed. Bottom lineSweden analyzed the problem, figured out what to do, and did it. That’s why they are closing in on the finish line while most of the lockdown states are still stuck at Square 1.

As of this writing, none of the other nations have identified immunity as their primary objective which is why their orientation has been wrong from the get-go. You cannot achieve a goal that you have not identified. 

The current US strategy focuses on stringent containment procedures (shelter-in-place, self-isolation) most of which have little historical or scientific basis. The truth is, the Trump administration responded precipitously when the number of Covid-positive cases began to increase exponentially in the US. 

That paved the way for a lockdown policy that’s more the result of groupthink and flawed computer models than data-based analysis and nimble strategic planning. And the results speak for themselves. The 8-week lockdown is probably the biggest policy disaster in US history. Millions of jobs have been lost, thousands of small and mid-sized businesses will now face bankruptcy, and the future prospects for an entire generation of young people have been obliterated. The administration could have detonated multiple nuclear bombs in the country and done less damage than they have with their lunatic lockdown policy.


At present, 24 states have begun the process of reopening their economies. There is no uniform criteria for lifting restrictions, no standardized approach to opening one sector over the other, and no plan for dealing with the inevitable surge of new cases and deaths. It all looks like another disaster in the making but we’ll reserve judgement until the results are in. What we know for certain is that no one in the Trump administration gave the slightest thought to the problems that might arise from eventually lifting the restrictions. We know that because we know that there was no “exit strategy”, just make-it-up-on-the-fly and hope for the best.
In contrast, Sweden won’t need an exit strategy because it never shut down its economy or quarantined its people to begin with. So the transition to normal life and stepped-up economic activity is not going to be as difficult. That’s the benefit of strategic planning, it anticipates the problems one might encounter on the path one’s goal. Here’s a clip from an interview with Swedish an infectious disease clinician, Johan Giesecke, , who served as state epidemiologist of Sweden as well as Chief Scientist at the European Centre for Disease Prevention and Control. Giesecke helps explain why the Swedish approach is different. It’s a matter of perception as well as analysis:

“What we are seeing is a rather mild infection spreading around the globe. I think there is relatively little chance of stopping this whatever measures we take. Most people will become infected by this and most people won’t even notice. We have data now from Sweden that between 98 and 99% of the cases have had a very mild infection or didn’t even realize they were infected. So we have the spread of this mild disease around the globe and most of it is happening where we don’t see it because it happens among people who don’t get very sick and , spread it to someone else who doesn’t get very sick… What we looking at (with the official number of cases and deaths) is a thin layer at the top of people who do develop the disease and an even thinner layer of people who go into intensive care and an even thinner layer of people who die. But the real outbreak is happening where we don’t see it.” (“Swedish scientist Johan Giesecke asks Australia how it plans to lift its lockdown without deaths”, you tube…52 second mark to 1:48)


Giesecke’s analysis veers from the conventional view of the virus which explains why the Swedish response has been so different. For example, he says: “I think there is relatively little chance of stopping this whatever measures we take.”
This gets to the root of the Swedish approach. Sweden is not trying to suppress the infection which they see as a force of nature (like a tsunami) that cannot be contained but only mitigated. From the beginning, the Swedish approach has been to “control the spread of the virus”, not to suppress it through containment strategies. There’s a fundamental difference here, and that difference is expressed in the policy.


Second, “We have data now from Sweden that between 98 and 99% of the cases have had a very mild infection or didn’t even realize they were infected.” In other words, this is highly-contagious infection that poses little or no threat to most people. That suggests the economy can be kept open without endangering the lives of low-risk groups. The added benefit of allowing certain businesses to remain open, is that it creates a controlled environment in which the infection can spread rapidly through the healthy population who, in turn, develop the antibodies they need for future outbreaks. This all fits within Sweden’s plan for managing, rather than avoiding, the virus.
Finally, “What we looking at is a thin layer at the top of people who do develop the disease and an even thinner layer of people who go into intensive care and an even thinner layer of people who die.” The vast majority of people who die from Covid are over 65 with multiple underlying conditions. It’s a terrible tragedy that they should die, but destroying the lives and livelihoods of millions of working people in a futile attempt to stop an unstoppable force like Covid, is foolish and unforgivable. The appropriate response is to protect the old and infirm as much as possible, carefully monitor the rise in cases to prevent the public health system from cratering, and keep the economy operating at a lower level. And that’s exactly what Sweden has done.







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