COVID Projections – what is going on in Sweden?

COVID_Actuary - July 23, 2020

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So it seems to me that the two most important things to understand when considering my prepping/general actions over the next 6 months are:

1. What is the rate and severity of long-term COVID complications across the age/comorbidity spectrum

2. What path is the virus likely to take in the fall

I’m going to avoid #1 for now because I have yet to find many good sources to contribute to the discussion. For #2 I’ve been thinking about Sweden (and to a lesser extent, New York) lately.

Both Sweden and New York saw very steep growth and very high mortality. Sweden is 5th in the world at 556 deaths per million, and New York is around 790 deaths per million. If I am doing my math right, NYC is nearly 2800 deaths per million.

Sweden: https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
New York/NYC: https://www.cdc.gov/covid-data-tracker/#cases

Both Sweden and New York have deaths that dropped off fairly precipitously and have remained low. Sweden’s case counts have bounced around a bit before returning to low levels, while NY has remained low for quite some time.

These cases have been in my mind recently as I have started to see more mainstream articles around cross-immunity and heterogenity driving herd immunity.

Here’s the Atlantic on heterogenity (most susceptible get it first): https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/

And Vox on the different components of Morbidity (linking to numerous other places):
https://www.vox.com/2020/7/22/21324729/getting-covid-19-twice-immunity-antibodies-vaccine-herd-immunity

(sidenote: do we have access to html [url = ][/url] and that sort of thing? That and a preview button would be nice)

Those theories represent a possible explanation for both Sweden and New York’s drop. One problem is that Sweden sero studies have returned prevalence roughly half that of New York – ~10% vs ~20-25%. Sweden is a fairly obese country from what I can tell, so I’m not sure population health covers it either. And obviously Sweden has been hit much harder than its Nordic neighbors.

So I guess my main questions are:
1. Do you think there is anything to Herd Immunity coming at a much lower threshold?
2. Is there another explanation for Sweden’s drop? I have not found good sources for what is happening on the ground regarding voluntary social distancing, mask wearing, closing of indoor dining/bars. Google mobility data seems to indicate movement is back to normal levels?
3. If New York or Sweden are indeed at some high proportion of herd immunity, should that change anything I plan for/do? I think if they are it should not impact me decisions too much in the short term – NYC/Lombardy/Wuhan still got very very bad. It might influence my more long-term decisions on how best to allocate prepping resources though.

Looking forward to hearing your thoughts!

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I am still really confused about Sweden. It feels like the story changes so much depending on which article you read. Would love some better info but your 2nd question is the same problem I think a lot of us are having, which is not having a reliable source there.

 

I really like the Antlantic article on herd immunity and I think it’s largely correct: numbers do seem to start dropping off at around a 20% attack rate. I think there’s more to the story that we’re missing. Antibodies drop off fast, but T- and B-cell-mediated immune factors are still present for those exposed, and that’s not showing up on seroprevalence tests. There probably is some protective cross-reactivity in children who have recently had colds as well. 

As for Sweden, it’s also possible that folks started altering their behavior when it became apparent that their approach wasn’t working like they’d hoped. Perhaps more mask-wearing and more distancing. 

None of this changes how I, personally, do anything. I still mask up and do hand hygiene obsessively. I haven’t been to a social function since February. I had an antibody test which was negative, but I don’t know what that means (I could have been exposed previously and the antibodies dropped off–or maybe not). So I operate as I always have. 

 

Just figured this is worth a bump – as we try to predict what’s next going into the fall season the question of whether hard hit areas such as NYC are going to be hit hard again seems very important, especially given the secondary effects of that occuring (schools closing again, potentially a new wave of lockdowns with more unrest, and so on).

It seems like Sweden has continued to do very well recently, even as some other European countries have seen cases begin to increase (including the other nordics). This case spike has not yet translated into deaths and may not translate too much into deaths – it seems to be concentrated in a younger population. 

 

Thank you for bringing this up again. I looked around for an update on Sweden and am still seeing so many conflicting headlines. Is there an overview you think does a good job with current info?

 

I don’t think there’s any way to know yet. Antibodies often fade rapidly, even within weeks or months. Maybe there’s still t-cell or other cellular immunity, but this has not been established in a large-scale study. If some children may be protected because they had recently had another, cold-type coronavirus, this probably means that any protection fades rapidly, since nearly everyone in the world has presumably had cold-type coronaviruses (though cold-type rhinoviruses and adenoviruses are still more common).

Do 13% of Swedes in Stockholm still have antibodies? It was only about 3% in all of Sweden. Was whatever they got worth the lives of the 6,000 Swedes who died, while locked-down Norway only had about 200 deaths? Do 20% of those in NYC still have antibodies? There are several strains, what difference does that make?

Probably the most important thing happening now is the so-called false positives. The PSA test was erroneously calibrated at the beginning, culturing samples, concentrating them, then doing it again, often 40 times. But those not positive at 25 or 30 times have no symptoms and are not sick. It would be better to change the testing criteria and say that if you’re not positive at thirty times, you’re not positive, period, even though you may have a tiny amount of the virus and are positive if you do the culturing forty times.

 

I should have said that regardless of what may happen this winter, it’s a good idea to take D3, zinc, and C every day. We’re taking 5000 IU D3, 500 mg zinc, and 1,000 mg C every day. Many studies have shown how this prevents or greatly ameliorates Covid should it occur. The government of every country in the world should make this known to every resident, and make them available in areas which might not otherwise have access to them.

 

I think your focus should be less on the virus and more on the fallout from a sickened economy, societal decay, forced evictions, general poverty, and rising crime rates.  With or without a vaccine the virus is likely to peter out within 2 or 3 years.  Living thru a 2nd great depression could be another matter.  I would prioritize home and personal security as well as food and water storage.