While the number of infected people is rising elsewhere in Europe and the next lockdown is approaching, Sweden can afford to reduce the restrictions
More than 15.000 corona infections per day in Belgium and the Czech Republic, with a doubling in the last two weeks, give rise to fears that health systems will soon be unable to cope with the influx of patients. Neither the increase can be explained by an increase in PCR tests alone, nor by false positives, as critics point out. Their argument still had a certain plausibility until the end of September, when the proportion of people testing positive in Germany fluctuated around one percent. Currently, however, it is approaching the four percent mark.
While the WHO has recorded a decline in new infections in the global malaria picture, there has been an almost exponential increase in Europe since the beginning of September. Some Eastern European countries, which have so far remained largely unaffected by the Corona epidemic, have been particularly hard hit. The trend is now reflected in the death statistics: compared to the spring, the number of deaths caused by Sars-CoV-2 has tripled in Romania, quadrupled in Poland and increased sevenfold in Ukraine.
Epidemiologists see the main cause in the longer survival time of the viruses in low temperatures and low humidity. Since people spend most of the cold season indoors in heated rooms with a maximum humidity of 40 percent, the risk of spreading the disease increases considerably. Another reason cited is vitamin D deficiency during the winter months, but this is controversial. Finally, the increase of infections during the last weeks is attributed to growing carelessness and the opening of schools after the summer.
The Swedish special way
While the number of infections has multiplied almost everywhere in Europe compared to the spring and the number of deaths is increasing, Sweden is an exception. Although there has been a seasonal increase, the October figures are (still) below the average for the months of April to June, and this has been accompanied by a sharp increase in PCR testing. Although the Swedish population is similar in number to that of Belgium and the Czech Republic, the daily incidence of new infections is less than one tenth (ECDC).
The Swedish government was still subject to harsh criticism in the spring of this year. Am 5.4. said the FAZ of "End of the Swedish special path", which was characterized by the fact that it put recommendations in place of restrictions. The only exceptions were the ban on gatherings of more than 50 people and, later, the ban on visits to nursing homes. The latter was considered necessary because protective equipment was not available in sufficient quantities, which led to a rapid increase in the number of deaths.
The country’s state epidemiologist, Anders Tegnell, came under prere to explain and was self-critical in this regard. Nevertheless, he defended the Swedish approach, pointing out that the country would be spared the negative consequences that a lockdown would inevitably cause. He was convinced that with the chosen anti-corona strategy the coming winter could be survived without any major corrections. Despite the criticism of some experts, the Swedish leadership continued on the special path, with the broad support of the population.
The herd immunity already expected for the end of May, however, did not seem to materialize. According to a study by the Swedish National Board of Health, only 7.3 percent of burgers in the particularly affected Stockholm area had antibodies in their blood at the beginning of May. Although the poor numbers at the time offered little reason for this, Tegnell remained optimistic. He promised his countrymen that the future would be bright: "We are far from the end of the road, so we do not know what the final result will be."
Recent research has shown that T cells play a key role in the fight against Covid-19. The fact that a significant proportion of the population does not become ill despite contact with Sars-CoV-2 viruses is explained by the activation of macrophages. However, in order to eliminate the infected cells, they must be detected. This is achieved by T-cells, which have acquired this ability through earlier infection by corona viruses. A key advantage is that T-cells are much longer-lived than anti-bodies. The Swedish physician Sebastian Rushworth is convinced that in his home country it has been possible to achieve the desired herd immunity by means of T cells.
The moderate infection figures support this assessment, especially since no further restrictions were decided by the Swedish government. On the contrary, the ban on visits to nursing homes has been lifted since the beginning of October. The only new recommendation worth mentioning concerns people who share the same household with people infected with corona: They are asked to stay at home for a week. But even here, daycare and elementary school children are excluded. Furthermore, there is no contact tracing app in Sweden, and the topic of the corona epidemic is covered much less in the media than in other Western countries.
Have other countries relied too heavily on containment??
Am 24.9. was the headline in the FAZ: "Sweden had the better strategy?" Despite partial concessions, critics of the Swedish path focus on the high number of victims, nearly 6,000. With 586 deaths per million burgers, Sweden is now in 17th place in the world. Rank in world corona statistics dropped. Among European countries, however, the country is surpassed only by Belgium, Spain, the United Kingdom and Italy. Since only a few people infected with Sars-Cov-2 have died each day since the beginning of August, Tegnell’s argumentation, with its reference to the "Final result at the end of the strabe" nevertheless gain in persuasiveness.
It should also be taken into account that the death rate in Sweden is in line with the long-term average. During the first 35 weeks of this year, there were 620 deaths per 100.000 inhabitants, which is five times higher and five times lower than in the previous decade. The highest number of infections in 2012 was 650, which corresponds to approx. 3000 more deaths than this year means. At that time, a severe influenza epidemic was raging, which apparently claimed more victims than the current Sars-CoV-2 virus.
With 564 deaths recorded last year, the lowest number since 2010, Sweden had more highly morbid and immunocompromised people than normal last spring. If we compare this with the average annual figure, the number is about 5000. This supports the amption that the main cause of death for a large proportion of those infected with Covid-19 was elsewhere, even though the viral infection may have accelerated the onset of death. The median age of infected deaths is 86 years, which is five years older than the international average, and supports this view.
What Sweden has gone through during the months of April to June is still to come for other European countries. The timing seems important, given that the stated intent of the anti-Corona decreases was in the "Flatten the Curve", in order to prevent an overload of the health care system. While German hospital staff was put on short-time work in the summer because the infection rate – which was to be expected – fell sharply, there are currently fears that the capacities could soon be insufficient. Some neighboring countries are already in a dramatic situation, and here, too, those responsible would have been well advised not to rely so massively on containment at the beginning of the summer.
The repeated warnings of a second wave were apparently not taken seriously by Western leaders. The suspicion arises that they were mainly used to justify the restrictions imposed, instead of being included in the strategic considerations at an early stage. The Swedish government acted differently: by only moderately slowing down the spread of the virus, a partial herd immunity was able to develop. The summer climate ensured that new infections did not exceed a threshold that had overwhelmed the health system. On the other hand, those who did everything they could to contain the Corona virus as much as possible are now victims of their own shortsightedness.
Despite comparatively low numbers of infected, Swedish state epidemiologist Tegnell expresses concern at rapid rise in recent days. Although the protection of nursing homes, which have accounted for about half of the fatalities to date, is largely ared. But even though the people currently affected are mainly young people, Sweden should not rely on its higher immunity compared to other countries. The spread of the Corona virus should be kept in check by tracing the chains of infection and by local special collections to ensure that treatment capacity is sufficient in the future. Nevertheless, he does not foresee any serious problems like those in other European countries in his homeland.