Sweden’s model to beat the coronavirus

State epidemiologist Anders Tegnell of the Swedish Public Health Agency and Johanna Sandwall of the National Board of Health and Welfare prepare for a coronavirus press conference in Stockholm (Reuters)
State epidemiologist Anders Tegnell of the Swedish Public Health Agency and Johanna Sandwall of the National Board of Health and Welfare prepare for a coronavirus press conference in Stockholm (Reuters)

Human beings fight and win wars. So we were able to mobilize more than the Nazis and the Japanese to win World War II. We were able to spend and innovate more than Soviet Union to win the Cold War. But when we face a challenge from the Mother Nature (like a virus or climate change), the goal is not to beat her. No one can do it. She is only made up of chemistry, biology, and physics. The goal is to adapt.

The Mother Nature it does not reward the strongest or the most intelligent. It rewards the species that adapt best by transforming the chemistry, biology and physics with which it has endowed them to develop, no matter what they put on them.

So I think one of the most important questions we have to answer, as these confinements end, is: Are we going to adapt to the coronavirus Natural way -as Sweden is trying to do- or we are going to go in the same direction of Sweden, by default messy Or are we just going to say “to hell with confinements” and act in 50 different ways?

In case you are not aware, Sweden has applied a radically different method to deal with coronavirus. In essence, it has opted for a strategy of “collective immunity”Through exposure.

This strategy states that most people younger than 65 who get the coronavirus -if they do not have significant pre-existing diseases- they experience it as a normal or strong flu, or in a totally asymptomatic way, and those who become ill to the degree of requiring hospitalization or urgent care are surely less than the number of beds to attend them.

So if they do their best to protect and safeguard people over 65 and those with significant pre-existing diseases -mainly lung, heart and diabetes diseases- and they allow a large part of the population to circulate and expose themselves to develop immunity naturally, since around 60 percent of the population has done so, there will be collective immunity and the transmission of the virus will be prevented. (This anticipates that temporary immunity is the result of exposure, as most experts believe it will be.)

After all, our goal is collective immunity, either through a vaccine or because enough people have developed natural immunity. Those are the only ways to do it.

The advantage of the strategy Sweden -if it works- is that the economy is not as affected by confinements. It is not like the containment strategy that all the cities of the United States are implementing now -like those around the world- where, by the time quarantine is over, the majority population will not have developed immunity And then almost all people will remain vulnerable to the virus and a second outbreak in the fall.

Let’s think about the challenge of the city of NY. Their hospitals would have been overwhelmed by the sudden stream of patients, so months of confinement millions of people will have safely and crucially saved lives. But this it has meant huge costs in terms of jobs and business and not much progress has been made in achieving immunityIn addition, there is a possibility that the virus will strike again as soon as the restrictions are released, unless there is a level of evidence such as China to identify, track and quarantine those who are infected. And maybe even that doesn’t work.

Now let’s look at the case of Stockholm. Anders Tegnell, epidemiologist head of the Swedish Public Health Agency -the country’s main official in charge of infectious diseases and creator of the response of Sweden to coronavirus– He said in an interview to USA Today published on Tuesday: “We believe that up to 25 percent of people in Stockholm have been exposed to the coronavirus and may be immune. A recent survey of one of our Stockholm hospitals found that 27 percent of staff are immune. We believe that most of them developed transmission immunity in the community, not in the workplace. In a few weeks we could have a collective immunity in Stockholm

Gothenburg citizens practice social distancing outside the entrance to the Tradgardsforeningen city park as the spread of the disease COVID-19 continues (Reuters)
Gothenburg citizens practice social distancing outside the entrance to the Tradgardsforeningen city park as the spread of the disease COVID-19 continues (Reuters)

Tegnell explain what Sweden is not carelessly leaving that all Swedes contract the disease to achieve collective immunitybut is following a strategy designed to move through this pandemic in the most sustainable way. So universities and other higher education institutions are closed, but Schools open for preschool through ninth grade, as well as many restaurants, shops, and businesses.

But the government has also issued social distancing guidelines that many people are complying with, has promoted work from home and discouraged non-essential travel.. And most importantly, he has exhorted everyone over the age of 70 to stay home and has banned congregations of more than 50 people and visits to nursing homes.

So far, the result has been a gradual generation of collective immunity among the least vulnerable people at the same time that mass unemployment and an overload of the hospital system have been avoided.

However, it has involved a high cost. As pointed out USA Today: “Sweden has a population of ten million people, almost double that of neighboring Scandinavian countries. As of April 28, the number of COVID-19 deaths in this country reached 2,274, about five times more than in Denmark and eleven times more than in Norway” Nursing home residents account for more than a third of all deaths.

Tegnell said: “For a long time, there have always been problems in the safe management of these asylums in Sweden. It is something that we are observing now and that we intend to improve from now on.

Regarding experts who warn that it has not been conclusively proven that people who have had COVID-19, due to the presence of antibodies, they are immune to re-contract the virus, Tegnell he said to USA Today that this reasoning discourages the intention of wanting to find a vaccine: “If we cannot create immunity in the population, then how can we think that a vaccine will protect us?

Tegnell concluded: “What is happening now is that many countries are beginning to adopt the Swedish method. They are opening schools and trying to find a strategy to fix it. It all comes down to sustainability. We must have measures that we can continue to apply in the long term, not only for a few months or for several weeks

When asked about the focus of United StatesHe noted: “It seems to me that the Americans pushed the coronavirus too far before coming up with a real strategy.”

This is the harsh truth: There are only so many dreadful ways to adapt to the pandemic and save both lives and livelihoods.. I speak of Sweden Not because I think you’ve found the magic balance – it’s too soon to know – but because I think we should be debating about all the different models and the costs of acquiring immunity.

However, when I analyze United States and I see that the governors are partially lifting the restrictions – because they feel that their people can no longer support them for economic or psychological reasons, despite the fact that their population has not developed immunity or has acquired very little – I am concerned that we may end up generating more collective immunity, but in a painful, deadly, costly, and uncoordinated way that still causes the coronavirus to strike again and saturate hospitals.

One of the most renowned computer scientists in Israel, Amnon Shashua, founder of Mobileye, for weeks has been recommending for Israel a route to immunity similar to that of Swedes. “The risk-based quarantine model is not only advantageous from the point of view of economic sustainability“, But also because”When the high-risk group is released from confinement, they will have a mostly immune population, and naturally there will be a very slow spread of infection with good chances of driving the storm away until there is a cure or a vaccine“He wrote in Medium last month.

Michael Osterholm, director of the Infectious Disease Policy and Research Center at the University of Minnesota, he pointed out in an interview with WCCO radio on Monday: “I think Sweden has a model that we should pay attention to, and while it is not the only model, we should have these discussions. ” Because there won’t be a miracle vaccine anytime soon, Osterholm said, “This virus won’t stop making people sick until we contract it at least at the 60 or 70 percent level.”

Collective immunity “has been, throughout history, the way that nature has to end pandemics“He added David Katz, the public health physician who helped start this debate in an essay he wrote in The New York Times on March 20 and in a subsequent interview that we had.

We have to submit to its force, even if we as a species are responsible for unleashing it“He commented Katz. This implies the design of a strategy, based on risk profiles, to bring the least vulnerable people back to work in a staggered manner, so that we gradually generate the protection of collective immunity, “while concentrating our health and social services on the protection of the most vulnerableUntil we can announce that there is no longer any danger.

(C) The New York Times.-


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