The number of international coronavirus infections and deaths has fallen to the lowest level in four years. The data allowed comparisons between Sweden's controversial laissez-faire strategy and the United States' more restrictive approach, emphasizing lockdowns, which are also adopted by most countries in Western Europe.
Sweden's approach relied on individual responsibility and voluntary action rather than government coercion or restrictions. This attitude, although ultimately justified, was attacked at the time by health authorities and media outlets in Western Europe and North America.
How do America and Sweden compare?
Cases related to COVID-19: The results for COVID-19 were similar. In terms of officially reported infections since the start of the pandemic, Sweden has had roughly 27 out of 100 infections, while the United States has had 34 out of 100, according to statistics site Worldometer. did. This is only reported cases; the best estimates are: If all cases, reported or not, are considered, the number of cases in both countries would be between 80 and 90 per 100 people, and the difference in infection rates would disappear. Neither intensive lockdown nor permissive strategies could minimize the ultimate number of coronavirus cases.
COVID-19 related mortality rate: The numbers again lean slightly towards Sweden, but this is probably due to the health of the Swedish population and the health of the United States, rather than the superiority of Sweden's strategy. In the United States as a whole, there were 3.7 deaths from COVID-19 per 1,000 people. In Sweden, 2.7 deaths from coronavirus infection per 1,000 people. No one can argue that the US did better than Sweden on this basis, but that is not a strong endorsement of the Swedish approach. Neither country protected nursing home patients, who had high mortality rates, especially early in the pandemic. Many countries, including neighboring Scandinavian countries, have had fewer COVID-19 deaths per capita than Sweden. Norway, Denmark, and Finland all quickly closed their borders. Finland has established internal borders.
The lesson is that COVID-19 cases and outcomes are probably not primarily determined by national strategies. After four years, no major country has been able to avoid high infection rates of COVID-19. Approaches that protect high-risk patients may marginally limit morbidity and mortality, but deaths from COVID-19 are more related to population health, age and population breakdown, and herd immunity. . Measuring the number of coronavirus infections and deaths to evaluate lockdown strategies is often flawed. Counterexamples abound.
Results other than COVID-19: Public health experts use the term “excess deaths” to describe deaths from any cause over a period of time when compared to the expected number of deaths based on historical patterns. From 2020 to 2023, excess mortality rose in all developed countries, but only by 5% in Sweden, compared with 10% to 15% in the United States. The 5% figure is the lowest among developed Western countries, including Scandinavian countries. The mortality rate due to the new coronavirus infection is low. Many of the excess deaths in the United States can be attributed to lockdowns, including deaths from despair such as suicide, drug overdose, and alcoholism, as well as deaths from delayed medical care.Sweden almost certainly avoided many of the US lockdown-related deaths
Economic statistics during the pandemic tell a similar story. Although the U.S. economy has been fairly resilient, it has contracted by an unexpected 1.2% since 2021, according to the Organization for Economic Co-operation and Development. (The eurozone fell by 2.1%.) Sweden's economy unexpectedly grew by 0.4%. In Sweden, post-pandemic inflationary pressures have not been as severe as in the United States, where the government has adopted larger fiscal stimulus programs that can cause inflation.
The most important difference in results between the United States and Sweden was in children's education. Prolonged school closures in the United States have caused educational damage to students not seen in Sweden. U.S. public schools have been closed since March 2020, sending 50 million students home. Although some private and religious schools, as well as some schools in Florida, opened in the second half of 2020, as many as half of all public school students in America did not attend school until the second half of 2021.
Researchers at several American universities have found that by spring 2022, the average American student will be about a year and a half behind in math and one-third of a year behind in reading. .
The Swedish Public Health Agency advised secondary schools and universities to switch to distance learning for the last three months of the spring 2020 term, although schools opened in the autumn. There were additional two-month school closures in December 2020 and January 2021 during the variant outbreak, but almost all kindergartens and elementary schools remained open. Swedish researchers have concluded that the decision to keep schools open has benefited Swedish primary school students, with no evidence of a decline in their learning ability in early reading.
Considering all aspects of the pandemic, including excess deaths, economic health, and children's education, suggests that Sweden's strategy was good, if not ideal, from a long-term perspective. The coronavirus is so contagious and mutates so quickly that even strict lockdowns have been unable to contain its spread. And the longer the lockdown lasts, the greater the damage caused to the public by factors other than the coronavirus infection.
The effectiveness of lockdowns during the COVID-19 pandemic is an important scientific and historical question, but it is not a definitive blueprint for the future. The next infectious disease may spread differently and may require different measures.
The most important takeaway from Sweden's COVID-19 experience is not that Sweden had better control of COVID-19, but that any national strategy should improve the country's economic, social, educational and This means that the impact on mental health must be considered.
Dr. Corey Franklin is a former intensive care physician and co-author of the new book, The COVID Diaries 2020-2024: The anatomy of the epidemic in which it occurred. ”
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