Week 9 - What can we learn from Scandinavia?

No Scandinavian country is as severely ill with the virus as the UK, all of them have ways of responding to the pandemic that are less severe than the lockdown that we are experiencing.

 

                                    Norway           Sweden          Finland           Denmark       (UK)

 

Area /1000 Km2       385                 480                 338                 43                   242

 

Population                 5.4M               10M                5.5M               5.8M              67M

 

P.Density /Km2          15                   25                   15                   135                 231

 

Tests/K March21      10                   2.5                   1.9                   2.2                  1.1

Tests/K May 3           33.6                14.7                19.3                40                  13

 

Lockdown                   12.3                never               16/3               13/3            19/3

 

Covid Cases/M          8.1                  67.6                19.6                22.3                80.4

 

Covid death/M          0.25                10.6                0.8                   1.1                   8.9

(3 day rolling)

 

Case fatality rate       2.6                  12.4                4.5                   5.1                              14.7

 

Days to double prevalence 

Cases                          144                 26                   34                   62                   31

Deaths                                    110                 23                   41                   54                   42

 

Within the 4 Scandinavian countries, the best country is in bold type, the worst is underlined. The first three lines largely confirm what we already know: Norway, Sweden and Finland are huge, thinly populated countries, with Denmark intermediate between them and the UK (included only for comparison purposes).

 

 

Norway large sums of money early on for vaccine development, digital solutions for contact tracing, for a mobile app  for contact tracing, for remote medical consultation, for training medical personelle in intensive care medicine, and for updating and distributing a digital tool. They use various interventions: detection & isolation of infected people; contact tracing; closing down businesses & events; Norway emerges as the most interesting country in terms of low covid cases and deaths, and many days to double prevalence of both cases and deaths, reduce unnecessary travel. Social distancing at only 1 metre. All those arriving who are +ve  quarantined whether or not symptomatic. Meetings of <50 people allowed, detailed exit plans.

 

Sweden has no lockdown at all. They have the highest prevalence of both cases and deaths, with the shortest number of days to double prevalence. Their chief epidemiologist, Dr. Anders Tagnell, argues that, left to themselves, by end of May 40% of population of Stockholm will have had the virus, and any upswing of morbidity will be quite low. Schools, restaurants and shops stay open, voluntary social distancing only control measure. A Trumpian epidemiologist? He warns against huge upswings in other Scandinavian countries when control is released – young people have his likeness tattooed onto them. Sweden has the highest Covid Cases and deaths, and also the shortest days to double prevalence. Sweden also has the lowest rate of testing (and their covid death rate even worse than us!)

 

Finland  Has large sums of money for businesses, and money for families to cover rents and special money for those who have to give home schooling to children. Travel to and from the capital is restricted, and restaurants closed.  The state of emergency closed schools, universities, libraries and museums. People >70 advised to avoid human contact. Groups of <10 may attend meetings. Borders closed.  Arriving Finns face 2 week quarantine. Restrictions lifted after only 4 weeks. Libraries open 4 May, schools open 14 may, by 1 June groups of <50 can meet. Much less stringent than UK rules.  Covid Cases and deaths similar to Denmark, but well above Norway.

 

Denmark  Many cases came from holidays in Italy, and were quarantined. Before lockdown hospitals were postponing non-urgent operations, and meetings of up to 1000 people were allowed. By March 11 this was reduced to 100 people, concerts cancelled or postponed. People were advised to walk or cycle to work of possible. After lockdown on march 13 all non-essential workers advised to stay home. Home schooling started ‘in some degree’. Schools universities museums and libraries closed. March 15 hairdressers, night clubs also closed. Restaurants open only for take-aways. Grandparents told not to see their grandchildren. Gtoups of >10 people not allowed. Like a milder version of the UK lockdown. Cases intermediate between Norway and Sweden (but much less severe than UK).

 

 

Conclusion What can a country get away with in designing its program?  The great success story is of course Norway, with their early financial investment in well chosen projects, and their commitment to case finding. Finland and Denmark are hard on their heals, with both countries good at contact tracing, and Denmark also good at increasing its testing capabilities: both countries are successfully lowering rates.  It will be very interesting to see how Dr Tagnell succeeds in his strategy (he is only like Mr Trump in being worshiped by young people who admire his boldness). My prediction is that Sweden will not do as well as the other three countries, and will pay a price for avoiding the lockdown. 

 

 

David Goldberg

63 days served, endless lockdown stretches ahead.

 

 

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