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Comparing the responses of the UK, Sweden and Denmark to COVID-19 using counterfactual modelling

Swapnil Mishra, James A. Scott, Daniel J. Laydon

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Seth Flaxman, Axel Gandy, Thomas A. Mellan, H. Juliette T. Unwin, Michaela Vollmer, Helen Coupland, Oliver Ratmann, Melodie Monod, Harrison H. Zhu, Anne Cori, Katy A. M. Gaythorpe, Lilith K. Whittles, Charles Whittaker, Christl A. Donnelly, Neil M. Ferguson, Samir Bhatt

2021 · Scientific Reports

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AbstractThe UK and Sweden have among the worst per-capita COVID-19 mortality in Europe. Sweden stands out for its greater reliance on voluntary, rather than mandatory, control measures. We explore how the timing and effectiveness of control measures in the UK, Sweden and Denmark shaped COVID-19 mortality in each country, using a counterfactual assessment: what would the impact have been, had each country adopted the others’ policies? Using a Bayesian semi-mechanistic model without prior assumptions on the mechanism or effectiveness of interventions, we estimate the time-varying reproduction number for the UK, Sweden and Denmark from daily mortality data. We use two approaches to evaluate counterfactuals which transpose the transmission profile from one country onto another, in each country’s first wave from 13th March (when stringent interventions began) until 1st July 2020. UK mortality would have approximately doubled had Swedish policy been adopted, while Swedish mortality would have more than halved had Sweden adopted UK or Danish strategies. Danish policies were most effective, although differences between the UK and Denmark were significant for one counterfactual approach only. Our analysis shows that small changes in the timing or effectiveness of interventions have disproportionately large effects on total mortality within a rapidly growing epidemic.

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5 selected excerpts · 5 total mentions

brigandish
Neutral mention · rule
> > it's not pointless to consider how deaths could be reduced even if we were reduced to wild guesses. > This thread isn't considering how deaths can be reduced though… it's just people throwing around cherry picked "guestimations"f based on their prior assumptions. I have not made any wild guesses or guestimations about death tolls, nor made reference to such. You might try simply responding to my comments instead of trying to dismiss them by pointing to (alleged) mistakes made by others. > > However, we don't need a parallel universe… > Health care systems vary wildly from country to country. COVID infection rates varied wildly. As do cancer treatments and diagnosis.…
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You can get some approximate figures to make speculations but it's a long way off a proof. Do you have a specific reason to dismiss the Macmillan report's methodology or findings other than your own assertion that it's not possible to provide a report that isn't full of "speculations"? > > People aren't stupid, > I wish I could agree with you on that one but the last 5 years has really made me change my mind about the degree of common sense in a great many people :-/ Common sense is not the same as stupidity. > > - were lockdowns more effective than not? > > - which kinds of lockdowns were beneficial? > > - what lessons can we learn? > We had a lot of data on that already quite early on I'd love to hear more on this. > this isn't even the first outbreak that has needed to be contained (it's not even the first coronavirus outbreak let alone the first infectious virus). Those behind the [Great Barrington Declaration] have pointed out repeatedly that the mitigation strategies used in the past were different and would be more effective than what are known as "lockdowns": > Inconsistent with the standard pandemic preparedness plans that existed before the COVID-19 epidemic, lockdowns are, and have always been, a radical approach to infection control. You continue: > A large part of the problem isn't just what technically works better but what is more socially acceptable for a particular culture. If we're looking for things in this thread that aren't relevant, this would be one, interesting though it might be. Moreover, since many of the lockdowns were backed by law and punitive sanctions then what is socially acceptable is moot. > For example South Korea was a lot more effective at restricting the spread of COVID than America but America's culture is based on different principles than South Korea's. This chart is why "a lot of data on that already quite early on" looks hasty: https://ourworldindata.org/explorers/coronavirus-data-explor... > This is why I say you cannot come up with a proof without spinning up a parallel universe. You keep using the word proof but I'm not sure in what sense. Scientists keep making the mistake of thinking it's possible. From a report in [Nature] on school closures: > Here we assess the causal effect of school closures in Japan on reducing the spread of COVID-19 in spring 2020. By matching each municipality with open schools to a municipality with closed schools that is the most similar in terms of potential confounders, we can estimate how many cases the municipality with open schools would have had if it had closed its schools. We do not find any evidence that school closures in Japan reduced the spread of COVID-19. Our null results suggest that policies on school closures should be reexamined given the potential negative consequences for children and parents. But if we're using special pleading arguments then this isn't possible, and nor is it even comparable with the act of comparing between countries. If only the US were as homogeneous as the Yamato culture! [Duke] university looked at school closures in North Carolina but instead comparing spread within schools to community transmission. How can two different environments with different populations be compared? Well, they take you through it in the methodology of their paper. I didn't see mention of interdimensional travel. We even have scientists and doctors comparing lockdown between… countries![Nature2] Not one of them is called Dr Strange, unfortunately. No, they simply compared things using methods that are well known. > While you can gather information from observing other responses in other countries, it's not proof that the same would have held true in your own country too. This is a dismissal prior to a claim being made, which makes it look more like a habit than a reasoned response. An open mind is more important than both common sense and IQ in ascertaining truth. > > You can't on the one hand use a there is no parallel universe argument for your own rebuttal and then hope to avoid it by claiming bigger problems without a lockdown. Be fair. > They're not conflicting arguments so it's absolutely fair to make both statements. They're absolutely conflicting and strike me as a wild guess without proof. [Great Barrington Declaration] https://gbdeclaration.org/focused-protection/ [Nature] https://www.nature.com/articles/s41591-021-01571-8 [Duke] https://today.duke.edu/2021/01/duke-study-when-schools-take-... [Nature2] https://www.nature.com/articles/s41598-021-95699-9
native_samples
Neutral mention · rule
Well because they see science as a means to an end (political control), not an end in and of itself. For example, epidemiology has this problem. Epidemiologists routinely publish supposedly scientific papers that are actually policy papers in disguise. Often these papers violate the scientific method in some major way. Nobody seems to care. They get published regardless. Here's an example: https://www.nature.com/articles/s41598-021-95699-9#Sec7 It unashamedly cherry-picks the UK, Denmark and Sweden to try and argue that the UK/Sweden should have adopted Danish policy. Why not study all countries for which data is available? They easily could have done, the data is there. But they don't because if you do that you end up with a null result (no policy makes reliably makes any difference). So they cherry pick in order to be "informative" (as they put it) with respect to policy.
smt88
Neutral mention · rule
> And no excess deaths. False[1][2][3][4][5]. Sweden had 7.7% higher mortality in 2020 than it averaged from 2016-2019. By comparison, Sweden's closest neighbors (geographically, demographically, and socioeconomically) had far, far lower mortality because of lockdowns, mask mandates, and closing restaurants[3][4]. > "Sweden, with a COVID-19 attributed death rate of 0.54 per 1000 population as of July 5, has a higher death rate compared with its neighbours: 11.5× compared with Norway (0.05 deaths per 1000 population), 5.1× compared with Denmark (0.10 deaths per 1000 population), and 9.1× compared with Finland (0.06 deaths per 1000 population)."[1] Even more damning: we now…
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know that Sweden intentionally allowed the virus to spread and never believed their own words about people behaving responsibly without mandates[5]. They knew that their lack of action would kill people. You can argue all you want that some of those deaths are a fair price to pay to eat at restaurants, but you can't argue that they didn't happen or that no one could have prevented them. 1. https://journals.sagepub.com/doi/full/10.1177/14034948209802... 2. https://www.reuters.com/article/us-health-coronavirus-europe... 3. https://www.nature.com/articles/s41598-021-95699-9 4. https://www.science.org/content/article/it-s-been-so-so-surr... 5. https://foreignpolicy.com/2020/12/22/sweden-coronavirus-covi...
brigandish
Neutral mention · rule
> It's an impossible comparison to make. And yet Nature published Comparing the responses of the UK, Sweden and Denmark to COVID-19 using counterfactual modelling in August[1]. It's not as if that's the only paper making comparisons, even if we only look in Nature. > A younger population, with a better healthcare system may have fared better if we didn't lock down. I live in Japan, are you going to tell me it's a younger population? Or perhaps you'll make some claim about the healthcare system here based on… what I could not say as you have yet to give any indication of how your notions are backed, other than by political, tribal concerns. > I'm not a scientist, so I…
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can't show you specific papers to back up my assumptions. As I've shown, one simple search should've turned up something, as I have a whole host of results. Biases should not go unchallenged, especially not through wilful ignorance. [1] https://www.nature.com/articles/s41598-021-95699-9 Edit: formatting
native_samples
Neutral mention · rule
There were no Sweden-specific cirumstances that mattered. The belief that Sweden is somehow uniquely special or that it can only be compared to its neighbours is a tired, unconvincing talking point that must surely come mostly from people who have never actually been there. Swedes are normal Europeans who live in normal cities in a normal western country, and the virus is tiny. To the extent Sweden is "different" to its neighbours it's only in things like the proportion of non-Swedes who live there, which it seems inherently raises their numbers relative to their more anti-immigration neighbours (given that COVID seems to hurt African immigrants more in all regions of the…
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world including the USA). "obviously the academics and public policy experts have not stopped talking about Sweden (and the verdict is not even close to rendered), but since they are doing so out of the public eye it doesn't so much count." The academics and policy experts are refusing to talk about Sweden, because it reveals that they aren't really experts at all - just playing at being experts. It is easy to see this. Here's one of the only recent academic pronouncements on Sweden, published in Nature: https://www.nature.com/articles/s41598-021-95699-9 Except it's not really recent at all. Despite being published in August the first sentence of the article is a false claim about public statistics and it goes downhill from there. The reason is, to build its argument it has to simply ignore all data from after July 2020. If it didn't then it couldn't possibly make the arguments it's trying to make. Also, it cherry picks its countries and its calculations aren't even consistent with each other. It's not science. It's policy advocacy pretending to be science. These people deserve to be raked over the coals in public because their credibility is zero.

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