Thread by @DearPandemic

1/ Q: Is it true that #Sweden has gotten to herd immunity without lockdown? Should we all be doing what they are doing?

A: No, Sweden has not reached herd immunity, nor have they fared well economically or with respect to COVID-19 mortality.

2/ While there has been a fascination with being Sweden during this pandemic, there are many misconceptions about their experience that are worth clearing up:

2/ *Myth 1*: Sweden didn’t place restrictions on activities due to #COVID19

*Reality*: While it’s true there was no nationwide mandatory lockdowns as in Spain, Italy, the UK & US, Sweden did have a “lockdown lite."

3/ This included closure of high schools & universities (schools for under 16 stayed open), limits on large gatherings, strong encouragement to work from home & physical distance.

4/ This resulted in a high level of *voluntary* social distancing. Mobile phone data suggests travel in Stockholm fell to 40% of its normal level, though still short of the 20% of other major European cities with mandatory lockdowns.

5/ *Myth 2*: Sweden is doing well with #Covid_19 cases & deaths despite not locking down.

*Reality*: Sweden has suffered dramatically higher mortality than its Nordic neighbors Denmark, Finland, & Norway, all of whom enacted stricter measures early in the outbreak.

6/ Sweden has seen almost 5X as many deaths per capita as Denmark, & over 11X more than Norway (See figure).
Sweden does have lower per capita mortality than hardest hit Spain, Italy, & the UK, but has the worst mortality per capita in Europe after these countries.

7/ *Myth 3*: Sweden’s approach saved its economy.

*Reality*: Spending, an indicator of economic activity, since mid-March fell almost as much in Sweden compared to Denmark (25% compared to 29%), but this spending has recovered more quickly in Denmark.

8/ 2nd quarter (April-June) GDP in 2020 fell 8.3% compared to the same period last year for Sweden, compared to 5.2% in Finland, 5.3% in Norway, & 8.5% in Denmark.

9/ Since Sweden’s economy is heavily reliant on exports, it’s not surprising that they would see declines. To date the least impacted countries economically have been those who kept a tight lid on infections, such as Taiwan (-0.6%) & South Korea (-3.0%).
ourworldindata.org/covid-health-e…

10/ *Myth 4*: Sweden’s approach got them closer to herd immunity, & they will be safer going forward.

*Reality*: While there is debate about whether this was ever an explicit strategy in Sweden, the lax approach is often taken to mean the goal was herd immunity.

11/ While there has not been a nationally representative SARS-CoV-2 seroprevalence study in Sweden, estimates from blood donors & other samples find levels in Stockholm of 7-15%, well below the 60-70% estimates for herd immunity.

12/ Since most of Sweden is still susceptible, their higher burden of mortality in the first wave did not buy them additional protection due to herd immunity, and their cases are rising again.

13/ *BOTTOM LINE*: The Swedish picture is not as rosy as some have let on. But the full picture will take more time to reveal itself.