What do you think about Thomas Friedman's idea to at least talk about the Swedish approach?

[LAS14]

https://www.nytimes.com/2020/05/05/opinion/coronavirus-us-immunity.html

https://www.cnn.com/videos/tv/2020/05/09/friedman-make-america-immune-again.cnn

[Salviati]

1. 1.3 million deaths.

That what I think about that.

[LAS14]

3. The important thing to understand is that the Swedish approach....

... doesn't increase the number of cases. It only makes them happen faster. If the health care system is overrun, then there will be more deaths, but that didn't happen in Sweden. Sweden acknowledges that it didn't implement the part about sheltering vulnerable populations in place.

BUT - Please understand. Flattening the curve does NOT reduce the number of cases. It only keeps them from peaking and overruning the health system.

[LisaM]

4. But treatments might be found.

I saw two doctors politely arguing this on TV the other night.

[Demsrule86]

11. Sweden did not treat people about a certain age...I call it murder myself...no different than what

Trump wants to do.

[Celerity]

33. that's a flat out lie, pushed by RWNJ's here on white nationalist websites, distorted, and then run

with by sloppy journos outside of Sweden.

ANY nation that had areas where there were such massive systemic overruns of the healthcare system like Northern Italy or NYC did would be forced to start to do that sort of triaging. Our healthcare system was never overrun at that point.

The RW Independent in the UK (owned by the ex-KGB Russian oligarch Alexander Lebedev since 2010) picked up on a now month old Swedish newspaper's (Aftonbladet) report that was obtained a preliminary set of protocols issued by Karolinska Universitetssjukhuset (our biggest hospital system here) that ONLY applied in the event of systemic overrun.

from the Aftonbladet link

here is the document



It speaks about biological ages as well, not chronological.


For those with a biological age over 80, intensive care is to be chosen via triage guidelines in the event of severe shortages. The same applies to people over 70 who have significant failure in 2 or more organ systems. Persons between 60 and 70 who have already failed in 3 or more organ systems should also be assessed based off the situation.

Applies only when there is an absolute lack of space

Björn Eriksson, Director of Health in Stockholm Region, writes in an e-mail to Aftonbladet that the assessment should only be made when there is an absolute lack of places, which it is not yet.

- The number of patients in need of intensive care has increased, but also the number of places. Today we have over 300 intensive care places and on the Thursday morning, 79 of them were vacant. Thus, there has not been reason to make generally the tough priorities that the National Board of Health's guidelines should guide.

Footnote: In an earlier version of the article, it was incorrectly stated to apply to people between 60-70 who have a failure in a maximum of two organs. It is addressed to people who have failed in more than two organ systems.

You really need to self-delete this reply as it is pure disinformation.

[The Velveteen Ocelot]

19. But that's not the only thing that flattening the curve does.

It buys time for researchers to understand the disease and develop treatments and eventually a vaccine. The result will ultimately be fewer deaths. If I'm going to get it I'd rather get it a year from now when I have a better chance of surviving, because by then there will probably be drugs and treatment protocols that actually work, even if there isn't a vaccine. Flattening the curve means fewer deaths in the long run because ICU bed availability isn't the only issue.

[Blues Heron]

28. not sure where you got that idea

Of course reducing the spread reduces the cases. Letting it spread increases them. If you don't get sick because you stayed at home guess what -you didn't get sick! Wow what a concept. THis idea that no metter what we do the same number of people will get it it is pretty dumb.

[Tom Rinaldo]

29. Correct. What is relevent is that it decreases the percentage of deaths per infection.

Our health care systems are not designed to ordinarily operate with massive excess capacity. Our health care systems are not equipped to handle massive, large region surges of major medical emergencies. They function by distributing excess cases to neighboring hospitals from where an emergency is occurring, but in Italy or New York, for example, the crisis dwarfed the ability of hospitals in the region to provide mutual aid; they all were being hit simultaneously. Furthermore, serious cases of Covid-19 can require multiple weeks per patient in an IC unit, often spending most of that time tying up a ventilator. That is not normally the case. Flattening the curve provides for better care per patient, resulting in fewer deaths. Flattening the curve also makes contact tracing more feasible, allowing for more manageable case loads for those undertaking it,

And, as others have pointed out, it can buy health care professionals crucial time to experiment with and share data on different treatment regiments for Covid-19. We are learning things about this virus every week. By flattening the curve many cases that occur weeks or months later can be treated more effectively than would otherwise have been the case. And of course we are all trying to hang in there while work proceeds on developing an effective safe vaccine.

[Cicada]

2. It has been talked about. Search herd immunity.

[LAS14]

7. Yeah, but when I posted this idea on DU early on...

... with the caveat that we should wait for the next pandemic, after we had built in enough resilience in our health system, I got nothing but scathin replies implying that I had no concern for deaths. It showed a misunderstanding of not flattening the curve, but, I think, it shows a misunderstanding of the devestating effects that shutting down the economy has on the less economically advantaged classes, including deaths from suicide.

I'm hoping the discussion can shift so that this idea isn't owned by the far right. That's why I was so glad to see 3 time Pulitzer prize winner Friedman raise the issue. He seems to think it is not discussed enough.

[Demsrule86]

12. Honestly, that is the GOP's argument. Mine is simple, there will be no economy until the virus is

contained. Trump makes your argument everyday. I strongly disagree with you. And the 'economy' can reopen. but I am not going to the movies, to restaurants, shopping ...anywhere. And if money is spent to help Main street as it should be, people will get through this without risking our citizens.

[Salviati]

13. The only way to stop the economic devastation is to stop the pandemic.

Or for the government to take a more direct hand in helping people who are being hurt by the pandemic.

You can open up the states for business, but 60%+ are more concerned with easing shelter at home restrictions too soon rather than the economic concerns. Are businesses going to be able to successfully open when they're at 40-50% of their normal business?

There is no easy way out. There is not a choice between economic devastation or a high body count. The only choice is between economic devastation or economic devastation with a high body count.

[crickets]

15. "so that this idea isn't owned by the far right"

Um, I'm OK with that, actually. They can own this one.

[Cicada]

23. I agree it deserves consideration

But herd immunity has a big flaw. Assuming each infected person will infect two people, herd immunity requires that two thirds of the population get infected. That will take at least into 2021. And in the meantime medical systems will be overwhelmed and many will die or at least suffer.

So maybe it has been discussed and resolved.

[rusty fender]

32. You should go ahead and try it

Do the herd immunity thing; you’ll be doing us stay-at-homers a service by letting us know how it works out for you. Thanking you in advance

[Hoyt]

5. Need to discuss all alternatives as things change. Good article that's about much more than Sweden.

And the comments are very good.

From NYT article:

" . . . . . .In sum, if we are going to save the most lives while getting the most people back to work to prevent an epidemic of unemployment, depression and despair, it is going to require a federally coordinated, democratic version of the China strategy.

"But Trump resists that kind of science-based, nationally coordinated approach, because it serves him politically to urge his supporters to resist his own administration’s health guidelines.

"Trump seems to think he can bluster, bluff and talk out of both sides of his mouth with Mother Nature — the way he did in real estate and has done on so many issues as president, when his party could always cover for him.

"But it doesn’t work that way with Mother Nature. She is not a contestant on “The Apprentice.” She is just chemistry, biology and physics. We’re the contestants on her show. We don’t get to fire her. She gets to fire us.. . . . . "

[DFW]

16. Nature is so misunderstood

[IMG][/IMG]

[Delphinus]

35. Amen!

[stopbush]

6. I think he's an idiot whose stock in trade is to act the illogical contrarian.

[Marrah_Goodman]

8. I think it is a big "fuck you" to people in high risk catagories

Because you know once everyone goes back to work and stores are all open then any help or protections for the most vulnerable will go away. They will be stuck staying away from everyone and will lose their jobs and benefits if they don't go back to work. People will still be dying and hospitals will still be overwhelmed.

[genxlib]

9. The Conservative are all over this Sweden thing

I keep getting that thrown into the conversation everywhere I turn

I keep pointing out that their outcomes remain to be seen.

More importantly, we should not assume that we will have similar results.

Indeed, NY state has a larger population than Sweden and it ALREADY has seen a death rate of 1376 per million. If you consider that antibody tests show about 15% of the population of NY have been exposed, it projects out to 2 million deaths nationwide before we get to herd immunity.

Perhaps the answer is somewhere in between but that would be a huge risk to take to assume that Sweden results can be attained here.

That and we have a population with a high percentage of idiots

[genxlib]

10. Having said that

I suspect we are going to do it anyway.

Not because it is the smart thing to do.

Because we are a spoiled nation of whiners with no leadership.

[Delphinus]

36. Your last sentence ...

Unfortunately, spot on.

[snowybirdie]

14. Doesn't his family own shopping centers? He's fabulously rich.

So, of course the little people need to get out and about while he stays ensconced in his mansion. Which one? Who cares.

[Buckeye_Democrat]

17. I think that I don't care what Friedman says.

I have personally shunned him since his support of the invasion of Iraq.

If that seems harsh, it's certainly not worse than what happened to the two Utah scientists whose careers were ruined years ago because they reported their discovery of "cold nuclear fusion", which was later proven to be wrong.

I think more people in positions of influence should be held similarly accountable for their errors.

[tonedevil]

18. The idea is dim witted at best...

the opinion of the inventor of the Friedman unit is not something to be considered except for the humor value.

[The Magistrate]

20. That Mr. Friedman, Sir, Remains An Idiot

A notch above Brooks, mind, but an idiot nonetheless.

[Downtown Hound]

21. Thomas Friedman on the Iraq War

https://www.huffpost.com/entry/tom-friedmans-six-months_b_21251

His repeated assertion of wait another six months was sarcastically named a "Friedman unit." Basically, I'm not interested in anything that epic tool has to say about ANYTHING, especially when we're talking about sacrificing millions of lives.

[DemocratSinceBirth]

22. Governmental orders only go so far.

Folks will only venture out of their homes and engage in non essential activities in so far as they believe it is prudent to do so:

Link to tweet

[dawg]

24. I already thought the idea was stupid and heartless.

Friedman pushing it is just icing on the cake.

We don't currently have any idea how long survivors are immune to Covid-19. If they are immune for only twelve months or so, then we could lose over a million people and the damn virus could still continue to circulate as the first cohort of victims begins to be vulnerable again.

There's a reason we've never achieved herd immunity to the common cold, which is caused by several much milder corona viruses that have become endemic.

[uponit7771]

25. Sweden's Herd Immunity Doctor, "not convinced" unconventional anti-lockdown "was the best option"

https://www.democraticunderground.com/100213408059

This has already been discussed and no ... it didn't help Sweden's economy either because enough people self quarantined to badly effect GDP.

This was a stupid idea

[dawg day]

26. Well, okay, talk about it--

But it doesn't actually seem to be working, so at some point talking about it is going to be useless.

[Blues Heron]

27. "letting it spread" is not a viable approach with this virus

It's not "an option" it's nothing more than .... letting it spread. Letting it spread means letting people get sick and die.

[Dave Starsky]

30. Why the fuck would anyone care what Thomas Friedman has to say about this?

My cat has just as much epidemiological experience as Thomas Friedman, and he doesn't have a documented reputation for saying stupid shit.

[old guy]

31. I don't read or listen to Friedman about anything. Anything!

[Voltaire2]

34. Speaker for Billionaires wants the peasants

back out in the fields.

[DeminPennswoods]

37. Tom Friedman remains mightly impressed

by Tom Friedman.

[JHB]

38. Has he moved to Sweden to test it out for the rest of us?

Remember, Friedman's a rich guy who's removed form most people's everyday concerns. He's the type who is very comfortable with talking about, say, raising the Social Security age because 1) he's operating off of old "conventional wisdom" without updating it for al the holes subsequently pointed out about it, and 2) on a personal level, it would affect him and his less than tweaking the base and treble on his stereo (or whatever sound system he uses these days).

He plays a deep thinker on TV and the NYT columnist pages, without going to the trouble of actually digging deep.

[Ms. Toad]

39. You keep peddling this idea of creating herd immunity

in a variety of ways.

The most significant issue is that there is no evidence yet that it is possible to become immune to a second (third, fourth, etc.) infection. So pursuing a policy that is based on our ability to become immune is a fool's errand. Before we risk the death and permanent injury necessary to create that immunity, we need to know that the goal is real.

Second, you have suggested in the past that the young and healthy should actively seek this disease. That is based on two flawed premises: First that there are populations that are not vulnerable. To the extent that it may have been true in outbreaks in other countries - it is far less true here. Increasingly, we have previously healthy dead children. We have more previously healthy dead individuals through age 40 (in your presumed safe groups who should seek infection). Second, that this is an innocuous disease in the mythical invulnerable population. This disease leaves many (in all populations) with permanent damage to their lungs and other organs. It is not innocuous even in the populations presumed to be least likely to be infected. Your suggestion is like telling people to seek out polio to get it over for the purpose of creating a mythical (see the first point) herd immunity - even those who lived were left with lifelong permanent injuries.

Third, the premise that we can protect vulnerable populations assumes that there is no crossover between the vulnerable v. mythical invulnerable populations. We live and work in extended populations. You see that in nursing homes now. Someone has to take care of the vulnerable populations. Due to economic conditions, not only do these caregivers interact with the "outside world" - they often work in two (or more) nursing homes. So whatever they take to one vulnerable population (or encounter in one vulnerable population) - they take to another. Increasing the viral exposure in the "outside world" dramatically increase the possibility of exposure to those who are vulnerable - their caregivers are directly exposed to all of those presumed invulnerable people you are encouraging to get the disease now. Even if those caregivers are taking precautions to avoid exposure, their children and spouses are not necessarily taking those precautions. When they go shopping for their essential needs they are exposed to people not taking precautions. There is simply no way to separate vulnerable populations from a mythical invulnerable population.

Fourth, the exponential nature of this illnesses' contagious capabilities has not changed. We started to shut things down in Ohio on March 3, when there was a single infected person - to prevent it doubling (in Ohio) roughly every three days from 1, to 2, to 4, to 8, and so on. By now, 68 days later - doubling every 3 days, had we not taken precautions there would be roughly 3.3 million cases. There are currently 23, 697 cases - because we successfully slowed down the transmission. (Our hospitals are able to handle 23, 697 cases spread over 68 days; they would have been unable to handle 3.3 million cases spread over 68 days).

What the Swedish model suggests is going back to doubling every 3 days - let nature take its course (depending on individuals - including gun toting terrorists, airlines who still pack their airplanes, etc.) to take the precautions necessary to avoid overwhelming hospitals. Because there are currently (in Ohio) 23,697 cases., we're starting somewhere between day 39 and day 42 (without taking any precautions). So all we would have done by more than a month of pain and economic devastation will be for naught, since we are right back on the path to overwhelming our hospitals - and we're starting not from 1 person on day 1, but we're back between day 39 and 42 with 23,697 cases to start already under our belt, doubling every 3 days.

All the evidence staring us in the face is that individual in the United States are not responsible enough to protect each other without restrictive orders. Most governors - even in Ohio where the initial leadership was exemplary - are not following even the very aggressive WH guidelines. We're about to head into phase II, without having even met the guidelines to start Phase I. They are doing this in an attempt to balance safety v. the violent reaction to being ordered to behave responsibly - and it is going to be an unmitigated disaster. When we recognize it, it will be after several more doublings have occurred, and it will be too late to roll back the clock. It is far harder to roll back clock when 12 days of trusting citizens to do the right thing means 15 additional cases than when it means 245,760 additional cases. I hope it will not be that bad - that there are enough to people being responsible that it will be that bad - but my shopping trip yesterday leaves me with very little confidence.

Moving to a Sweden-like plan will result in even more people than now behaving irresponsibly - since those people who are restrained only because there is a public health orders will feel free to join their more radical counterparts who are currently violating orders.

As someone else said - I'm quite happy letting the right wing own this idea. There are too many of them in the US (who will behave irresponsibly) to make leaving it up to us to behave responsibly a choice that we can survive.

[Mendocino]

40. Sweden vs Ohio

Sweden has about 10.25 million people, Ohio has about 11.7m. The total populations of both is comparable. Sweden has been more open.

Ohio has been very proactive with a basic shutdown of retail, bars and restaurants, schools, restrictive nursing homes and elective procedures.

Sweden 26,322 cases/3225 deaths/2606 cases per million/319 deaths per million

Ohio 24,081 cases/1341 deaths/2060 cases per million/115 deaths per million

I live in Ohio so I may be a bit bias, but it seems that open is worse than restrictive.

[Celerity]

41. Our large fail, a horrid tragedy (and the main reason we are so badly off in terms of deaths

per million compared to Denmark, Norway, and Finland) was our nursing homes. They account for as much as 70% (there is a shedload of argument here atm, some say it is even higher, some say it is lower,, around 50%, but certainly it is higher than our neighbours) of our deaths en toto. We (unfortunately) had a FAR more lax system in terms of visitation/protocols and in terms of higher staff turnover than the other Nordics do with their elderly-care homes. Those arguments and finger-pointings are now the hottest topic in the whole country atm. They fucked up bad.

A couples of days ago, on SVT (out state TV, a group of doctors and healthcare experts (these fall into the group that say it is around 70% of all deaths) said we if had similar nursing home deaths and overall elderly deaths per million rates that Denmark has, our deaths per million OVERALL (for all age cohorts) would only be a wee bit higher than the Danes. They said we would be at around 110-120 deaths per million versus the Dane's rate of 90pm (which will soon cross 100.)

They also said that other Nordics are being far more conservative than Sweden has been with their COVID-19 death attributions so all the other Nordics have higher death rates than they are letting on (that war of words has been going on for months, and has gotten REALLY nasty at times, especially with Denmark versus Sweden, quelle surprise), All the other Nordics have a very hostile stance in regards to Sweden in terms of our refugee/immigration policy. That group (the refugees/immigrants) have also be really hard hit here as well, as they do not practice social distancing to a level anywhere near to what the native Swedes do, plus they are less well-off income wise, and also health wise (for a number of reasons.)

Refugees/immigrants also make up a much, much higher percentage of of the Swedish population than they do in Norway, Denmark, and especially Finland. In the past 23, 25 or so years, we have taken in the US-equivalent of well over 50 million refugees, the vast bulk post 2002 (starting with the 2003 US-led 2nd Iraq war, and continuing on with all the other US/UK/NATO-led ME shitstorms like Libya, Syria, etc) Before that is was the Balkan wars that the US/UK/NATO (we are NOT in NATO) also played a huge role in. Before that it was all the other US shit-stirs (the murder coup against Allende in Chile (when Chile played Sweden in football a couple years back at Stockholm's Friends Arena, 80% of the giant stadium was Chilean), the multiple Central American murder coups and wars, various African coups, etc.) This has been going back to the staring major event, Operation Ajax in 1953, when the CIA led the coup d'etat of Mossadegh in Iran and installed the murderous thug Shah and his SS-style SAVAK into power. It is why we have a shedload of Persians here (and they have integrated in more or less wonderfully over the past 67 years they have been migrating here), but that is a LONG discussion for another time, lol.


Sweden COVID-19 deaths per age cohort

Here in Sweden, we have kept all the under high school level schools opened, have never went into total lockdown, and yet we have a total of 20 deaths from COVID-19 under 40 years of age, 7 under 30yo, zero deaths under 20yo. Even in the 40 to 49yo cohort, there have only been a total of 31 deaths.

Almost 99% of the deaths are OVER 50 years of age, yet that under 50yo cohort is roughly TWO THIRDS of our entire population. In other words, amongst a group of 6.7 million people here (out of 10.1 million total pops) we have had a total of 51 deaths, and most of those had comorbidity factors.

The youngest half of the population in Sweden has had a grand total of 20 deaths, with zero deaths under 20 years of age, and again, that is with almost all the middle schools (and under) wide open the whole time, and no true lockdowns anywhere.

95% of the COVID-19 deaths here are over 60yo, 88% over 70 years of age. 65% have been over 80 years old.

see the reports (updated daily) from Folkhälsomyndigheten (Public Health Agency of Sweden) here:

https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa





Finally, I keep seeing over, and over, and over, that our main strategy is to reach herd immunity as the fundamental goal of our approach.

This is not the case, and it has come up over and over again because some officials have started talking about Stockholm (where we live) reaching this level by the end of May. That has been misconstrued by so many to think that the drive for herd immunity is the principal core strategy, when it is not.

Hallengren: Sweden Not Pursuing Herd Immunity

https://www.bloomberg.com/news/audio/2020-04-29/hallengren-sweden-not-pursuing-herd-immunity

Sweden’s Minister for Health and Social Affairs, Lena Hallengren, explains the country is not pursuing a policy of ’herd immunity’ when it comes to coronavirus and that looser restrictions in Sweden are being used because of how long they may have to stay in place. She tells Daybreak Europe’s Caroline Hepker and Roger Hearing it is too early to make comparisons about which countries have made the right policy choices in addressing the pandemic.

Running time 11:20

(Audio at the link.)