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COVID-19 Options; New Zealand Hard Elimination, Sweden's Light Suppression

In late July, Dr. Gigi Foster, Professor, Director of Education, School of Economics, with a PhD in economics, University of Maryland, and a BA, magna cum laude in Ethics, Politics, and Economics, Yale University, made the suggestion that Australia "... can follow in the footsteps of many other countries in the world, some of which have not had lockdowns as strict as we have had here, such as again, Sweden - and look at the death tolls in those countries.." Indeed, Dr. Foster is quite correct, one should look at the empirical data. Because the argument that Australia should follow "the Swedish model" when managing COVID-19 has become a bit of a talking point among some in the community who feel that the economic damage is too much compared to the lives saved. Some, such as commentator Andrew Bolt, argued that all that the movement restrictions was doing was saving a few months off the lives of the elderly. The Prime Minister, Scott Morrison, has confirmed that as far as the National Cabinet is concerned, Australia will be following a path of suppression, rather than elimination.

Let us look at the evidence, and how well suppression has worked in Sweden, which has community social distancing, minimal movement restrictions, no mandatory masks, and an excellent health-case system. First, with any sort of comparative analysis, one should compare the nation in question with those who have similar conditions to ensure a close correlation for policy comparison. The following is as of August 5, 8.38am AEST (Denmark is August 10, 11.02pm, because I didn't include them originally), from world meters.

Sweden 8,034 cases per million, 569 deaths per milion, 80,193 tests per million
Norway 1,726 cases per million, 47 deaths per million, 83,880 tests per million
Finland 1,350 cases per million, 60 deaths per million, 68,718 tests per million
Denmark 2,557 cases per million, 107 deaths per million, 302,951 tests per million

Quite clearly, Sweden's lax suppression policy has been an absolute disaster compared to its neighbours; Australia should not follow Sweden's model, especially given their own increasing doubts on its effectiveness; the numbers do not lie. Australia, in comparison, on a state-by-state level, has engaged in a strong suppression model with the following results, and by way of comparison, New Zealand's policy of "go-hard, go-early" and seek elimination, rather than suppression.

Australia 734 cases per million, 9 deaths per million, 175,348 tests per million
New Zealand 313 cases per million, 4 deaths per million, 94,714 tests per million

Anyone who advocates the Swedish approach is effectively arguing for 10x as many cases, 63x as many deaths, and to half the number of tests. By the facts alone, NZ is twice as successful as AU and AU is tens times more successful than Sweden, in terms of cases. Strong suppression is better than lax suppression, as data shows that Melbourne's stage 3 restrictions in July prevented 19,000 additional infections. An elimination strategy is better than a strong suppression strategy. Whilst the argument paraded about is that minimising suppression measures is necessary for the economy (because an abstract noun is far more important than a visceral person in the minds of some), it has been discovered that keeping people alive and healthy has economic benefits as the country reached one-hundred days of being virus-free.

True, there has been a recent outbreak, cause currently unknown, in New Zealand and the country has reacted appropriately by re-imposing movement restrictions. Which, it is readily acknowledged, quite expected. A strategy of elimination is just that, a strategy. It reduces the number of infections to zero, but is aware that re-infection (from oversight, from outside sources) is possible. A combination of an elimination strategy, plus a hard suppression strategy subsequent creates an environment where infection numbers can be kept low.

On-topic, there is no herd immunity without a vaccine when it comes to this virus. Russia is planning to launch a nationwide vaccination campaign in October with a coronavirus vaccine that has yet to complete clinical trials, which one must ask "What could possibly go wrong?". In the United States, Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, has noted that any potential vaccine, perhaps next year, will only be 55%-60% effective. In other words, various restrictions will still have to apply. Vaccine research is valuable, giving us all sorts of new information and knowledge about the virus, but it does not seem that they will not be the magic bullet that we have come to expect, and we must be prepared for the very real possibility that this will never go away.

The final matter worth considering is whether such harsh measures are economically acceptable, both to lives and livelihoods. Sweden's economy has contracted, although not as badly as other countries that had a harsher initial experience and response to the virus. No longer part of the EU, the United Kingdom's results are truly woeful, and the United States is even worse. Elimination strategies again, provide some benefits in these circumstances; whilst movement restrictions and isolation are certainly a challenge to mental health, the single group that suffers the greatest suicide risk are those who have contracted and recovered from COVID-19. Another modest benefit is that the deaths caused by influenza have also declined dramatically.

From the available evidence at hand, an elimination strategy first and strong movement restrictions second seems to be the approach that allows the lowest number of infections and deaths, the best secondary effects (reduced suicide, reduced associated disease deaths), and allows for the most rapid economic recovery. With the prospect that COVID-19 will be with us in some form perhaps forever, it is time that we move away from a society that "fluctuates between being half-complacent and half-paranoid", as was warned in April and adopts, with sober senses, the best possible stategies that provide life and security for all equally.

Commenting on this Story will be automatically closed on October 14, 2020.

Comments

I was confronted by a numbskull on an ALP forum who was seriously arguing that Iceland should be a model.

Iceland 5,853 Cases Per Million 29 Deaths Per Million

New Zealand 322 Cases Per Million 4 Deaths Per Million
(As of 8.31 AEST. August 16)

New Zealand, in terms of cases, is about 15x more successful than Iceland and in terms of deaths, 7x more successful.

By way of comparison, AU has 902 cases per million and 15 deaths per million.

Just so we know, anyone who argues for the "Iceland model" is saying that we should have almost 6x as many cases and almost 2x as many deaths.

Or maybe, anyone who advocates an Iceland approach doesn't know how to do basic math. They probably use raw numbers when per capita equivalent values are appropriate, right?

They either don't understand math or they want to double our death rate. There is no third alternative.

https://www.facebook.com/groups/1418068105173941/permalink/2701008160213...

Mary-Louise McLaws — whose career as an epidemiologist and advisor to the World Health Organisation has seen her work on responses to HIV/AIDS, and also SARS — is watching closely, too.

"I think New Zealand is still the poster country of the world," says McLaws, who believes the "very decisive, very fast" move to a stage 3 lockdown by the Ardern Government this week is "exactly what an outbreak epidemiologist would have done".

"New Zealand has been faultless when it comes to the handling of this outbreak," she says. "They have handled it with the right respect for the reality of this virus. You don't muck around with it."

https://www.abc.net.au/news/2020-08-15/new-zealand-coronavirus-new-cases...

Sweden recorded its highest death toll in 150 years in the first half of 2020, in a count not seen since an infamous famine in 1869.

https://www.news.com.au/world/coronavirus/global/coronavirus-sweden-has-...

Ok so the way Sweden's death rate % is portrayed to the public is very misleading.
Sweden is actually a perfect case study for what happens when you let the virus run through society. I understand they asked for people to socially distance yet as of mid may half the deaths came from aged care ( around 1850 of the 3698 deaths). This is relevant as there was meant to be an attempted safeguard on this demographic which failed for whatever reason but highlights to me the virus went "Through" society efficiently. It also highlights that on average half the deaths came from aged care and it's reasonable to assume that trend continued.
Ok so as of today Sweden has 84,294 confirmed cases and 5,783 deaths giving a CFR ( case fatality rate : a measure of confirmed deaths among the confirmed diagnosed) of %6.86.
Victoria on the other hand has had 16,764 cases with 309 deaths giving a CFR of %1.84 whilst going through two lock down and having about %63 of Sweden's population.
Here's where it gets tricky and from here on out i'll be using rounded out numbers. A CFR number comes down to a couple of factors.
A. How and when you test : how many people you're willing to test and when you choose to do so.
B. How accurate are the tests : Covid tests are all over the place and im not going to get into the science of whether they work or not, they are however without a doubt causing an exponential amount of false positives/negatives.
C. Is there malpractice? Are death certificates being written out properly without motive? : Is putting someone on a ventilator with an %80 kill rate considered malpractice? (I just put that there lest we forget). There's a plethora of evidence out there that death certificates are being intentionally fudged to list covid as the cause of death. This is not conspiracy private message me and ill link you one example.
Ok so Lets talk about how the IFR (Infection fatality ratio, the true number of infected to death ratio) differs from the CFR. The WHO puts the IFR at %0.6, I for one would love to see how they came to that number as to me it looks half or even less then half.
If we are to use Victoria as an example, with 16,764 confirmed cases and a population of 6.359million, that would mean only %0.26 of the Victorian population has been infected with covid.. Wait what???? Something doesn't add up here, that would mean that %1.84 of the %0.26 have died of Covid in Victoria?? This raises multiple alarm bells for me as it brings up two points which have been drilled at us.
1. We are to believe Covid is more deadly then the flu
2. Covid spreads much faster then the flu.
One or both of these "Facts" are false or exaggerated to the point they may as well be false, i'm sorry. I don't need to be a medical expert to analyse statistical data and I actually have proper field experience in statistics and patterns ( tens of thousands of hours worth).
Now let us go back to Sweden which has a population of 10.23m (10mill for short) and 5,783 deaths ( 6000short). Now remember they had no lock downs and it seems half their deaths came from aged care (estimate). We are now going to throw away the CFR for the IFR as Sweden is unequivocally the best country to use as a template/case study.
Let's start with the entire population as an IFR rate, so with 10million and 6k deaths the IFR sits at %0.06. This is unrealistic but lets continue.
If %50 of the population was infected then the IFR would be %0.12, at %25 it would be %0.24, but here's the kicker. A bad flu season results in around %20 of the population contracting it and if we are to correlate Covid infection rates to a bad flu season then the IFR would stand at %0.30 and that would be assuming covid is no more infectious then the flu and goes after the same demographic for the most part.
The two people I probably care the most about fit into that high age and comorbidity bracket, and people that really know me on a deep level know I do not have a selfish bone in my body and it gets me in trouble a lot. However, this is a joke, Sweden was a success which is being marketed as a failure,I wonder why?
It doesn't add up, it takes a lot to put this post out there so use some critical thinking please. I've seen some of the most disgusting human reactions I have come across through my entire life and it's only getting worse, and so is the government overreach.
Turn off your TV.

This is a good example of what happens when a lay-person, who is not even engaging in a selective covariance (let alone developing a correlation co-efficient, or simple linear regression) has numbers at hand and really doesn't know what they are doing.

Sometimes (indeed often) I teach postgraduate researchers at the University of Melbourne how to use mathematical and statistical software on high-performance computers.

In the past, I have done so in various higher education institutions and research agencies across the country.

But I am not a statistician (although I know a little about econometrics). Nor am I a mathematician (even if I have given a couple of papers at maths conferences).

So when it comes to crunching the numbers on COVID-19 I will go to a real expert.

Jacques Raubenheimer Senior Research Fellow, Biostatistics, University of Sydney

"Now everyone’s a statistician. Here’s what armchair COVID experts are getting wrong"
https://theconversation.com/now-everyones-a-statistician-heres-what-armc...