Op-Ed: Response to Gier’s Coronavirus Column

5ebed5d30f8fe imageMy Op-Ed ran in today’s Idaho State Journal. Enjoy! 

I appreciate the Idaho State Journal allowing me to respond to Professor Gier’s May 8th editorial regarding Sweden’s handling of the coronavirus pandemic (Coronavirus deaths may be undercounted by 60 percent).

To the layman, the data emerging from Sweden can be complex and nuanced, but properly interpreting the language is key to understanding the results of Sweden’s Coronavirus strategy. Swedish authorities publish daily figures by date of death (not all newly reported cases died within the preceding 24 hours) while the media shows cumulative figures by date of reporting. So, while the media shows a rising curve in Swedish deaths, there is actually a decrease in daily Swedish deaths.

Furthermore, Sweden reports deaths with and not necessarily from coronavirus, meaning their coronavirus deaths are over-reported. If you die from a stroke, but were an asymptomatic carrier of the virus, Sweden would count it as a Coronavirus death.

“Expert” data models predicted that Swedish hospitals would exceed ICU capacity if they didn’t quarantine everyone, predicting that Sweden would have 40,000 deaths shortly after 1 May, rising to 100,000 deaths by 1 June. As of this writing, Sweden has had a total of 3,313 deaths with coronavirus despite having the second lowest intensive care capacity in Europe. Furthermore, Sweden’s daily new cases and deaths appear to have peaked around April 21st and are on the downturn (https://www.worldometers.info/coronavirus/country).

Swedish professor Johan Giesecke is widely regarded as one of the world’s leading epidemiologists, and as such he is at the forefront of Sweden’s approach to the on-going pandemic. Sweden’s unwillingness to sacrifice their entire economy, while still treating the virus as a grave issue, is a solid reminder that this reasonable approach is the way societies have dealt with crises for millennia. It is the US, not Sweden, that is taking the novel approach.

Gier argues that the virus death rate could be 60% higher, but he fails to acknowledge that the data shows that the vast majority of coronavirus carriers are asymptomatic. In an interview with Austrian magazine Addendum, Giesecke said that 75 – 90% of the epidemic is “invisible” because most people develop few symptoms if any. A lockdown is therefore “pointless” and only harms society. In the end, Giesecke predicts a death rate between 0.1 – 0.2%, similar to the flu.

We should be looking to New York, not Sweden, to see how the Coronavirus can be handled poorly. Giesecke argues New York was poorly prepared and did not protect its at-risk groups. New York Metro ran their subways non-stop until May 5th when they finally decided to suspend them for four hours for cleaning. New York had a policy ordering nursing homes to accept infected coronavirus patients.

In Sweden, the average age of death from coronavirus is about 80 years old with 50% of the deaths occurring in nursing homes. While Sweden did have a slow start locking down nursing homes, they have acted quickly to remedy that. The US should learn from them and put their efforts into protecting the elderly more aggressively. Afterall, it’s worth noting that the average age of death from coronavirus is two years higher than the average US life expectancy, and nine years higher than worldwide life expectancy. It is clear which group we should pour our efforts into protecting, and (as Sweden has helped prove) it’s not the younger generations.

Without adequate time to develop a safe vaccine, the virus will continue to circulate through communities as the country reopens until herd immunity is achieved. None of our models or experts have prepared us to deal with the incoming second wave. If the US had adopted a more common-sense approach similar to Sweden’s, we would not be dealing with second (or third) waves at all, but would be steadily handling the virus without the mass hysteria. Gier’s claim that Sweden will suffer the same recession as the rest of Europe does not take into account that Sweden will not experience second and third waves of the virus’ effect on their economy.

Some Israeli researchers are promoting a “Controlled Avalanche” approach for dealing with the coronavirus, allowing for voluntary exposure by those who are not vulnerable so society rapidly reaches “herd immunity” (the CDC prefers the term “community immunity.”) As immunity builds within the population, the virus has fewer people to spread it to those most vulnerable: the elderly and those with comorbidity factors. Giesecke says that Sweden’s strategy is to “protect the old and the frail, try to minimize their risk of becoming infected, and taking care of them if they get infected.”

Allowing those who are in no statistical danger of dying to be exposed to a virus is not a new concept for those over fifty. Before there was a vaccine for measles, mumps, or chickenpox, we used to have “pox parties” where we would expose kids to the virus at a convenient time. Like the coronavirus, chicken pox is also disproportionately dangerous to the elderly, and therefore there could be benefits to helping the virus spread quickly through those with negligible risk so that they build up antibodies before it turns deadly to them.

Throughout our day-to-day lives, we make decisions about our safety by assessing risk trade-offs. We get into our car and drive because we have determined that the convenience and opportunities provided by driving outweigh the risks, despite the tens of thousands of people that die every year in their car. We never say that car crash deaths should be eradicated before we will enter a car again, because we allow men and women the liberty to weigh the risks for themselves before they make their own decision.

The US can still adopt the Swedish strategy: isolate the infected, quarantine the exposed and the vulnerable, social distance everyone else, and allow the world to continue as close to normal. Those who fear the risks of reopening society should stay at home. But we should allow others the liberty and dignity to immediately go back to work and earn a living.

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