If Someone Claims that Sweden was a Covid Success Story

They are an idiot, or a liar, or both.

Further conversation is unwarranted.

In truth the Swedish experience was catastrophic:

Over the past several months, a conventional wisdom has been solidifying in certain centrist and liberal quarters that the controls imposed during the COVID-19 pandemic Went Too Far. This idea has crystallized in a book by two Princeton political scientists, Frances Lee and Stephen Macedo—notably not epidemiologists, or virologists, or public-health experts—called In COVID’s Wake: How Our Politics Failed Us. The authors have gotten a respectable hearing from PBS, Jake Tapper, and, of course, The Daily podcast from The New York Times.

The podcast If Books Could Kill recently did a deep-dive debunking of this book, but I want to focus on its treatment of Sweden because of how it’s become a synecdoche for the whole argument. In the Financial Times, the normally level-headed Ed Luce recently cited the Swedish example: “Everyone could agree back then that otherwise liberal Sweden was foolish to take the herd immunity route. That Sweden ended up with one of the lowest mortality rates in Europe has not been similarly highlighted.” The book “should be compulsory reading across the spectrum. That it has not been reviewed by most major newspapers is troubling,” he added. 

………

What’s more, the U.K. figures are provisional, and actual studies have very different numbers. A study in The Lancet by Pizzato et al. found that Sweden’s excess mortality rate was 7.2 percent in 2020—worse than Germany or Greece—and only -0.2 percent in 2021.

Whatever the correct figure is, a lot of Sweden’s mortality drop in 2021 almost certainly was just moving deaths around. For instance, dementia deaths dropped by a lot in 2021-2022, and as a study in the European Journal of Epidemiology notes, “This might reflect that many frail individuals with dementia died prematurely in 2020, hence reducing the population of individuals with dementia who would be at risk of dying in 2021 and 2022.” Seeing a drop in dementia deaths because those individuals were already dead from the government letting COVID run wild in nursing homes is not anything to celebrate.

The lockdown-focused story about mortality is also misleading when it comes to 2022. Prior to that year, the other Nordics were doing far better than Sweden—but they got hammered by the omicron variant, while Sweden did not, which is why it ended up with the best overall mortality rate through 2023, per the Lancet study. Why? It wasn’t immunity from prior infections, as a study in Frontiers in Immunology argues persuasively, but rather that Sweden did its rollout of booster shots far faster than the other Nordics. Ironically, it was swift action by the Swedish public-health bureaucracy, not failing to lock down two years previously, that saved lives. It is simply not true that “interventions seemed to do little if any good beyond delaying the inevitable” or that “the stringency of pandemic restrictions made little evident difference for countries’ overall Covid mortality,” as the authors argue. If Sweden had locked down in the critical early months of the pandemic as its neighbors did, a great many of those 2020 deaths could have been avoided through vaccination and not crushing the hospitals.

While the Danny DeVito — Billy Crystal movie was a good movie, and surprisingly sweet, Throw Momma from the Train is not a good strategy for public health professionals.