Wednesday, July 1, 2020

Sweden’s No Lockdown Policy: How That Changed The Outcome

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Nikhita Gautam

Article Title

Sweden’s No Lockdown Policy: How That Changed The Outcome

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Global Views 360

Publication Date

July 1, 2020

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Anders Tegnell during the daily press conference outside the Karolinska Institute in Stockholm, Sweden

Anders Tegnell during the daily press conference outside the Karolinska Institute in Stockholm, Sweden  |  Source: Frankie Fouganthin   via Wikimedia

Sweden has gone against conventional wisdom in its response to the COVID-19 situation. While the neighbouring countries like Denmark, Finland and Norway imposed strict lockdown on the places and services frequented by the public, Sweden has chosen to not do so at all during the initial phases when COVID-19 started taking the shape of a worldwide pandemic. The public places like Cafes, restaurants, gyms, malls, playgrounds, ski slopes and some of the schools were kept open all across Sweden.

The country’s fight against the threat of pandemic was handled exclusively by the Public Health Authority, with no political interference. They believed that a lockdown only serves to delay the virus, which is not necessary since the health services are equipped to deal with the cases. They also made it clear that achieving herd immunity is also not their aim. The public authorities in Sweden instead relied on the public's sense of responsibility, and appealed to them to do frequent hand washing, observe social distancing and keep people over 70 years old from going out.

The state epidemiologist, Anders Tegnell, made multiple statements about the state’s unusual approach, such as 1) “Once you get into a lockdown, it’s difficult to get out of it,”, “How do you reopen?  When?” 2) “There is no evidence whatsoever that doing more at this stage would make

any difference. It’s far better to introduce stringent measures at very specific intervals, and keep them running for as little time as possible” , 3) " As long as the healthcare system reasonably can cope with and give good care to the ones that need care, it's not clear that having the cases later in time is better”.

The assumption of public responsibility did not work for Sweden and there were people out on the streets, in cafes, restaurants and playgrounds. Not wearing a mask was the social norm instead of the reverse. The models for charting the virus spread given by the concerned authorities also turned out to be faulty forcing them to rescind it. Over 2000 Swedish researchers and doctors signed a petition which claimed that there was not enough testing,tracking or isolation in the country. They believed that the authority has clearly not planned their response and that the authority’s claim for herd immunity has very little scientific basis, even though the government has repeatedly claimed that herd immunity is not what they were aiming for.

Sweden’s lax approach to the combating of coronavirus forced its neighbouring Scandinavian countries to close the border for the Swedish citizens. Some of the Swedish officials were worried for the possible harm to the long term relations between Sweden and its neighbours.  Also, the plan of letting life go on as usual to avoid the economic recession occurring due to a lockdown also failed as it didn’t shield  the country from economic slowdown.

Here comes the question; was the lockdown successful or not? There are some comparisons that have been drawn which indicate more deaths per 100,000 people than in nearby countries with homogenous population, even though it is significantly lesser than some of the European countries. While the infections rates are double that of Denmark, the death rates in comparison are much higher. This difference has been attributed to the fact that approximately half of these deaths have occurred in old care homes despite the stated priority of the officials to protect the elderly. This has been in part to the volunteer program, which replaced symptomatic old age home cares with new volunteers, hence increasing exposure. Another factor is the lack of protective equipment in such homes, along with laws preventing administration of medical procedures without the presence of doctors. There were reports of people threatened with lawsuits for banning visitors.

All of this led to Mr.Tegnell claiming that the ideal policy would have been something between what Sweden adopted and what the other countries did, in the light of what they know now. However this claim of Mr.Tegnell will be put to test when the second wave comes, later in time.

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February 4, 2021 4:48 PM

The Coronavirus Disease

Severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) is a novel virus from the family of coronaviruses which causes COVID-19 i.e. Coronavirus Disease-2019. It is the successor of the SARS-CoV-1 which caused the SARS outbreak in the year 2003-2004. This is a positive-sense single-stranded RNA virus which has rapid mutation properties.

The etymology of the name suggests that 'Corona' comes from the Latin word corōna meaning crown, garland, or a wreath. When seen under an Electron Microscope, the virion which has a diameter of 50-200 nanometres looks like the solar corona hence named Coronavirus.

When the virus enters the body; it attaches itself to the binding site or the ACE 2 receptors of healthy lung cells through its spike protein. Then it enters the cell via this attachment and causes apoptosis or cell death. The virus also affects organs other than lungs such as the brain, heart and kidneys. The multiple impact points make it problematic for the researchers to create a vaccine in addition to its rapid mutation properties.

The disease might have a zoonotic origin i.e. the transmission occurs from animals to humans. On comparing the genomic sequences the Human Coronavirus strain is found to be 96% identical to Bat Coronavirus samples and 92% similar to the Pangolins samples. Human transmission of the disease takes place via air droplets when the infected person is coughing, sneezing or talking.

The first cases of this respiratory illness were reported to the World Health Organization (WHO) from Wuhan City, Hubei Province, China, on 31 December 2019. It is the first severe outbreak since the 2009 H1N1 Influenza Pandemic. Initially, it was supposed that the site of origination is Huanan Seafood Wholesale Market but, in May 2020 the negative samples tested, by  Chinese Center for Disease Control and Prevention, from the livestock market suggested that it was the site of the super spreading of the virus.

SARS-CoV-2 is known to have an average reproduction number of 2.2-2.6 which means that, on an average, one infected person can spread the infection to 2-3 people. Although if measures like social distancing are put into use, to reduce the exposure of the infected population, it leads to a significant reduction in transmission rates. The infection fatality rate (IFR) of COVID-19 in various studies till 16th June 2020 was projected to range 0.60% to 1% of infected people . However few studies suggested the IFR as high as 3.6%.

The testing of an individual takes place through a method known as real-time Reverse transcription Polymerization Chain reaction (rRT-PCR). The process of obtaining strains and testing the patients usually involves nasal swabs or sputum swabs; the results come in within a span of a few hours to a couple of days.

Currently, there are no known vaccines available for the virus or any specific antiviral treatments, but there are numerous vaccines in works all over the world to tackle COVID-19. Experts believe that the minimum time required to test a vaccine is 12 to 18 months.

Trials are also going on for the repurposed drugs or the drugs which are useful for treating other diseases and might be capable against COVID-19: Some of these drugs are Hydroxychloroquine, chloroquine, Remdesivir, Dexamethasone, Lopinavir-ritonavir, and Convalescent plasma.

The only current solutions for tackling the pandemic are social distancing, hand wash, hygiene and face masks.

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