Northern Europe during Pandemic -- Summers 2020 & 2021 & onwards

[Seaworthy Lass]

Originally Posted by Dockhead

I don't know and I don't think anyone knows what is better or more sensible. It's far from over and not clear yet how any given policy is going to play out through the very end of this.

I fully agree. I also recognise that it is easy for us to criticise from the sidelines. I would hate to be the position of needing to make decisions, but governments can at least call on teams of experts from necessarily diverse fields (not just medical) to help make balanced decisions. I am just puzzling over this on my own.

I think it is a dangerous situation if politicians have the power to make these decisions unilaterally when states of emergency are declared, as in Australia.

SWL

PS Wottie, your post needs a long reply. I will do this later.

[Montanan]

Perhaps time to start a new thread titled: Northern Europe this Summer (2021)

European Union countries kicked off a debate on Monday on whether people who have received a COVID-19 vaccine should have greater freedom to travel and to interact [dine out, attend event centers, socially engage] in the summer than those not immunized.

An interesting point of discussion and public health policy.

https://www.yahoo.com/finance/news/e...155702128.html

[GordMay]

Originally Posted by UFO

Ahh But Corona Viruses are a very different beast [from smallpox], especially in the way that they easily and continually mutate.

UFO is right - the coronavirus is not smallpox.
However, the viral mutation isn't the prime problem with the SARS-CoV-2 virus. I believe it's the animal reservoir. The term zoonosis (zoonotic) refers to an infectious disease, that is transmissible, under natural conditions, from vertebrate animals to humans.
Because humans were the only reservoir for the smallpox virus, naturally occurring smallpox was eradicated, after the last human case was identified, isolated, and recovered.

But the implications for COVID-19 seem clear. Smallpox eradication depended on tried-and-true public health measures, that have been important in the fight against Ebola and COVID-19, including isolation, surveillance, case findings, contact tracing, and communication campaigns.

A Proposed Covid-19 Exit Strategy: [for discussion]
First, a global effort to control SARS-CoV-2 demands a global coordinating body (WHO?).
The same solidarity, that powered the final steps to victory over smallpox, is needed now, to control the COVID-19 pandemic.
1. We should create a time-bound program for COVID-19 control. This program should set clear, measurable objectives.
2. Eradication may not be one of those objectives, but extinguishing community transmission is achievable.
The reason that we won’t eradicate SARS-CoV-2, is that, like many viruses, it has animal "reservoirs." If public health efforts succeed at pushing it out of human populations, it will likely live on in fruit bats and ferret populations (at least), only to return to infect humans again.
Whereas Smallpox, for instance, does not have any animal reservoirs. No longer living in human hosts, it is completely defeated, At least in the wild, at least for now.
3. Countries must prioritise management, as much as medicine, in their control efforts. Management means a network of trained staff, allocation of sufficient financial resources, investment in logistical capacity, and the development of a realistic operational strategy.
4. Continued investment in COVID-19 research will be decisive. The first year of the pandemic has revealed the extraordinary contribution of science, to our understanding of SARS-CoV-2. Now is not the time to step back from investments in COVID-19 science.
5. And finally, WHO (?) should create an independent accountability mechanism, to monitor country responses, and to offer remedies, when those responses seem to be insufficient.

This moment may feel like it is without precedent, but COVID-19 is only the latest pandemic. And while past global disease outbreaks have involved other viruses, with different patterns of transmission, how the world community came together to deal with them, at the time, can offer some relevant lessons today.
Smallpox eradication was one of the greatest scientific, and humanitarian achievements, of the 20th century.
The smallpox virus is still kept in two maximum security laboratories, in Russia and the USA. Clandestine stocks may also exist; if so, they could be used as biological weapons someday.
That is especially worrisome, because no one in the world is currently immune to smallpox. Booster shots need to be given every three years to maintain immunity. No one has been vaccinated since 1980.

The SARS-CoV-2 virus is far easier to obtain than the smallpox virus. You don’t have to know anyone in Russia. You don’t even need a United States security clearance, or a key to a secret freezer.
Pretty much all you have to do is refuse to socially distance, wash your hands, or wear a mask.
Then see what happens.

[laird]

There's news tonight that 33 people over the age of 75 in Norway have died since receiving the Pfizer vaccine , authorities are trying to play it down at the moment apparently , in the UK we have vaccinated over 4 million ,so far there is no news on any adverse side effects, it will open up a complete can of worms if any of these vaccines are found to have high levels of reactions

[Seaworthy Lass]

Originally Posted by laird

There's news tonight that 33 people over the age of 75 in Norway have died since receiving the Pfizer vaccine , authorities are trying to play it down at the moment apparently , in the UK we have vaccinated over 4 million ,so far there is no news on any adverse side effects, it will open up a complete can of worms if any of these vaccines are found to have high levels of reactions

This will be well analysed. I hope people will not over react before then.

Most likely the majority of the 42,000 people who have now received a first dose of the Pfizer vaccine are the most vulnerable elderly. Some deaths in this group will unfortunately occur naturally. It can be expected that some may even occur due to the vaccine if extremely frail or ill people in their last weeks of life are subject to the usually temporary fever and ill effects from receiving the vaccine. It is not unreasonable to decide not to vaccinate these. It is also no reason to incite fear in everyone else. I hope the media acts responsibly.

[Seaworthy Lass]

Originally Posted by Wotname

There is a lot of truth in what you post Lassie. Allow to add my POV (and perhaps some minor corrections) to your post.

Re the 'heath advice' - Maybe not published in a written form but all through the 'dark' days of our first covid SH winter, the leading health officials in several (maybe all) states attended the daily broadcast Premier's briefing and took all questions presented. Sometimes these briefing went on for an hour or more. I watched the the Tassie ones in full along with highlights from VIC, WA and QLD. The premiers were un-usually politic free and to the point. Maybe I'm a sucker but I was impressed with the apparent honesty and absence of spin. These daily public briefings went on like clockwork for weeks and in Victoria's case, I think for four months.

Hi Wottie
Thanks for your well thought out reply and corrections.
Yes, these briefings certainly occurred and were a mammoth effort. They informed people what was occurring regarding the lockdowns and why they needed to be continued to stop community spread etc. And the actions were highly successful in doing so. I admit I had not thought this was going to be possible in Victoria given how widespread the virus was in the community and particularly in so many care homes in July of last year.

What the briefings failed to do was to release any information regarding what their policy of stopping community spread had been based on. This was repeatedly requested and ignored.

I am skeptical that there was any science at all driving the lockdowns. In the absence of any information I can only conclude the immediate saving of lives was the only focus (and a very popular notion) rather than thinking about the long term problems doing this. Simply altering policy to copy other states is not a sound reason in my opinion.

Exit strategies should have been in place for a whole host of possible outcomes before any restrictions were put in place at all. Again no information was released regarding these.

I was also not at all impressed with the “Yes Minister” type fiasco when everyone one in the Victorian government including Dan Andrews the premier and Jenny Mikakos the health minister at the time, all conveniently “forgot” who was responsible for the use of private security guards being used to guard quarantine hotels, resulting in the four month lockdown of 5 million people and 700+ deaths.
The lies did not elicit trust.

Maybe I am wrong and decisions regarding management of the pandemic were made for sound reasons that have not been revealed, but I do think this is unlikely.

Originally Posted by Wotname

FWIW, the state premiers had always had the powers of control when a state of emergency has been declared so nothing new here. Not saying they should or should not have such powers, just saying this is not new, such powers have existed since before federation.

I did not realise this until the pandemic. It was a shock. I am not very savvy politically.

Originally Posted by Wotname

As for the end game - you are right; no one knows or if they do, they are not saying. Early on, the Feds were always talking about the "vaccine" as the answer to the pandemic. It sort of made sense as they are the mob that regulate such things (i.e. the TGA). The feeling I got was the states had to hold the fort and do the heavy lifting until the Feds could buy in and approve a vaccine down the track, save the day and take the credit.

It was never expected that any vaccines would be 90-95% effective in preventing symptoms. The results have been astonishing for the Pfizer version, even if this is only known to occur during the short time of one week after the second dose, as is the case. However, the Oxford-AstraZeneca has only been found to be effective for 62% of people in this regard. 90% was found only for a small group of subjects who were accidentally (according to the media) given a half dose first.

How was it ever envisaged that a vaccine would “save the day” without allowing a substantial percentage of the population to become infected and develop some natural immunity, even if partial? Those under 18 make up about a quarter of Australia’s population and who would give children a vaccine that was not being tested in their age group, particularly given almost none of them have any serious symptoms when infected? They are not the ones at risk. Under these circumstances why expose children to a vaccine using relatively new technology? As far as I am aware an adenoviral carrier containing genetic material of the virus has never been previously approved for human use (I found one used to vaccinate against rabies in animals). Anyone know of any?

There seems to be quite a number of people who are in fear of genetically modified food (GMO’s). I have just looked up the possible numbers who consider it dangerous and it may be as high as 30%. How is the government planning to convince this group to have themselves injected with genetic material to alter what protein our bodies produce, even if this is apparently only temporary? This is the mode of action of the Oxford-AstraZeneca vaccine. Is the government planning not to inform people about this? If not, this is deceitful.

If children are excluded, even if you could manage to convince a large percentage of people at minuscule risk of severe disease to be vaccinated, the numbers don’t compute. The vaccine that will currently be used predominantly is only known to be 62% effective in eliminating symptoms and it is not known at all yet how effective it is in reducing transmission. It could be a lot less.

I think the premiers will turn the blame on the federal government when it becomes clear a vaccine will not stop all COVID-19 infections. No responsibility will be taken for not considering what would happen if this was the case.

Originally Posted by Wotname

Personally I think the PM is facing a tough future - the end game is in his bailiwick and he doesn't appear to holding a good hand. The people aren't going to be forgiving if the premiers' hard work and efforts in elimination come to naught.

Precisely! Allowing any spread would also be political suicide for all the premiers currently in control during declared states of emergency. So how do they get Australia back to functioning normally?

——————-
By the way, this has been a great discussion. So many diverse views have been expressed. It is a fascinating and thought provoking topic. I have gained lots. Thanks everyone.

[Montanan]

EU kicks off debate on vaccine travel certificates

European Union countries kicked off a debate on Monday on whether people who have received a COVID-19 vaccine should have greater freedom to travel or to socially interact, [e.g., to dine in restaurants, go to cinemas, gather together] in the summer than those not immunized.

Europe ministers from the 27 EU nations held a video conference to discuss greater coordination for the roll-out of vaccines.

Perhaps even an electronic vaccination certificate.



https://www.yahoo.com/finance/news/e...155702128.html

[Capn Jimbo]

A Public Health Perspective:

A Nordic response?







The notion that there is a "Nordic response" is hard to justify.



Of the Nordic countries three have done exceptionally well, Denmark has corrected nicely, but Sweden remains an outlier, mostly based on a late, tentative and response lite approach. Thus the notion of a "Nordic response" as somehow unique and "sustainable" lacks real meaning or application.

To me speaking of a "sustainable Nordic response" seems just a way to hide Sweden poor record by lumping this failed performer with their much more successful brethren. In my world there is no such thing.

CJ
Public Health, 30 years

[UFO]

Originally Posted by Capn Jimbo

A Public Health Perspective:

A Nordic response?

The notion that there is a "Nordic response" is hard to justify.
Of the Nordic countries three have done exceptionally well, Denmark has corrected nicely, but Sweden remains an outlier, mostly based on a late, tentative and response lite approach. Thus the notion of a "Nordic response" as somehow unique and "sustainable" lacks real meaning or application.

To me speaking of a "sustainable Nordic response" seems just a way to hide Sweden poor record by lumping this failed performer with their much more successful brethren. In my world there is no such thing.

CJ
Public Health, 30 years

So Sweden has had a bad couple of months....



The number of dead in November 2020 was 77.9 per 100,000 inhabitants, lower than 79.2 in November 2010, so as we can see they have had worse flu outbreaks in the last decade.


Also on a world scale, they are far from the best, but quite a long way from being the worst and this pandemic is not over yet, so maybe wait and see what happens before making such assumptions.


I find it very amusing that some of you get your knickers in a twist over the way Sweden has handled the Pandemic. It would have been the way that the UK handled it as well, if it wasn't for that rather bleak and completely wrong imperial college report. The UK couldn't be any worse off now if they had gone that route and to top it off they have totally tanked their economy and the jobless are through the roof because of the continual and in effective lockdowns.

[Sos]

Originally Posted by UFO

The UK couldn't be any worse off now if they had gone that route and to top it off they have totally tanked their economy and the jobless are through the roof because of the continual and in effective lockdowns.

The lockdown IS working in the UK.

[UFO]

Originally Posted by Sos

The lockdown IS working in the UK.

Really? They have been in continual on and off lockdowns of varying levels since this started and are one of the worst countries in the world (no 6) for deaths per million - So tell me once again how well the lock downs have worked.

[Dockhead]

Originally Posted by Capn Jimbo

A Public Health Perspective:

A Nordic response?

The notion that there is a "Nordic response" is hard to justify.

This is demonstrably false.

The distinctive Nordic pandemic approach comprises:

1. Intense public education

2. Voluntary measures of social distancing

3. Extensive recommendations to businesses about remote working

4. Voluntary self-quarantine after crossing borders,

5. Voluntary use of masks,

6. Very limited "hard" measures --closing schools occasionally and briefly, and limiting the size of public, and occasionally private gatherings, reducing capacity and limiting hours of restaurants and other public gathering places.

In none of the Nordic countries has there ever been any lockdown (defined as stay at home orders, mandatory limitations on mobility, mass closing of businesses). The only difference between the measures in Sweden and the other Nordic countries is that while Sweden closed universities and high schools, it never closed primary schools (and primary schools were reopened after only a few weeks in the rest of the Nordic countries and have remained open since). Sweden never closed restaurants, but limited capacity and hours. Restaurants were closed but reopened in the rest of the Nordic countries by May and have been closed since then only in Denmark, which was having a bad outbreak in the autumn; since May the other Nordic countries have emulated the Swedish approach of limiting capacity and hours, what we have right now here in Finland.

THAT is the Nordic pandemic response. And yes -- it is a distinct thing.

The Nordic approach is very different from what has been used in most of the rest of Europe, where there were stay at home orders for months enforced by fines, mandatory closing of all kinds of businesses, including even construction sites, severe limitations of mobility (in many countries 100 meters from home unless you had a pass, violations punished by fines), severe limitations on private gatherings. These measures nowhere in Europe worked better than the measures in Sweden; more about that anon.

Originally Posted by Capn Jimbo

. . .Of the Nordic countries three have done exceptionally well, Denmark has corrected nicely, but Sweden remains an outlier, mostly based on a late, tentative and response lite approach. Thus the notion of a "Nordic response" as somehow unique and "sustainable" lacks real meaning or application. To me speaking of a "sustainable Nordic response" seems just a way to hide Sweden poor record by lumping this failed performer with their much more successful brethren. In my world there is no such thing.

Your world as outlined in these posts is not the world of science. Some people rush in, where angels fear to tread. SCIENCE does not know easy answers to the question of why some countries have better outcomes than others, contrary to what you assert. "Outliers" are everywhere; the pattern is random. Apparently similar countries using similar measures have radically different outcomes; just look at Luxembourg and Belgium, just to name one example.

I know you don't read scientific papers (or if you do, you haven't let on), but you might make the effort to read this one, a peer-reviewed Stanford University study on the effectiveness of pandemic measures, which we were discussing earlier: https://onlinelibrary.wiley.com/doi/10.1111/eci.13484.

This study points to the reason WHY we see little correlation between measures and outcomes -- it doesn't make any difference -- the measures used in Sweden and Japan (the countries chosen for analysis representing less restrictive measures) had the same effect on the infection curves as the measures used in countries using the most restrictive measures. Far from being a "failed performer", Sweden had the same success in quelling a bad outbreak, as other countries using a more restrictive approach, for reasons which we discussed extensively in this thread. That is peer reviewed science.

Here is another really interesting scientific paper, which attempts to find correlation between a whole lot of different factors, and outcomes (death rates): https://pandata19.org/wp-content/upl...-variation.pdf. One of the factors investigated is the Oxford Stringency Index. There was NO correlation found between the Stringency Index and death rates:



From the Abstract:

"One of the most interesting features of the COVID-19 outbreak is the stark difference between mortality experience in different countries. No simple and plausible explanations that we are aware of have been advanced. Though various hypotheses have been put forward, some more hopeful than others, many display an element of confirmation bias in attempting to locate all differences in nonpharmaceutical intervention approaches."

This lines up exactly with the results of the Stanford peer reviewed study linked above. The scientists are baffled at what causes large variations in death rates between regions and between countries. They couldn't find ANY common factor with any strong influence on outcomes, and certainly not the stringency of measures.

The method and approach of managing the pandemic in the Nordic countries is based on all the same principles across the region, based on the same political culture, the same types of societies, the same administrative structure of public health authorities, and similar constitutional systems (Finland and Sweden almost identical; Norway and Denmark slightly different). These are facts. This approach is strikingly different from what was used, at least initially, in most of the rest of Europe. The fact that it worked better in some countries than in others doesn't change that -- the same is true of other regions. The fact that this approach worked exceptionally well in Norway and Finland (or that Norway and Finland were exceptionally lucky) does not make Sweden a "failed performer", when Sweden is close to the European average, dealing better with a bad outbreak than most European countries which are using the most restrictive measures, as demonstrated by peer-reviewed science, and with a significantly worse outcome than primarily other countries using the same measures.

I know you have a single-minded passion to demonize Sweden, but this is an irrational feeling unsupported by facts and unsupported by science. In fact almost no country in Europe which has done substantially better than Sweden, was using the most restrictive measures. Singling out and picking on Sweden, which is in the middle third of European countries in terms of cumulative death, and in fact has one of the lowest excess mortality rates in Europe in 2020 (Seaworthy Lass can speak to that), is a litmus test of bias.

[UFO]

This is one for you lock down Nazi's..... According to this the lockdowns will in the long term cause considerably higher mortality than the virus itself.

ABSTRACT

"We adopt a time series approach to investigate the historical relation between unemployment, life expectancy, and mortality rates. We fit a Vector-autoregression (VAR) for the overall US population and for groups identified based on gender and race. We find that shocks to unemployment are followed by statistically significant increases in mortality rates and declines in life expectancy. We use our results to assess the long-run effects of the COVID-19 economic recession on mortality and life expectancy.We estimate the size of the COVID-19-related unemployment to be between 2 and 5 times larger than the typical unemployment shock, depending on race/gender, resulting in a 3.0% increase in mortality rate and a 0.5% drop in life expectancy over the next 15 years for the overall American population.We also predict that the shock will disproportionately affect African-Americans and women, over a short horizon, while white men might suffer large consequences over longer horizons. These figures translate in a staggering 0.89 million additional deaths over the next 15 years."

https://www.nber.org/system/files/wo...304/w28304.pdf

[Dockhead]

Originally Posted by UFO

This is one for you lock down Nazi's..... According to this the lockdowns will in the long term cause considerably higher mortality than the virus itself.

ABSTRACT

"We adopt a time series approach to investigate the historical relation between unemployment, life expectancy, and mortality rates. We fit a Vector-autoregression (VAR) for the overall US population and for groups identified based on gender and race. We find that shocks to unemployment are followed by statistically significant increases in mortality rates and declines in life expectancy. We use our results to assess the long-run effects of the COVID-19 economic recession on mortality and life expectancy.We estimate the size of the COVID-19-related unemployment to be between 2 and 5 times larger than the typical unemployment shock, depending on race/gender, resulting in a 3.0% increase in mortality rate and a 0.5% drop in life expectancy over the next 15 years for the overall American population.We also predict that the shock will disproportionately affect African-Americans and women, over a short horizon, while white men might suffer large consequences over longer horizons. These figures translate in a staggering 0.89 million additional deaths over the next 15 years."

https://www.nber.org/system/files/wo...304/w28304.pdf

I would respectfully argue that this does not prove, by itself, that lockdowns were not worth it. We do not know how many deaths there WOULD have been without lockdowns. Maybe a lot more than 0.89 million.

However, one thing is absolutely true here -- pandemic measures have far-reaching consequences which may EASILY be worse than the pandemic itself. Policymakers have to be really careful. Not just this study, but many others, and the World Health Organization itself frets that deaths from hunger resulting from the economic fallout will dwarf pandemic deaths. And not just death -- the long-lasting harm to children kept out of school, etc., etc., etc.

There is some good science -- which we've discussed -- indicating that lockdowns (defined as stay at home orders, mass closing of businesses, and limitations on mobility) have not been shown to produce any better results than Nordic type measures.

But again -- we have to be logical -- that does not PROVE that lockdowns are useless. What if lockdowns have been used in countries where Nordic-type measures wouldn't work, because people don't follow voluntary social distancing measures?

This is the difference between my position, and the position (which I highly respect) of Seaworthy Lass. I think we really don't know. Seaworthy Lass might very well be right; but I just don't feel confident that we know enough to say that yet. I would hate to be in the position of making policy during this awful time.

[UFO]

Originally Posted by Dockhead

I would respectfully argue that this does not prove, by itself, that lockdowns were not worth it. We do not know how many deaths there WOULD have been without lockdowns. Maybe a lot more than 0.89 million.

Very true and a very valid point as we will never know what the mortality and economic consequences would be if those that locked down did not - Its a highly speculative area, but its hard to see on an economic front with the amount of $ being printed and thrown around that it would come anywhere near economically speaking and this then leads to what the WFP said in regard to starvation, that for children under 5 it could go up from 10 million a year to 30 million per year - That's a 20 million increase in mortality and more to the point it's not over 80's like covid, but under 5's! This is directly linked to the massive reduction in foreign aid and investment as the Western Nations have locked down and need to print money to bail out there own citizens, reducing the $ for aid and investment.