Sweden v Georgia: Gambling on COVID-19

Sweden v. Georgia: it sounds like a sporting match—(can I have Sweden by 5½ points?)—but it’s actually a high-stakes alternative approach to the battle against COVID-19. (Photo © Ralf Roletschek, Wikimedia Commons.)

It began in Sweden, which—unlike other countries—has had no lockdown, no mandatory restrictions.  Instead, using a “trust-based” approach, it merely offered general guidance: work from home when possible, wash your hands, avoid unnecessary travel, and be particularly careful if you are older or suffer preexisting conditions. What it did not to was to shut down business, ban public gatherings, etc.

The impetus appears to have been a conclusion that the virus was bound to spread no matter how strict the control measures, so there was no point in being too draconian, so long as the curve was sufficiently “flattened” that health system wasn’t overwhelmed.

But Swedes are also a community-minded people, the plan’s architect Anders Tegnel told Nature:

As a society, we are more into nudging: continuously reminding people to use measures, improving measures where we see day by day that they need to be adjusted.

That decision has been, to put it mildly, controversial. As of April 25, Sweden had seen 18,177 cases, with 2,192 deaths—a much higher death rate than neighboring Norway, Denmark, Finland and Germany.

But, it has nevertheless flattened the curve and, Tegnel told Business Insider on April 24, enough people in Stockholm have already had the virus for the city (and soon the country as a whole) to develop enough herd immunity to ward off a massive rebound of infections in the fall.

I.e., Sweden’s plan may have allowed it to take its lumps from the virus now, sparing it from even more deaths later on.

(Why its death rate is so high is not as clear, but it may simply be that Sweden, which isn’t doing an enormous amount of testing, has missed a great many mild cases, meaning that its death rate is not actually as high as it appears to be.)

One can argue that Sweden’s plan was cold hearted–people are dying for real, now, rather than hypothetically in the fall. But one thing it clearly was, is well thought-out and organized. And it may be a gamble that at least partially worked.

Which brings us to Georgia.

It has almost the same population as Sweden (both are around 10 million), and roughly the same number of cases (23,216) , though its death rate is considerably lower, at 907. And now, it’s starting to reopen businesses, even including such things as barbershops and hair salons.

What this means is that consciously or not, Georgia is attempting the same experiment that Sweden did.

What’s different is that it’s doing it in the midst of the pandemic, rather than at the outset.

Sweden’s gamble appears to have paid off, in part, Tegnel says, because its healthcare system was well-prepared, well equipped, and not overworked at the start of the program, unlike the case in much of America’s mid-pandemic hospitals: “There has always been at least 20 percent of the intensive-care beds empty and able to take care of COVID-19 patients,” he told Business Insider.

Georgia may fare differently. Nobody before has decided to let the lid off the restrictions at a time when hundreds of people a day are already falling ill, each with the potential to infect several others. Nor is it clear that the state’s government fully understands the risks.

My guess is that Georgia is in for some very rough times. Come fall, it is possible that they too might develop enough herd immunity to stave off the worst of the rebound, but unless they are more careful about reopening than they currently appear to be, getting that point might cost them dearly.

As I said at the beginning, this is a very high-stakes experiment. I just wish that in America, such risks could be weighed and evaluated rationally, rather than through the endless prism of politics.

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