Zero Covid is dead – official

“Government instructions to stockpile food are seldom a sign that all is well.” 

That’s how the Financial Times kicks off its editorial: Zero-Covid countries have run out of road.

Measures in support of a Covid elimination policy, like this, quickly become destructive once elimination is not possible.  The FT states bluntly:  

“Buying time made sense during the wait for vaccines.  Now, though, buying time buys nothing”.

Success depends on how quickly and effectively policy pivots to the new reality.

Time perhaps to see what Anders Tegnell, the oft-maligned Swedish public health boss, has to say.

He’s still cheerfully defending his record, emphasizing that Sweden closed down enormously during the pandemic but without the draconian measures used in some other countries.  The result:

“Sweden had one of the lower excess mortality levels in Europe, while on other pandemic measures it was closer to average.”

Quite.  But even more interesting is Tegnell’s overview of the situation now.

In particular, he seems to be critical not just of policy makers’ failure to properly assess the effectiveness of Covid measures, but also their approach to uncertainty:

“What they’re not talking about is what kinds of things did make a difference. That’s what we’re still struggling to understand. Some measures work sometimes in some places, but it’s very difficult to see a clear pattern …”

This is essential because the people who have to implement and endure the measures are not robots:

“Do we need to close restaurants? Do we need to close theatres? Do we need to tell people to work a bit more from home again? Because these blanket closing downs of everything, I don’t think there’s going to be much of an acceptance of that any longer.”

Indeed, it does seem time to embrace diversity and extend the principle of tolerance to anti-vaxxers.  Not least because if you don’t understand something you don’t like, you are unlikely to be able to deal with it.

It should be clear first of all that there is a solid and committed body of anti-vaxxers in the population, many of whom feel they have made enough compromises with their pro-vax compatriots.

It would surely be helpful to better understand the strength of the different reasons because they appear to vary enormously, ranging from cussedness and indifference; through an abundance of caution to a different assessment of health risks; to principled religious and political opposition.  

The backlash in United States military and defence circles suggests that applying blanket penalties, sometimes severe, to this diverse group is not going to end well.  Particularly when there is evidence that the main risk of non-vaccination is borne by the non-vacinatee:

“… a new study published in the The Lancet Infectious Diseases Journal found that those who have received the vaccine can spread the delta variant just as easily as unvaccinated individuals, leading to arguments that the shot only mitigates the impact of an infection but does not reduce spread.”

You have to wonder if things might be different if the official responses throughout the crisis had shown a little more Tegnellian uncertainty and humility.  It might have prevented pandemic response anger from leaking into more generalised political discontent. And it would surely have left both politicians and public health officials with more broad-based credibility than they currently seem to have.

The ever-logical Singapore government has decided that those who choose non-vaccination will have to use their own insurance to meet any Covid-related medical bills.  Evidently it understands that a carrot (even a negative carrot) is sometimes better than a stick.

Politics is the art of reconciling – or even just safely balancing – different political views inside the one polity.  Proclaiming uniformity in the face of diversity can be dangerous as well as insulting. We may find that the Tegnell approach was justified, not just on public health and economic grounds, but also on social and political ones too.

One thought on “Zero Covid is dead – official

  1. Regrettably, quoting Tegnell’s advocacy for the policy he led in Sweden greatly damages a case otherwise worth arguing.

    The post quoted Tegnell as saying;
    “Sweden had one of the lower excess mortality levels in Europe, while on other pandemic measures it was closer to average.”
    The comparison is grossly misleading because Sweden has arguably the best welfare support and one of the best health systems in Europe. Thus it’s excess death rate would be expected to be below that of Europe anyway if comparable policies had been used to manage the pandemic.

    By far the best comparison for Sweden is with other Nordic countries like Norway which are similar in terms of culture, demography and social policies.

    One such comparison is made in the peer reviewed scientific publication International Journal of Environmental Research and Public Health. It is by Rypdat et al and titled Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020 {1}.

    The article finds:

    The confirmed cumulative COVID-19 death toll in Sweden until 11 November was 6247, which corresponds to 611 deaths per million. This figure is typical for Europe but high compared to Sweden’s Nordic neighboring countries. In particular, Norway, which is very similar to Sweden in terms of culture, demographic development, and social policies, has chosen a much more strict approach against COVID-19. As a result, by 11 November, Norway had only 285 confirmed deaths (53 per million) related to COVID-19.

    Thus the Swedish policy led to nearly 12 times as many deaths per million as those in Norway over the first wave of the pandemic.

    This finding, supported by other papers in the literature, demolishes Tegnell’s argument and does damage to the important case made in the post.
    {1} Int. J. Environ. Res. Public Health 2021, 18, 3913. https:/ / doi.org/ 10.3390/ ijerph18083913

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