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Let’s talk about the state of New York and Sweden.
If you picked two places that were most dissimilar in the world when it came to their coronavirus responses, the state of New York and Sweden might be the best examples of opposite behaviors. Sweden effectively decided it wouldn’t change the countries behavior when the coronavirus arrived. New York tried everything to stop the coronavirus from spreading.
So what were the results?
In Sweden there were 78,504 confirmed cases, 5,667 deaths and a death rate per million of 561.
Here is what the case and death charts look like from Sweden.
New York, on the other hand, embraced a frenzy of governmental activities. The entire state was shut down, schools were closed, no one could go to work, the mayor and the governor had daily press conferences, the media covered hospitalizations on a minute by minute basis, there was going to be a ventilator shortage!, then there wasn’t, there was a hospital room shortage!, then there wasn’t, there was a ship that pulled into New York harbor to provide health care!, only it wasn’t needed, and what were the final results in New York?
435,753 confirmed cases, 32,602 deaths and a death rate per million of 1676.
So New York undertook all these drastic actions, Sweden did nothing, and yet somehow New York ended up with triple the death rate of Sweden.
Here is what the charts look like in New York.
Sweden and New York look pretty similar, except New York’s death rate and case rate was much higher on a per capita basis.
We already know New York was an absolute disaster when it came to dealing with the coronavirus. Earlier this week I pointed out that New York was on pace to have ten times the death rate as Florida and Texas despite a similar number of confirmed cases. You should go read that piece if you haven’t already.
But how is it possible that New York, which undertook a frenzy of activities that were designed to keep its citizens safe, ended up with triple the death rate of a country, Sweden, that did nothing at all?
Sure, New York’s governor, Andrew Cuomo, made the worst decision of any elected official in the 21st century when he sent sick patients back into nursing homes, but is that really the entire difference when it comes to deaths There are other hypotheses for sure. In general, Sweden’s people are probably far more healthy than New York’s. Since obesity has been shown to be the most impactful factor in terms of deaths, that probably factors in here as well.
But I think there’s also a strong hypothesis here that New York, aided by the screaming panic in the media and on social media, overreacted. That is, New York would have been better off if they hadn’t done anything than to do what they did.
Let me explain what I mean this hypothesis. We have a problem here: New York, which undertook a variety of actions that were designed to save lives, ended up with triple the death rate of a country, Sweden, that essentially did nothing at all. How is that possible?
Well, one hypothesis would be that New York made the worst decision in every action it undertook.
Here’s an hypothesis that would help explain the data: by the time New York acted to shut down the city, the virus had already spread widely throughout the city. As the city and state’s leaders panicked, it’s possible the peak had already occurred. That is, given that the virus is about two weeks ahead of whatever action we take — hospitalizations and deaths lag infection by around this amount — whatever action you undertake is already too late to deal with the existing situation on the ground.
If it’s true that New York was already near a peak then when the city made the decision to shut everything down then let’s consider what that impact might have been. Well, New York sent everyone home and told them to all stay inside lest they get sick. Except we now know the virus spreads more efficiently than anywhere else inside homes when people stay inside. Even worse than that, New York has many multi-generational homes, so not only did New York’s leaders send their people back into homes with elderly relatives they did it at the absolute worst time, when the virus was near its peak and there were more people to spread the infection inside homes, the most efficient way to spread the virus in the first place.
That decision to send everyone back into their homes then created many more serious infections, creating an artificial double peak in infections which lead to a continuation of the deaths.
In other words, New York would have been far better off doing nothing at all than undertaking all the decisions they did.
Again, that’s an interesting hypothesis to explain why the New York data exists as it does. It isn’t proven and I’m sure like all hypotheses it has flaws, but purely from an epidemiological perspective it helps to explain why the death data between New York and Sweden are so different. (Indeed, one of the most fascinating things about the coronavirus is all the data produced from so many different countries around the world. We have the data, but now we’re trying to make sense of it all.)
Okay, now let’s go back to the above charts, do you notice anything else? The virus died out in both places in pretty much similar patterns. That is, despite New York doing everything it could and Sweden doing nothing their graphs ended up pretty similar, the virus essentially vanishes. So far from producing exponential growth forever and ever, the virus eventually dies out, whether you undertake drastic action, like New York, or do nothing at all, like Sweden.
In fact, if you look at Sweden and compare it with other large countries in Europe, Sweden’s death rate per million and the charts tracking the viruses rise and fall look very similar as well.
Here are the countries in Europe and their death rates:
United States 439 (so far)
Again, all of these countries undertook drastic shut down actions as well: England, Spain, Italy, Sweden and France and they all ended up roughly in the same place when you look at death rates per million as Sweden, which didn’t change its behavior much at all. (Other countries neighboring Sweden did shut down and had lower death rates, but one hypothesis there would be these countries may be more vulnerable to a second wave of cases. Or it’s possible they acted before the virus spread as significantly and Sweden made a mistake in not undertaking drastic action. Either way, the key is Sweden is a fascinating epidemiological centerpiece because its behavior was different than many other countries).
All of these countries have since opened back up and the virus hasn’t surged there anew. This suggests that there may well be a percentage of infection or death in the country that conveys a substantial portion of herd immunity. And that herd immunity may be between 10 and 20% as was suggested by a recent Oxford study.
Oxford epidemiologists suggest herd immunity to coronavirus may occur at just 10-20% infection rate. If true, this would explain why virus disappeared in Europe and NYC once those rates were attained. https://t.co/IgrHGX8qg4
But my larger question for you is this: in undertaking all these actions to fight the virus are we not really having much of an impact at all? Worse than that, in the case of New York and the other northeastern states that followed New York’s lead, did our panicked actions actually create far more deaths than would have occurred if we’d just done nothing at all?
Because what you can argue right now is that the United States, large and diverse of a country as we are, is really just going through a series of rolling outbreaks. In other words, if New York, Florida, Texas, and California, for instance, were all different countries, isn’t it possible that all the lockdown did was prolong the amount of time it would take for the virus to run its course in those locations as well? That is, that these states didn’t do anything “wrong” it was just inevitable that they were also going to have viral spread as soon as they opened back up, no matter when that opening occurred.
If that’s the case then what we are seeing right now in the country isn’t some sort of a failure, it’s just the virus being the virus. In fact, given that Florida, Texas and California presently have a death rate that’s a fraction of New York’s, you can argue that we’re actually demonstrating with each day’s results just how much of a disaster New York was and how much smarter we have become about how to treat the virus.
Here are the present death rates per million in these four American states:
New York 1676
Again, look at New York. It’s even more staggering to see in the context of the other three most populous states in our country. I don’t think there’s any doubt that we have gotten smarter about how to treat the coronavirus and this helps to explain the better results now, but I also don’t think, if you look at the data, that there’s any doubt New York made the absolute worst decisions possible on every level in responding to this virus.
Far from being praised by the media for his leadership, every media member in the country should be asking how Andrew Cuomo got everything so wrong and why any other governor followed his lead. Because if New York just had the death rate of Sweden, which is still one of the highest death rates in the world, there would have been tens of thousands of fewer deaths of New Yorkers than actually happened.
Amazingly, New York’s governmental response to the coronavirus was so bad, it would have been far better if they’d just done nothing at all.
And ultimately this might be an important lesson that all of us should consider drawing from social media and its incessant demand for immediate action: sometimes doing nothing at all is healthier than overreacting.