Covid-19: Does Sweden have herd immunity?
At the beginning of August I wrote an article about my experiences working as an emergency physician in Stockholm, Sweden during the covid pandemic. For those who are unaware, Sweden never went in to full lockdown. Instead, the country imposed a partial lockdown that was almost entirely voluntary. People with office jobs were recommended to work from home, and people in general were recommended to avoid public transport unless necessary. Those who were over 70 years old, or who had serious underlying conditions, were recommended to limit social contacts.
The only forcible restriction imposed by the government from the start was a requirement that people not gather in groups of more than 50 at a time. After it became clear that covid was above all dangerous to people in nursing homes, an additional restriction was placed on nursing home visits. At no time has there been any requirement on people to wear face masks in public. Restaurants, cafés, hairdressers, and shops have stayed open throughout the pandemic. Pre-schools and schools for children up to the age of 16 have stayed open, while schools for children ages 16-19 switched to distance learning.
My personal experience is that people followed the voluntary restrictions pretty well at the beginning, but that they have become increasingly lax as time has gone on. As a personal example, my mother and my parents-in-law stayed locked up in their homes for the first six weeks or so of the pandemic. After that they couldn’t bear to be away from their grandchildren any longer.
In my earlier article in August, I mentioned that after an initial peak that lasted for a month or so, from March to April, visits to the Emergency Room due to covid had been declining continuously, and deaths in Sweden had dropped from over 100 a day at the peak in April, to around five per day in August.
At the point in August when I wrote that article, I hadn’t seen a single covid patient in over a month. I speculated that Sweden had developed herd immunity, since the huge and continuous drop was happening in spite of the fact that Sweden wasn’t really taking any serious measures to prevent spread of the infection.
So, how have things developed in the six weeks since that first article?
Well, as things stand now, I haven’t seen a single covid patient in the Emergency Room in over two and a half months. People have continued to become ever more relaxed in their behaviour, which is noticeable in increasing volumes in the Emergency Room. At the peak of the pandemic in April, I was seeing about half as many patients per shift as usual, probably because lots of people were afraid to go the ER for fear of catching covid. Now volumes are back to normal.
When I sit in the tube on the way to and from work, it is packed with people. Maybe one in a hundred people is choosing to wear a face mask in public. In Stockholm, life is largely back to normal. If you look at the front pages of the tabloids, on many days there isn’t a single mention of covid anywhere. As I write this (19th September 2020) the front pages of the two main tabloids have big spreads about arthritis and pensions. Apparently arthritis and pensions are currently more exciting than covid-19 in Sweden.
In spite of this relaxed attitude, the death rate has continued to drop. When I wrote the first article, I wrote that covid had killed under 6,000 people. How many people have died now, six weeks later? Actually, we’re still at under 6,000 deaths. On average, one to two people per day are dying of covid in Sweden at present, and that number continues to drop.
In the hospital where I work, there isn’t a single person currently being treated for covid. In fact, in the whole of Stockholm, a county with 2,4 million inhabitants, there are currently only 28 people being treated for covid in all the hospitals combined. At the peak, in April, that number was over 1,000. If 28 people are currently in hospital, out of 2,4 million who live in Stockholm, that means the odds of having a case of covid so severe that it requires in-hospital treatment are at the moment about one in 86,000.