Sweden goes from beautiful Covid-19 pandemic gold to shameful bronze

In terms of excess mortality, Sweden was ahead of Australia with excess deaths from 2020-21 at three per cent and four per cent in Australia. Picture: AFP

In a flurry of commentary, it’s gold, gold, gold for Sweden. Sweden without lockdowns won the pandemic. Hooray!

The commentary relied to an extent to an OECD report released last year.

Let’s start with deaths by Covid. In cumulative Covid deaths to March 21, 2023, 23,813 Swedes have died of Covid, a rate of 2257 deaths per million. Over the same period 19,447 Australians have died of Covid at a rate 743 per million.

But the goal posts have shifted. Everyone from the World Health Organisation down now count excess mortality as the measure of pandemic lethality. The reasons for it are that in the developing world, where health systems are limited or non-existent and diagnoses and stated causes of death fraught, it is considered a preferred measure.

One thing the OECD report clearly identifies is that of the 38 countries under the umbrella of the organisation predictably, it is the poorer nations that have fared worse. Mexico and Colombia are at the top of the table in excess mortality. A range of factors account for this, including low vaccination rates and poor public health systems.

The OECD report which measured excess mortality over the period of 2020-2021 with the period 2015-2019 as the baseline, had Mexico and Colombia at the top of the table.

In terms of excess mortality, Sweden was ahead of Australia with excess deaths for the period at three per cent and four per cent in Australia.

But when we extrapolate more recent data, not covered in the OECD report, Sweden’s excess deaths are much lower than Australia’s and the envy of Europe.

People have lunch at a restaurant in Stockholm in April, 2020, when much of the world was enduring lockdowns. Picture: AFP

It’s all a question of lies and damned statistics, I’m afraid. One measure of Sweden’s low mortality rate was a 2017-2019 baseline which put the country’s excess deaths on the bottom of the heap and thus the best performer. But using the same baseline cited in the OECD report, that of the period 2015-2019, compared with 2020-2022, Denmark stands atop of the podium and to paraphrase The Simpsons, Norway wins so-so silver with Sweden collecting shameful bronze.

Both Denmark and Norway had lockdowns.

The very same OECD report revealed a measure of what we might broadly call wellness with the shares of each of the populations in all of the 38 OECD nations “suffering from depression or showing symptoms of depression”.

By that metric Australia went from 10 per cent to 28 per cent by the end of 2021.

In Sweden without lockdowns, presumably there would have been dancing in the streets, singin’ the Dancing Queen etc. Well, no. According to the OECD report, pre-pandemic Sweden’s rate by the same metric was 11 per cent and by the end of the 2021, it was 30 per cent.

There are other measures of wellness, of course, and the biggie is the strength or otherwise of the economy. Sweden’s pandemic driven recession was longer and deeper than ours, extending for three quarters. While Sweden’s economy grew at a very healthy five per cent in 2021, it narrowly avoided recession again in 2022 with tepid growth in the middle two quarters bookmarked by negative growth in the first and fourth.

Australia’s GDP per capita climbed at a higher rate than that of Sweden in the period 2021-2022.

But by any measure, Sweden’s excess mortality rate in the post-pandemic period is superior to Australia’s.

In the last measurable period in figures published by Australia’s Bureau of Statistics, Australia’s excess mortality for the period of November 2022 to January 2023, there were 22,886 excess deaths (using the 2015-2019 baseline) or a rise of 15.1 per cent.

Depending on which epidemiologist you listen to Sweden’s is around four per cent.

In Australia, this has led to some odd reasoning. LNP Senator Gerard Rennick got to his feet recently to ponder why the Covid vaccines had not prevented excess deaths.

Never mind the Swedish excess mortality stats where vaccine rates are similar to that in Australia, (the stand out exception is Sweden has higher rates of boosters at 65 per cent; Australia’s 54 per cent). But let’s not let facts muddy the waters here.

Even a quick glance at the causes of death on the ABS stats reveals spikes in death due to diabetes, up by 19 per cent and dementia including Alzheimer’s disease up by 17 per cent. Deaths by cancer are down in age standardised terms and death by strokes are down by 8.7 per cent. Death by respiratory illness is up by 5.7 per cent.

Does the senator think Covid vaccines cure diabetes?

I was no fan of lockdowns. With the possible exception of agoraphobics, no one enjoyed them.

In 2020, when we had no vaccines and little science to go on, I accept lockdowns in some form may have been necessary in the understanding that they would have profound social consequences. Imagine for a moment being a woman or a child being trapped in a home where domestic violence was the order of the day.

Schools were closed and truancy rates remain high to this day.

And later there was some heavy-handed state control going on.

Victoria’s long lockdown extended until the state and then Melbourne had zero community transmissions.

Victoria’s long lockdown extended until the state and then Melbourne had zero community transmissions. That is an extreme, even absurd measure for opening up, writes Jack the Insider. Picture: Getty Images

That is an extreme, even absurd measure for opening up. Like many others, I would love to see the health advice on how that figure was arrived at, but it remains a deep secret that only a royal commission could and should explore.

Other states closed their borders for no good reason. And in New South Wales, parts of western Sydney were locked down and some ugly measures introduced that were tougher on the people in one swathe of postcodes than others.

It was a tacit admission from governments across the nation that the state and territory public health systems were not up to scratch.

There was state intrusion going on that simply had no basis in medical advice. Melbourne had curfews. No one could take their hourly and then by the grace of Dan, two hourly exercise periods on the streets after 11 o’clock? What the hell was that all about, other than a government following police advice on the best means of controlling the populace?

There was other nonsense, too. Closures of playgrounds in public parks for reasons that made no sense then, let alone now. During these lockdowns, travel beyond a 5 km radius from one’s home was verboten, unless they had a permit. Why five or not four or six or seven?

But attributing the rates of excess mortality to lockdowns and thus declaring one nation’s success or otherwise compared to another is one very large step too far.

It’s not so much a question of comparing apples and oranges. The commentary is comparing apples to narwhals.

But don’t listen to me. Listen to an epidemiologist. And in the interests of fairness, let’s make it a Swedish epidemiologist.

“It’s very difficult to compare countries and the longer the pandemic goes on for the harder it is, because you need a proper baseline, and that baseline depends on what happened before,” Karin Modig, an epidemiologist at Sweden’s Karolinska Institute said last month.

“Mortality doesn’t tell the whole story about what effect a pandemic has had on different countries. The excess mortality measure has its weaknesses.”

And some terrible assumptions have arisen as a result.