Sunday 24 May 2020

TO MASK, OR NOT TO MASK ...


Even if the Corona virus continues to create havoc across the globe, isolating yourself at home becomes more and more cumbersome. Of course, only in your mind, less so in reality. What you can endure for a month or two, gets irky thereafter, in particular since the authorities see no end to it.

But this blog is not about complaining about self-isolation. Far from it! We have to look the grim reaper squarely in the eye and deflect the scythe he is swinging at us. Instead, let me spend som moments on the plague strategy exercised by the Swedish authorities, in particular, to what extent it is helping us elderly to avoid the death stroke.

The reason I am writing about this at all, is, of course, that many a foreign friend has contacted me about the subject, wanting to know more about our ways of dealing with the plague, at the same time informing me about the status of research in their own countries and querying me about progress in that regard here in the land of the all-knowing.

Sorry to say, my answer to them is, at present, that the Swedish authorities seem to be committed to a specific conception of the plague, which they reached early on in their actions and which they have been clinging to, without blinking, ever since. This conception is based on the vision, that this plague is being spred in analogy to the recurring invasions of influenca virus, with a virulent beginning and a relatively timely end, once a sufficient rate of the population has been through the ordeal and has developed anti-bodies. And indeed, in the case of influenca so called "herd immunity" will be reached eventually, which will greatly slow down and ultimately stop the disease.

Although the Swedish Public Health Authority denies that it relies on a timely reaching of herd immunity in enacting its strategy, this idea is still permeating the authority, shutting down its eyes to alternative findings from research abroad, which would oblige it to change its messages to the general public. To find a reason for this, look no further than to Professor Johan Giesecke, the former Chief State Epidemiologist, who acts as adviser to the authority. In contrast to the present State Epidemiologist and his colleagues, he is rather outspoken about the above mentioned vision inspiring the Swedish strategy. With his mature age and a certain self-imposed authority he has no qualms about speaking out what the agency is holding close to its chest. Why not listen to him in person in the video below:


I am no medical or epidemiologic scientist, but let me put forward an alternative vision of the spread of this virus. You may not be aware of it, but humanity has lived with a special sort of Corona virus since ages past. It is one of the viruses behind the "Common Cold", "Schnupfen" in German and "Snuva" in Swedish. Scientists without Sweden are increasingly looking at the properties of this illness to try to understand how the present plague is spreading and what could constitute its eventual demise. With the common cold, humans apparently do not develop anti-bodies against the virus involved; the general immune system deflects it within a short time period. This is of course no long-term remedy, you will get it again next year!

Compared to this, the present Corona virus is developing anti-bodies in some of the cases, mostly the more severe cases of illness, whereas probably a majority of the infected recovers without developing anti-bodies, many of them without even experiencing any symptoms – but still spreading the virus. This means that, increasingly, scientists abroad question the possibility of developing herd immunity against the disease; we may have to reckon with, on the one hand, a drawn-out first wave of the sickness and, on the other, recurring waves of new infection. Developing a vaccine against the virus becomes adamant in getting rid of the virus.

Seen in this light, it seems to me that the Swedish authorities have completely overlooked one major and all-important difference between its strategy and that in our Nordic neighbours and, indeed, the rest of the world: the obligation to wear a mask in confined quarters, such as, shops, restaurants and service centers implying close contact between people. By now, there is a lot of research showing that a mask diminishes the outflow of virus-laden mucus by up to 50 %, drastically lowering the infection rate in close quarters. For me, not prescribing the use of masks in Sweden accounts for most of the difference in the death rate between us and the other Nordic countries.

We have to realise that a simple recommendation to wear a mask in close quarters would not be enough to get the Swedes to actually do it. The simple reason is that a mask does not prevent you from getting infected, it only prevents you from spreading the disease if you are infected, so there are no incentives to do as the state recommends. This means that it takes a legal obligation to get everyone to wear a mask indoors in close quarters to reach an appropriate mitigation of the disease.

To me it seems, that the Swedish authorities are paying lip service when they claim that their main goal is to protect the elderly from the disease. By stating that wearing a mask has no great preventive effect, as is being repeated by them at regular intervalls, they may be directly responsible for the premature demise of maybe thousands of elderly in Sweden to date. And the number is rising by the day. Shame on you, you Swedish Bureaucrats!

11 comments:

Birgitta Bucht said...

Hej Emil,

Jag håller med dig helt och hållet. När jag kom hem tyckte jag att allt verkade bra. Det verkade som om alla höll social distans. Nu inte alls. Det är bara äldre personer som gör det. Unga personer verkar att strunta i det helt och hållet. Det som upprör mig mest är att ingen använder mask. Mask hjälper. Om du inte har följt Andrew Cuomo så gå in på youtube och se på en av hans imponerande presskonferenser. Han ger en presskonferens varje dag 11.30 NY tid. Jag har inte lyckats få in en direktsändning men ser den på youtube så fort direktsändningen är över. Viruset kom till New York, en tättbefolkad stad från Europa genom två stora flygplatser, JFK och Newark. Spridningen gick snabbt upp och nu snabbt ner tack vare social distans och användandet av masker. Nu när så många har testats så har det visat sig att spridningen är lägst bland hälsovårdspersonal och andra "first responders" därför att dom skyddar sig och högst bland allmänheten. Därför är det nu mandat för alla att ha mask. Det finns snygga fashionabla masker.

Ha det bra och håll dig frisk. Hälsningar, Birgitta

Anonymous said...

Very interesting, Emil.
All best,
Thorvaldur

BeachyGal said...

It is true that we,individually, can avoid the virus but, sooner or later, we must confront it and survive (or not) via anti-bodies acquired one way or the other. In Northern California we have been very good at dodging it now for months at staggering economic cost. As we "open up" we will see if that strategy was the most efficient/effective one.

Stay well in your hotbed of infection, Emil! :}

Anonymous said...

Hej, Emil!
Det verkar vara en tävling mellan de nordiska länderna om vem som har gjort rätt!? Det kommer nog att visa sig i höst, eller när pandemin är över!
Hälsningar
Kaj

wimpissingernews.blogspot.com said...

Für mich zählen die Toten und diese Zahl ist 5x höher als in Österreich. Es scheint auch das Vertrauen in die schwedische Bekämpfungspolitik und Selbstdisziplin stark rückgängig. Zum wichtigen wirtschaftlichen Schaden: kaum ein Unterschied zu den restriktiven Ländern, wir sind zu stark vernetzt. Wir diskutieren weiter in einem Vierteljahr!

Alan McCornick said...

Emil:

Thank you for that posting. I listened to the interview with Dr. Tegnell with great interest.

You've taken a stand against the Tegnell approach, and I respect that. The fact that Sweden has more deaths per million than even the United States gives weight to your argument. You may well be right to charge this policy was wrong-headed and ultimately disastrous.

What distresses me more than anything is how the coronavirus has been politicized in the United States, with Republicans arguing for opening and Democrats arguing for keeping closed. The fact that the news media make it sound as if these arguments are being made on ideological grounds rather than rational medical grounds only furthers my dismay over what has happened to the United States since the 2016 election.

We wait and we watch and we try to keep up to date with the conflicting ideas flying at each other and changing moment by moment.

I just passed my 80th birthday, so I have a vested interest in an approach that would keep the health and safety interest of seniors front and center. In addition, I have a serious lung disease - pulmonary fibrosis - so I'm at the head of the pack of those at risk. That makes me wonder how it could be that the Tegnell approach, which seems to have thrown seniors under the bus, was able to take hold and gather such broad support - I understand most Swedes go along with it.

But perhaps there is a greater argument, that it's a more rational long-term approach and in the end it will prove its worth.

I just wish I could feel a little less like I am duty-bound to be a necessary casualty in this war!

Best wishes, and thanks again,


Alan

Emil Ems said...

Dear Alan,

How nice to hear from you again and get your views on the crisis.

Maybe just a few comments. I am not really against the Swedish strategy, as it has evolved in practice. Just that the authorities appear unable to adjust that strategy in view of new knowledge coming in. I approved of it at the outset, since we all then shared the understanding that our way of dealing with the plague may in the end result in about the same number of deaths as that of a more restrictive regime. What is new now is the insight that a majority of the infected may not develop anti-bodies and that, therefore, we may have to live with the sickness until a vaccine is found and applied. Seen in this vane, it makes a lot of sense to try to avoid as many deaths as possible.

Still, it is not too late for Sweden to adapt to this new insight, neither does it take a lot of changes in the strategy. Just a legal obligation to wear masks in close quarters, keeping the rest of the strategy as it is, would do the trick. So, I am only really upset about the responsible authority's refusal to accept the most recent research results: that even a simple mask substantially reduces the emission of the virus and therefore the risk of getting infected. As you have heard Tegnell say, he maintains his view that there is no scientific result in that regard; a polite Swedish way of saying that he does not believe in those research results; or even worse, that he does not want to admit, in public, that the authority's original stance was wrong.

Yours sincerely
Emil

Per Wijkman said...

Dear Emil,
One reason few people wear masks in Sweden is that they are not available to purchase! I have attempted to buy one at several pharmacies only to be told that they are out of stock and that the government gives civil servants priority! How such a system can arise - and be tolerated - beats me!

Per

jerry Fitzpatrick said...

In our county everyone has to wear a mask outside but not while driving a car.
I enjoy all your blogs. Thanks Jerry Fitzpatrick

Anonymous said...

Hej Emil, och tack för dina återkommande ljusa och kloka idéer. Problemet med den svenska från världen avvikande Coronastrategin är att regeringen, som har det politiska ansvaret för landets styre, hittills litat blint på landets s k experter, Folkhälsomyndigheten par excellence, som ju väntas uttala sig strikt moraliskt och politiskt neutralt, från första början lagt sig i politiken, både i det sociala och i vård- och omsorgspolitiken, när FHM till exempel haft synpunkter mot att stänga skolor med motivering att det skulle drabba vissa (läs utsatta) områden och hemmiljöer mer än andra. För att inte tala om FHMs orealistiska förhoppningar om s k flockimmuniteten. Allt detta har lett till de oerhörda konsekvenser som vi idag genomlever både inrikes men även utomlands, där vi nu håller på att bli rena pariafolk som snart ingen vill ta emot.
Lev väl och håll dig frisk.
Farouk

Anonymous said...

Hej Emil,
Tack för dina tankar om Sveriges situation med bekämpning av Covid- 19. Att ansiktsmask skyddar även mot Corona Viruset ser vi om man jämför den relativa små spridningen i Japan, Korea, Taiwan. Att bära mask i flera timmar på sommaren och vara glasögonbärare kräver tillvänjning och helst en tygmask den man tvättar varje dag. Här i Portugal kan du köpa dessa på många ställen.
Portugal har lyckats bra att hålla siffrorna på ca en femtedel döda trots lika många infekterade som Sverige. Lösning låg i en ödmjuk uppmaning att 88 % bör stanna hemma för att sjukvården ska kunna ”ta hand om dig och dina närmaste” med en belastning kalkylerat på 75 % beläggning i IVA.
Den åldringen i Sverige från hemmet, som är positiv testat och avvisas ifrån vård i IVA, ges morfin som i kombination med Corona avslutar vårdinsatsen och livet inom ett par dagar och kostar bara ca en procent av en (oftast) tre veckors vård på IVA med individanpassade insatser som inte garanterar ett tillfriskande för åldringen.
Italien och Spanien har välutbildad personal på sina IVA avdelningar, men kunde oftast inte ge en individanpassad behandling som kan kräva upp till nio personer, då de blev kvantitativ helt överbelastat och personalen sjuk med 55 döda läkare redan tills mitten april månad.
Flockimunitet är allmän känd att fungera på harar rådjur, hjordar. Djuren reser inte två gånger om året till utland på semester och träffar i sitt revir inte så många av sin art efter ett tag.
Det svenska valet av hur man bemöter pandemin är i grunden ett ekonomiskt val, som här accepteras politiskt, där den äldre generationen visas mindre respekt. Det blir påtaglig effekt på lite längre perspektiv: Allmänna pensionskassan sparar miljarder, visst antal lediga bostäder i storstaden, lediga platser i åldersvården. Detta blir stora sammhälliga vinster i ett samhälle der etiken redan glidit på ett sluttande plan och får en tyst skyldig redan definierat och serverat att använda.
Att man inte stängde ner affärer, krogar och företag ger en betydande ekonomisk skadebegränsning för individen, men huvudsakligen skatteintäkter för mervärdeskatt och arbetsgivaravgifter till staten.
Vaccin, tar tid att utveckla och förse en hel värld med. Det kommer troligtvis lik vaccin mot influensa bara ge skydd ett år.

Håll dig frisk genom själv- isolation och bär mask när du träffar folk!

En hittills trygg äldre i Portugal
Michael