This is a guest post written by a colleague who works as a care home doctor in a small Swedish town. In other words, he is responsible for the wellbeing of frail elderly people living in care homes. He has treated a lot of patients with covid-19. Since the situation may be different in some other countries, I think it is useful to know before reading the article that in Sweden, people stay in their own homes until they are very close to the end of their lives. 50% of people who move in to care homes are dead within six months.
September 2020 was the least deadly month in Swedish history, in terms of number of deaths per 100,000 population. Ever. And I don’t mean the least deadly September, I mean the least deadly month. Ever. To me, this is pretty clear evidence of two things. First, that covid is not a very deadly disease. And second, that Sweden has herd immunity.
Dietary fibre is the name we use for complex plant based carbohydrate molecules that our intestines are not able to digest. Since we can’t digest fibre, it goes straight through the intestine after we eat it, and comes out the other end. And since it fills up the intestine, it contributes to a feeling a fullness. It can also bind up certain substances, so that they travel through the intestine and come out the other end, rather than being absorbed by the body. In theory, these effects should mean that increased intake of dietary fiber results in weight loss, at least if you’re overweight.
Last year I spent a couple of months working as a physician in a geriatric hospital, i.e. a hospital that specializes in taking care of elderly people. One thing that struck me particularly was the large number of medications each patient was on. I don’t think it would be much of an exaggeration to say that the average patient had ten or more medications that they were taking on a daily basis.
I recently took part in a podcast with Ivor Cummins of Fat Emperor to discuss covid-19. Over the course of an hour we discuss what has happened in Sweden and what my experiences have been working in the Emergency Room of a hospital over the course of the pandemic. We also discuss the reasons I reached the conclusion that we must have herd immunity in Sweden, and go in depth in to the immunological reasons of how this is possible. We finish up with a discussion of mortality, and how it can be the case that 6,000 people have died of covid in Sweden without that having any measurable effect on the overall mortality rate.
After my article showing that prostate cancer screening with the PSA-test does more harm than good, I was asked to follow up with an article looking at breast cancer screening with mammography. That turned out to be easier said than done, because virtually all studies of breast cancer screening only report the effect of screening on breast cancer mortality, not on overall mortality.