Covid-19: Does Sweden have herd immunity?

Covid is over in Sweden. No sign of it on the front pages of newspapers.

UPDATE 14th November 2020: In light of the recent increase in hospitalizations and deaths during October and November in Sweden, I no longer believe that Sweden reached a state of herd immunity during spring. The text below represents my thinking on the 19th of September, when I wrote the article, and doesn’t represent my current thinking. It is clear that a significant level of population immunity did build up during spring and summer, since the rise in hospitalizations has been much slower during the autumn than it was during the spring, and also seems to be stabilizing at a much lower level. However, the level of population immunity is clearly not as high as I previously thought. The reason I made this mistake is that the early evidence on covid suggested that it was not behaving in a seasonal manner. This caused me to underestimate the seasonal effect of summer to push down infections, which caused me to overestimate the level of population immunity that had built up during spring. It is now clear that covid is a highly seasonal virus.

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.

Since March, the Emergency Room where I work has been divided in to a “covid” section and a “non-covid” section. Anyone with a fever, cough, or sore throat has ended up in the covid section, and we’ve been required to wear full personal protective equipment when interacting with patients in that section. Last Wednesday the hospital shut down the covid section. So few true cases of covid are coming through the Emergency Room that it no longer makes sense to have a separate section for covid.

What about the few formal restrictions that were imposed early in the pandemic? The restriction on visits to nursing homes is going to be lifted from October 1st. The older children, ages 16-19, who were engaging in distance learning during part of the spring, are now back in school, seeing each other and their teachers face to face. The Swedish public health authority has recommended that the government lift the restriction on gatherings from 50 people to 500 people.

When I wrote my first article, I engaged in speculation that the reason Sweden seemed to be developing herd immunity, in spite of the fact that only a minority had antibodies, was due to T-cells. Since I wrote that article, studies have appeared which support that argument. This is good, because T-cells tend to last longer than antibodies. In fact, studies of people who were infected with SARS-CoV-1 back in 2003 have found that they still have T-cells seventeen years after being infected. This suggests that immunity is long lasting, and probably explains why there have only been a handful of reported cases of re-infection with covid, even though the virus has spent the last nine months bouncing around the planet infecting many millions of people.

As to the handful of people who have been reported to have been re-infected. Almost all those cases have been completely asymptomatic. That is not a sign of waning immunity, as some claim. In fact it is the opposite. It shows that people develop a functioning immunity after the first infection, which allows them to fight off the second infection without ever developing any symptoms.

So, if Sweden already has herd immunity, what about other countries? How close are they to herd immunity? The places that have experienced a lot of covid infections, like England and Italy, have mortality curves that are very similar to Sweden’s, in spite of the fact that they went in to lockdown. My interpretation is that they went in to lockdown too late for it to have any noticeable impact on the spread of the disease. If that is the case, then they have likely also developed herd immunity by now. Which would make the ongoing lockdowns in those countries bizarre.

What about the vaccine? Will it arrive in time to make a difference? As I mentioned in my first article, lockdown only makes sense if you are willing to stay in lockdown until there is an effective vaccine. Otherwise you are merely postponing the inevitable. At the earliest, a vaccine will be widely available at some point in the middle of next year. How many governments are willing to keep their populations in lockdown until then? And what if the vaccine is only 30% effective? Or 50%? Will governments decide that is good enough for them to end lockdown? Or will they want to stay in lockdown until there is a vaccine that is at least 90% effective? How many years will that take?

So, to conclude: Covid is over in Sweden. We have herd immunity. Most likely, many other parts of the world do too, including England, Italy, and parts of the US, like New York. And the countries that have successfully contained the spread of the disease, like Germany, Denmark, New Zealand, and Australia, are going to have to stay in lockdown for at least another year, and possibly several years, if they don’t want to develop herd immunity the natural way.

You might also be interested in watching the interview I did with Sky News about covid-19 or reading my article about the role of vitamin D in treating covid-19.

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139 thoughts on “Covid-19: Does Sweden have herd immunity?”

  1. Thank you for this article, Dr Rushworth. I have become an avid reader of your blog since your early August post regarding the possibility of herd immunity in Sweden and I had been considering sending you an email asking if you would bring us up to date about what has been transpiring in the weeks since. I live in Maine and the American press still reports the “disastrous” and “catastrophic” outcome in Sweden as part of an simply astonishing barrage of manipulated, “cherry picked” information that remains devoid of scientific truth and is clearly meant to divide us politically as the presidential election approaches. It has been exceedingly difficult in the U.S. to find science-based, unbiased information about Covid and your blog has become an important resource for me. Thank you for writing it—I look forward to your next post.

  2. Thank you for keeping us up to date with truths. People like yourself and Malcolm Kendrick are a breath “unmasked “ fresh air. Keep up the good work

  3. Maybe in Stockholm there is a degree of immunity. But there have not been many cases here in the South of Sweden, I cannot see how there could be immunity here. Yet there are few cases and practically no hospitalizations here either. Although behaviour is as normal as in Stockholm.

  4. Thank you for your very interesting article and I am glad that Sweden has developed herd immunity. I am not sure that it is the case yet in the UK. We locked down a bit late so hopefully parts of the UK have some herd immunity but case numbers are currently rising rapidly again. So far the death rate has only risen a small amount, which is hopeful, but this is probably because most of the cases are in younger age groups. The elderly and those with underlying health conditions now know better how to avoid infection. The next few weeks will tell if the death rate is going to rise rapidly again. Hopefully it is just a case of those who did not get Covid in the first wave are now developing herd immunity while the vulnerable are trying to avoid infection.

  5. The expression ‘herd immunity’ has unfortunate overtones for some. If the french version, ‘community immunity’ (immunité communautaire) were used, it might be easier to sell to the public.

  6. Thank you doctor! Please, keep us inform about herd immunity in Sweden as seems that our authorities do not agree that it is true.
    One more thing. I saw this study, published 2 days ago in BMJ and on last part I saw this: ”
    Theoretically, the placebo arm of a covid-19 vaccine trial could provide a straightforward way to carry out such a study, by comparing the clinical outcomes of people with versus those without pre-existing T cell reactivity to SARS-CoV-2. A review by The BMJ of all primary and secondary outcome measures being studied in the two large ongoing, placebo controlled phase III trials, however, suggests that no such analysis is being done”
    Does it means that if volunteers included in the trial 3 are not tested before vaccine administration if they have pre-immunity(based on T-cell) and they might test only for antibody the result of vaccine do produce false efficiency status ? The person was already immune, does exist the chance to assume in trial reports that vaccine did created the immunity ?
    I do not have medical background so not sure if my understanding is correct.
    Here it is the study: https://www.bmj.com/content/370/bmj.m3563

    1. HI,
      The results of a trials shouldn’t be affected in terms of showing efficacy, since randomization should result in equal numbers with existing T-cell immunity in both groups. But it would be useful to have data pre-vaccination and post-vaccination on how many have Covid specific T-cells, since that would help to determine what effects the vaccine has. It’s a shame that the vaccine studies are not including that information.

  7. Hi Sebastian, I am the editor of The BFD in NZ. I am writing to request your permission to republish this article on The BFD. I would give full attribution and two links back to your site, one at the start of the article and one at the end.

  8. I agree for Sweden but UK, France and Spain locked down a bit earlier so now the wave raise again. Please, check and update your article otherwise won’t be trusted by public neither in Sweden matter. Or if the intention was to say parts of UK, France and Spain have herd immunity and not entire country as a whole, please mention this.
    Very glad for the news, keep up the good work you do!

  9. It is true that Spain locked down relatively early when compared to the UK for example. But only after they had allowed nationwide demonstrations go ahead only days prior where 100s of thousands took to the streets to protest about an unrelated matter. It ater transpired that some protesters were already infected and barely a mask in sight, such as it was then.

  10. I so wish the Spanish government would read this and finally understand how health works. it’s so frustrating how they keep on imposing lockdowns and like you said, are they waiting for a vaccine? it’s so damaging for everyone’s mental and emotional health that I think we’ll have a much bigger crisis to deal with than just an economic one after this is ‘over’. thank you for informing us. I’ll send it to as many people as I can!

  11. Thank you for another great post. Your articles explain the situation simply and without bias on what’s going on on the ground. They are a breath of fresh air to read, and make so much sense. I hope the rest of the world follow’s Sweden’s example soon.

  12. Dear Sebastian, very good article. I am living around 8 month a year in Spain (Mallorca) and I was there into the first lockdown. I would not agree that Spain was able to develop herd immunity. The infection rate at the time of lockdown i.e. in the balearic islands was too low and too few were being infected.. But I do have a theory or a question: In Spain there is one of the strictest mask wearing regulation all over the world, and there are very high case rates. Yesterday I was in a supermarket and watched to all the people wearing masks. What I have recognized was that the mask and face touching numbers are increasing if the people are wearing masks during a daily process. Under your perspective, could it be, that wearing masks incorrectly, and the wear of masks correctly is for normal people nearly impossible to handle, can increase the spread of a virus ?

  13. Hey Sebastian,
    Thanks for writing these articles. I find it absolutely fascinated to read about life in Sweden at the moment. One thing that is talked about a lot here in the media in the US is how we don’t know the long term impacts of the virus. All of the people, including young people, who have post covid symptoms that don’t seem to get better. What’s your take on this in Sweden? If Sweden has reached herd immunity then certainly there should be a lot of people suffering from these post covid symptoms? I would love to hear your opinion? Do you think the Swedish population is just generally healthier? Do these people with post covid not present themselves to the hospital system? thanks in advance for your thoughts!

    1. Hi Ryan,
      I think this “long covid” is blown out of proportion by the media. Post viral syndrome, i.e. lingering symptoms after a viral infection is nothing new, we see it with many viral respiratory infections. The vast majority of people recover completely within a few months.

  14. Hi Dr Rushworth

    Your article indirectly criticizes Germany, Denmark, Australia and NZ for not trying to develop “herd Community” to their people like Sweden did. But let’s look at the figures as on today:

    Sweden
    Cases per million: 8,725
    Death per million: 580
    Test per million: 137,757

    Germany
    Cases per million: 3,262
    Death per million: 113
    Test per million: 173,623

    So, by calculating population of these countries; Germany’s death number should reach 48,000 to matches Sweden’s pro-rata’s death! That is 40,000 more death (now they have 9,000 death only).

    New Zealand
    Cases per million: 383
    Death per million: 5
    Test per million: 182,094

    by also calculating population of these countries; NZ’s death number should reach 2,900 to matches Sweden’s pro-rata’s death! That is 2,875 more death (now they have 25 death only)!!

    That’s why, I think, Germany and NZ and maybe many other countries would think more than once before listening to these suggestions!

    1. Hi Salah,
      I’m not criticizing those countries. I am saying that they will have to get to herd immunity one way or another. Either the natural route, which they can do now, by letting the disease spread among the healthy population while protecting risk groups, or by vaccine, which means staying in lockdown for at least another year, and more likely several years, if they want a vaccine that is over 90% effective.

  15. Sebastian I’d also ask you – do you have any information on the frequency of lasting post covid symptoms? The frequency of lasting post covid seems to me to be a critical point for evaluating what is the better approach.

    1. Hi John, I’m not aware of any good studies of this yet. But post viral syndrome is nothing new, and the vast majority of people recover within a few months. As far as I can see from personal experience, it is a small minority of people who continue to have lingering symptoms for a few months after infection. I am aware of one such case in my immediate surroundings, and that person has now recovered completely.

  16. Sebastian,

    Thank You for sharing Your experience and knowledge.

    If Sweden has herd immunity with less then 10 % antibodies. How can this study in Iceland be
    explained?

    https://www.nejm.org/doi/full/10.1056/NEJMoa2026116

    Would be very interesting to hear Your thoughts about that:

    m pretty sure alot of people does not develop antibodies, to many people I know had covid symptoms in march/april. Quite a few with and quite a few without antibodies, despite similiar symptoms. In some cases even in the same family.

    1. Hi Jonas,
      The sicker someone has been, the more likely they are to have antibodies. This has been shown in multiple studies. Among the people who are so sick that they need hospitalization, most people end up having antibodies. Among people who are asymptomatic or so lightly symptomatic that they don’t bother to visit a health care provider, few have antibodies. But even the ones who don’t develop antibodies do seem to develop T-cells. See this:

      https://sebastianrushworth.com/2020/08/08/what-is-the-best-way-to-measure-rates-of-covid-immunity/

  17. Dr Rushworth, Some countries contained the virus without a hard lockdown, e.g. South Korea, Taiwan, Thailand, Germany and Iceland. They managed without high number of deaths in the first round and still a second wave of deaths is not seen. How should those countries be understood in this context?

    1. Hi Håkan,
      I don’t know enough about Taiwan or Thailand to comment. When it comes to South Korea, Germany, and Iceland, I think they have been able to contain it without as repressive measures as many other countries thanks to the fact that they were doing widespread and effective tracking and tracing from the start. Iceland obviously has the additional advantage of being a small island, which makes it easier to control the new infections coming in to the country.

  18. I do not want to come ahead of Sebastian, but I think your question has an internally answer. A lot of countries who went into a strange lockdown just at the beginning of the pandemic could have luck with a early adopting secure vaccine or have some worse time and figures in front of them. I would say that is what he in my view wants to tell us.

    1. As I’ve said before, cases are meaningless. The only statistic that matters is deaths, which continue to remain at a low level. If the test has a 1% false positive rate, and only one in a thousand people tested actually has the infection, then 9 out of 10 positive cases is a false positive. When the disease is rare, as it is now in the UK, you get many more false positives than true positives. See this:

      https://www.spectator.co.uk/article/how-many-covid-diagnoses-are-false-positives-

  19. “I engaged in speculation that the reason Sweden seemed to be developing herd immunity, in spite of the fact that only a minority had antibodies, was due to T-cells.”

    What’s not explained is why other countries don’t have this herd immunity thanks to T-cells.
    There are many countries or places that had higher per capita case rates and death rates than Sweden. Yet those countries don’t seem to have any “herd immunity” and are experiencing second waves.
    Why? Is Sweden the only country in the world with T-cell immunity from cross reactive coronavirus infections? That’s implausible.

    1. Like I said in the article, I think the countries like England that have experienced a lot of deaths also have herd immunity by now. The rise in cases in England at the moment does not reflect a rise in true cases, only a rise in testing and thereby false positives. Note that deaths in England are remaining at a low stable level, indicative of herd immunity.

  20. They can’t. Unfortunately their experience contradicts the “herd immunity” concept as applied to Sweden, but I’ve no doubt that Sebastian will come up with some contrived explanation that has been made to fit his hypothesis, which is not how scientists should consider explanation of observations.

  21. Sebastian, your presumption is that a vaccine will take another year… but several will likely be available in the first part of next year.

    Your presumption is also that a vaccine needs to be 90% effective. It doesn’t. If we assume that populations have some natural immunity to begin with, and you only need 50-60% as your herd immunity threshold, then you need maybe an additional 30% immunity from a vaccine.
    If it’s only 50% effective, this can be achieved with vaccination of 60% of susceptibles.

    1. Being available is not the same thing as being widely available. Although there will likely be some vaccines available at the beginning of the year, it will take at least until the middle of the year before they are widely available for mass vaccination to be feasible.

  22. I don’t. They have significant economic downturn, more than their Scandinavian neighbours, and 10 times as many deaths as Norway and Finland pro rata.
    If you want a model to follow, try Norway.

  23. Have been wondering if lasting aftereffects of all kinds of viral infections is nothing new, rather that its the first time they’ve gotten this much attention.

  24. Michel the UK is seeing a rise in the numbers of people testing positive but no matching rise in deaths and hospital admissions .

  25. Michael, you missed some points in regards with vaccine:
    1. The population does not trust this vaccine made in rush, so hardly will find 60% to vaccinate;
    2. As usually vaccines do, are less effective for elderly due to luck of immune response;
    3. In adult vaccination, how we know that we do not overlap vaccination on people which has already immunity due to T-cell but has been completely asymptomatic and they are not aware that are already immunized. So, this overlap, which might be huge by the time when vaccine will be wildly available, will make vaccine immunization path even less a good choice.

  26. Using your stance as a hypothesis, what is your null condition? In other words, under what condition(s) would you say “I was wrong”? For example. if ICU rates increase beyond those at the previous peak [and] travel restrictions remain (local transmission), would that qualify? Any other possible outcomes which would invalidate your stance?

    1. Hi, if the death rate and/or ICU admission rate returns to the level it was at at the beginning of July, i.e. 10-20 deaths per day, then I will say that I was wrong about herd immunity. At the peak the death rate was 110-120, so I am willing to concede defeat at a much lower level than the peak rate.

  27. Sebastian hi!
    I agree with your latest article. You and your followers ought to be interrested in the report from the region of Östergötland dated 06082020. Journals of 240 people which died WITH CV-19, turned out 15% to died OF CV-19: 15% died of some other disease: 70% had several diseases, among them CV-19. 50% of the died was 88 years or older
    So, why are media only publishing death rates of people dying WHITH CV-19? news paper in Sweden doesn´t write mush anymore, but public service are still on the chopping block.

    A report from OXFAM is also fearsome: 120 000 000 miljones of people are threatened of starvation – because of the lockdowns!

  28. With respect, Dr. Rushworth, the claim that the number of deaths is the only statistic that matters suggests a surprising lack of awareness of the significant numbers of people who have experienced serious, long-term degradations of health, and what that implies.

  29. Hi! What about that herd immunity and individual immunity? I think there is some missunderstanding as I think for herd immunity at least 50% of population must be immunized for this desease and take many years to achive this. In Sweden as I know there is no such evidence and we must wait to see how next waves will hit this country for some confirmation.

  30. [Looks like the alt-right have got their own doctor now.]

    I seem to be missing your actual scientific argument.

  31. Thank you for this detailed information. I live in Sun Valley, Idaho in the US. We have a lot of sickness and some death in March and few cases since. At one point we had the most cases per capita in the US. Unfortunately, our children are still not allowed in school full time and our entire community is hysterical with fear. I will pass this along to as many people who will listen.

  32. Well said! Should we really listen to the theories of a junior doctor who only qualified this January and fails to explain major facts relating to Sweden’s population density instead of experienced virologists? It’s interesting how right wing publications have shared his articles!

    1. If you are the kind of person who only listens to old doctors with several decades experience, then I can recommend you turn to Malcolm Kendrick or Johan Giesecke. Personally, I think the strength of an argument matters more than the age of the person making it.

  33. I think Dr Rushworth has done a terrific job in presenting evidence based facts on his blog in plain language comprehensible for us laymen. And so far most commentators have shown good manners. Please, let’s keep it that way and skip the politics. Facts don’t care about politics, facts are just facts.

  34. @suddyan.

    There is no scientific argument, that’s why.
    A lot of questions, maybes, ifs and general supposition.
    No conclusion to match the headline.

  35. Dr. Rushworth: Dr. Kendrick is not old, just comfortably middle-aged. Like you, he is a truth-teller. Something tells me there are plenty more physicians who are truth-tellers but whose voices are not-often-enough heard.

  36. Hakan: Thank you. It is appalling the way so much has been politicized in the U.S. by those who hate Trump, including demonizing HCQ + zinc as a treatment, which many doctors have used to save many lives. Politics has no place here. Dr. Rushworth is sharing with us the fruits of his knowledge and experience of the ‘Rona in Sweden, which is invaluable to all of us wherever we live.

  37. The conclusion that Sweden has herd immunity seems to be based on one physician’s observations of few people in the emergency room. What about the prevalence of antibodies to Covid-19, if you are a proponent of “evidence based medicine” shouldn’t that weigh into such a conclusion? It disturbs me immensely to see so many “experts” claiming much higher rates based on NOTHING. How can you make a claim like herd immunity when the antibody prevalence rate remains only 17%?

    Important to also stress to all the Americans on this board that Sweden is not America– they have free access to health care and much better health outcomes than Americans do…They are also much smarter than much of America; if told to wear masks and stay home, they do! I’ll bet you they aren’t having big rallies in arenas like your current President is. Many also disappeared to their summer homes for the summer which could be an explanation for the drop in mortality. They are also not nearly as fat as Americans and have a much lower rate of pre-existing conditions associated with mortality. So if it is mortality that is driving the conclusions here, don’t assume that what Sweden did can or should be replicated in the United States…

  38. Here in the US, if any term like herd immunity, or drug, or anything, is mentioned by the president, the entire mainstream media gets together to plan out a coordinated strategy to dismiss it, bash it, or worse – get the FDA to ban it (think hydroxychloroquine). Sadly, honesty is not allowed in the US anymore as bigPharma has a trillion dollar profit agenda and all of their puppets are working hard to make sure that fear remains, that nobody gets exposed (and thus gets better and immune), and that everyone is still clamoring for a vaccine when it finally becomes available. And heaven forbid you mention how well Sweden is doing. You might as well say that Hitler was a great guy. You get the same reaction. Money has controlled this from the beginning. How Sweden was lucky enough to have politicians that did the right thing is something we will hopefully learn. Until then, the insanity will continue along with the non-stop lies and fearmongering.

  39. Ah! The USA’s “National Treasure” Dr. Fauci, who through the NIH funded “Gain of Function” research at the Wuhan Lab, with tax payer money after it being banned in 2014. When will the MSM ask the good OLD doctor about that. Crickets on that little bit of information being withheld from the tax paying American citizenry.

    Every person concerned with this should do their due diligence on “Gain of Function” virus manipulation and the Wuhan Lab.

    With that random troller’s are here to discredit the Doctor… why? People on this blog are reading to hear the front line experience of a Medical Doctor. Were any of these trolls, attempting to divert the conversation on the front lines? Or are they regurgitating from a script provided to them by the Bill & Milanda Gates foundation and their brought and paid for cronies. We all know who they are.

    To the trolls, you can keep trying to suppress the success of the Swedish Model of guiding their citizenry thru this with humanity, civility and foresight, but not for long. I plan to share the good Doctors information with each and every person I know.

  40. The rise in cases is too great to be explained by testing. For example in the UK, since August 1, cases are up 730% while testing is up 178%, suggesting an actual rise in cases of 410%.

    Regarding T-cells, is it possible that some countries have higher pre-existing immunity because they have in the past experienced an immunity-inducing coronavirus?

    1. Hi JJ,
      I guess that is theoretically possible, but considering how infectious coronaviruses are, it seems unlikely that one would be constrained to a single country or a few countries. I think covid shows pretty well how quickly a reasonably infectious virus spreads to every country on the planet.

  41. Pig Latin: You don’t seem to have read or understood Dr. Rushworth’s explanation of innate immunity, which involves, in the main, a T-cell response. The majority of people, upon exposure to coronaviruses, show no antibody response because their innate immunity have neutralized the invader. The vaccination religion relies upon the development of antibodies (the adaptive immune system) in the vaccinated to determine efficacy. This is a major flaw. At 71 I have never had a cold of any consequence or flu at all in my adult life. I take good care of myself; thus my immune system is robust. One of my guiding principles is when the government says something about health or nutrition, I generally do the opposite.

  42. Hi Sebastian, You seems to be so far the most reasonable doctor I know. You may have some points where you might be false but over 80%, I consider right.
    We all agree that it is a pre-existing immunity in the population. But this not explain the big differences across man vs women and elderly vs children.
    We may assume that all those categories have been exposed in the past equally on coronaviruses. Not women more than men and not children more than the elderly.
    So, I consider that it is not just this pre-immunity, it’s something more.

    I suspect that it can be due to thymus capacity to stimulate T cell and those with a high degree of thymus atrophy are on higher risk on complications in COVID-19.
    We know that thymus atrophy occurs with age and after 60 years thymus works at 40% capacity and also WE KNOW male thymuses atrophying more rapidly than those of females and this would explain why men die twice than women in Covid-19. If will look on reports we see that man deaths on group age 50-59 is equal with women deaths from 60-69 age…and so.on.
    Furthermore, all comorbidity conditions listed in Covid-19 coexists with thymus atrophy. Only two examples: Atrophy of the thymus is one of the consequences of severe insulin deficiency and so on.;

    “Thymulin, a zinc-dependent enzyme that stimulates the development of T cells within the thymus, may be involved. Production of cytokines by mononuclear cells is also reduced by zinc deficiency. These effects can be of clinical significance.”
    The main symptom in Zinc deficiency – loss of or diminished smell and taste.

    I think that vitamin D has also a huge role in Thymus atrophy.
    What do you think?

  43. As I read some info herd immunity slowly grows about 4% per year for infection diseases. How in Sweden scientists calculated that population has achieved herd immunity? Give some scientific evidence, thank you!

    1. Hi Peter, I’ve never heard this claim before that herd immunity grows by 4% per year. Please provide a link so I can see what evidence it is based on. Herd immunity happens when a sufficient proportion of the population is immune, and happens at different rates for different infections.

  44. Two points:

    There is no dispute that SARS-CoV-2 was first carried into Europe from travellers out of Wuhan. It’s irrelevant if it was European travellers or Chinese travellers. If the strategy were to detect every single infected person in a country, to isolate and treat them – what is the endgame? Close the borders forever? Impose mandatory quarantines for arrivals forever? Yes, there are supposedly rapid antibody tests, but those, too, have false negatives, and as most international business hubs across Europe see hundreds of thousands of arrivals every single day even a 99.9% sensitivity in those rapid tests means that hundreds or thousands of new cases will be imported every day when considering the fact that the vast majority of the planet’s population is insufficiently vaccinated against pathogens that were eradicated in Europe decades ago and that it’s unreasonable to assume that all 8+ billion people on Earth would be vaccinated against COVID-19 at once.

    There is also the mathematical model of “Six degrees of separation” that’s disproving the notion, mostly peddled by politicians of which the vast majority has no meaningful background in engineering or mathematical fields, that somehow you could interrupt transmission chains without closing borders and cutting off whole regions. Further reading:

    https://en.wikipedia.org/wiki/Six_degrees_of_separation#Mathematics

    To us in the field of mathematics and CS this has been a very frustrating time, seeing how naive politicians, journalists and assorted water carriers believe that somehow, without closing borders, you could force whole societies into locking down to such a degree that no path can be established anymore between an infection cluster and people who were never exposed to the SARS-CoV-2 pathogen before.

    From this also follows that the assumption that, somehow, the virus emerged in November or December 2019 in the population of Wuhan, then, somehow, made its host carriers not interact with their peers, and that, somehow, in January 2020, the virus made the hosts release the brakes and made them flood Europe and the American continent at once, is wrong and naive.

    A much sounder, scientific assumption would be that the virus was already spreading across the globe at the end of 2019, and that the “spike in cases” in mid-March was not the beginning of the pandemic but rather the end but that it appeared to be a spike because mass-testing was rolled out, and that the RT-PCR screening tests were rather detecting the tail of the pandemic and that the subsequent increase in testing was just amplifying the noise floor of the false-positive rate in the test system itself. This is not disproven by an increase of hospitalizations due to COVID-19 – even today people are hospitalized across Europe with severe diseases because they were not vaccinated and because an infected person was travelling to Europe spreading a pathogen that was thought to be eradicated in Europe. But the vast majority of Europeans is already immune against measles etc, and therefore won’t fall ill.

    As exemplified by the vast majority of SARS-CoV-2 “cases” who are asymptomatic – they are asymptomatic because the hosts are already immune, which doesn’t stop the RT-PCR screening kits from detecting harmless levels of live or dead virus RNA strands.

    I should note that the very definition of “immunity” in the clinical sense means that someone won’t fall ill from the pathogen, be it through previous exposure, vaccination, or because their immune system can fight off the pathogen on its own. Immunity means you won’t develop the disease, it doesn’t mean that the pathogen can’t enter your body. The alternate definition of immunity as peddled by politicians, journalists, and – sadly – quite a few virologists and epidemiologists is wrong, as are claims that nobody could be immune to SARS-CoV-2/COVID-19 because no vaccine exists.

    In other words, herd immunity has not only been reached in Sweden but across most societies. Claiming anything else is ignoring basic math.

    Bonus point:

    Think back to your school years, then try to think of all your school peers that went on to become politicians and journalists. How many excelled in math, or scientific classes in general? Fact is that across all OECD members, the vast majority of politicians and government members have a law degree or a degree in social “sciences”. I think it’s only fair to assume that 99% of political leaders across the OECD, and their hysterical amplifiers in the media, struggle with basic math and scientific methods.

  45. jj,your observation is incorrect. There is no public information (a) which RT-PCR screening kits were used for the tests, and (b) which amplification setting, in particular which cycle threshold (CT) was used. The positive rate can be easily increased, i.e. manipulated, by increasing the CT from 30 (the standard in most EU countries) to 40 or higher, which also happens to be the standard in the US, the country with the highest “spread of the killer virus”.

    A CT of 40 effectively means that a healthy, non-infected person who happens to pass through a room where a person was staying many hours earlier who was infected 4 weeks ago will have a “positive test result”. If we assume a constant factor of 2 in the exponential replication of the PCR, a CT of 40 means an amplification by 2 ** 40, i.e. a single dead virus that this person picked up from the air will be amplified by a factor of 1 trillion.

  46. Niko

    Your final comment about politicians and journalists is partially true. There has been an explosion of knowledge over the past fifty years. However, there has also been a dumbing down among students in various disciplines though perhaps less among engineers and physicists. The cleverest seem woeful deficient in logic and reasoning. This is even worse among political animals. Try to reason carefully with a politician or reporter and notice how often they pivot from the topic to a smokescreen or personal attack.

    While a mere language person, I understand what Douglas Altman, a professor of statistics in medicine at the University of Oxford, wrote in 1998
    “The majority of statistical analyses are performed by people with an inadequate understanding of statistical methods. They are then peer reviewed by people who are generally no more knowledgeable. Sadly, much research may benefit researchers rather more than patients, especially when it is carried out primarily as a ridiculous career necessity.”

    The late Professor Altman would, I think, be dismayed by the coronavirus statistical debacle today.

  47. Thanks Gary, so if i understand your argument it’s that you can have herd immunity despite having only a low percent of the population with antibodies (according to a pre-print only 6.8% of blood donors/pregnant women in Sweden have Covid-19 antibodies) because despite exposure, innate immunity has taken care of the virus.

    To me, this seems like an untestable hypothesis, one that contradicts what all infectious disease epidemiologists are saying.

  48. There might be a very strong seasonal effect, known from other coronaviruses(1), in the infectivity and virulence of SARS-Cov-2 (2) due to the effect of the infectious dose (“inoculum”)(3) which is much higher in winter (stability of the virus in dry and cold air, plus people being in closed rooms) and due to seasonal physiology which increases the deadliness of sepsis (4) and sepsis-like intravasal blood clotting. The increase in the CFR in the Southern Southern hemisphere (=where countries have a winter) in their winter (from July 2020 on) confirms this (5) as none of the countries in the Northern hemisphere had an increase in the CFR during that time. If this analysis is true, the Northern hemisphere will see a huge (increased infectiousness) and deadly (increased IFR) winter wave of Covid-19, icluding Sweden.

    1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106380/
    2) https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2767010
    3) https://www.sciencedirect.com/science/article/pii/S1201971220304707
    4) https://journals.lww.com/ccmjournal/Abstract/2007/02000/Seasonal_variation_in_the_epidemiology_of_sepsis_.11.aspx
    5) https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&time=2020-07-16..latest&country=ARG~ZAF~AUS~NAM~ZWE~MDG&region=World&cfrMetric=true&interval=total&aligned=true&hideControls=true&smoothing=0&pickerMetric=location&pickerSort=asc

  49. Igpay Atinlay, the same pattern has been observed in swine flu (2009) when first they was alarming and then discovered T-cell with strong response to swine flu. Herd immunity was reached very easily despite that many countries did not used vaccination.
    ” But by 2020 it seems that lesson had been forgotten.” https://www.bmj.com/content/370/bmj.m3563

  50. Interesting hypothesis. The UK has low levels of zinc in our diet. Zinc is important for the thymus immune response. Could there be a link between zinc and the coronavirus in different countries? Does Spain and Italy also have low levels of zinc? I don’t know, it might be worth someone finding out.

  51. Philip, has been studied already but it is much silence over: “In conclusion, there is an urgent need to implement dietary recommendations for all populations at risk of zinc depletion. In addition, prompt implementation of zinc supplementation should be considered in high–risk groups for zinc deficiency. These preventive and nutritional intervention measures have the potential to improve antiviral immune response for COVID–19 as well as for any future viral outbreaks. Large–scale studies are urgently needed to investigate the role of micronutrients in antiviral immunity, particularly drug–micronutrient immunity interaction.”
    Here the entire article: https://nutrition.bmj.com/content/3/1/111

  52. Hi Sebastian, here is what says one of experts in my country;
    – How credible can this be, given that it has already been pointed out that COVID-19 has already mutated and its immunity to it is short-lived?

    – These statements are based on the antibodies that are detected. And the real immune response that lasts a long time is not the antibodies, but the so-called cellular immune response. This was also the reason when talking about the coronavirus, to hypothesize that the BCG vaccine affects how severely we suffer from COVID-19. This is almost completely confirmed because cellular immunity is stimulated in an appropriate way. Thus, it has a greater effect on viral stimulation. Here we have the same effect when in the past we have encountered a similar coronavirus circulating in our territories. Thus, it is likely that some people have developed immunity. If we take into account that we already have 4% group immunity, in general, in 10 years they are approximately 40%. But this is a bit speculative. In any case, we have a virus that is very similar to the current SARSCoV2, found in our country in 2008.

    Here is some articles:
    https://www.theatlantic.com/health/archive/2020/07/herd-immunity-coronavirus/614035/
    https://www.nature.com/articles/s41586-020-2550-z

    1. Hi Peter,
      Here’s a direct quote from the Atlantic article you link to:

      Effects like this—“selective depletion” of people who are more susceptible—can quickly decelerate a virus’s spread. When Gomes uses this sort of pattern to model the coronavirus’s spread, the compounding effects of heterogeneity seem to show that the onslaught of cases and deaths seen in initial spikes around the world are unlikely to happen a second time. Based on data from several countries in Europe, she said, her results show a herd-immunity threshold much lower than that of other models.

      “We just keep running the models, and it keeps coming back at less than 20 percent,” Gomes said. “It’s very striking.”

      What they say is that herd immunity is reached when 20% have antibodies. In Sweden 7% of the population had antibodies in June (compared with 0,5% in April. Most likely we’ve reached 20% by now (in Stockholm we definitely have), and we could easily be well beyond that by now. The most recent Swedish antibody data is at least three months old.

      I can’t find anything in either article about immunity developing at a fixed rate of 4% per year.

      As to the statement from one of the “experts” in your country, no-one knows how short lived immunity to covid is, but we definitely know it’s at least nine months, since large numbers of people aren’t getting re-infected yet.

  53. Dr. Rushworth: If you are correct, how come Sweden only needed under 600 deaths/million to achieve population (“herd’) immunity and yet England already has far more than that and the current death stats indicate that it’s nowhere near achieving it? Population density? Healthcare spare capacity? Diet? Alcohol consumption/smoking?

    1. Hi Arthur,
      Of course, as you point out, there are big differences between countries’ populations that could differences in the share of a population that needs to be immune for herd immunity to be reached. There are also differences between countries in terms of what is defined as a “covid” death, which can make the numbers seem bigger or smaller. Sweden currently has 575 deaths per million while the UK has 626, which isn’t a very big difference, and both countries have similar death curves, with deaths now having dropped to very low levels. The main risk factor for dying of covid, other than age, is obesity, so that might explain any difference.

  54. Ivan: not innate immunity, adaptive T-cell immunity which is not detected by antibody tests. It would be great if a test for T-cell immunity were developed.

  55. UK had 40 Covid-19 deaths yesterday, Sweden 0. That’s quite a big difference. Of course you can argue that the low absolute numbers make the current data unreliable.

    Thanks for suggesting obesity. I thought population density leading to higher mean initial viral loads might be the answer, as well as healthcare spare capacity – AFAIK no-one in Sweden was sent home, or left at home by ambulances, to die of Covid-19.

    1. UK population is seven times bigger than Sweden’s, so if it is at the same stage in the pandemic it should have seven times the number of deaths, which i think has roughly been the case if you look at average numbers for recent weeks.

  56. Hi Sebastian. Thanks for your information.I watch this VIDEO the other day and may be you would like to watch it. and may be you can share. People need to know the truth. Regards. Rosa.

  57. On the claim above that, allegedly, the number of positive test results in the UK had risen by 410%, here’s the official data:

    https://imgur.com/a/DRdv2pL

    As of now the positive rate is at approx. 1.7%, i.e. at the noise floor level of the operational false-positive rate of the used RT-PCR tests. If there are any true COVID-19 infections in the UK at the moment then it’s, at most, countable by ICU admissions and clinical diagnoses of COVID-19. I highly doubt that there are actual COVID-19 patients being treated in the UK at the moment, considering that even Scotland has now closed their special Glasgow Nightingale Hospital.

  58. I think there are a lot of anti-epidemic measures in Sweden, as in many countries. We will see how would going next waves there.
    … In my country one oracul says – corona will stay at about 4 years, she rarely misses prediction 🙂

  59. Good point Niko, I was assuming that the criteria for a positive test have not changed. However I doubt that this has changed in all of the countries with ‘second waves’. Do you have any sources for the actual CT threshold used in various countries? (I’ll be impressed if you do — this type of useful data is so hard to find)

  60. jj, in Germany a cycle threshold of 27 to 30 is used in most certified labs, while it’s 40 to 45 in the US. Of course I have the sources:

    Interview with Dr Drosten, one of Germany’s top virologist and the very same person who created the first RT-PCR screening kit for SARS-CoV-2, in German langugage only:

    https://www.ndr.de/nachrichten/info/54-Coronavirus-Update-Eine-Empfehlung-fuer-den-Herbst,podcastcoronavirus238.html

    Translation:

    https://translate.google.com/translate?sl=auto&tl=en&u=https%3A%2F%2Fwww.ndr.de%2Fnachrichten%2Finfo%2F54-Coronavirus-Update-Eine-Empfehlung-fuer-den-Herbst%2Cpodcastcoronavirus238.html

    New York Times article pointing out the high CT in US labs:

    https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

    Dr Drosten also points out that labs are free to choose the CT, which effectively makes most statistics meaningless because you can’t compare results from lab A with results from lab B and put them into the same pool. It also means that labs can “accelerate a pandemic” by increasing the CT, or “make the virus retreat” by lowering the CT.

    It’s pretty obvious that this whole situation has been politicized from the very beginning, and not “science-based”, as so many interested parties in politics still claim today.

  61. Arthur, a few months ago the UK government halted reporting of “COVID-19 deaths” because it became known – not through introspection within government but through an Oxford study – that basically Public Health England had tracked every single positive test result in a database, and when that person died at any point later the death was attributed to COVID-19 instead of the actual cause. Considering that the vast majority of these fatalities were in cohorts within the last stretch of their life expectancy, and with severe comorbidity, it’s more than reasonable to assume that these people did not die from COVID-19 at all.

    Government promised to make changes, but never did, and still continue to use the same reporting system. So when “40 people die in the UK from COVID-19” on a single day, what it really means is that at some point in the past they tested positive, i.e. with a very high probability they received a false-positive test result, and now they died from something entirely unrelated.

    It should be noted that recently Matt Hancock was asked what the number of people was who were under 60 and had no comorbidity and who died “from COVID-19” in the past 6 months. He couldn’t give an answer, so the interviewer revealed the number: around 300. That’s, on average, 10 per week.

    So less than 1% of the public number of COVID-19 deaths were under 60 and had no comorbidity.

  62. MD/PhD to MD, you really should probably wait a year before being so celebratory and proclamatory. I’m not an expert in infectious disease or epidemiology (and you don’t appear to be either), but I’ll defer to those that are experts who are not so convinced as you.

    1. Hi Christopher,

      I’m not an epidemiologist, nor am I an infectious disease specialist. But I am a thinking person who draws conclusions from the evidence I see in front of me, and I have a good understanding of human biology, physiology, and pathology, which I think helps me to draw reasonable conclusions.

      And I would say that the evidence is pretty conclusive at this point. I have not heard the so-called experts, like Anthony Fauci, for example, provide any reasonable alternative explanations to the ones I provide. And there do seem to be highly respected epidemiologists who agree with me, like Johan Giesecke for example.

      Apart from that, I think it’s my responsibility as a doctor to speak out when I see political decisions being made that are harmful to people’s health. So that is what I am doing. If we always only deferred to the so-called experts at the top of their respective hierarchies, we’d probably still be bloodletting patients.

  63. Wisdom learned is priceless. A Geneticist Methylation Report ordered by an Oncologist Naturopath Doctor identified trace minerals and nutrients deficiency provided quantitative science. Vitamin D3 and Zinc were not solely deficient; sulfate was deficient. The frequency of infections lessened, cancers in remission after 5 years, and twice daily meditations make any pandemic more bearable.

  64. Lawrence: Interesting. There is no RDA for sulfur in the U.S., but Dr. Stephanie Seneff thinks there should be. She has written at length about the role and importance of sulphate, such as its ability to render lipophilic molecules like cholesterol and vitamin D hydrophilic as well.

  65. Hi Sebastian. I’m in a clinical discussion group that only accepts journal articles and I’d like to forward your position. Have you, or will you submit a preprint?
    Kind regards

  66. Further to my comment above that the pandemic is already over in large parts of Europe, Dr Mike Yeadon has now proven it for the UK:

    https://lockdownsceptics.org/what-sage-got-wrong/

    I believe at this point medical measures to counter the acute psychosis in high-risk groups, i.e. politicians and journalists, who seem to believe that there’s a pandemic that can only be fought with lockdowns, should be intensified, starting with declaring a number of government heads incompetent in the clinical sense.

    I’m being serious.

  67. Coming back 3 weeks later and it appears I cannot find my comment asking about your null hypothesis and your response. You noted that reaching 2-5 deaths per day would invalidate your assumptions. However, the comment appear to be deleted. As the numbers continue to increase, are you still confident in your hypothesis? Why would you delete the comment?

    Thanks.

    1. Hi AL,
      No, it hasn’t been deleted. Click on ”older comments” and you will see it. I said I would concede that I was wrong if deaths went back up to 10-20 per day. Sweden is currently averaging 1-3 deaths per day.

  68. Sebastian, I’d recommend to link this somewhere prominent, the latest official data from Sweden (in Swedish, but easy to understand):

    https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa

    ICU admissions are basically flat, as are deaths. And as in the UK, there’s a question if ICU admissions are because of COVID-19, or if admissions are because of something entirely else, and the patients test positive after admission.

    Fun fact I just learned: The European Center for Disease Control is headquartered in Stockholm.

  69. Hello looking at the very high new numbers of positive cases in France does it make sense to say they havent achieved herd immunity ? maybe because they did lockdown in April May, then when they reopened there was very little contamination. Then it seems the virus came back with a mutation from abroard.
    I can see there are more cases in Sweden too. What does it mean in terms of immunity ? and why are there much fewer hospitalisations in Sweden today than in France – where they are going to lock down again for fear the hospitals will be overwhelmed by Nov 11. What do you see in Sweden ? (sorry I ask a lot about France because I am French, even though I live in Australia, a country where we had a horrible lockdown and probably 0 immunity)

    1. Hi Agathe,

      I think it’s reasonable to think that Sweden has at this point achieved a higher level of population immunity than France, which is why France is seeing a bigger increase in hospitalizations and deaths at the moment.

      Sweden is currently seeing a big increase in cases, but only a small increase in hospitalizations. I think the disconnect is due to the fact that testing has increased hugely in recent weeks – the more you test, the more cases you find. I think that the small but real increase in hospitalizations being seen in Sweden is due to seasonality.

  70. Hello Dr Rushworth

    I tend to agree with a lot of what you have posted about Covid-19, but I would just like to highlight an inconsistency between what is happening in Sweden and what is happening here in Belgium in terms of herd immunity.
    Both countries are similar in population, but population density and the level of lockdown restrictions appear to be the big differences.

    As of today, around 0.1% of the Belgian population (over 11000 people) have died with Covid-19. This might be an overestimation (many people dying ‘with’ rather than ‘because of’ Covid-19), however the true value it is still likely to be far higher than the current total in Sweden. We are currently experiencing a large increase in cases which coincided almost perfectly with schools and universities reopening in September, and my not-so-complicated calculations suggest that the death toll in November is likely to exceed March and April by some margin.

    If Sweden has herd immunity, which I really hope is the case, I wonder what could explain the large differences between the two countries. Current estimates of the R value in Belgium are around 1.3 to 1.4, so perhaps the lower population density in Sweden is keeping it below or close to 1.

    1. Hi Michael,
      I’m no expert on Belgium so can’t really comment on what’s happening there. As I understand it Belgium has probably been more generous than any other country in defining a death as a covid death. What is overall mortality like in Belgium at the moment? Is there a big difference compared to previous years?

  71. You need to remember that cases are not cases but positive test outcomes from a test which has a false positive rate on pillar 2 tests of between 0.8% and around 5% depending on a number of factors including the quality of the sample taking process (from professional via self-swabbing to deliberate attempts to mislead), the quality of the testing staff (not adequately trained in clinical testing procedures), the unsuitability of premises used, the variability of the testing process from lab to lab (amplification factors and software analysis of the results), the lack of quality control and finally some confusion over testing dates versus results dates.

  72. Thank you Laura. I am in my mid-70s and the only precaution I am taking voluntarily (as is my wife) is to supplement my zinc and vitamin D levels. It is very low cost and has no side effects at the levels I am taking them. All other measures I am forced to take on pain of fines and abuse when out, not because I believe them to be effective.

  73. Excess mortality in 2020 appears to be pretty close to the declared number of Covid-19 deaths in Belgium. I think the authorities are doing a decent job of counting Covid-19 deaths here. A heatwave in August (when the SARS-CoV-2 infection rate in Belgium was at its lowest) means that we didn’t really experience the same low mortality that you had in Sweden over the summer.

    My calculations suggest that we are going to experience a 100% increase in mortality throughout November and this will take the overall Covid-19 deaths to around 0.2% of the population. If we have reached herd immunity by the end of the year then I think that would put the IFR just under 0.3%.

  74. Do you still think we have herd immunity in sweden given that our death rates are trending towards double digita per day?

    1. Hi Jack,
      Like I wrote earlier in this thread, I’m less confident now than I was six weeks ago. It’s possible that I overestimated the extent of immunity that developed during spring, and underestimated the impact of seasonality. The early evidence suggested that covid didn’t behave in a seasonal manner, so I didn’t think the seasonal effect would be as big as it now seems to be. Having said that, the growth we’ve seen in October has been gradual, nothing like the exponential growth seen in spring, and will therefore likely also peak at a much lower level this time – to me that is a sign that there is now a significant amount of population immunity, although perhaps not as much as I first thought.

  75. Sounds like a fundamental misunderstanding what herd immunity is.

    It does not mean that _nobody_ becomes sick. The estimated herd immunity threshold (HIT) for COVID-19 is 60 to 75%. In a population of 10 million Swedes, that leaves 2.5 to 4 million Swedes susceptible to COVID-19 when Sweden has reached herd immunity, and it’s reasonable to assume that it did. At this HIT a disease can not and does not cause a pandemic.

    To put this into perspective, in the past 30 days the peak of ICU admissions in Sweden was at 0.00017% of the population on a single day, and peak mortality was at 0.00012% of the population on a single day. That’s not a pandemic, but the virus has become endemic in the population.

    I find it puzzling that people would try and set an articificial threshold not founded in science, e.g. “if Sweden reaches double-digit deaths per day then it proves they don’t have herd immunity”. It’s the same nonsense as the arbitrary incidence of 50 per 100.000 that denotes a region as a “high risk zone”, which is not founded in science but something politicians made up.

  76. The answer is “no”, Sweden does not have herd immunity.

    Sweden is now blasting through the metric the author set for this (10-20 deaths per day) and climbing.

    Most likely, most other parts of the world don’t either, including England, Italy, and parts of the US, like New York.

    Time to put a big bold retraction on the top of this post if this blog is going to unironically use the subtitle “Health and medical information grounded in science”.

    1. Hi David,
      Well, I wouldn’t say blasting through. Sweden is currently at 10-20 deaths per day. We will see whether it goes higher, but it is a far cry at present from the 110+ deaths per day seen in spring. The fact that growth has been much slower than in spring and now also seems to be stabilizing at a much lower level suggests that we did build up a significant level of population immunity. Having said that I agree that I was wrong in my estimation of how much population immunity had built up during spring and summer. The early evidence on covid suggested that it wasn’t a seasonal virus, so I underestimated the power of the seasonal effect in pushing down infections during summer, which caused me to overestimate the level of population immunity. It has now become clear that covid is highly seasonal.

  77. November 17 Status – Briefings are on Tuesday and Thursday, number updates are from Tuesday until Friday. Today is the day after the weekly cross-check between death register and the positive-tests database so there might be older deaths added to the total numbers. 179 are the current ICU patients with COVID-19, this is 12 more than yesterday. In Sweden ICU numbers reported are exclusively patients on respirator, and there are currently about 1300 patients with COVID-19 hospitalized in intermediary care units or geriatrics and other wards.

    The newly reported deaths today are spread between 30/10 and 17/11. Even with the lag in reporting week 46 (previous week, considered incomplete yet) already has 129 deaths total, compared to week 45 which has now 141 and week 44 which had 77. 9/11 and 10/11 are first days with over 30 deaths in the autumn. Regions with most reported deaths from the newly reported are Skåne +19, Stockholm +35, Västra Götaland +13 and Östergötland +12. Östergötland has been known (together with few other regions) to report deaths in larger numbers but more rarely, covering larger period so it is possible this is what happened today as well)

  78. Sebastian, when you say you were wrong – what are the numbers of ER admissions in your hospital? Previously you had mentioned that for weeks or months not a single person had been admitted with SARS, now you’re saying that you were wrong and herd imminity hasn’t been achieved. Wouldn’t that imply that your hospital is seeing a significant number of ER admissions? If so, how large is it?

    1. I haven’t seen the numbers for my own hospital recently, although I know there are a number of patients currently being treated for covid. In total about 600 people are currently being treated for covid in all of Stockholm’s hospitals. At the spring peak that number was 1,100.

  79. Sorry, not trying to be tense, but where is the official source that says that 600 people in Stockholm’s hospitals are being treated for COVID-19? And I mean that in the clinical sense (one or more of confirmed pericarditis, lung consolidation, pulmonary oedema, minor serous exudation, minor fibrin exudation, pneumocyte hyperplasia, large atypical pneumocytes, interstitial inflammation with lymphocytic infiltration and multinucleated giant cell formation, diffuse alveolar damage with diffuse alveolar exudates, organisation of exudates in alveolar cavities and pulmonary interstitial fibrosis, disseminated intravascular coagulation, microvesicular steatosis), not anecdotal.

    I’m asking because as far as I’m aware, all EU countries are instructed to treat suspected cases of respiratory illness as COVID-19 even in the absence of any of above clinical diagnosis but in presence of a positive RT-PCR screening kit result. Sweden, as all other EU countries, is using cycle thresholds so high that non-viable virus RNA can be detected up to 90 days. Which means that a patient who was exposed to the pathogen in September and fought it off just fine, but is now struck by bacterial pneumonia, will test positive for “COVID-19” even though the lung infection was caused by bacteria.

    I haven’t seen any indication that Stockholm’s hospitals are performing chest CT scans on all suspected cases of COVID-19, therefore all such claims should be read with the usual reservations.

    1. Hi Niko,
      You are absolutely correct. There are currently 600 people being treated in Stockholm hospitals who have had a positive covid PCR. We don’t know what proportion of them are actually in hospital due to covid.

  80. Hi Sebastian,

    Now that the backfilling for those dates should be completed, it appears that Sweden was in the 10-20 deaths per day range from November 1st to November 6th:

    https://ourworldindata.org/grapher/daily-covid-deaths-7-day?tab=chart&time=2020-05-16..latest&country=~SWE

    I stand by calling that “blasting through” the 10-20 deaths per day metric, but I suppose it’s a relative term.

    Fair enough on the rest. Hope you folks somehow manage to get this under control, quickly.

  81. Sebastian,

    I have read of quite a few confirmed reinfections. I know people who have been reinfected after less then 7 months. No difference in symptoms the 2nd time. (Confirmed both times via pcr and most common covid specific symptoms)

    That implies no vaccine, no herd immunity. This might be like the flu vaccine, you need to take it every year. Unless the vaccine gives better protection then the infection itself.

  82. Jonas, worldwide there are less than 10 clinically confirmed reinfections.

    When you say you personally know people (plural) who have been reinfected within 7 months, then it either means you are an extremely busy person, or it means that your observation is incorrect, for whatever reason. I’m not saying it’s untrue that someone told you they have been reinfected twice, but I am saying that maybe you shouldn’t believe everything people tell you.

    And it’s not true that “you need to take [the flu vaccine] every year”. No public health body, not even the WHO, is recommending that your average citizen takes the flu jab. It is only recommended for at-risk persons, the average healthy adult is not advised to be vaccinated against the flu. Why? Because (1) the flu vaccine might not protect you at all, and (2) it might actually increase the probability of a severe flu infection. For at-risk persons the pros outweigh the cons, but not for healthy adults.

    Also, all confirmed reinfections survived both, so that should inform you how risky a second reinfection really is.

  83. Niko

    You are misinformed regarding reinfections. In sweden we have >150 that are investigated. I know one family where the adults got reinfected in Nov. First infection late april. Confirmed via pcr and a school book example of covid symptoms. Second time was worse then first for the female. She is working for a hospital.

  84. I’m not doubting that someone told you this. I’m doubting that it’s actually true. And, no, if someone tests positive and 30 days later tests positive again that isn’t a reinfection, it’s a positive test result for the same continuous infection. In fact, traces of virus RNA can be detected up to 90 days after first occurence. That’s not reinfection. Neither is an “investigation” evidence. So far all I’m reading from you is anecdotes. Anyway, it’s all inconsequential and a non-issue.

  85. Thank you Dr. for your excellent articles. Considering your estimates in September now in January 2021 the total count of deaths in Sweden is reaching 9000 deaths compared to the 6000 in September.

    How can this match the heard immunity theory ?

    Thank you very much in advance

  86. Right wing, GOP channels are full of bunk. You can see poor, dear, highly Peter Hitches, go on about some research he read about masks not working, and the whole world is using mask. You don’t hear them yammering ‘Look at Sweden’ now.

  87. Hi Dr Sebastien
    Thanks for your inputs articles and your excellent book.
    From what I see from your last article back from Sept you said Sweden has probably reached herd immunity. At that time your had near 6000 deaths. Can you comment on the new data I saw today 27 April where the number is over 13000 ?
    Can we conclude herd immunity is still to be reached ?
    Thanks
    Luís

    1. Yes, I was wrong back then. My mistake back then was due to listening too much to the experts who at that time point were saying that covid was not behaving in a seasonal manner. It turns out it is super-seasonal!

      1. Then we should expect the seasonal effect to kick in this week if the same pattern as last year is applicable. The number of deaths is already lower than april last year, but cases and hospital admissions are high. What is your prediction, Dr. Rushworth?

      2. I think there will be very little covid this summer, just like last summer. Covid clearly follows the pattern determined by Edgar Hope Simpson several decades ago for epidemic influenza.

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