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It can be very difficult to compare Covid-19 experiences from different countries. Populations are not evenly distributed in terms of age, location, ethnicity, social class, or culture. Different groups and regions are not equally susceptible to the virus.
Then there is the fact that countries measure the impact of the coronavirus differently. For example, Ireland is one of the few European countries that includes both nursing homes and suspected or probable Covid-19 cases in official numbers.
However, this does not prevent people from making international comparisons. With so many people trying to get out of the running of the bulls, many point to the different experience in Sweden without blocking. It raises questions about whether Ireland’s travel, work and social restrictions had to be so harsh after all.
For anyone who asks that question to the Medical Director, Dr. Tony Holohan, he has a very sharp and succinct answer: “Have you seen the figures for intensive care admissions for Sweden?”
Well, not really, not really. We have not seen those figures. The workload in the Swedish ICU is not main story here. Maybe it should be. Because there is something important that Sweden’s critical care experience can tell us. It is this: There was never a realistic alternative strategy that Ireland could have followed.
Our health system simply could not have coped with the more relaxed approach taken by Sweden. This graph showing the number of people treated in intensive care in Ireland and Sweden shows why.
There are two surprising observations about the graph. The first is that the underlying level of Covid-19 disease in Sweden, as evidenced by the numbers in intensive care, is well above the disease levels in Ireland and has been doing so from the start.
In fact, the level of illness in Sweden is three times higher than in Ireland if ICU occupancy rates are a guide. If anything, the gap between the two countries appears to be widening as Ireland continues to strangle the spread of the virus by withholding the blockade while Sweden pursues its more relaxed approach.
The second surprising observation is that while the number of confirmed cases of Covid-19 in intensive care in Ireland dropped to 72 on May 10, in comparable terms the number in Sweden was 233. That is more than three times the level of disease in Ireland.
This is a big gap. He suggests that if Ireland had followed the more relaxed Swedish approach to social distancing, we would have required at least another 161 beds in intensive care only for confirmed Covid-19 patients.
Add to that the additional beds required for three times as many “suspected or suspected” cases of Covid-19, which have always been a significant and consistent feature in intensive care. The number of additional beds required for Covid-19 patients would then be over 200 for now.
We just don’t have that capacity in intensive care. Despite the question of where in the country those empty beds might have been required, by May 10 we could accommodate, at one point, an additional 150 additional patients in ICU beds with all staff across the country.
Before this crisis began, Ireland had only about 225 intensive care beds nationwide. By May 10, including non-Covid-19 patients, there were 257 people receiving critical care in Irish hospitals. That means that even with the blockade, if the HSE had not struggled to expand critical care capacity, hospitals in Ireland would have already had serious problems as doctors would have to make tortuous decisions about who to allow to enter care units. criticism and who to reject.
Our healthcare system could not have coped. Fortunately, that did not happen due to the additional critical care capacity that was established.
But what if our National Public Health Emergency Team had advised the government to follow the Swedes? What if the level of Covid-19 disease was more than three times higher in Ireland than now? Because that is precisely what the Swedish intensive care numbers tell us.
It would have been a disaster. It would have put Ireland on par with Italy and Spain, in terms of the horrible scenes and experiences we would have had to endure and witness. The European Center for Disease Control noted that Ireland started the crisis with the lowest number of intensive care beds per capita in Europe.
Our health system was never strong enough to withstand the journey the Swedes undertook. He simply could not have coped and it is hard to imagine how Irish society would have coped.
In an interview with the Financial Times last Friday, Swedish state epidemiologist Anders Tegnell, who devised Sweden’s non-blocking approach, claimed that his country will have an advantage over other countries in the fall. This is when he waits for a second wave of coronavirus to arrive.
Mr. Tegnell says that a very high proportion of the Swedish population, particularly in Stockholm, will have had the virus by then and therefore will have developed some form of immunity. That will bring Sweden closer to the so-called herd immunity, which is a pretty horrible term when you consider that we are talking about real people and the disease, anguish, fear and grief that many have to suffer to achieve such immunity.
Here, however, the medical director, Dr. Holohan, makes it very clear in his press conferences that Ireland is not going to seek herd immunity. Nor does it hide the fact that he is going to be very cautious and conservative (his words) when it comes to easing social restrictions, the opposite pole of his Swedish counterpart.
All signs suggest that there is likely nothing coming from the Covid-19 numbers in Sweden that would make you change your mind.
Sweden Ireland details
one) The numbers in the chart for Ireland come from HSE’s Covid-19 Acute Hospital Daily Operations Update. Swedish numbers are published daily in the Swedish Intensive Care Register. But given that Sweden has twice the population of Ireland, 10 million people compared to 5 million here, the Swedish UCI daily total has split in two, so the chart shows the numbers receiving critical attention for Covid -19 for every 5 million people in both countries.
2) Crude official figures show that Sweden, with twice the population of Ireland, has 2.2 times the number of Covid-19 deaths, suggesting at first glance that Ireland and Sweden could be side by side in the the international league of coronavirus.
3) Sweden has done very badly when it comes to Covid-19 in nursing homes, something Anders Tegnell says he deeply regrets. Deaths in nursing homes in Sweden are not included in the official figures, but they are in Ireland, where they represent approximately 60% of all Covid-19 deaths.
4) Sweden’s numbers also do not include Covid-19’s “suspected or suspected” cases. They are included in Ireland.
5) The level of admission to intensive care is a key international comparator for the underlying level of the disease, and represents approximately 2.4% of all cases diagnosed according to the European Center for Disease Control.
6) In Sweden, most primary and secondary schools are still open. So are restaurants, cafes and shops. Meetings must be over 50 people before they are banned. People themselves are allowed to voluntarily participate in social distancing, while working from home is an option that is encouraged rather than imposed.
7 7. Google’s Weekly Community Mobility Report Covid-19, which uses big data collected from mobile phone locations, shows a 73% drop in activity in the retail and recreational sector in Ireland compared to a 9% drop in Sweden. . The footprint in the grocery and pharmacy sector is down 15% in Ireland, but has increased 14% in Sweden. The use of public parks decreased by 27% in Ireland, but increased by 44% in Sweden.
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