“We Have to Compare Sweden to Its Neighbours” Isn’t a Convincing Argument

In a recent post on Lockdown Sceptics, I argued that the case for lockdown basically collapsed in May of 2020, when Sweden’s epidemic began to retreat. Sweden was the only major Western country that didn’t lockdown in 2020, yet it saw age-adjusted excess mortality up to week 51 of just 1.7% – below the European average.

A common reply is that, although Sweden did better than the European average, it did worse than its neighbours. Here its neighbours are taken to be the other Nordic countries: Denmark, Norway, Finland and Iceland. Looking at age-adjusted excess mortality, it’s true that the other Nordics did better than Sweden. All four saw negative excess mortality up to week 51.

Does this mean lockdown sceptics are wrong to cite Sweden as evidence that the benefits of lockdowns are vastly overstated? No, I don’t believe it does.

First, the economist Daniel Klein and his colleagues have identified 15 different factors that may account for the higher death toll in Sweden as compared to the other Nordics. These include the greater number of frail elderly people alive at the start of 2020 (the ‘dry tinder’ effect); the larger immigrant population; and the lack of adequate protection for care home residents in the early weeks of the pandemic. 

Second, as the researcher Philippe Lemoine has pointed out, the epidemic was already more advanced in Sweden by the time most European countries introduced lockdowns and social distancing. The other Nordic countries therefore had a head start in responding to the deadly first wave. This is particularly important because, when the first wave struck, the best ways of treating COVID-19 were not yet well understood.

I would add that, with the exception of Denmark (which saw a moderate second wave), the other Nordics are small, geographically peripheral countries for which a containment strategy was actually workable. As I’ve noted in Quillette, all the Western countries that have managed to keep their COVID-19 death rates low (Norway, Cyprus, Australia, etc.) benefited from pre-existing geographical advantages. And all imposed strict border controls at the start (something the UK Government’s scientific advisers cautioned against).

Third, as the legal scholar Paul Yowell has argued, the Baltics (Estonia, Latvia and Lithuania) are similar to the Nordics in terms of climate and population density, and once you include them in the comparison, Sweden no longer stands out. Lithuania actually had higher age-adjusted excess mortality than Sweden last year, despite imposing a strict winter lockdown.

Finally, as Yowell also points out, the ratio of Sweden’s COVID-19 death rate to Denmark’s isn’t that much higher than the ratio of Denmark’s to Finland’s. And this is despite the fact that Denmark has taken a more restrictive approach than Finland. One could therefore take the comparison between those two countries as evidence against the efficacy of lockdowns.

What’s more, this exercise could be repeated with other pairs or trios. For example, despite taking a slightly less restrictive approach than Spain and Italy, France has reported fewer deaths from COVID-19 (as well as lower excess mortality). Of course, these kinds of comparisons don’t tell us very much. But that’s the point. We shouldn’t only compare a country to its immediate neighbours.

And when researchers have analysed European countries and US states in a systematic way, they haven’t found evidence that lockdowns substantially reduce deaths from COVID-19.

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