Britain's and Sweden's Covid responses compared

Original title: "Lawson's vaccine jab at lockdown sceptics"

by George J. Dance

Early in the month this blog announced the world's first government permission of a Covid-19 vaccine, the UK's emergency authorization to Pfizer/BioNTech, by quoting an article from the Lockdown Sceptics site. The Sceptics author quite rightly applauded the vaccine as "a medical breakthrough and, on the face of it, good news." However, like a sceptic should, he mentioned reasons for doubting that it is the deus ex machina deliverance from the plague that so many are anticipating. 

First, many Britons are themselves sceptical about the vaccine. According to the Mail Online, 20% of Britons are 'not confident' or 'not very confident' that the jab is safe, while 43% are still only 'somewhat confident'. The 27% who were 'very confident' in its safety would probably all be vaccinated by Christmas (if that were possible), but they would be nowhere near enough to end the pandemic.

Second, those 63% have grounds for scepticism. Health authorities do not normally approve new vaccines in less than eight years, much less eight months. Nor are they approving these vaccines, but merely allowing their emergency use. Until the new vaccines are generally used in the population, there is only so much we can know for sure about them. The article quoted a former Pfizer CEO, Mike Yeadon, who highlighted a number of risks that need study; one that bothered me was Dr. Yeadon's claim that the Pfizer antibodies may respond to "syncytin-homologous proteins, which are essential for the formation of the placenta in mammals" – which sounded to me as if women with the antibodies possibly might be unable to bear children. 

Searching the web later for more information on that topic, I found a mention of both lockdown sceptics and Dr. Yeadon in a Sunday Times article by Dominic Lawson, "This vaccine needles the lockdown sceptics." Eagerly I clicked, scrolled down, and found that, yes, Lawson had dealt with my concern: 

Yeadon added that “in particular” the vaccine developed by his ex-employer, Pfizer, could cause “infertility of indefinite duration ... in vaccinated women”. Any argument will do. 

I did not find that rebuttal reassuring, or even particularly logical; but I then read the whole article and understood it better. In Mr. Lawson's mind, no rebuttal was needed, because the only argument that counts, the one over lockdowns is, now over. Lockdown sceptics have lost it; the coming of a vaccine proves that "they were wrong" to have opposed them. Furthermore, lockdown sceptics know they have lost the argument, and they are simply reacting to their loss "with churlishness, even outright hostility" like the sore losers they are.

As Lawson sees it, in March Britain faced a choice between two competing strategies of epidemic control. The first was to copy "what [was perceived] to be Sweden's approach: to go for 'herd immunity' via naturally acquired infections (whatever the cost in lives)." It would be more correct to call Sweden's approach the normal 'mitigation' strategy used in flu epidemics – I suspect that, like Tomas Pueyo, Lawson calls it a 'herd immunity' strategy because that sounds nastier. The second was to "clamp down with legislative force now when infections threaten to proliferate exponentially, in the belief that a saving vaccine was likely to arrive by the year’s end." That is often called a 'lockdown' strategy; but, as a Clash fan, I would like to use Lawson's term and call it a 'clampdown' strategy here. 

Sweden and Britain took different paths. The former stayed with mitigation, not knowing how soon a vaccine would arrive and, therefore, how long the epidemic would last. In Lawson's view, that has led to a clear disaster: "They’re worried now. More than worried. Over the past two weeks Sweden has recorded way more deaths from Covid-19 than Norway or Finland have had in the whole year: more than half the patients in Sweden’s intensive care beds are coronavirus victims [sic]." 

In contrast, after a brief experiment with mitigation, Britain's government opted for a clampdown, a "strategy of (intermittently) strict enforcement of social distancing until the arrival of a vaccine." The government's hope was that the right mix of interventions would keep deaths low until the vaccine showed up, which they gambled would be soon. Health Secretary Matt Hancock told Lawson that gamble was "a judgement based on facts;" and an early vaccine was in fact forecast by some scientists. For example, Lawson reminds us that Sarah Gilbert, 

the head of the Oxford University vaccine project (partnered with AstraZeneca) declared in April that it was “possible” their product might be ready as soon as the autumn. 

Dr. Gilbert's "prediction" (as Lawson calls it) has not yet come true, but she still has more than a week of autumn left to make it good. Meanwhile, another vaccine has arrived, with others on the way. That last is enough for Lawson to call the pandemic over, and declare victory for the clampdown camp. All those deaths in Sweden are for him enough to show that mitigation was the wrong strategy. "But rather than admit that Gilbert (and Hancock) had proved their no-alternative-to-herd-immunity-through-naturally-acquired-infection strategy wrong, prominent 'lockdown sceptics' have instead cast doubt on the vaccine approved by the MHRA."

Certainly there is some truth in all this. Sweden's chief epidemiologist, Anders Tegnell, did reject a clampdown in favor of mitigation, in part because he did not believe society could be locked down until a vaccine arrived; he opted for less stringent measures that could be maintained over a longer time period. It is theoretically possible that Sweden could have clamped down for eight months; that latter option might have saved lives (resulted in less deaths), and would have been the better option if it had. Since that is what the British government did opt for, gambling on a quick vaccine, then its gamble can  be seen as a success – if and only if it had resulted in less deaths than the Swedish strategy. It is at this point that Lawson's narrative falls apart; for Britain's clampdown has not resulted in less deaths than Sweden.  

As of December 11 (per Worldometer's coronavirus dashboard), Sweden had suffered 7,514 deaths from or with Covid, while the United Kingdom had 63,507. The UK had suffered more than 8 times as many dead as Sweden. Of course those raw figures alone can be misleading, as the UK has more than 6 times Sweden's population. Adjusting for population size gives the UK 933 deaths per million (933/M) versus Sweden's 742/M. Per capita, the UK has had roughly 25% more Covid-related deaths than Sweden. 

But what of Lawson's "past two weeks"? In the two weeks ending December 5 (the day before the publication of Lawson's article), Sweden had 705 deaths, or 70/M. In the same time, the UK had 6,388 deaths, or 94/M – 34% more than Sweden. Not only has clampdown Britain consistently had more Covid deaths than "go for 'herd immunity' via naturally acquired infections (whatever the cost in lives)" Sweden, but the gap is widening.  

Does this prove that clampdowns or lockdowns cost lives? Not by itself; it is only one comparison, and there are other factors that may explain the difference. What would be needed to make such a judgement is a comparison of all clampdown vs. non-clampdown countries, and a look not only at their death tolls but at all the possible reasons for the difference. This comparison is only enough to show that the two countries' experiences, the subject of Lawson's article, provide no support at all for his belief that Britain's clampdown strategy saved any lives.  

Again, there may be other reasons why Britain had so many more Covid deaths than Sweden; Lawson lists a few possibilities, which may or may not be significant. (He provides no evidence that any of them are.) And he does point to other examples to support his belief. To show that Sweden lost more lives through mitigation, he ironically cherry-picks Norway and Finland (both of which, like Sweden, have rejected a clampdown or lockdown strategy this fall). And to show that Britain saved lives through its clampdown, he compares it to an imaginary Britain: 

Try to imagine what would have been the outcome if the UK, much less advantageously placed [than Sweden] in all these respects, had adopted the same approach. 

Britain’s lockdown sceptics never attempted that act of imagination 

I doubt that lockdown sceptics are unable to imagine possible outcomes. Perhaps, like me, they were just sceptical that acts of imagination produced anything other than imaginary evidence or proof – which is all we have seen from Lawson and his ilk to date.