Sweden coronavirus press conference, April 15, 2020

On this day, there were 1.9 million cases globally. In Sweden, there were 11,927 cases. And about 1200 deaths in Sweden.

Yesterday, Anders Tegnell, who is the national epidemiologist, got a grilling, so he must have been tired. So today, it was Anders Wallensten talking. He’s the vice-national epidemiologist.

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He said: we think we finally have most of the lag-reported cases in the system from the Easter weekend. And it looks cautiously positive, because as you can see, the new numbers of daily cases has gone down compared to before Easter. We should, though, wait another day to see if any more lag-reported cases come through.

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They showed then graphs that showed only cases for different regions of the country (Göteborg and Skåne). They were showing that things are pretty stable in those regions.

Then they showed the graph of deaths by day. Wallensten said, we still might get lag-reportevd deaths, but he said it was good that it appeared the number of deaths had gone down compared to before Easter.

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Reporter question: The death rate has been increasing, but the number of people going into the intensive care has stayed constant. Are there signals that we’ve not been admitting everyone into intensive care who needed it, since there’s a gap between people in intensive care and the death rate?

Anders Wallensten: I haven’t gotten such signals. (Turns to Johanna Sandvall)

Johanna Sandvall: no, absolutely not. (Not sure what she said by way of explanation, but she ends with:) those who need care, get it.

Reporter question: have you done any analysis of what happened during the Easter long weekend such that cases have gone down?

Anders Wallensten: well, the numbers of deaths are usually people who have been in intensive care for a few weeks. So it’s hard to say that the Easter holiday had anything to do with that. But it could be that the measures we took earlier and changes that were made have led to this. But we have to look further to see if this is a true reduction.

Question: what percent of the population has or has had coronavirus, do you think?

Anders Wallensten: that’s a very good question, because it affects when we can start taking away some of these restrictions. If there is an immunity among the people, that helps to stop the spread. We’ll know more once antibody tests have been developed. Unfortunately, we haven’t gotten those tests approved yet.

Follow-up  question: well, last week Anders Tegnell said it was 10% so … oh, and then I got bored so forget this question.

Question: you’ve gotten quite a bit of criticism recently. Has it made your work harder?

Anders Wallensten (trying to be very nonchalant): Well, I think most of the criticism was yesterday. It continues. We have also support from a great deal of researchers out there, so there’s different pictures of our work. As you’ve seen, we’ve stood our line and we’re working from what we believe in as far as infectious disease goes.

Question: the fact that there were fewer cases over the Easter holiday, do you think it was because less testing was done?

Anders Wallensten: ah, that I have a hard time believing. We’re talking about patients here, and they are all tested. Of course, as we start to test more people (I thought they’d already started doing that two weeks ago) who have mild symptoms, like medical staff and the like, we can get a false increase in the graph again. So what we try to do is to separate those who are tested for reasons other than sickness to be able to follow this curve under the same conditions, and not have it change because we changed our testing strategy.

Then it was back to the Studio. This lady was the main newscaster:

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who if you remember, has been a sidekick reporter at earlier press conferences. Now she was the lead.

And she had a very nice conversation with the day’s reporter, Iva Horvatovic, who we’ve seen so often before. They summarized all the coronavirus news.

At one point, Iva Horvatovic was explaining all the different ways countries have of counting coronavirus deaths, such as:

  • in Belgium, they count almost everyone who dies in retirement homes as having died of coronavirus (whether or not there’s an official test done, I guess)
  • in the UK, they are only counting people who die in the hospital. If they counted people who die elsewhere, the statistics would rise by a couple hundred
  • in New York, they are counting even people who are suspected of having coronavirus, even if it’s not confirmed

They were bringing this up in light of worldwide coordination.

Then it was time for the individual interview with Anders Wallensten.

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Anders Wallensten

Question: Today, there are 170 deaths. How can we interpret that?

Anders Wallensten: those figures are spread out over several days, not just one. The number of deaths per day has not gone up, so maybe it’s a little lift.

Question: where do we find ourselves on the curve?

Wallensten: I think it might be that we have approached a change in the direction. But I want to wait a day or two longer to confirm that, to make sure there’s not numbers leftover from the Easter holiday that we’ve missed.

Question: an abnormally high number of people died the first week in April. Yesterday it was said that only in certain cases is a dead person tested for coronavirus, if the disease had not already been confirmed. Can it be that the statistics are wrong and that they are missing people who died of coronavirus?

Wallensten: We have another system to check for mortality of coronavirus — we check if there’s more deaths than usual. We do see a certain increase in deaths. We’ll continue to analyze that.

Question: how is the disease developing in the rest of the country?

Wallensten: we are always keeping our eye on that. But we don’t see large increases anywhere the way that we had in Stockholm.

Sweden coronavirus press conference, April 14, 2020

Today it was very tense in the press conference. I never saw it like this before.

On this day, there were 1.9 million cases worldwide. They gave the numbers for Sweden, as well, but they said: there’s still probably cases stuck in the system somewhere that haven’t reached the national database. (Spoiler: I think they believed this because the reported cases in the last few days was quite low. But actually, the revised numbers from the next day’s press conference were not that different.)

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On April 14, 2020, there were 11,445 cases in total, with almost 500 reported in the last day. In total, 915 people had needed intensive care.

They also showed the number of new deaths by day, but they said that graph was afflicted by an even greater lag in reporting (the green bars show the update in deaths reported from the last day).

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Anders Tegnell, the national epidemiologist, said again that the infection curve was flattening out.

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Anders Tegnell

And Johanna Sandvall said that the medical supply situation was getting better — more availability, more stored up.

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Johanna Sandvall

And then came the questions:

Reporter: Twenty-two researchers have today released an article with strong criticisms of Sweden’s mortality rate from coronavirus, which now is about the same level as Italy’s. And the numbers from today are only making the mortality rate worse. Also, what do you think of the criticism that we don’t have a well-working, well-thought-out strategy?

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Anders Tegnell’s unamused look

Anders Tegnell: First, I want to absolutely reject the idea that we don’t have a well-working, well-thought-out strategy. That we absolutely have. Also, the mortality rate they cited was incorrect. Um. They don’t match the Swedish mortality rate that we are seeing on the figures here. Besides, in Italy are they now only reporting deaths that happen in the hospital (?). So unfortunately there are a number of inaccuracies in this article. I don’t have more comments about that.

Reporter again: And when it comes to the reporting lag in deaths … there were 114 new deaths reported late today … how many more such late-reported deaths can we expect?

Anders Tegnell: I don’t want to … if you look at the curve, you’ll see that we’ve had about 60 deaths a day recently. It’s gone up a bit from week to week. So we might go up to 65 deaths a day this week.

Reporter again: That this daily number of deaths continues to rise, what does that signify …

[Cut off by Anders Tegnell] No, no, but, no, if you look at the death data, you’ll see we don’t have an increasing curve, it’s linear (?). What I’ve said is that we’ve had a very unfortunate development in Sweden, especially compared to our neighbors, where we’ve had coronavirus infect our retirement homes. That is reflected in these figures. And we and many other agencies are working hard on this. To see what happened, and make sure it is not repeated in the rest of the country.

A new reporter [and it’s a reporter who works at the publication at which the 22 researchers published their critique!] She says: I want to continue on the same topic (you bet she does!) These 22 researchers say that if Sweden had taken stricter measures, then that would have given us some breathing room to do the preparations that now have to be done in parallel with tackling the infection. So why didn’t we decide to do that?

Anders Tegnell: Yes, well, I don’t really understand exactly what they mean. Our medical system has the whole time been able to stay one step ahead. It’s been hard, but we haven’t had a crisis. We’ve the whole time had empty rooms in the intensive care. The problem with the care for the elderly is <something something> that <something> a few weeks back. And then we can look at some countries that took very strict measures, for example, Belgium, where things are much worse than in Sweden. so there’s a lot of things to be looked at. And you should be very careful to make judgments about how well things have worked in different countries at this point, when we’re in the middle of the infection, and we’re all at different points in the developments.

A new reporter: Back to this article, the 22 researchers say that you all at the Public Health Agency are career employees (?) without talent. What do you say to that?

Anders Tegnell: Mumble mumble. OMG, I didn’t understand what he said at all. But it was short.

A new reporter: you said that you’ve done a survey to ask municipalities (?) about (?) what else concrete are you doing to support the municipalities with elderly care and home care?

Johanna Sandvall answers this: Yes, we’ve done a whole lot … I didn’t really pay attention. I’m sure it was great.

Reporter again: but have you identified where the failings in the retirement homes are happening?

Anders Tegnell: That’s what we’re looking at now. This is where we must be careful and not come to quick solutions, and think if we only give everyone a face-mask (direct translation: mouth-mask) things will get better. It’s certainly more complex than that. We’re working on this analysis with Stockholm, which has seen the worst of retirement home infections. There’s surely many different things we need to do, and we need to do better. And the most important thing is to spread the knowledge and experience to the rest of the country. We are working on getting all the information together, and then it will be the job of the retirement homes to implement (?)

A new question from a school group: We represent teachers, and we hear from teachers saying that we can’t both follow the restrictions of the Public Health Agency and do our job. They don’t feel like they’ve gotten clear answers for how they should act. They cannot separate the kids and get them to wash their hands (????)

Anders Tegnell: well, at its core, the Swedish approach relies on many different actors doing the best possible job they can. We have chosen not to have absolute, keep-your-distance rules. Instead, we try to minimize the risks as much as possible. I am convinced that there’s a lot to do in the schools, and that the schools have already done a whole lot. But these rules you mention are not absolute, and it’s kind of up to each teacher (?) to find a way that works best for them, to minimize the risks; not to take the risks completely away.

Follow-up question: What the teachers have a hard time with is, sure, the rules aren’t so strict, but … we talk about how children don’t really get infected so much, but the teachers aren’t children. They can be infected as much as anyone. So there’s some worry about that, and the teachers don’t feel like they are getting good answers.

Anders Tegnell: we’ll have to look at that, but so far we have not gotten any signals that teachers are sicker than any other group. We have coronavirus spreading throughout the country, and if we look at other places, we see that the place you most are likely to get infected in is your home, with people you stay  in very close contact with all day long, and not in other places. That’s probably also true for Sweden. And we have very little evidence of spread in schools. The few cases that popped up were when adults who were sick came in and made other adults sick. Kids weren’t involved in the transmission chain. So I don’t think — there’s no evidence that this environment is more infectious than any other.

A new reporter: The infectious disease doctor here at the island of Gotland says that he, until now, has not seen any spread of coronavirus in the retirement homes on Gotland, where they have 600 spots. They prohibited visits to retirement homes on March 12. The infectious disease doctor doesn’t say anything further, but … ? (The reporter is getting at: if all of Sweden had prohibited visits to retirement homes that early on, would less people at retirement homes have died?)

Anders Tegnell: Our signals are that for the most part, there was a more or less total stop on retirement home visits throughout Sweden from that date. It happened in some places and not others, though. We’re still looking at it, but our preliminary analysis doesn’t show that whether or not visits were prohibited was the big problem, but that other aspects needed to be strengthened instead.

New reporter: the annoying American who showed up a few weeks back: asks in English: For deaths in Sweden, if someone has not been tested for Covid-19, and they die and they were showing symptoms, what happens and who decides if there’s a post-mortem test done to find out if they had the virus or not? Or is there always a post-mortem test done?

Anders Tegnell: No. It’s always the attending physician who decides if there should be a post-mortem test. That is is always the case, not just for coronavirus. I would say that’s the same case in all countries, as far as I know. I would say we catch more deaths here than probably most other countries. We also have a system for looking back at death rates to see if there were excess deaths during a particular period. We are currently doing that, we are seeing an increase*,  but we need to calculate further to see how much it was related to coronavirus.

*a few days ago, they said the death rates seemed unchanged.

Follow-up from the American: are there guidelines for the physicians for how to determine if a test should be carried out or not? And to end up on the death toll list, do you have to test positive, or are assumptions sometimes made based on your symptoms?

Anders Tegnell: No, there are no specific guidelines. I would say the opposite. The main point is not to find the cause of death, but to stop the spread (?) so that’s mainly why … And yes you have to test positive for the virus, it’s never assumed. I would say that’s the same for all countries. In the very beginning, assumed cases were sometimes counted, but no countries are doing that now. We need all to remember that the number of people we test and catch is a small portion of all the cases we have in society. So we have to be very careful if we discuss if it should be one or two or three more (tests?) a day because that’s never going to catch anything.

A question from the old German reporter: We talked before Easter about the Swedish strategy. If you only look at the mortality rates from Germany, Norway, and Denmark, and compare to Sweden, would you still say that the Swedish strategy works? And do you have an explanation for why the mortality in Sweden is so high compared to other countries? Is it maybe because of the restrictions the other countries have?

Anders Tegnell: Ehhh, yes, at the same time if we compare to New York, which is about as big as Sweden in population* but has 10 times the death rate; or to Belgium (poor little Belgium is getting sledge-hammered here!) which also has many more deaths. And again, we have to be very careful in comparing this early in the pandemic. It can change a lot before it’s all done. For us, it’s very clear that what happened in Sweden is that the coronavirus infiltrated the retirement homes. That’s a very sensitive environment to have the infection. And you do get a lot of deaths there. I’ve looked at least at Norway and the median (or mean) age of those who are sick there is much lower than in Sweden. So I state here that it’s not the general strategy in Sweden where we’ve failed, but we have failed in our way of protecting the elderly in retirement homes.

*BUT NOT IN SIZE BY AREA AND DENSITY!!!!

German reporter again: So you think the infections in retirement homes is why the death rate is so different between Sweden and Germany?

Anders Tegnell: Yes, I don’t know if Germany has such figures, but we know that here in Sweden, about half of all the deaths among people over 70 are from those living in retirement homes, and that means that living in a retirement home is a large risk. But I don’t believe you have the same types of statistics in Germany. I don’t know, I haven’t seen them at least.

German reporter: we do have retirement homes in Germany with many cases, but another question. In Germany and Denmark they’re discussing school-openings, and they’re taking measures to keep distance between students, and having small groups in kindergartens. In Sweden, I haven’t seen as many measures, I visited a school where the kids were together as usual in the class without keeping distance, and out on the playground, they were all playing together. Do you in Sweden have some sort of experience that Denmark and Germany can use as far as infections in schools go?

Anders Tegnell: We’ll have to look at it, but we can say this much: we have very little cases among this age group. We don’t have more cases among school-children than in other countries. You might say, well, they don’t show a lot of symptoms. Sure. But so it doesn’t cause a rise in infections by having the schools open.

Question from a new reporter: how many times have you met the Prime Minister and kept him up-to-date?

Anders Tegnell: yes, my boss meets and has contact with the government many times a week.

Reporter again: how many times has he talked to the Prime Minister, do you know that?

Anders Tegnell: not exactly.

Reporter a third time: A question to Johanna Sandvall. Now that there’s many more intensive care places, does this mean that each nurse is now responsible for many more patients?

Johanna Sandvall: how the care is organized is up to every hospital. (Nice swerve)

A new reporter: you just said a while ago that no country just assumes someone died from coronavirus, a test is always carried out. But the CDC came out with a guideline in early April saying that they could count someone as a coronavirus death even without a test, if the other aspects checked out.

Anders Tegnell: says a whole long thing, but the thing I think he most enjoyed saying was this: the USA has a whole different situation, and they had problems with testing, and back in March, we did more testing in Sweden than the entire US. So that’s probably why they decided it would be okay to assume someone died of coronavirus without doing an official test. Their testing capacity was so bad.

Reporter again: does this mean that the deaths in the US will be higher than in actuality.

Anders Tegnell (enjoying himself again, I’ll wager): I don’t believe you can over-estimate the deaths in the US, they are just too high.

Whew! So that was the end of the press conference.

Then it was time for the individual interview:

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Anders Tegnell, stoic in the face of his grilling

Question: last week, we talked about how the spread was slowing down in Stockholm, but maybe picking up in other parts of the country. What can we say now?

Anders Tegnell: it’s still very low in other parts. We’ll look at it again tomorrow.

Question: you got very sharp criticism from the 22 researchers who wrote that article. What do you say?

Anders Tegnell: we also have many researchers and colleagues all over the world who are very positive about what we’re doing. I think debate is good, but it needs to be done with the correct statistics and data to take us constructively forward. I listen always to criticism, and see if they’re relevant, and if they cite sources we hadn’t seen before, or if they have figures we hadn’t seen before.

Question: and about the higher mortality rate in Sweden compared to our Nordic neighbors?

Anders Tegnell: I think there’s different reasons that explain that. First, we are on different places of the curve. Second, unfortunately in Sweden, we had a very unhappy development with the infection spreading to retirement homes, which we haven’t seen in the neighboring countries. That we must analyze further, why did the Swedish retirement homes end up like that? Third, we can compare to Nordic countries, but we can also compare to Belgium, the US, and other countries, and our death rate is lower.

Question: how certain are you that Sweden’s way is the right one?

Anders Tegnell: I am certain that we are doing the best we can the whole time, based on the assumptions we have, and that we’re working really hard on it.

Question: many countries in the EU are now lightening their lock-down restrictions. What can be the consequences?

Anders Tegnell: They are worried about precisely what we in Sweden have tried to avoid, that you suddenly would get a sudden spike in cases as soon as you lighten very strict lockdowns that quite simply cannot be maintained any longer. It’s not that the infection has been reduced, it’s that you simply of economic reasons cannot keep the lockdown going. Here in Sweden, we have a very sustainable strategy compared to other countries.

Question: The EU chief said over the weekend that the elderly might need to continue to be isolated for the rest of the year, at least until we get a vaccine. Do you share that prediction?

Anders Tegnell: it’s hard to say. I think it will be different in different countries, based on the developments. There’s absolutely signals that we have to be much better at protecting our elderly.

Question: when will we know what’s gone wrong at our retirement homes?

Anders Tegnell: we’re still finding out, it’s complicated on many levels. But I think there’s many things in retirement homes that can be changed, tweaked, etc, to reduce the risks.

 

Sweden coronavirus press conference, April 13, 2020

On this day, there are 1.8 million cases worldwide.

Today, it was Anders Wallensten giving the main updates.

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Anders Wallensten

When Anders Wallensten saw the first slide, he said: eh, eh, this is an old slide-deck, no?

But he was told, no, this is the current one. So he went on, in a very hesitant voice, reciting the statistics, but then he finally stopped and said: no, this is wrong, yes?

This time, the slides were switched out for the most recent ones, and they started over. ‘The real numbers are not so different, but we must show it correct.’

However, even with the correct slides, Wallensten kept saying how not all the numbers from the weekend have been reported yet. Thus, while it appears as though there’s been a sharp fall in new cases, it will look differently once the lag in reporting has been corrected. So we’ll wait till tomorrow to know what the real numbers are.

So for my part, I am not even going to include the numbers here.

After Wallensten was finished talking, it was the turn of this lady in the ponytail.

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She was talking about what medical supplies are available, and what the outlook for any shortages looks like. The whole time she was talking, Wallensten, who perhaps was very troubled on this day, kept giving her confused looks. So she kept looking back, and pausing a bit, and sometimes he’d nod back, confusion still in place though. But the nod would be enough that she’d continue.

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The last person to talk from the press conference was this nice lady:

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Maria Bergstrand

She always has a speech prepared, with a neat and clear introduction, middle, and end. She’s the one who says things like: guys, good job! Keep it up. This time she said that there is a risk of shortages of the chemicals needed to purify drinking water. And also that if enough truck drivers get sick, there will be difficulties in delivering supplies and goods across Sweden. She wasn’t saying that these risks were immediate, just that they might pop up later. Also, the spring flood season is coming up. And after that, the forest fire season will be upon us. The people in charge of dealing with these annual issues need to plan now for how to deal with them during coronavirus times.

Look at the serious look of this reporter as he listens:

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There were lots of questions during this press conference.

Reporter: Do we know why there’s been so much spread in retirement homes?

Anders Wallensten: We have a group looking at that now. They don’t have conclusions yet.

Reporter again: But the spread in retirement homes is a problem not just confined to Stockholm now. We’re seeing it pop up in other parts of the country. So what kinds of suggestions and tools can be offered to help them?

Anders Wallensten: Yes, we want to stop the spread. But just because coronavirus has popped up in a retirement home, doesn’t mean everyone in the home is sick. It could be that a single patient is isolated and no one else gets it.

Question: Where do you think Stockholm is on the curve?

Anders Wallensten: as I’ve said, since we don’t yet have good figures from the weekend, we can’t say. But we hope that things will look steady. We have people calculating when we should be reaching the peak, and we will in the coming days or next week be presenting about that.

After the end of the press conference, there was the individual interview.

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Anders Wallensten

Reporter: Why are tomorrow’s updated figures so important?

Anders Wallensten: It’s been a long holiday weekend, so there should be a large increase in the number of reported cases.

Reporter: Has there been an unusually sharp decrease in cases reported this particular weekend? And what might that mean?

Anders Wallensten: There’s some difference every weekend. If we should interpret that in some way, I don’t really way. Maybe it’s due to a lower number of cases, but it could also be due to how many people were at work and what the internal processes were for reporting. It’s hard to know all those processes during Easter.

Reporter: What’s the biggest worry right now?

Anders Wallensten: the spread in retirement homes.

Reporter: Denmark and Sweden have very large differences in their mortality rate from coronavirus. Why do you think this is? (Denmark’s is lower)

Anders Wallensten: Well, it can depend on several factors. You mentioned earlier that different countries have different ways of reporting cause of death, so it could be due to that. It could be due to: how actively have  you tested disease spread in retirement homes? It can also be that the disease is striking different people in each country. We also maybe don’t know right now how this will end. When other countries relax their restrictions, they might get a second wave of infections. There might also be more cases in the fall. So I think it’s too early to say anything.

Sweden coronavirus press conference, April 10, 2020

This press conference was different from all the others. This time, all the speakers (and there were four) were women. How nice.

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Instead of either Anders Tegnell or Anders Wallensten, the main epidemiologist was this lady. She speaks so nicely and clearly. Anders Tegnell is always slurring his words and ending in a mutter. Her name is Karin Tegmark-Wisell.

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Karin Tegmark-Wisell

On this day, there were 1.56 million cases worldwide. They start by saying, oh, it’s bad in the US. There were 9685 cases total in Sweden. They say, like the last few days, that new cases appear to have hit a plateau (remembering that the dip in cases is due to lag reporting during the weekends).

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By the way, remember how yesterday Anders Tegnell kept talking about how a person carries the virus for about five days? A reporter asked today, what did he mean by five days?

Karin Tegmark-Wissel answered: it is referring to people with mild cases of the virus. Studies have shown that the first five days of infection is the period during which the virus most infects new cells and populates, and after that, it drops off.

Now, even though all the speakers were women, Anders Tegnell was actually joining them through audio link. And the reporters were able to ask him questions if they wanted to. What was the point of that? And the only reporter to ask him a question was a man, of course. He needed his fellow man to confirm what all the women had already said.

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Motioning with solemn hands

Any case, this guy asked: there’s been reports of a 60-year-old birthday party from which several people got infected, very early on in the coronavirus epidemic. Was this a super-spreader event, and should the Public Health Authorities have had restrictions in place earlier?

Anders Tegnell: Well, it’s very hard to say. We can say that the development of coronavirus in Sweden doesn’t at all look like what it does in places that did have these super-spreader events, where you have a very dramatic spread after such events. Like Karin said, we’ve had a pretty slow spread the whole time. And that speaks loudly to that we didn’t have a single event that led to a kick-off of the virus.

That same man reporter then needs to ask Anders Tegnell a second question, to access more of his authority. He asks his questions in a super annoying way, too — really slow, as though what he is asking is of such weight and import that he cannot do otherwise than weigh each word for 3 seconds before uttering it with the appropriate mien of gravity. God, he’s annoying! Lord have mercy, just SPIT IT OUT.

Question: (in my quick paraphrasing of his long-winded and unnecessary wording): Compared to the spread of the virus in neighboring countries, should the Public Health Authorities have made stricter recommendations on gatherings earlier?

Anders Tegnell: I think it’s too early to draw conclusions there. There’s so many other things happening at the same time. In Sweden, there’s very little evidence that large gatherings of people had an effect on coronavirus spread, because we haven’t seen these large jumps in the number of cases that would have resulted. Instead, we’ve had a very slow climb that is evidence that we had fewer cases of spread occurring in many different places from many different people.

When the press conference was over, they had an interview outside with Karin Tegmark-Wissel.

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Karin Tegmark-Wissel

She says: even though we’ve reached a plateau, keep in mind that still means a large number of  new cases every day. It’s really important to still be trying to stop the spread. Don’t interpret this as: oh, it’s calm now. No, there’s a large strain with the medical resources, we need to still be careful.

Reporter: what would have to happen in the near future so that you could indeed confirm that we are actually in a plateau?

Karin Tegmark-Wissel: we’d need a couple of weeks with a stable number of new cases per day.

Reporter: What about spread in retirement homes?

Karin Tegmark-Wissel: this is very bad.

Reporter: who’s responsibility is it to stop the spread?

Karin Tegmark-Wissel: It’s a shared responsibility between the public, the authorities, but most of all, it’s up to the people managing the retirement homes to look over all their routines and turn over every stone to make sure that people working in the retirement homes are staying home when sick, even with just the tiniest little symptom.

Reporter: what’s the situation looking like globally?

Karin Tegmark-Wissel: Well, there’s some plateauing of new cases in Spain and Italy. But there’s word that small outbreaks keep popping up in China. This is really worrying, and we don’t know the outlook for the “second wave” of illness.

Sweden coronavirus press conference, April 9, 2020

Among the first things they say: and in fact, the very first thing when it came to international updates: that the US has had a hard day. For the second day in a row, have almost 2000 people died. It’s the highest figure so far. The USA has so far over 14,000 people dead of coronavirus.

On this day, the global number of cases was 1.48 million. There were 9141 cases total in Sweden. There were 722 people who got sick in the last day. Anders Tegnell, the national epidemiologist, calls it a pretty stable situation. In total, 793 people have died.

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When it comes to flattening out the curve, Anders Tegnell says that hopefully, at least when it comes to Stockholm, they might now lie on the very top of the curve, the plateau of which can be quite long if your curve is flat. We lie somewhere along there now, we think, Anders Tegnell says.

They’ve done a study to see exactly where things like in Stockholm. They tested 773 people between ages 2 and 86. They found that 2.5% of them had the virus. I’m not sure if all of those people were asymptomatic. After Easter, they’re going to do another study on the whole country. The way it works is that the people swab themselves (or test themselves in some way), and then the military goes around and picks up the swabs and delivers it to the authorities.

Anders Tegnell later further explains: this study was done last week. About every 7-8 days, the number of coronavirus cases in Sweden doubles. So therefore, by this point, that 2.5% figure uncovered in the study is probably more like 5-10% who have the virus. And even more would have previously had the virus.

Also remember, this 2.5% figure shows how many people carried the virus at the moment of the study. It does not count all the people who carried the virus before, but had already cast it off. Anders Tegnell mentioned 5 days as a period of time for carrying the virus.

He also adds, that 773 people being part of the study is a good number, and it means there’s very little uncertainty.

Question from the SVT reporter pictured here: how decisive will Easter be in the spread of the virus?

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Anders Tegnell: all holidays make a difference, because people meet different people than they usually do, they move about a little differently. So there’s new chains of infection possible.

Question: what do you think is the risk of uncounted coronavirus deaths?

Anders Tegnell: Every country will have uncounted deaths. In Sweden, I think we are the best at reducing that, because we go back and look at registers (??) so I think the uncounted number here is not so large. But it will always be there. On the other side, a lot of the deaths reported as due to coronavirus are practically caused by something else, like a heart attack or a blocked artery. So this is not black and white. It’s very hard. What we will do in the end, as soon as we can, is to compute the “over-morbidity”, that is, how many people died during this period of coronavirus epidemic versus how many people in normal times died during this time. A quick analysis was done on that precise question yesterday, and so far, we don’t see that there are more people who have died during these weeks as those who died during the same period last year.

Reporter again: so you’re not worried about the uncounted deaths?

Anders Tegnell: no, not especially. Of course, you can’t find every single case, but it’s important to follow the trends. I am definitely worried about the developments in retirement homes and the rising death toll there, that’s something we must help out to stop.

Question: something about how many people is each coronavirus patient infecting?

Anders Tegnell: I think it’s around 1. But what you really want to look at is the curve. Is it going up or down? That’s a better expression of the status of your epidemic compared to trying to compose a instantaneous picture that varies a lot from day to day. Looking at trends is much better to know where you are.

After the press conference was over, they went back to the Studio and talked a bit about the growing numbers of coronavirus patients from retirement homes, not in Stockholm, but from another large city — Göteborg (also known as Gothenburg). There are now 40 retirement homes there where patients have been infected. They don’t know why, because there have been visiting restrictions to the homes for a while.

Sweden coronavirus press conference, April 8

On this day, there were 1.39 million cases globally. This was almost the same amount as the day before, so they thought, maybe updated figures were stuck in some database.

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There were 8419 cases in Sweden, out of which 726 people had been reported sick under the last day. I think not all those people actually got sick the last day — there was some lag with getting new illnesses from the days before. That is why you see 3 days in a row directly preceding with fewer cases. The intake into intensive care is also still constant.

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Anders Tegnell, who is the national epidemiologist, thinks that they have now reached a plateau. They no longer have an increase in cases from week to week. (Personally, I do not see a plateau in the graph).

Then they showed data from Stockholm versus data from the rest of the country. Anders Tegnell says this shows even more clearly a plateau, at least in Stockholm. In fact, he continues, Stockholm’s curve is pretty flat, and Stockholm’s medical staff has done a great job. Also, they’ve started to look at retirement homes and the number of deaths. Preliminarily, they’ve found that in Stockholm, 40% of everyone over 70 years who died of coronavirus lived at a retirement home, while in the rest of the country, it was only 4%. This means that when it comes to Stockholm, retirement homes are way over-represented in contributing to the number of deaths. They’ll keep on analyzing these figures.

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The blue bars are Stockholm, the orange is the rest of the country.

Then Anders Tegnell had some words to say over asymptomatic people, and face masks. First, he says they don’t know how many people have coronavirus but have no symptoms, but they do know that people like that are far less symptomatic. Second, that face masks are most essential for hospital workers, and there’s no good evidence that they stop you from getting sick — only that they can help stop a sick person from getting other people sick. But in fact, a sick person should not be out and about. A sick person should stay home.

So then Anders Tegnell comes back to his common refrain, which is that stopping coronavirus means staying home if you’re sick. Also, wash your hands.

This lady spoke next about a survey they had done to see how people have changed their behaviors to reduce coronavirus risk. Over 80% say they now wash their hands more often and more carefully. About 75% have stopped shaking hands. Women are more likely to be following these recommendations than men. There’s about 10 different behaviors shown, but the text is too small to read. She talked a long bit more, and then said: good job, everyone, on changing your behaviors! We’ve done it together!

Question from a reporter: you’ve said that if you don’t have symptoms, but you actually are infected, then you are unlikely to infect someone else. So should medical workers who test positive keep working if they have no symptoms?

The reporter adds, by way of motivation for his question, that there have been quite dramatic figures coming out of the hospital in Linköping, where the doctors and nurses have been tested and a lot them without symptoms tested positive.

Anders Tegnell: First of all, no, the figures from the hospital in Linköping are not dramatic at all, this is completely expected. And also, no, absolutely not, medical workers testing positive should not keep working, that’s a big risk to take.

** Note! In previous press conferences, Anders Tegnell has many many times stated how you can’t test non-symptomatic people. In fact, see further below. But now, he forgets this when talking about the testing of asymptomatic medical workers testing positive.

Question: Other countries in Europe, like Austria and Denmark, are sending signals that they want to relax some of the restrictions. What do you see as risks there?

Anders Tegnell: There’s some studies and models that show if you open up quickly, you can get large peak, and a dramatic strain on the medical resources. So many countries are now asking, what can we do? I think there’s an agreement that we can’t do everything at once. It will be very important to see how it unfolds.

Question: Do you know anything else about what’s behind the quick spread in retirement homes in Stockholm?

Anders Tegnell: We have just started looking into this. It’s a complex question, so it’s going to take some time to figure it out. And then we can take those lessons to other parts of the country so that the situation will not be repeated there.

Question: Given the dramatic rise of coronavirus cases in Stockholm, what can be done to put the brakes on that situation?

Anders Tegnell: A lot. We can test the staff working there. Train the staff better, put better routines in place, check out who’s coming and going, make sure you can isolate people who get sick. We don’t know yet how many retirement homes have done this.

Question: But should we be testing all the staff at retirement homes?

Anders Tegnell: That’s a problem. The test is only good for when you take it. It’s not good at all if you don’t have symptoms. You can test negative now, and then you could be positive two hours later. So testing is really only important when you have symptoms.

Question — in English! — from a reporter from Reuters: Last night the US president Ugly Loser said that Sweden is suffering very greatly. I wonder if you were surprised by his assessment and if you share his opinion.

Anders Tegnell: No, as we’ve said here before, we don’t share his opinion. Of course, we’re suffering. Everyone in the world right now is suffering in different ways. But Swedish healthcare, which I guess he alludes to — it’s difficult to understand — is taking care of this in a very, very good manner. It’s a lot of work, a lot of stress on the staff, but it’s working. And the Swedish healthcare is delivering results just as good as they’ve ever done. And Swedish healthcare is one of the best in the world, and it continues to be like that.

Question: right  now, people are exercising less than usual. What’s the impact on public health?

Anders Tegnell: yes, this is not good at all. In the short term, it maybe isn’t a big deal, but we don’t want people to lose good habits. People should absolutely keep moving. And especially activities for children should go forward. We can’t just blindly steer past one set of consequences from this epidemic, but we have to pay attention to other consequences, too.

Back to the Studio, the main newscaster summarized the press conference:

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and he especially pointed out the part about women following the guidelines better than men, and that’s quite expected, he adds with a chuckle.

Then the reporter beside him at the desk summarizes the comments and questions that people are leaving on the chat. People are upset that the death rate in Sweden is so much higher than in neighboring countries, and are feeling unsafe with the lighter restrictions on movement in place.

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The main newscaster answers: Yes, this is the line the government has taken, different from neighboring governments, and it’s very hard to know … and you know, during a regular season of flu, we have about 2,500 people who die, and right now with coronavirus deaths, we’re up to … 678 deaths. But …  of course people are worried. Sure.

Absolutely, says the reporter beside him. But look at her face.

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Wow, the reporter beside him is so different from Iva Horvatovic (who holds a similar role on other days). Iva is always saying things like: bad things happening in Sweden are happening in other countries … and the recommendations from the government have been very clear. This new lady, whose name is Mikaela Somnell, has a totally different stance on things. First, when the newscaster was joking with her about it being expected that women would follow the recommendations more carefully than men, she shut him down! I didn’t add that detail above, but she did — she basically ignored him — and launched instead into the bit about people commenting that Sweden’s death rate is much worse than neighboring countries.

Then she reports other complaints: that other people have commented that all schools — not just high schools — need to be closed in Sweden.

Then they start talking about Easter vacation trips and travel. And the man just said, well, the government has recommended that people don’t really travel. And Mikaela says (completely opposite to what Iva has said) that people are asking for more clarifications about what type of travel is allowed, because the government has been so unclear about it.

Then it was time for the individual interview with a contemplative Anders Tegnell:

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Question: We’ve been talking about how during Easter, we shouldn’t travel far, and we shouldn’t visit old relatives. So how about summer? What’s the outlook for summer? Will I be able to travel to the south of Sweden and visit with my dad?

Anders Tegnell: Yes, I think so. There’s quite a bit of evidence that shows that by summer, we should have a pretty quiet situation in Sweden, so that you can travel around here. But the rest of the world will still be quite disturbed. It’s also hard to know exactly what it will be like in different regions in Sweden. But we hope for a much better summer than Easter.

The reporter again: A question about people without symptoms. I understand there’s no test that shows if you have had the virus or no. So as someone who hasn’t had symptoms, what should I do? Should I stay home or can I meet people … ?

Anders Tegnell: No, you can keep on living your life just within the restrictions we talked about today. Stay home and work from home if you can. Don’t go out and meet people if you have symptoms. If you want to travel, think about if you really need to do it now, or if it can wait. And don’t visit old people.

Then it was again back to the Studio, and the main newscaster – the man – said: yes, so that was Anders Tegnell with some positive outlook there, a little hopeful for the summer … what do you think, Mikaela? It feels a little positive at least, doesn’t it?

He turns to Mikaela; Mikaela is stuck. What can she say? So she ekes out a “ye — ee — es” … sure, in comparison to how the Easter is turning out, the bit about summer sure is positive.

But the main newscaster wants more. Mikaela’s been reading all the angry comments on the news-chat; now he demands that she read out some glad comments. Mikaela says, ehhhh …

Finally she says, yes, well, a lot of people what to thank the medical workers and express their gratitude … so yes, there’s some positive comments.

But Mikaela can’t help herself, the very next thing out of her mouth is:

And … then, people are still worried that we still see an increase in cases … but … yes, people do like this togetherness that this pandemic has created.

The main newscaster takes this and runs with it: Yes, there’s always those things that are positive during this difficult time.

Sweden coronavirus press conference, April 7, 2020

Here were the press conference people today:

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And here were the reporters:

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So what were the main points to be said today?

There are 1.32 million cases worldwide. It’s growing a lot in the US, they never fail to say.

In Sweden, there were 7693 cases total, with 490 cases over the last day. And 640 people had been or still were in the intensive care.

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Anders Tegnell, the national epidemiologist, said that it appears the number of new cases per day is going down. Does this mean they have reached the peak? Not sure, because their models hadn’t predicted that the top would come so quickly.

As for the number of fatalities, it is at 591. They showed the graph. The green bars show the filled-in numbers; sometimes there’s a lag until a death is counted as a coronavirus death.

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Then it was time for questions:

One of the reporters asked his question in sign language; the lady at the edge spoke the question out-loud while looking at his hands.

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He asked if people with hearing difficulties or other disabilities were more vulnerable than others in intensive care. The answer was no.

Question: Norway says their epidemic is under control, and they have had only 83 deaths. What’s behind that they have so many fewer deaths?

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Anders Tegnell: (clearing his throat repeatedly) First, we have to think about what it means to have it under control. It means that you don’t have a very large increase, but you still have an increase. Even though they have many restrictive measures in place. There’s two reasons for which Norway has a lower mortality rate than Sweden so far. First, because their infection is mostly among younger people than we have it in Sweden. You can see it very clearly in the age pyramids. And the other reason is that in Norway they have much less spread in retirement homes. We have this discussion with our colleagues in Norway to understand what the difference is in testing and structures, such that Norway retirement homes have been better at controlling the spread in retirement homes than in Sweden.

Questioner continued: In hindsight, do you think we should have done as they did in Norway, which was to have a restriction on visits to retirement homes?

Anders Tegnell: I don’t think that would have made a big difference. That wasn’t where the problem was, it’s more complicated. In reality, visits to retirement homes ended about the same time in Norway and in Sweden.

Question: In Norway, they say that they have gained some time in terms of cases and fatalities. Do you, Anders Tegnell, agree with that description and does it mean that they have been able to flatten their curve?

Anders Tegnell: Those are two different things, winning time and flattening your curve. You can gain time in different ways, one way is to lock everything down as they did in Norway. What that probably does is to kick your curve forward. Now their biggest problem is, how can you open the country back up without getting a very steep curve? Also, when your time comes, what will happen? Will your medical system be able to cope? Here in Sweden, our medical system has coped. It’s been hard, but we’ve done it.

Cue: self-satisfied glare.

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Question from the Norwegian reporter from the other day: I have a question for Anders Tegnell. Are there internal discussions amongst the public health authorities about whether you’ve solved this problem in the correct way?

Anders Tegnell: if we’ve solved … ? My Norwegian needs some help …

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Norwegian reporter again, enunciating carefully: are there internal discussion amongst the public health authorities as to if you’ve solved this problem the right way?

Anders Tegnell: Ah, okay. We have a continual discussion every day about whether we’re doing the right thing, and if we need to do anything differently. If you’ve done it right or wrong, is very hard to know. Different countries have done very different things. Italy took the most drastic measures, but still has a very bad situation. Other countries were more moderate. So … I think we will be analyzing this in the years to come, as to what was effective and what wasn’t. I think the most important is to have a continual analysis like we have, look at the developments, note what isn’t going properly, as we have done with the retirement homes, that there we have a spot that hasn’t worked well. So we have to look at it and see if we can understand what would help it to work better. Also when it comes to restaurants, we see it’s not going well. We pointed this out, and we’re working with provinces and municipalities so that restaurants will be better at handling their responsibilities.

Question from another Norwegian reporter: Over in Norway, we think that each person with coronavirus is infecting 0.7 other people. What is the corresponding statistic in Sweden? Higher or lower?

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Anders Tegnell: Last we looked at it, we were around 1.7 or 1.8. I don’t know where the statistics from Norway came from. The statistics we have suggest it should be somewhat higher in Norway. But I’ll have to talk to my Norwegian colleagues to see how they calculated that.

Norwegian reporter continued: You don’t believe our statistics?

Anders Tegnell: I don’t believe anything until I’ve seen the developments.