COVID-19—a very visible pandemic

Abstract

Johan Giesecke1Giesecke J The invisible pandemic.Lancet. 2020; 395: e98Summary Full Text Full Text PDF PubMed Scopus (48) Google Scholar referred to the COVID-19 pandemic as an invisible pandemic, estimating that 25% of the Stockholm population was infected by the end of April, 2020, of which 98–99% are unaware of being infected. On April 1, 2020, the media reported that half of the Swedish population might be infected by the end of April, 2020.2TTHalva Sveriges befolkning smittad i april.https://www.aftonbladet.se/nyheter/a/K3mzq7/halva-sveriges-befolkning-smittad-i-aprilDate: May 11, 2020Date accessed: May 11, 2020Google Scholar More conservative estimates suggested that at least one-third of the Stockholm population may be seropositive by mid-May, and later that Stockholm might reach herd immunity by mid-June.3Jones E Tegnell: ”Flockimmunitet betyder inte att faran är över”.https://www.dn.se/nyheter/sverige/tegnell-flockimmunitet-betyder-inte-att-faran-ar-over/Date: May 9, 2020Date accessed: May 10, 2020Google Scholar, 4Majlard J Ny kalkyl: Stockholm kan nå flockimmunitet i juni.https://www.svd.se/ny-berakning-stockholm-kan-na-immunitet-i-juniDate: May 9, 2020Date accessed: May 10, 2020Google Scholar With a belief that Sweden is now close to herd immunity, many respiratory symptoms are falsely assumed to be caused by COVID-19, and because of the limited availability of testing unless a patient requires hospital care, many believe they are, or have been, infected. Findings from studies in other European countries have revealed a low seroprevalence, and WHO has recommended countries not to rely on herd immunity. Although the numbers are not entirely similar, plotting results presented in the media against the reported cases per million inhabitants (with a lag of 2–4 weeks, since exact sampling dates are unknown; appendix) gives an estimate of a 3·8% seroprevalence in Sweden, which is in line with media reports.5Eriksson H Antikroppstester färdiga – klart högre tal i Stockholm.https://www.svd.se/folkhalsomyndigheten-haller-presstraff-om-viruslagetDate: May 20, 2020Date accessed: May 20, 2020Google Scholar The media reports on how close Sweden is to herd immunity might cause public underestimation of the severity of the outbreak, and a false belief that many are already immune. Thus, there is an urgent need for large-scale and continuous serological screenings, and it is time to realise that there might a long way to go until herd immunity is established in Sweden. We declare no competing interests. Download .pdf (.1 MB) Help with pdf files Supplementary appendix COVID-19—a very visible pandemicJohan Giesecke's1 many claims lead to two concepts. First, that lockdowns were bad, with the Swedish way being the best approach to the pandemic; and second, that everyone in the world would get COVID-19 in a thinly veiled argument that herd immunity was the only way that the virus would be controlled. Full-Text PDF COVID-19—a very visible pandemicWe read the Correspondence by Johan Giesecke,1 a senior consultant to the Swedish Public Health Agency, with considerable concern. Full-Text PDF COVID-19—a very visible pandemic – Author's replyLet me express thanks to the many colleagues who have provided valuable feedback. I will not address each of these responses individually, but give a collective answer. Full-Text PDF COVID-19—a very visible pandemicMany predictions have been made regarding the slowing spread of COVID-19; it is not my intention to refute the epidemiological position of Johan Giesecke in his Correspondence.1 However, I will respond as a student doctor concerned about the broader implications. Full-Text PDF The invisible pandemicMany countries (and members of their press media) have marvelled at Sweden's relaxed strategy in the face of the coronavirus disease 2019 (COVID-19) pandemic: schools and most workplaces have remained open, and police officers were not checking one's errands in the street. Severe critics have described it as Sweden sacrificing its (elderly) citizens to quickly reach herd immunity.1 The death toll has surpassed our three closest neighbours, Denmark, Norway, and Finland, but the mortality remains lower than in the UK, Spain, and Belgium. Full-Text PDF COVID-19—a very visible pandemicI read with interest the Correspondence by Johan Giesecke.1 Applauding the Swedish model, Giesecke1 posits a “relaxed strategy” or the development of a herd immunity as the way forward in dealing with the COVID-19 pandemic. He recommends that the crucial task is not to stop the spread, “which is all but futile, but to concentrate on giving the unfortunate victims optimal care”. Given the drastic adverse economic consequences of the lockdown globally, the advocacy of herd immunity as a way out appears attractive. Full-Text PDF COVID-19—a very visible pandemicThe COVID-19 pandemic is exacting a confronting and extraordinarily visible toll in lives and livelihoods globally. The last occasion where humanity fought a similar calamitous infectious disease threat was the 1918–19 influenza pandemic. There are many lessons from that pandemic that are still relevant. The first pandemic wave did not grant adequate herd immunity and was followed by one or more subsequent waves, with those waves being more deadly than the initial wave.1 Additionally, stringent public health measures flattened the epidemic curve, preserving hospital capacity and saving many lives. Full-Text PDF