by Freddie Sayers
Wednesday, 29
April 2020
Seen Elsewhere
10:27

Johan Giesecke stands firm: death rates in Sweden will go down

The Swedish professor responds to our Neil Ferguson interview
by Freddie Sayers

Swedish Professor Johan Giesecke has given a follow-up interview to the main Swedish broadsheet, Svenska Dagbladet, in which he responds to Professor Neil Ferguson’s interview on UnHerd: “I know [Ferguson] a little and he is normally quite arrogant, but I have never seen him as tense and nervous as during that interview,” he said.

Giesecke stands by his fundamentally different assessment of the threat of the Covid-19 threat:

Ferguson modified quite a few of the straightforward statements [from his report], but still seems to think that the lethality is somewhere at just under one percent, while I think it is actually much lower, perhaps as low as 0.1%.
- Johan Giesecke

He flatly rejects Professor Ferguson’s prediction that deaths in Sweden will continue to rise.

No, on the contrary, I think the number will go down — although it may tick up slightly when we get an outbreak in West Götaland or Skåne [provinces of Sweden that have so far been less badly affected].
- Johan Giesecke

Challenged on the apparent success of New Zealand in eliminating the virus completely, with a highly interventionist approach, Professor Giesecke asked whether that will really look like success in the long term:

Yes, it seems they have [suppressed the virus completely]. But what are they going to do now? To keep the country virus free, they will have to keep their borders closed. Everyone travelling in must be quarantined for 14 days before being admitted to the country, and if no good vaccine arrives, New Zealand will have to keep that quarantine for a long time. A very long time…
- Johan Giesecke

 

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Paddy Kay
Paddy Kay
2 years ago

I enjoyed both interviews and thought Freddie’s style of questioning really brought out the best in both subjects. However I did feel that Ferguson’s body language was tense and defensive, whereas Giesecke was exactly the opposite.

Martin Z
Martin Z
2 years ago
Reply to  Paddy Kay

There is plenty of evidence that the IFR is much higher than 0.1%. Ferguson mentions some of it in the interview, and has co-authored several papers detailing the evidence and methods. Accumulating evidence (e.g NY, Heinsberg, Wuhan) is completely inconsistent with at 0.1% IFR. So what is Giesecke basing it on? I have not been able to find anything he has published on the subject.

I take the opposite message than you from their behaviour – perhaps because I am a scientist, and am guessing you are not. Ferguson appears to have an appropriate level of confidence given the uncertainties in the data and models. And right or wrong (and I think he is very likely wrong), I find it very worrying how confident Giesecke appears to be because it is not possible to be so confident given our current knowledge.

Scott Allan
Scott Allan
2 years ago
Reply to  Martin Z

Isn’t Ferguson also the guy that got the mortality numbers of MERS and SARS deaths wrong by a factor of 9 as well.

Let us check the accuracy of Ferguson in the past: Ferguson’s models predicted that 65,000 people could die from swine flu. In the end, no more than 500 died.

So many experts getting is so very, very wrong. Please give us your scientific plan to get out of this lock down? Should we just all hide for 6 years under the bed?

I think the major difference with GIESECKE is that he is looking at all the deaths over 3 years. This is essentially his statement. UK, Sweden or any other country will have essentially the same number as a percentage. The difference is Sweden take all of theirs now and successfully keep the curve to a level where intensive care in hospitals are not overwhelmed, just like the UK.

However, as Ferguson admitted in his original interview he is not looking at the deaths from lack of access to elective diagnostic and treatments for all other serious illnesses like cancer. Also excluded additional injury and death due to suicide, mental illness, Alcohol and Drug addiction. One projection for those additional deaths next year in the UK is 18,000. Meanwhile the blight of the financial carnage is going to last a decade.

Surely the goal is to do the minimum total harm to all. It just stinks like another ploy to have the population driven by fear mongering into being totally dependant on big government, just like the EU.

In the end government can make recomendations and citizens should be able to self determine their application.

wattysmail
wattysmail
2 years ago
Reply to  Martin Z

pity we can’t see Ferguson’s body language when he was spectacularly inaccurate with his Foot and Mouth prediction.

saintsorsceptics
saintsorsceptics
2 years ago
Reply to  Martin Z

I agree

saintsorsceptics
saintsorsceptics
2 years ago
Reply to  Martin Z

And worth remembering flus cfr is 0.1%…it’s IFR much lower

Rich Smith
Rich Smith
2 years ago
Reply to  Paddy Kay

If one person thinks we’re in the middle of a very serious pandemic and the other person is more chilled about the whole situation, you might expect their body language to reflect that. Are you suggesting we read more into it than that?

D Alsop
D Alsop
2 years ago

Ferguson sounded rattled as well he should be, once this is all over a full inquiry needs to be made. This is just like foot and mouth all over again, hundreds of thousands of healthy cattle slaughtered on scientist say so and afterwards it turns out this didn’t need to happen. Will the inquiry find we have made a huge mistake again? This time though we have tanked the economy in the process and put thousands out of work and into poverty.

Michael McVeigh
Michael McVeigh
2 years ago

It was a heck of a coup for Freddie to get both these opposing experts to give video interviews. Ferguson was foolish to respond & his response was wooden and without crystal clear data backing up his case. We have to wait a little longer for the picture to evolve more fully, but if I had to put money on the outcome, it would go on the calmer & coherent Giesecke.

wattysmail
wattysmail
2 years ago

at the moment the UK is attributing anyone with Covid19 as a Covid19 death even if the victim gets it in the very late stages of a terminal illness.

Peter KE
Peter KE
2 years ago

Good articles. I am more convinced of the approach in Sweden. When will the work of Ferguson be published and peer reviewed?

David Isaac
David Isaac
2 years ago

I suspect what Dr Giesecke is suggesting is that the excess annual mortality that will be evident at the end of the epidemic in Sweden will be of the order of 0.1% of the number infected. This might mean an extra 5000 deaths are experienced in Sweden over a year assuming 50% of the population get infected in that period. Many of the people who are dying with this disease were going to die this year anyway. I think if you only include people under 65 then his figure will be about right.

The Australian epidemic is now quite mature with almost all cases apparently identified and very few new cases in the last 10 days. The case fatality rates here likely approximate to the infection fatality rates in an environment where medical care is optimal.

Compare the case mortality rate in each age group to the annual mortality rate of a person in that age group in Australia.

None of our 2500 cases under the age of 40 has died. (0.05%)
From 40-60 the rate is 0.2% ( 3 dead out of ~1500). 0.2%
For those 60-69 the mortality is 1% ( 11 out of ~1100). 0.8%
For those 70-79 the rate is ~4% (27 out of ~710).2.2%
For those 80-89 the rate is ~16% ( 29 of ~180). 8%

https://www.health.gov.au/sites/default/files/documents/2020/04/coronavirus-covid-19-at-a-glance-coronavirus-covid-19-at-a-glance-infographic_25.pdf

https://www.aihw.gov.au/reports/life-expectancy-deaths/grim-books/contents/general-record-of-incidence-of-mortality-grim-data

This suggests that under 70 years of age getting SARS-cov2 doubles your very small risk of dying this year, over 70 it trebles your much larger chance of dying this year.

Now decide whether Sweden’s approach is sane. I believe it is.

Frank Lodge
Frank Lodge
2 years ago

One angle these admirably balanced comparisons tend to omit is Neil Ferguson’s track record of spectacular over-estimates of the impact of previous viruses (or ‘pandemics’ as Prof. Ferguson would presumably term them, or would have at the time), such as swine flu

colin hay
colin hay
2 years ago

Still, his arguments have merit.
CDC reports that USA normally suffers 40-60k flu deaths each season. So Covid does appear to be worse, but not by apocalyptic standards.
Lockdown is widely agreed to be only a short-term measure and Giesecke’s point is what are eg NZ going to do now….they’ve won a ‘battle’, but the war remains. And lockdown has other, probably deeper, certainly broader, likely longer-term consequences on a broader % of society.

William MacDougall
William MacDougall
2 years ago

At least three commentators below have said New York is contrary evidence. But the professor didn’t say it would be 0.1% everywhere, but that it would be much lower than 1%, which New York does not contradict. And it might average 0.1% but be higher in some places, perhaps New York is one. The disease does appear to be racist, affecting Blacks and Jews more than other ethnic groups, so one would expect the New York average to be higher.

Rich Smith
Rich Smith
2 years ago

Giesecke is suggesting the IFR is as low as 0.1%.

The NY city population is 8.4 million and they have had 12,509 Coronavirus deaths. That’s already about 0.15% of the population.

Even if you assume every person in NYC has already had the virus (and it’s looking like it’s far lower than that) then he’s already wrong.

Fraser Bailey
Fraser Bailey
2 years ago
Reply to  Rich Smith

NY is very much an outlier due to population density, public transport, demographics and socio-economic conditions etc. Moreover, the statistics are almost certainly being fiddled in order to maintain the lockdown and economic suppression of productive people.

Rich Smith
Rich Smith
2 years ago
Reply to  Fraser Bailey

Population density and public transport should affect the infection rate but I don’t see how it would affect IFR.

Demographics do affect IFR. NY has an ethnic makeup that may skew that upward, but they have a young population that would skew it downward.

croftyass
croftyass
2 years ago
Reply to  Rich Smith

Giesecke is referring to “lethality”-the big problem with the mortality data is that deaths with and deaths from C-19 are conflated-so when you refer to “Coronavirus Deaths” are you saying that none of the 12,509 would hav edied otherwise?

Tripod
Tripod
2 years ago
Reply to  Rich Smith

Giesecke said “perhaps as low as 0.1%”. During his unherd interview his estimate was 0.1-0.3%, I think. The WHO’s early figure was >3%. Ferguson is sticking to his 0.9%. Time will tell who is closest. I hope voices like Giesecke are not shut down in case the truth is somewhere in between.

Andrew Baldwin
Andrew Baldwin
2 years ago
Reply to  Rich Smith

Giesecke is making policy for the Swedish population, not for NYC. New York City is one of the most polluted cities in the United States and there is evidence that pollution raises the IFR for COVID-19. Giesecke seems to be using 0.1% as a lower bound, not a point estimate for the IFR, although he clearly believes the point estimate is substantially lower than 1%. So do you think Giesecke is wrong about the number of COVID-19 deaths going forward in Sweden? Do you think it will trend up rather than down? This is really what matters in deciding whether the Swedish policy has been a success or not, is it not?

Rich Smith
Rich Smith
2 years ago
Reply to  Andrew Baldwin

Pollution does raise IFR, but not by 50%. But 0.15% is just the lower bound; the serological studies suggest the IFR will be about 5 times that if 20% of people are infected.

Why wouldn’t deaths trend upwards in Sweden? That’s explicitly their policy, isn’t it, to get a controlled wave of infections through the population?

Scott Allan
Scott Allan
2 years ago
Reply to  Rich Smith

You have to factor in for NYC that miraculously there have not been any regular deaths recorded since lockdown. No cancer deaths, no heart attacks… Would this be because Governor Cuomo is seeking Federal money per death. No can’t be true the Liberal SJW’s would never manipulate a humanitarian crisis for personal gain.

Unless it was for more ice cream for Nancy Pelosi’s freezer.
“Let them eat ICE CREAM”

Rich Smith
Rich Smith
2 years ago
Reply to  Scott Allan

If you look at the figures, you’ll see that total deaths are up by 341%. Something is causing those excess deaths. Even if you’re a conspiracy theorist and believe the stats are being massaged by a moustache-twirling evil governor you’ll have a hard time explaining that away.

https://www.ft.com/coronavi

olivps
olivps
2 years ago

I enjoyed his reply particularly regarding the future of the “victory” of NZ. Regarding USA cases these need to be carefully evaluated since they are younger than European cases and we all know that obesity particularly in males and Afro-American in USA is much higher than here and seems to be associated with more severe outcome.

Peter B
Peter B
2 years ago

Italy has been hit hard and currently the mortality per million is 453, less than half the low end of the Giesecke estimate of .1%.

r j
r j
2 years ago

Unfortunately the true mortality rate for this cannot be estimated at present. Susceptibility to death from this or any pandemic infection in time is obvioulsy non linear. Those most at risk of death in any affected community will be affected much earlier than those least at risk. Thus any estimate taken at an early stage (defined as before fully complete pandemic is concluded) will over represent its lethality by potentially a considerable margin (the denominator is wrong). The obvious contrast in the two epidemiologists demeanor reflects there very diferent backgrounds, training and experience. One is a retired ID physician advising Government and has no professional axe to grind. The other is a professional academic who has taken a gamble with his personal reputation and sought media attention to defend it. Understandably he looks a lot less comfortable answering prudent and well delivered questions. Who is right or wrong in the face of evidently appaling added deaths rates (very poorly defined in the UK), even taken into context, remains to be seen.

gbauer
gbauer
2 years ago

Go Giesecke!

kazyasuda
kazyasuda
2 years ago

According to New York Times, the anti-body testing that they did to 3000 people at grocery stores suggest that 20% of New Yorkers have been infected. If 0.15% of New Yorkers have died from Covid-19. IFR would be about 0.75% Much closer to 1% that everybody else assumes. Many people seem to think that New York would be outlier but it would not be this far. I think that 0.1% IFR is a gross under-estimation. Besides Giesecke never mentions where he got this 0.1% figure.

Rich Smith
Rich Smith
2 years ago
Reply to  kazyasuda

0.75% seems reasonably close to Ferguson’s estimate of 0.6% IFR for NY.

thomaspelham
thomaspelham
2 years ago
Reply to  kazyasuda

Depends on the sample bias assumptions; are they more or less likely to have it at a store than general population? Also important for IFR: What part of the population became infected? They discharged (as we do) elderly patients back into care homes, and got a lot of problems that way – the CFR in care homes is really high.

Pollution, crowding, obesity, BAME all seem to feed into this. The IFR in NY is probably higher than it is, say, in the countryside (indeed, this seems to be the case – the NY state IFR is lower on average I believe). The breakdown in the NYC health system would have been a serious multiplier too.

I think 0.1 is optimistic. 0.3-0.5% seems realistic. A lot of serological studies are coming in at around there.

saintsorsceptics
saintsorsceptics
2 years ago

My goodness,…the political turns very personal!

Robin Taylor
Robin Taylor
2 years ago

Several comments below refer to the relatively high rate of deaths in NYC and among people from BAME backgrounds, while another refers to the rate in Australia as being on a par with Giesecke’s assessment.

I can’t help feeling that it would be useful for hospitals to at least be testing Coronavirus patients for vitamin D deficiency so that this can be researched to establish if it has a role to play. NYC has been coming out of winter, many from BAME backgrounds have low vitamin D levels; while Australia has just had it’s summer. There are a lot of other anecdotal pointers across the world to suggest vitamin D may be a factor in mitigating aspects of the disease so why not test levels in hospital given that it is relatively cheap and easy to do.

Abir Ballan
Abir Ballan
2 years ago

Check out my article: While Sweden forges ahead, the rest of Humanity makes a sharp U-turn.
https://aromatumbleweed.blo

donovanmike82
donovanmike82
2 years ago

This guy is in total denial now. More than 0.1% of the total population of New York have already died of covid. If it the same as the flu then why is Sweden taking any measures against it at all?

Fraser Bailey
Fraser Bailey
2 years ago
Reply to  donovanmike82

NY is very much an exception. And, conveniently, the numbers of people in NY who died from the flu suddenly collapsed in recent weeks from thousands to hundreds. Essentially, deaths due to flu are being categorised as C-19 deaths so that Democrat state govts can maintain the lockdown and destroy the economy, thereby increasing their chances of taking the White House.

Meanwhile, in California, there is evidence to suggest that the C-19 death rate is 0.03%. Yes, 0.03%. And that’s even with medics being pressured to designate almost all deaths to C-19. Funnily enough, the medics who produced these figures were removed from YouTube, but not before millions had seen and shared their video.

Dave Weeden
Dave Weeden
2 years ago
Reply to  donovanmike82

But Prof Gieseche said

perhaps as low as 0.1% [my emphasis]

First, he didn’t say it would certainly be as low as 0.1%. Second, even if he had, there’s going to be some variation and 0.1% might be the mean. If the NYC population is 8.3M, and 12k have died, that’s about 0.15%.
The 12k figure does not, by itself, constitute a refutation to Giesecke’s conjecture.