In early March of 2023, the American dialogue surrounding the U.S.'s COVID-19 response veered into choppy waters, the issue at the helm: America "did too much." Opinion and science writer David Wallace-Wells, a best-selling essayist, reports that Sweden's contrarian and deliberately nonregulatory approach may have broached a new type of disease mitigation. Many on the American right view Sweden's libertarian response to be enlightened. However, did Sweden's pandemic public health policy allow them to "win" this global catastrophe, or do regulations and mandates tip the scales for the better?
Some Americans think that, like Sweden, the U.S. should have let things play out without mandates, stay-at-home orders, or social distancing. In response, Wallace-Wells emphasizes that the millions who died are not an afterthought. Their deaths are the result of U.S. public health policy. Yet, the question remains: what was the best way to respond to the pandemic? China is one extreme, reporting zero cases in Shanghai. Sweden was the other, allowing daily life to continue as it calculatedly remained open, attempting to reach herd immunity as fast as possible and limit the death toll. However, no country thus far has achieved herd immunity, whether on lockdown or completely open.
Additionally, Wallace-Wells emphasizes that it is essential to understand that Sweden's libertarian answer to the pandemic's problems did not result in anything exceptional. Its data displays that the Swedish pandemic was average compared to its neighbors. Statistics Sweden's analysis of excess mortality rates claims the Swedish death toll was less per capita than all the other E.U. members. However, the data did not account for recent demographic trend lines and factors. More reliable and valid results from the W.H.O., The Economist, and Our World in Data display a different effect. The Economist states Sweden ranked 109th in excess mortality, while its neighbors like Denmark, Norway, and Iceland were 65th, 85th, and 53rd, respectively. Finland faired worse, ranking 145th, as did much of Europe. The U.S. was considerably lower ranked than all of these nations. Sweden's response did not result in extreme death rates nor the savior of thousands more people.
In the wake of these findings, Wallace-Wells speculates that social behavior and disease are more effective predictors of infection rates and death tolls than public policy and mandates. So, how did this play out? How did different nations abide by public health policy? George Thiruvathukal, a professor of computer science at Loyola University Chicago in cooperation with colleagues at Purdue, in the article "Observing Human Mobility Internationally During COVID-19," examines just that. The CAM2 Project at Purdue investigates visual data from cameras in the public domain to observe human mobility during the pandemic. The data gathered from the 67,000-camera network, as Thiruvathukal explains, can quantify the public's response to lockdown policy.
First things first, data must be collected. Cameras within the network are public cameras with footage readily available online from national parks or ski lodges. Data is collected from this footage once the analysts identify cameras in the public domain and their location is confirmed. The program Pedestron counts people in an image, and YOLOv3 counts vehicles. However, assessing whether groups are social distancing on low-resolution cameras can be challenging through this system. Instead, the analysis mainly focused on measuring mobility in general rather than assessing if they were standing a certain number of feet apart. Mobility was also examined through traffic patterns, which shifted dramatically during the pandemic. Data was tracked by counting the amount of pedestrians and vehicles in public spaces from April 2020 to March 2021.
Data is collected from five European countries (Austria, France, Germany, Australia, and Italy) and three U.S. states (Georgia, Hawaii, and Oregon) due to their specific public health policies. Mobility data was then compared to public health policy in the form of a leniency curve. The data shows that countries that were more restrictive and had more people follow policy had more of a correlation between observed mobility and leniency. In contrast, regions with less stringent policies where people did not stay at home had flatter curves, less correlation, and more selective lockdown policies that were shorter. The data found that in European countries with extensive lockdowns, people adhered to the stay-at-home order, and as restrictions lifted, slowly, life became more social again. Therefore, mobility tracked over time changed dramatically. In countries like Australia and in states like Hawaii, they merely placed a travel restriction on visitors coming to their regions. Due to policy being more lenient and mobility less restrictive, people went about their daily lives. No significant shift was observed.
Human mobility was not clear-cut during the pandemic. Even from state to state in America, public health policy was distinct, and people engaged in different levels of social and public behavior. However, did social distancing and staying at home have an effect on the course of the disease? Would these nations have fared better if they all acted like the European countries with more stringent policies who ranked much higher than the U.S. on the Economist's excess mortality list? In an article assessing 25 studies about COVID-19 prevention from the Archives of Public Health, social distancing, stay-at-home orders, travel restrictions, and lockdowns all contributed to preventing the spread of COVID-19. Girum et al. stated that these measures reduced the median number of those infected by COVID-19 by 92%. Like those implemented in Australia and Hawaii, travel restrictions and lockdowns averted 70.5% of exported cases in China. Stay-at-home orders significantly decreased morbidity and fatality by 48.6% and 59.8%, respectively. They can be considerably effective if these strategies are implemented early enough and on a sizeable enough scale for enough time. Why, then, does it seem like Sweden got the results without doing the work? Wallace-Wells found that although Sweden did not have statewide mandates, they were given guidance and directives about social distancing and encouraged people to make responsible choices at the individual level rather than statewide. Swedes, especially during the first year, were more mobile, and their death rates were much higher than that of their neighbors who had stay-at-home mandates. Sweden did not "win" the pandemic, but it did find a way to encourage disease mitigation in a non-coercive way. We only knew which approach was most effective because of this mobility data. Big Data is essential for our knowledge about the world. Hopefully, we can continue to research it to formulate a more effective response to future global pandemics should they occur again.
References:
Girum, T., Lentiro, K., Geremew, M., Migora, B., Shewamare, S., & Shimbre, M. S. (2021). Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: a systematic review. Archives of Public Health, 79(1). https://doi.org/10.1186/s13690-021-00663-8
Parlapiano, A., Badger, E., Miller, C C., & Sanger-Katz, M. (2022, December 31). Readers sent us pandemic photos in 2020. Here is how their lives look now—the New York Times. https://www.nytimes.c m/interactive/2022/12/31/upshot/pandemic photos-then-and-now.html?searchResultPosition=14
Wallace-Wells, D. (2023, March 31). Opinion | How Did No-Mandate Sweden End Up With Such an Average Pandemic? The New York Times. https://www.nytimes.c m/2023/03/30/opinion/sweden-pandemic-coronavirus.html?searchResultPositio =4
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