child mask
September 2020 was the least deadly month in Swedish history, in terms of number of deaths per 100,000 population. Ever. And I don't mean the least deadly September, I mean the least deadly month. Ever. To me, this is pretty clear evidence of two things. First, that covid is not a very deadly disease. And second, that Sweden has herd immunity.

When I posted this information on my twitter feed, the response from proponents of further lockdown was that the reason September was such an un-deadly month, was because everyone has already died earlier in the pandemic. To me, that seems like a pretty self-defeating argument. Why?

Because 6,000 people have died of covid in Sweden, a country with a population of 10,000,000 people. 6,000 people is 0,06% of the population. If it is enough for that tiny a fraction of a population to die of a pandemic for the pandemic to peter out so completely that a country can have its least deadly month ever, then the pandemic was never that deadly to begin with.

In August, I wrote an article where I proposed that the mortality for covid is only 0,12%, roughly the same as influenza. That number was based on a back-of-the-envelope calculation. I figured that, since the death rate had dropped continuously for months and was at very low levels, Sweden must have reached a point where it had herd immunity. And I figured that at least 50% of the population must have been infected for herd immunity to have been reached. 50% of Sweden's population is five million people. 6,000 / 5,000,000 = 0,12%

At the beginning of October, one of the World Health Organisation's executive directors, Mike Ryan, said that the WHO estimated that 750 million people had so far been infected with covid. At that point, one million people had died of the disease. That gives a death rate for covid of 0,13% . So the WHO said that the death rate is 0,13% . Not too far off my earlier back-of-envelope estimation. This of course begs the question why there are continued lockdowns for a disease that is no worse than the flu.

How deadly is covid-19? Not very!
A short while later, the WHO released an analysis by professor John Ioannidis, with his estimate of the covid death rate. This analysis was based on seroprevalance data, i.e. data on how many people were shown to have antibodies to covid in their bloodstream at different times in different countries, which was correlated with the number of deaths in those countries. Through this analysis, professor Ioannidis reached the conclusion that covid has an overall mortality rate of around 0,23% (in other words, one in 434 infected people die of the disease). For people under the age of seventy, the mortality rate was estimated at 0,05% (in other words, one in 2,000 infected people under the age of 70 die of the disease).

As I've discussed before, I don't think antibody data gives a very complete picture, since there are studies showing that a lot of people don't produce measurable antibodies in their bloodstreams, but still have immunity, either thanks to a T-cell response, or thanks to local antibody production in the respiratory tract. So I think that the fatality rate is significantly lower than what the analysis by professory Ioannidis found, and more in line with what the WHO stated earlier in October.

But even if the antibody based number is the correct number, then covid still is not a very deadly disease. For comparison, the 1918 flu pandemic is thought to have had an infection fatality rate of 2,5%, i.e. one in forty infected people died. So the 1918 flu was 11 times more deadly than covid if you go by professor Ioannidis antibody based numbers, and 19 times more deadly than covid if you go by the fatality rate provided 12 days earlier by the WHO's Mike Ryan.

And this is missing one big point about covid. The average person who dies from covid is over 80 years old and has multiple underlying health conditions. In other words, their life expectancy is very short. The average person who died in the 1918 pandemic was in their late 20's. So each death in the 1918 pandemic actually meant around 50 years more of life lost per person than each death in the covid pandemic. Multiply that by the fact that it had a 19 times higher death rate, and the 1918 flu was in fact 950 times more deadly than covid, in terms its capacity to shorten people's lives.

Ok, I've discussed the fatality rate of the 1918 flu pandemic, and compared that to covid. But what about the fatality rate of the common cold viruses that are constantly circulating in society? How does covid compare to them?

Many people think that the common cold viruses are harmless. But in fact, among elderly people with underlying health conditions, they are frequently deadly. A study carried out in 2017 found that, among frail elderly people, rhinovirus is actually more deadly than regular influenza. In that study, the 30 day mortality for frail elderly people admitted to hospital due to a rhinovirus infection was 10% . For frail elderly people admitted to hospital due to influenza, 30 day mortality was 7% .

What is my point? If you are old and frail, and have underlying health conditions, then even that most harmless of all infections, the so called "common cold", can be deadly. In fact, it often is. Covid-19 is not a unique disease, and does not appear to have a noticeably higher mortality rate than the so called "common cold".

There is one final aspect to all this that needs to be discussed. And that is the effect of covid on overall mortality. If it turns out that covid has no effect on overall mortality, then that really brings in to question why we are locking down, since we're not actually preventing any deaths. So, what is the effect of covid on overall mortality?

Let's look at Sweden, since that is perhaps the country that has taken the most relaxed approach of any to preventing spread, and which should therefore also reasonably be expected to have had the highest impact on its overall death rate. From January to September 2020, Sweden experienced 687 deaths per 100,000 population. The last time Sweden had a deadlier year was 2015. Personally, I don't remember any big deadly pandemic happening in 2015.

In fact, 2020 is so far one of the least deadly years in Swedish history, and is largely in line with the average for the preceding five years. To be precise, it is 2,7% higher than the average for the preceding five years, which is well within the margin of error. In 2019, mortality was 6% lower than the average, so it should be expected that 2020 would have a slightly higher mortality than average, even without covid.

What does this mean? It means that covid, a supposedly deadly viral pandemic, has not killed enough Swedes to have any noticeable impact on overall mortality.

How can this be explained, when we know that 6,000 Swedes have died of covid?

As I see it, there are two possible explanations. The first is that most people who died "of" covid actually died with covid. In other words, they had a positive covid test and were therefore characterized as covid deaths, when the actual cause of death was something else. The second is that most people who died of covid were so old, and so frail, and had so many underlying health conditions, that even without covid, they would have died by now. There are no other reasonable explanations.

I am not saying that covid is nothing, or that it doesn't exist. I am saying that it is a virus with a marginal effect on longevity. And yet, public policy in most countries has been driven by doomsday scenarios based on completely unrealistic numbers. To put it simply, we've acted like we're dealing with a global ebola outbreak, when covid is much more like the common cold.

UPDATE (26th October 2020): After SCB updated their numbers it has become clear that September 2020 was in fact the second least deadly month in Swedish history, not the least deadly month. That award goes to June 2019.

You might also enjoy reading my article about why I think Sweden has herd immunity, or enjoy watching my conversation with Ivor Cummins of Fat Emperor about covid-19.