Why Do Michigan and New York Have COVID-19 Death Rates Higher Than Sweden? Is Liberty Better Than Lockdown?

Today (April 27), there were 41 new COVID-19 deaths reported in Michigan, which puts total deaths in Michigan at 3,315.  At the same time, there were 2 new COVID-19 deaths in Sweden, which puts total deaths in Sweden at 2,194.  Since Michigan and Sweden have the same population--about 10 million people--the COVID-19 death rate is much higher in Michigan than in Sweden.  The death rate per million population is about 331 in Michigan and about 219 in Sweden.  Sweden is also doing much better than New York State, where there have been 17,671 COVID-19 deaths, for a rate of 883 per million.

Although it's too soon in the history of this pandemic to draw final conclusions, it does seem that so far Sweden's strategy of voluntary self-isolation is working better than the American strategy of state-enforced lockdowns.  The Swedish government has not imposed a mandatory shutdown of social and economic life.  Primary schools remain open, although secondary schools and universities are closed.  Bars, restaurants, and other businesses are open.  Workplaces, gyms, libraries, and shopping centers are all open.  The public health officials in Sweden have strongly recommended that people over 70 remain home and that others remain home as much as possible.  Their borders are open.  But people are urged to restrict their travel.  All of this is voluntary.  Retail shops and restaurants have seen a drop in customers, but at least they remain in business.

Compared with other European countries, the COVID-19 death rates for Sweden appear to be somewhere in the middle.  Sweden's 219 per million is much lower than France's 350, the UK's 305, Italy's 440, Spain's 496, and Belgium's 621.  Sweden's number is higher, however, than Finland's 34 and Norway's 35.  But these low numbers for Norway and Finland could be the result of undercounting--Norway counts only those COVID-19 deaths that a doctor decides to report to the country's public health authority.  Many countries don't count COVID-19 deaths outside of hospitals.

Most of the COVID-19 deaths in Sweden are in nursing care facilities for the elderly.  The average age of the dead is 81, which is close to Sweden's average life expectancy of 83.  So most of the deaths are of people who have reached the end of their normal life span.

In my previous post, I pointed out that the political leaders who have ordered mandatory lockdowns have done so without anyone having engaged in any cost-benefit analysis based on scientific evidence that would prove that lockdowns are morally justified as being more beneficial than harmful.  The epidemiologist who is largely responsible for Sweden's public health strategy--Anders Tegnell--has made the same point:  "Closedown, lockdown, closing borders--nothing has a historical scientific basis, in my view.  We have looked at a number of European Union countries to see whether they have published any analysis of the effects of these measures before they were started, and we saw almost none."

In response to a pandemic, political rulers do have the "police power" to invoke emergency powers in doing whatever is required to secure the "public good."  But then they must persuade us that they have engaged in the kind of moral cost-benefit analysis that would justify their policies as for the "public good" in being more beneficial than harmful.  It is not clear that those who have ordered lockdowns have done that.  I have seen no evidence that they considered the possibility that the Swedish herd-immunity strategy would be best.

As I have argued in a previous post, every country going through a pandemic must reach herd immunity, and the political leaders in Sweden think herd immunity is best achieved through liberty rather than lockdown.  The ultimate test will come next fall and winter.  If the Swedish strategy has been successful, there will be enough immunity to forestall a severe second wave of coronavirus infections, while other countries will have to go through a bad second wave.

A short essay by Karlson, Stern, and Klein explains the social and intellectual history of Swedish classical liberalism that supports Sweden's relatively liberal COVID regime.

Thomas Friedman in the New York Times has summarized the case for the Swedish strategy.