Covid-19 : Sweden – more than one in five people in Stockholm were believed to have developed antibodies to the virus

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Sweden, which has controversially taken a softer approach to the coronavirus pandemic, said Wednesday that more than one in five people in Stockholm were believed to have developed antibodies to the virus.

An ongoing study by the country’s Public Health Agency showed that 7.3 percent of a sample of randomly selected people in Stockholm – Sweden’s worst-hit region – had antibodies when they were tested in the last week of April.

“The figures reflect the situation in the epidemic earlier in April, since it takes a few weeks before the body’s immune system develops antibodies,” the health agency said in a statement.

Asked about the study during a press conference, state epidemiologist Anders Tegnell said he believed that to date “a little more than 20 percent” had probably contracted the virus in Stockholm – where over a third of Sweden’s confirmed cases have been recorded.

A total of 1,104 tests were analysed.

In other parts of the country, the number of people who tested positive for antibodies was much lower, with 4.2 percent in the far south and 3.7 percent in the region around Gothenburg.

The results also showed the spread was greater among people aged 20-64, of whom 6.7 percent had developed antibodies, compared to 2.7 percent among those aged 65 and up.

Tegnell said this was “a sign of that group actually being pretty good at keeping themselves isolated and protected.”

Meanwhile, around 4.7 percent of those aged zero to 19 had antibodies, which Tegnell said showed “what we have said all along, that this is not where we are seeing a large spread” of the virus.

Sweden has not imposed the extraordinary lockdown measures seen across Europe, but has urged people to follow hygiene and social distancing recommendations and behave responsibly.

The Swedish approach to the novel coronavirus has come under criticism both at home and abroad, particularly as the number of deaths has far exceeded those in neighbouring Nordic countries, which have all imposed more restrictive containment measures.

While it is still unclear whether exposure and development of antibodies means that a person will build up at least some immunity, in theory it should do so and thereby help reduce the spread of the virus.

On Wednesday, Sweden reported a total of 31,523 confirmed cased of the new coronavirus and 3,831 deaths.

Sweden’s strategy is aimed at pressing down the curve so the healthcare system is not overwhelmed, while allowing the rest of society to function as near normally as possible.


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Figure 1
Worldwide heat map for total COVID-19 cases by country (as of March 25, 2020).
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Figure 2
European heat map for total COVID-19 deaths by country (as of March 25th, 2020).

Italy is the first country facing serious issues and a large number of deaths due to COVID-19 in Europe, followed by Spain, France, Germany, and the United Kingdom [5]. The main issue in all affected countries is that of the health systems’ capabilities and performance. Toward this direction and based on early Italian data about the spread of the disease, all European countries have taken measures aiming at “flattening the curve” [6], meaning to spread the cases—and, consequently, the patients that need to be admitted to the intensive care unit—over a longer period of time.

Said measures mainly consist of flight restrictions, borders closing, shutting down cafes and restaurants, closing of schools, and self-isolation at first and restriction of movement afterwards, with a total lockdown being the last resort, which has unfortunately been taken in several cases, like that of Lombardy and Spain.

The United Kingdom and the Netherlands followed a different approach at first, despite the Imperial College’s Response Team’s reports led by Prof Ferguson [7-9], with many claiming that they were aiming at herd immunity, which also posed several ethical concerns. Even these two countries, however, resorted to some measures and restrictions at the end [10,11].

As Gunther Eysenbach, who first proposed the concept of infodemiology (ie, information epidemiology [12-14]), suggested during the SARS pandemic, the use of population health technologies such as the internet can assist with the detection of diseases during an early stage [15].

Given the serious impact of the novel coronavirus and toward the direction of using new methods and approaches for the nowcasting and forecasting of this pandemic, in this paper, Google Trends data are used to explore the relationship between online interest in COVID-19 and cases and deaths in severely affected European countries (ie, Italy, Spain, France, Germany, and the United Kingdom).

During these times, infodemiology metrics, especially if combined with traditional data, can be an integral part of the surveillance of the virus at the regional level.


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