Abstract:
BACKGROUND:While the COVID-19 outbreak in China now appears suppressed, Europe and the USA have become the epicentres, both reporting many more deaths than China. Responding to the pandemic, Sweden has taken a different approach aiming to mitigate, not suppress, community transmission, by using physical distancing without lockdowns. Here we contrast the consequences of different responses to COVID-19 within Sweden, the resulting demand for care, intensive care, the death tolls and the associated direct healthcare related costs. METHODS:We used an age-stratified health-care demand extended SEIR (susceptible, exposed, infectious, recovered) compartmental model for all municipalities in Sweden, and a radiation model for describing inter-municipality mobility. The model was calibrated against data from municipalities in the Stockholm healthcare region. RESULTS:Our scenario with moderate to strong physical distancing describes well the observed health demand and deaths in Sweden up to the end of May 2020. In this scenario, the intensive care unit (ICU) demand reaches the pre-pandemic maximum capacity just above 500 beds. In the counterfactual scenario, the ICU demand is estimated to reach ∼20 times higher than the pre-pandemic ICU capacity. The different scenarios show quite different death tolls up to 1 September, ranging from 5000 to 41 000, excluding deaths potentially caused by ICU shortage. Additionally, our statistical analysis of all causes excess mortality indicates that the number of deaths attributable to COVID-19 could be increased by 40% (95% confidence interval: 0.24, 0.57). CONCLUSION:The results of this study highlight the impact of different combinations of non-pharmaceutical interventions, especially moderate physical distancing in combination with more effective isolation of infectious individuals, on reducing deaths, health demands and lowering healthcare costs. In less effective mitigation scenarios, the demand on ICU beds would rapidly exceed capacity, showing the tight interconnection between the healthcare demand and physical distancing in the society. These findings have relevance for Swedish policy and response to the COVID-19 pandemic and illustrate the importance of maintaining the level of physical distancing for a longer period beyond the study period to suppress or mitigate the impacts from the pandemic.
journal_name
Int J Epidemioljournal_title
International journal of epidemiologyauthors
Sjödin H,Johansson AF,Brännström Å,Farooq Z,Kriit HK,Wilder-Smith A,Åström C,Thunberg J,Söderquist M,Rocklöv Jdoi
10.1093/ije/dyaa121subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1443-1453issue
5eissn
0300-5771issn
1464-3685pii
5909271journal_volume
49pub_type
杂志文章abstract::The paper reports on the trends of induced abortion in Italy since its legalization in 1978. Data collected through the national surveillance system show that the abortion rates and ratios in Italy, after an initial increase, have been stable in the last four years, and are comparable to those of other European countr...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/15.3.343
更新日期:1986-09-01 00:00:00
abstract::A multidisciplinary approach to research has been one of the hallmarks of Walter Holland's outstanding career in medical research. Studies arising from evaluation of the Cancer Research Campaign's health education programme for the early detection of cutaneous malignant melanoma were reviewed at Walter's Festschrift b...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/24.supplement_1.s39
更新日期:1995-01-01 00:00:00
abstract::The extensive rubella epidemic which occurred in Israel in 1972, had a considerable impact on the population at risk: 1. The spread of rubella infection into the community strongly influenced the extent of legal abortions: (a) 1 x 5 as many abortions for all causes were recorded in the epidemic year, as compared to th...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/4.4.331
更新日期:1975-12-01 00:00:00
abstract::A case-control study has been performed for occupational risk factors of acute leukaemia, based on 185 cases more than 30 years old and 513 matched controls. There was a significant excess of polyvalent farming and electronic engineers among professions of cases, and, in addition of metal workers when considering the ...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/21.6.1063
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Violence among adolescents may have serious developmental, physical, and mental health consequences for the affected individuals. In this study, we assessed the prevalence of violent behaviour and its correlates among 15-16 year old schoolchildren in Iceland. METHODS:In 1997, a cross-sectional survey was co...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyh190
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:We conducted this combined analysis of available data from studies with information on this issue to clarify the association between Trichomonas vaginalis infection and cervical neoplasia. METHODS:We performed MEDLINE searches (1966-1993) using the key words and phrases 'trichomonas vaginitis' and 'neoplasm...
journal_title:International journal of epidemiology
pub_type: 杂志文章,meta分析
doi:10.1093/ije/23.4.682
更新日期:1994-08-01 00:00:00
abstract::Carcinogenesis, at least for some types of cancer, can be interpreted as the consequence of selection of mutated cells similar to what, in the theory of evolution, occurs at the population level. Instead of considering a population of organisms, we can refer to a population of cells belonging to multicellular organism...
journal_title:International journal of epidemiology
pub_type: 杂志文章,评审
doi:10.1093/ije/dyl185
更新日期:2006-10-01 00:00:00
abstract::Associations between drug consumption during pregnancy and the birth of children with oral clefts were studied in material from the Finnish Register of Congenital Malformations, consisting of 599 children with clefts and their matched controls. Information concerning maternal drug consumption was partly prospective. D...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/4.1.37
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:Predictions of primary liver cancer (PLC) incidence rates and case numbers are critical to understand and plan for PLC disease burden. METHODS:Data on PLC incidence rates and case numbers from 1990 to 2017 were retrieved from the Global Burden of Disease database. The estimated average percentage change (EA...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyaa196
更新日期:2020-12-08 00:00:00
abstract::Rapid changes in national rates, with little evidence of cohort effects, must substantially reflect changes in incidence rates due to socioeconomic and behavioral influences, operating with a rather short incubation period. Every newly-rich society usually experiences its epidemic of coronary heart disease. Rate chang...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:So far, no randomized controlled trials with a mean mammographic screening interval of > or = 2 years has demonstrated statistically significant mortality reduction for women younger than age 50. The issue of screening frequency is vital in detection of primary breast cancer. METHODS:The study group consist...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/29.5.803
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:The stability of mammalian serum and urine in large metabolomic investigations is essential for accurate, valid and reproducible studies. The stability of mammalian serum and urine, either processed immediately by freezing at -80 degrees C or stored at 4 degrees C for 24 h before being frozen, was compared i...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dym281
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies. METHO...
journal_title:International journal of epidemiology
pub_type: 杂志文章,meta分析,评审
doi:10.1093/ije/dyq207
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Being a zoonosis, the transmission of haemorrhagic fever with renal syndrome (HFRS) is influenced by climatic, reservoir and occupational factors. This paper has quantified the incidence and potential risk factors of HFRS in Yingshang County, a low-lying epidemic focus of the disease in China. METHODS:Corre...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/31.1.189
更新日期:2002-02-01 00:00:00
abstract::John Snow was a genius in epidemiology. His achievement was to evolve an elegant, internally and externally consistent theory which concerned the mechanisms and processes involved in every aspect of the subject he had chosen to study. In order to do this he did not restrict himself to any method. He used all skills av...
journal_title:International journal of epidemiology
pub_type: 传,历史文章,杂志文章
doi:10.1093/ije/12.4.393
更新日期:1983-12-01 00:00:00
abstract::The Ballabgarh Health and Demographic Surveillance System (HDSS), also known as the Comprehensive Rural Health Services Project (CRHSP) Ballabgarh, is located in north India and was established in 1961 to develop a model for rural health-care practice in India. In addition to demographic surveillance and community-bas...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyt055
更新日期:2013-06-01 00:00:00
abstract::Seemingly contradictory data support controversies concerning the relationships between food intake and illnesses. The present study of 1035 adults, aged 30-39 years, shows that (1) daily energy intake is not higher in obese than in non-obese people, (2) obesity is more prevalent in social groups where energy intake i...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/19.3.571
更新日期:1990-09-01 00:00:00
abstract::The 'Mendelian randomization' approach uses genotype as an instrumental variable to distinguish between causal and non-causal explanations of biomarker-disease associations. Classical methods for instrumental variable analysis are limited to linear or probit models without latent variables or missing data, rely on asy...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyp397
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Knowing the starting date of the BSE epidemic and its size at the very beginning is crucial to interpret the timing of the nvCJD cases and to forecast the nvCJD epidemic. The first cases occurred in 1985. The models devised by Anderson (back-calculation) and Dealler (age-period-cohort) led to an estimate of ...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/28.3.526
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Perinatal characteristics are associated with subsequent risk of several chronic diseases. Previous studies regarding endometriosis were based on small samples and retrospective data and were limited by unmeasured confounding bias, leading to conflicting and inconclusive findings. We investigated the associa...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyz140
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:In designing prevention strategies, it may be useful to understand how early and midlife cardiovascular disease risk factor (CVDRF) exposures affect outcomes that primarily occur in mid to late life. Few single US cohorts have followed participants from early adulthood to late life. METHODS:We pooled four p...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyy264
更新日期:2019-06-01 00:00:00
abstract::This paper argues that the perspective of economics is valuable in assessing the desirability, purpose and effectiveness of public intervention to reduce occupational accidents and diseases and suggests that the concept of efficiency provides one (although not the only) important criterion by which to judge policy in ...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/12.1.77
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:Since 1997, an unexpected 2-5-fold increase in the incidence of pertussis has been reported in Poland in comparison with the previous 10 years, although the introduction of the diphtheria-tetanus-pertussis (DTP) vaccination in 1960 reduced the incidence of pertussis approximately 100-fold in the 1980s. The a...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyh012
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:The reproducibility and validity of self-administered questionnaires on physical activity and inactivity were examined in a random (representative) sample of the Nurses' Health Study II cohort and a random sample of African-American women in that cohort. METHODS:Repeat questionnaires were administered 2 yea...
journal_title:International journal of epidemiology
pub_type: 临床试验,杂志文章
doi:10.1093/ije/23.5.991
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort. METHODS:Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 ...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dyt279
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Many European countries have in recent decades reported growing socioeconomic differentials in mortality. While these trends have usually paralleled high unemployment and increasing income disparities, Sweden had low unemployment and narrowing income differences. This study describes trends, 1961-1990, in to...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/26.4.782
更新日期:1997-08-01 00:00:00
abstract::The STEPS Study aims to search for the precursors and causes of problems in child health and well-being by using a multidisciplinary approach. The cohort consists of all mothers (Finnish or Swedish speaking) who had live deliveries in the Hospital District of Southwest Finland from January 2008 to April 2010 and their...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dys150
更新日期:2013-10-01 00:00:00
abstract::The relationship between pet ownership and respiratory allergy and symptoms was investigated in a population of 3344 Dutch children of 6-12 years old. Pet ownership was defined by the presence of cats, dogs, birds and/or rodents in the home. The reported prevalence of respiratory allergy and symptoms was lower among c...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/21.2.338
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:In this paper we investigated whether the capture-recapture method is useful for a cancer registry to monitor its completeness of case ascertainment on a routine basis. METHODS:The capture-recapture method was used to estimate the completeness of case ascertainment in three regional cancer registries in the...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/23.6.1111
更新日期:1994-12-01 00:00:00
abstract::The Themba Lethu Clinical Cohort was established in 2004 to allow large patient-level analyses from a single HIV treatment site to evaluate National Treatment Guidelines, answer questions of national and international policy relevance and to combine an economic and epidemiologic focus on HIV research. The current obje...
journal_title:International journal of epidemiology
pub_type: 杂志文章
doi:10.1093/ije/dys029
更新日期:2013-04-01 00:00:00