Swedish mortality in 2020 – It’s a lot better than you might think

Sweden has been the ‘outlier’ in terms of handling the global Covid-19 pandemic as the country’s health authorities have relied on a more laissez faire approach which have relied on the common sense of the Swedish population rather than on draconian government measures such as lockdowns and mask mandates.

In that sense Sweden has been different than basically every other country in Europe and Northern America.

Consequently, Sweden has also become the benchmark case to compare other countries to.

Unfortunately from day one of this pandemic it has all been about counting the number of people who have died from or with Covid-19. The countries with the least Covid-deaths are the “winners” – at least according to the media, commentators and politicians.

I must say I have long ago come to the conclusion that it makes very little sense making such comparisons without taking what I have termed ‘health fundamentals’ into account.

We for example now well know that the elderly and the obese are much more at risk from dying of Covid-19 than the young and healthy. Therefore, it makes little sense for example to compare a country with a lot of old people like Italy or the UK with a country with a young population like Pakistan. Or an obese nation like the US with a much more fit nation like Japan.

Hence, in my view the outcome in terms of Covid-deaths is mostly explained by these health fundamentals rather than by policies, behaviour or culture. These later factors may have an impact in the very short-term (weeks or months) but over months they are much less important than health fundamentals.

But one thing is to look at Covid-deaths and compare them across countries, but what about total mortality? After all the important thing really isn’t Covid-19. The important thing is total mortality (and age-adjusted mortality).

Thinking about this got me to look at Swedish mortality over the last couple of years. In this blog post I will share my main conclusions from looking at the numbers.

I have looked at daily deaths in Sweden from 2015 and until today.

Daily deaths spiked in April-May 2020

Lets start with the clean numbers for daily deaths for each of the years since 2015.

The years from 2015-19 are different shades of grey while 2020 is is red.

The first thing we notice obviously is that starting from around mid-March 2020 daily death numbers started to rise fairly sharply. In the same periode in the previous years the ‘normal’ seasonal pattern had been a gradual decline in daily deaths.

So there is no doubt that the Covid-19 pandemic clearly is visible in the numbers. Furthermore, this period of “excess deaths” lasted until around the beginning of June.

However, what we also see if we take a closer look is that prior to the pandemic had hit in mid-March the number of deaths had actually been rather low compared the previous years and similarly from around mid-May deaths have again dropped below the average number of deaths in prior years.

This is an indication that there was a significant amount of fragile elders who had survived longer than normally would had expected.

Therefore, some of the excess deaths during the March-May period might therefore be explained by “too few” deaths during January and February compared to what we would have expected.

In fact if we look at 2019 we see that year had somewhat lower general mortality in Sweden normally – further supporting what my fellow Danish economist friends Christian Bjørnskov and Jonas Herby have called the ‘dry tinder’-effect.

In the graph below we see this fairly clearly. Looking at the last decade we see a pretty strong ‘dry tinder’-effect – if the number of deaths is high one year (eg 2012) then change in the number of deaths will likely be negative the following year (eg 2013).

Based on this simple historical relationship we should expect thee dry tinder-effect to have had around 2,300 deaths to the total number of deaths in 2020 due to the ‘low base’ in 2019.

However, even if we ignore the ‘dry tinder’-effect the mortality rate in Sweden during 2020 has been a lot less dramatic than some pundits would have you believe.

We can see that by simply looking at the total number of people who has died in Sweden so far this year.

We see that during March-May there was a considerable excess mortality so by the end of May total deaths was more than 10% above normal levels.

However, since then we have see a gradual return towards ‘normal’ and presently the total number of deaths if around 4% above normal.

In total numbers this means around 3,000 more Swedes have died in 2020 than ‘normally’, which is less than half of the number of people who has officially died with/from Covid-19.

This to me is a strong indication that the Covid-19 pandemic more than anything has moved forward deaths by weeks or months rather than by years and it is an indication that Covid-19 to a considerable extent has ‘replaced’ other ‘normal’ causes of dead among the old such the flu or

In fact if the trend from recent months continue during the next couple of months we might we the entire excess mortality for the ‘pandemic year March 2020-March 2021’ disappear.

So yes, a deadly pandemic hit Sweden in 2020, but if one steps back a bit and look at the total number of deaths for the entire year it to see the pandemic.

A way to illustrate that is to forecast how many deaths in total we will see in 2020.

I have done that by assuming that we will see the numbers of deaths in the reminder of the year as normal then we are likely to see around 94,000 deaths in total for all of 2020.

That will mostly likely make it the most deadly year over the last decade but it will none the less be fairly close to the number of deaths in 2012, 2017 and 2018. Sweden was as fairly hard hit like other European countries by influenza pandemics during these years.

Mortality is higher in Denmark than in Sweden

The number of deaths with/from Covid-19 in Sweden has been considerably higher than the other Nordic countries, but what about total mortality.

As a Dane (of Swedish descent) I of course can’t help comparing Swedish and Danish mortality.

The graph below shows the number of daily deaths in Denmark and Sweden adjusted for population size.

It is clear that Sweden was much harder hit by the pandemic in March-May than Denmark.

However, it is also clear that Swedish mortality was considerably lower both period to the pandemic and from May and onwards.

In fact if we look at the total number of deaths in Denmark and Sweden more Danes have died than Swedes adjusted for population size.

The reason for this simply is that the ‘normal’ mortality rate is higher in Denmark than in Sweden. Or said, in another way – a lot more Danes die from cancer than Swedes die from Covid-19.

Mortality has been high, but certainly not catastrophic

Every death is tragic and Sweden has certainly been hard hit by Covid-19. However, when we take a closer look at Swedish overall mortality in 2020 it is also clear that 2020 hardly is the kind of disastor that some pundits would like it into being.

Covid-19 is not “just a flu”. It is certainly more deathly for particularly the elderly. However, in terms of the impact on total Swedish mortality it has more or less been on a comparable level to the ‘bad flu-years’ 2012, 2017 and 2018.

Furthermore, while Sweden has been hard hit by Covid-19 the overall mortality rate is still lower than in neighboring Denmark, where Covid-19 hardly is visible in the mortality rate.

All data in this blog post is from the Swedish statistics office (SCB) and from Statistics Denmark.


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