Browncast episode 101: The “Swedish model” of Covid-19 response

By Razib Khan 10 Comments

Another BP Podcast is up. You can listen on LibsynAppleSpotify,  and Stitcher (and a variety of other platforms). Probably the easiest way to keep up with the podcast since we don’t have a regular schedule is to subscribe to one of the links above!

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In this episode, I talk to Yeyo, a Peruvian-based-in-Sweden. We discuss the Nordic nation’s response to coronavirus, and Yeyo’s own change in views.

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10 Replies to “Browncast episode 101: The “Swedish model” of Covid-19 response”

  1. Interesting mention of Somali people in Sweden getting impacted with disproportionately seriously. Same thing with black people in NYC.

    Vitamin D has been linked to more severe covid-19 outcomes.

    Been telling all the brown and black family and friends who live in high latitudes to supplement with vitamin d and/or go out in the sun more (ideally both).

    Most darker skinned people at these latitudes suffer from Vitamin D deficiency.

  2. the prevailing theory is more hypercoaguability among SSA compared to whites and whites compared to asians. That’s how covid kills fast and messes with one hard. Blood clots. SSA people are more genetically predisposed to clotting disorders. I think that is main thing.

    Btw, Italians have stuff like higher factor V leiden compared to say Chinese. Was theory for more death there

    COVID 19 down regulates ACE2. Normally this produces stuff that has opposite effect of vaso consteictor angiotensin. So you get more vasoconstriction. And add in cytokine stork and upreg of acute phase reactants like fibrinogen. and bam, more blood clots.

    Vitamin D is likely ancillary. But always good to supplement what is low. Swedish btw have a lot of factor V leiden (predisposes to more clots). It means a protein they have (protein C) is resistant. The end result is less down reg or factor V (a clotting promotion factor).

    1. Good to know. I understood about 40% of that, but seems Vitamin D not as bit a deal as I thought then.

      1. i wrote it in a mumbo jumbo way, full of technicalities. I should have distilled what was important,.

        Her are the take aways.

        1. The major hypothesized racial differential factor for COVID-19 morbidity and mortality is genetic propensity for clot formation. Blood clots stop blood from flowing to vital organs. The organs don’t get enough nutrients, most critically oxygen. Oxygen is necessary for cells to make energy. The cells in these organs don’t have energy and become dysfunctional and die. When this happens in organs like the lung, heart, and brain, the chance of quick death is there. The order for that is SSA people> Whites> E Asians.

        The trends, when attempting to control for confounders (this is kind of rough because groups like African Americans are poorer and thus have worse access to care and also have worse lifestyle habits, both of which contribute to more comorbidities), all showcase this.

        2. Certain genetic variants are known contributors to clotting. What they are isn’t so important. Just for info purpose: the most common one in the United States is Factor V Leiden. Others include homocystnuria, protein C deficiency, protein S deficiency, anti thrombin III deficiency, and a host of a whole bunch of others. Diseases like Lupus, also more common in Blacks, also promote more blood clotting.

        3. Other things that promote clotting are drugs (birth control pills are a common example), smoking, pregnancy, being stationary in one place and not moving around, cancer, and states where your blood vessels are damaged over time (eg. long standing hypertension and diabetes)

        4. Vitamin D is important. It is good to replace. Many are deficient. It allows for the gut to absorb calcium and kidneys to not reabsorb it, such that too much is not lost in the urine. When it is low, the body leaches calcium from the bones, and the bones become weaker. That is primarily its role. There are other roles, such as immune function as well. But these are more ancillary.

        Regarding, it’s relationships to clots. I know one big study came out showing low levels DID NOT correlate to great incidence of heart attacks (primarily caused by a blot clot on top of an atherosclerotic plaque [cholesterol deposition in arteries over the years and an immune reaction and smooth muscle growth over that collection which narrows the space of the artery]).

        Wikipedia says “People who take vitamin D supplements before being admitted for intensive care are less likely to die than those who do not take vitamin D supplements.” They cite

        https://pubmed.ncbi.nlm.nih.gov/24414552/

        This article does not support that strong conclusion. So the authors need to edit. Nonetheless, vitamin D is cheap and easy to supplement. It is low hanging fruit. Most darker pigmented people in the West are deficient and even many office type workers in sunnier places. So it is good to supplement.

        5. If anything, zinc might be the most important vitamin to have enough of. There are some studies showing zinc has had benefits for ailments like the common cold, specifically the rhinovirus via stopping its multiplication. But these are controversial. Nonetheless, it is the one vitamin proven, in some cases, show some efficacy for reducing the duration for the common cold. Granted, don’t go nuts. Too much zinc has its own problems.

  3. sorry for random typos in there some “or” should be “ofs” and “stork” should be “storm”

    lol hard to type on phone, even after all these years texting

  4. i wrote it in a mumbo jumbo way, full of technicalities. I should have distilled what was important,.

    Her are the take aways.

    1. The major hypothesized racial differential factor for COVID-19 morbidity and mortality is genetic propensity for clot formation. Blood clots stop blood from flowing to vital organs. The organs don’t get enough nutrients, most critically oxygen. Oxygen is necessary for cells to make energy. The cells in these organs don’t have energy and become dysfunctional and die. When this happens in organs like the lung, heart, and brain, the chance of quick death is there. The order for that is SSA people> Whites> E Asians.

    The trends, when attempting to control for confounders (this is kind of rough because groups like African Americans are poorer and thus have worse access to care and also have worse lifestyle habits, both of which contribute to more comorbidities), all showcase this.

    2. Certain genetic variants are known contributors to clotting. What they are isn’t so important. Just for info purpose: the most common one in the United States is Factor V Leiden. Others include homocystnuria, protein C deficiency, protein S deficiency, anti thrombin III deficiency, and a host of a whole bunch of others. Diseases like Lupus, also more common in Blacks, also promote more blood clotting.

    3. Other things that promote clotting are drugs (birth control pills are a common example), smoking, pregnancy, being stationary in one place and not moving around, cancer, and states where your blood vessels are damaged over time (eg. long standing hypertension and diabetes)

    4. Vitamin D is important. It is good to replace. Many are deficient. It allows for the gut to absorb calcium and kidneys to not reabsorb it, such that too much is not lost in the urine. When it is low, the body leaches calcium from the bones, and the bones become weaker. That is primarily its role. There are other roles, such as immune function as well. But these are more ancillary.

    Regarding, it’s relationships to clots. I know one big study came out showing low levels DID NOT correlate to great incidence of heart attacks (primarily caused by a blot clot on top of an atherosclerotic plaque [cholesterol deposition in arteries over the years and an immune reaction and smooth muscle growth over that collection which narrows the space of the artery]).

    Wikipedia says “People who take vitamin D supplements before being admitted for intensive care are less likely to die than those who do not take vitamin D supplements.” They cite

    This article does not support that strong conclusion. So the authors need to edit. Nonetheless, vitamin D is cheap and easy to supplement. It is low hanging fruit. Most darker pigmented people in the West are deficient and even many office type workers in sunnier places. So it is good to supplement.

    5. If anything, zinc might be the most important vitamin to have enough of. There are some studies showing zinc has had benefits for ailments like the common cold, specifically the rhinovirus via stopping its multiplication. But these are controversial. Nonetheless, it is the one vitamin proven, in some cases, show some efficacy for reducing the duration for the common cold. Granted, don’t go nuts. Too much zinc has its own problems.

  5. However, the result of these liberal measures, which were reduced to the recommendation to the citizens “keep a social distance and take responsibility for your actions”, showed a dangerous shortcoming. Sweden today has 358 deaths per million inhabitants, compared to 267 in the United States, where the epidemic is also not subsiding. When you look at other Nordic countries, which have applied strict quarantine measures, it is noticeable that the Swedish model failed the test: Denmark has 93 deaths per million inhabitants, Finland 53, and Norway 44.

    Frightened by the consequences of the recommendations of the chief state epidemiologist Anders Tegnel, who was against quarantine measures, 22 scientists and doctors made an appeal on April 14: “The approach in the fight against the epidemic must change radically and quickly. As the virus spreads, we need to increase social distance. Politicians have to intervene, because we have no alternative. ”

    <<<<<<<<<<<<<<<<<<<<<<<<<<<
    Belorussia is the only country which has not introduced any measure against Covid. People moved freely, the soccer championship was not interrupted, the President and his family mingled among the people and attended the crowded Easter church service.

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