More Swedes died in one month 1993 and 2000, compared to april 2020 — why?

Sweden’s mortality rate was unusually high in April. But it was not higher than in December 1993. And in terms of population, it was not higher than, for example, January 1996 or 2000. Hardly anyone remembers what happened then. But Åke Nilsson does. He was responsible for Sweden’s population statistics during the period. So what was the cause of this high mortality rate? Actually, it was a nasty flu epidemic, but it did not attract much attention.

This story was first published in Swedish – read original post.

10,458 Swedes died in April 2020, according to preliminary statistics. This is unusually high, as a total of around 90,000 Swedes die each year. But in December 1993, 11,057 Swedes died. And you have to take into account that the population then was significantly lower than in today’s Sweden. January 2000 was even worse — 110.8 inhabitants per hundred thousand died. That is higher than the Covid-19 numbers. This April, twenty years later, the figure was 101.1.

Åke Nilsson was responsible for Sweden’s population statistics in the 90s and does not remember that anyone talked about the difficult months around the turn of the millennium or in 1993 or 1996. Of course, none of these epidemics were nowhere near the numbers of the Spanish flu of 1918. During that pandemic, 17,278 Swedes died in a single month, and back then, the population was just 5.8 million, almost half of today. But during the 1980s and 1990s, influenza vaccine had not yet been introduced and the disease could therefore hit very hard during the winter months. It would mostly affect the old and fragile, but would in some cases also claim younger victims — much like now, during the Corona pandemic. Åke Nilsson recalls that funeral contractors were the first to react to the increase. But he also recalls that Annika Linde, later state epidemiologist, called him a few months after the high death toll in 1993.

– It was known to her, of course. And I think we wrote a small article for a medical magazine about the matter, but I do not know if they published it, says Åke Nilsson.

Åke Nilsson is not an expert on epidemics and is careful to point out that the Corona pandemic is not a regular seasonal flu. But he does recognize patterns in the statistics and thinks there is no perspective in the current debate.

– Let me give you an example. Every year, 90,000 people die in Sweden. If we assume 10,000 would die from of Covid-19, that doesn’t mean that a total of 100,000 people will die in Sweden this year, but rather something like 94,000. What happens is that 6,000 people die prematurely, who would have later died of other causes.

During each of the influenza epidemics of the 1980s and 1990s, approximately 3,000 people died. During Covid-19, even more people will die. In absolute terms for sure, since Sweden has a larger population, but also because the number of seniors has increased significantly. Over the last 30 years, the group that is over 70 has grown by almost half a million. And the most severely affected group — those over 90 — have more than doubled in size during the same period. According to Nilsson’s calculations, it is therefore reasonable to believe that between 5,000 and 6,000 people will die this time.

– It may be even more, but then it is probably because we misjudged the virus or failed in our ability to deal with the spread of infection, says Åke Nilsson.

He thinks it is strange that the authorities are so surprised that the elderly are affected. There have always been a lot of vacancies in the homes of the elderly after an influenza epidemic. And after such a wave follows a period where the death toll instead becomes lower than average. He thinks we should focus less on the daily death toll.

– What to look out for are changes in the remaining life expectancy of the population. Generally, it increases each ten-year period, with just over one year for women and 1.5 years for men.

In 2019, the average life expectancy in Sweden for men was 81.34 and 84.73 for women. An increase of 0.66 years and 0.48 years, respectively, compared to 2018, which was an unusually large increase.

– In 2020, the average life expectancy will not be as high as 2019, but not likely to be as low as 2018. There will be a small notch, but not a deep notch, in the curve.

Åke Nilsson also believes that Sweden’s high death rate will adjust somewhat over time. Sweden certainly has unusually accurate reporting, but even so, there is an under-reporting of deaths with Covid-19.

– Actually, it is only when all countries have compiled the statistics on deaths per month that we will be able to compare correctly. Then you can calculate the monthly mortality in connection with the epidemic, country by country, and make comparisons both between countries and with previous epidemics, says Åke Nilsson.

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