The statistical evidence missing from the Swedish decision-making of COVID-19 strategy during the early period: A longitudinal observational analysis.

A controversy about the Swedish strategy of dealing with COVID-19 during the early period is how decision-making was based on evidence, which refers to data and data analysis. During the earliest period of the pandemic, the Swedish decision-making was based on subjective perspective. However, when more data became available, the decision-making stood on mathematical and descriptive analyses. The mathematical analysis aimed to model the condition for herd immunity while the descriptive analysis compared different measures without adjustment of population differences and updating pandemic situations. Due to the dubious interpretations of these analyses, a mild measure was adopted in Sweden upon the arrival of the second wave, leading to a surge of poor public health outcomes compared to the other Nordic countries (Denmark, Norway, and Finland). In this article, using data available during the first wave, we conduct longitudinal analysis to investigate the consequence of the shred of evidence in the Swedish decision-making for the first wave, where the study period is between January 2020 and August 2020. The design is longitudinal observational study. The linear regressions based on the Poisson distribution and the binomial distribution are employed for the analysis. We found that the early Swedish measure had a long-term and significant effect on general mortality and COVID-19 mortality and a certain mitigating effect on unemployment in Sweden during the first wave; here, the effect was measured by an increase of general deaths, COVID-19 deaths or unemployed persons under Swedish measure relative to the measures adopted by the other Nordic countries. These pieces of statistical evidence were not studied in the mathematical and descriptive analyses but could play an important role in the decision-making at the second wave. In conclusion, a timely longitudinal analysis should be part of the decision-making process for containing the current pandemic or a future one.