THREAD
Many disagree with Sweden's strategy. Respected academics should though make claims after examining data.

@devisridhar makes inaccurate claims here. That Sweden doesn't admit pat. above 80 to ICU is wrong. Below figure shows age distribution of ICU covid-19 patients

1/n https://twitter.com/devisridhar/status/1250182592009207810

The second claim that Sweden doesn't admit patients aged 60-80 with pre-existing conditions is also wrong.

Fig. below shows ICU patients distributed according to different risk groups (e.g. chronic disease) .

It is reasonable to believe that majority of these patients are 60+

Many pat. with severe covid-19 above 80 will be living in nursing homes. Not everyone should be admitted.
Possible to treat some conditions (pneumonia with i.v. antibiotics & oxygen), provide palliative and end-of-life care of high quality in a nursing home. 3/N

Elderly in nursing homes who get covid-19 deserve case-by-case assessment of expected ICU gains against harms. Might explain why absolute no. of pat. > 80 in ICU drops in first figure. 4/N

Should be noted that in Sweden, Tegnell has admitted that enough has not be done to prevent covid-19 among the elderly in nursing homes. That is very unfortunate of course - regardless of whether they would have received ICU treatment or not 5/N

It is true that in the case ICU capacity is exceeded/demands are extraordinary, Sweden has produced principles for priority setting. The guidance (in Swedish): https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/dokument-webb/ovrigt/nationella-prioriteringar-intensivarden.pdf

6/N

First principle to increase overall ICU capacity. Guidance is explicit about not prioritising based on chronological age. Assessment of expected gain from ICU complicated (frailty, organ function). Must be determined by clinicians case-by-case. 7/N

In case of an extreme situation where need exceed ICU capacity, Sweden has had a conversation about prioritising away patients who, in an ordinary circumstance, would have benefited from ICU treatment. We all hope Sweden does not get there. 8/8

The data is collected from the Swedish ICU registry: https://www.icuregswe.org/data--resultat/covid-19-i-svensk-intensivvard/.

Updated daily with the figures I have used here.