I’ve been writing this post between 4.-21. February 2022, when questionable information is rampant in Finnish public discussions: Omicron is thought to be comparable to the flu, a trend of ever-milder variants is considered an inevitable biological law, the pandemic is (again) claimed to be over, and the sentiment is that there’s nothing much we can or need do about it anyway. This post is a historical reference so we don’t forget what happened to a relatively successful Finnish pandemic management scheme between June 2021 and February 2022. I also present two future scenarios to consider, when the hopium in current media discourse turns out to be hot air again. My hope is, that individuals and communities will shift their perspective and start buffering the nation against bad outcomes, not the best-case scenarios – which do not require preparation anyway. The post does not reflect views of the behavioural science advisory group (KETTU) operating in the Finnish Prime Minister’s Office, nor those of the Citizen Shield pandemic prevention project.
Hi. We’re Finland. You may remember us from hit songs such as Don’t Stand So Close to Me, Unless We’re in the Sauna and Nokia’s Gonna Last Forever. In more recent times, we’ve been cited as one of the best countries in pandemic management: in fact, by fall 2021 had only had approximately one thousand recorded COVID-deaths. Reasons for the relative success include remote geographical location, low population density, and cultural features, including the general avoidance of close physical proximity between individuals – and perhaps less so public health prowess (in fact, we only narrowly avoided going Full Tegnell on the pandemic). Let me just quickly recount what happened to the success story in the latter half of 2021, because it’s kinda funny.
It’s June 2021, right before government officials start their holidays. I’m telling people we should make preparations for the Delta variant. The suggestion is shrugged off with humour, and in all fairness, it did look like we were going to near-zero cases again for the summer… Before a bunch of football fans returning from Russia kicked off the Delta wave. After the usual debate on whether new variants will find Finns attractive, cases started going up, and we were soon in the slow initial growth of the exponential curve. So, there I was in August 2021 when the holidays ended: anxiously awaiting for someone to state, that in order for us to keep the freedoms we had during the summer, we’re going to need to smash the curve (something akin to what various countries from Portugal to Japan later did). Instead, in early September, the government announced everyone has a great need to go back go normal, and that now is the time to do it: “It’s Time to Live!”
Our health officials agreed, because after all, Denmark had already decided, that September 2021 was the time to end precautions*. To quote our director of health security: “We are on the home stretch of the pandemic […] and due to the vaccination rate, don’t need to worry about the pandemic in Finland any more [although minor setbacks may occur]” (September 2021). Also in September, in a particularly funny episode, an epidemiologist from the Finnish equivalent of CDC, called a multidisciplinary group of local precaution-advocating scientists “a crackpots’ day care club”.
*footnote: some may forget, that this did not turn out very well for them or any other of the “we’re going to live with the virus now” countries – Denmark’s end of the pandemic was cancelled, until announced again in early 2022.
Here’s some survey data to describe the Finnish situation from a perspective of personal protective behaviours:
Figure 1: Despite the late adoption of masks, Finns rapidly increased their uptake in Fall 2020. Precautions decline during Fall 2021, under heavy mainstream media pressure to return to normal, and go up again as the situation worsens rapidly.
Major news media seemed convinced not only that the pandemic was over (again), but that they needed to perform psychological interventions to reduce the public’s risk perception – despite rising case numbers. Reporters were calling me on the phone: “You’re a social psychologist; how can we make people go back to normal?”. Chief editors of the largest newspapers made flashy statements such as “COVID is over when everyone stops being afraid”, and “[despite scientists who called for unnecessary suppression] Finland is nearing herd immunity, while Australia and New Zealand are in trouble” (aside: they weren’t, but we were).
The need to go back to normal was couched in statements about the people being tired of protective actions. This was curious, because all the while surveys indicated that people actually thought it was pretty important to continue exercising precaution, even after vaccinations:
Figure 2. Rising trend in stated need to continue precautions from mid-2021 to early 2022 – meanwhile, officials repeat the statement that people are very tired. Note: the behavioural science advisory group combined survey and interview data, concluding in a report in December, that people (mostly younger age groups) are mostly annoyed of restricting close contacts, while e.g. masks in public spaces remained highly acceptable.
In the end of November 2021, Omicron caught us in the midst of an exponentially worsening delta epidemic, and by the time of writing (February 2022), we are waiting for BA2 close to the worst situation of the pandemic’s history. Here’s a summary of what happened when the pandemic management strategy was changed in September 2021, to cater the people’s supposed need to go back to 2019 ASAP:
Figure 3. After Finland switched its pandemic management approach (less testing, never mind total case numbers, aim to go back to normal), things went somewhat awry.
What are we doing currently, to remedy the situation? Surely not repeating any past mistakes? Memorable bits of recent news: Our aim should be to open up quickly, COVID will be just like the flu by summer 2022, Vaccinations and a weakening virus are making the epidemic lose its edge. Central assumptions – I repeat, assumptions – include that everyone will get sick, the population becomes stronger with better immunity, and after some time (One year? Ten years? Hundreds / thousands of years?), we don’t need to mind the virus any longer. Seeing our new director of the Ministry of Social Affairs and Health cite the inevitability of getting ill, it just makes me wonder: What none of this is true, who has a Plan B? To a non-doctor, long term neurological and cardiovascular damage does not look like something to aim for, in order to gain short-lived immunity. Also, many public officials in Southern Finland have ignored the law which says you should not let dangerous infectious diseases run amok – does this mean they now have a mental investment in the nothing-could-nor-can-be-done narrative?
If you’re Finnish, you may be suprised that many countries around the world are way better vaccinated than us, and are doing quite a good job in pushing down Omicron with vaccines and protective public health measures. The situation reflects the WHO Director General’s statement calling for a “vaccines-plus” -strategy:
I need to be very clear: vaccines alone will not get any country out of this crisis. Countries can and must prevent the spread of Omicron with measures that work today. It’s not vaccines instead of masks, it’s not vaccines instead of distancing, it’s not vaccines instead of ventilation or hand hygiene. Do it all. Do it consistently. Do it well.
– Director General of the WHO, Tedros Adhanom Ghebreyesus, as quoted in Covid-19: An urgent call for global “vaccines-plus” action
I end with two long-term scenarios, just to record what I considered the most important at the time of writing:
An optimistic scenario. There’s some critical threshold of disability caused by the pandemic, as well as global supply chain malfunctions from the ever-increasing pace of immunity evading variants. Upon crossing this threshold, health officials, the business sector and/or government representatives understand, that the only way out is to go for the exit – i.e. an elimination strategy. It can be done, but not if you insist traditional epidemiological models are the reality, instead of just ways to simplify some part of it. There’s a paper coming out, which outlines how elimination can be achieved with mass testing; will add link when it’s out. [Note that it is clearly disinformation to state, that talking about elimination means advocating for an eternal lockdown.] Depending on your belief structure, the elimination strategy may seem far-fetched right now, but nonlinear impacts of not doing it can accumulate fast, if and when the pandemic continues its course instead of going away.
A pessimistic scenario. Finnish Health officials await for a scientific consensus, which keeps proceeding at the pace of Planck’s principle (i.e. every step forward requires the funeral of an influential person keen on retaining the status quo). People “Swedify” and grow complacent, quick to normalise every new turn to the worse. We go back to accepting mortality rates of the pre-antibiotic era, until a new type of vaccine is created, which handles all potential variants. The vaccine is refused by some 5% of the population, from which forms the basis of a polarised societal system. In this system, the official services which refuse the unvaccinated, are replaced by underground / black market equivalents catering to their needs. The default option for countering the next pandemic becomes wait for the vaccine because we learned that anything else is ridiculous and a conspiracy theory. Then, while twiddling our thumbs, the next pandemic kills a billion people, which due to global interconnectedness, permanently changes the lives of several generations.
Tell me I’m wrong.
[with thanks to Kaisa Saurio for helpful comments]