Age, gender and risk group
The biggest risk factor for dying of coronavirus, in Sweden as everywhere else, is age, and this is confirmed in data collected by Dagens Nyheter, from Statistics Sweden and the Swedish Board of Health and Welfare.
In Sweden, 72 percent of those who had died of coronavirus up until March 8th this year were 80 years old or older, according to DN’s breakdown. Of the roughly 13,000 people who have died of the virus, 16 were under the age of 30, and only 6 under the age of 19.
There also appear to be differences in risk factor linked to gender. Men under the age of 60 had a coronavirus death rate of 27.9 per 100,000, compared to just 9 per 100,000 for women the same age. For those between 60 and 69, the difference was 87.2 to 32.6, and for those between 70 and 79, it was 313 compared to 165.3.
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According to Sweden’s ICU register, of the 5,645 people who have been treated in intensive care, 81.9 percent had some sort of risk factor. Risk factors included being over 65 years old, high blood pressure, chronic pulmonary heart disease, chronic liver or kidney diseases, reduced immune protection, obesity, neuromuscular diseases, and diabetes.
Of these, the most common risk factor among intensive care patients was high blood pressure, which affected 45 percent of those treated, chronic pulmonary heart disease which affected 29.7 percent, and diabetes, which affected 26.4 percent.
As many elderly are not seen as likely to respond well to intensive care treatment, the mean age of those treated was 61.4, and the median age 63.
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Driving instructors are the profession in Sweden which have been hardest hit by coronavirus, followed by dentists, doctors, and physiotherapists, according to a new study by CAMM, the Karolinska Institute’s centre for occupational and environmental medicine.
According to the study, driving instructors are 2.7 times as likely as the average person to be treated in hospital for severe coronavirus. It’s worth noting that there were only 1,910 driving instructors among those whose data was studied, of whom just 14 were hospitalised.
“They sit together with pupils in cars for a fairly long time and both of them need to sit in the front seat,” explained Maria Albin, a professor at CAMM, of the high risk profile for the profession. “We know from earlier studies that coronavirus spreads very easily between people who are travel together in minibuses.”
Driving instruction is also a profession that it is impossible to do from home, or with an adequate social distance, and where you are forced to share the same confined space with your client.
According to the CAMM study, dentists and doctors are also at elevated risk, with dentists having a 2.11 times higher chance of being treated in hospital with Covid, doctors 2.09 times higher, and physiotherapists, naturopaths and occupational therapists a risk 2.05 times higher.
Albin said that there was a higher risk for professions that require close physical proximity to others, and also for those that deal with people who are sick.
“It is worse if you are both working close to other people and exposed to others’ sicknesses and infections than if you are only exposed to one of these factors,” she said.
She said she had been surprised that the risks for these exposed groups had remained so elevated, when a previous analysis carried out after the first wave of infection in spring had already shown that they were at a higher risk of infection.
She said this might reflect the onset of the winter season rather than employers’ failing to take action to protect their staff.
“This doesn’t necessarily mean that employers haven’t taken action to reduce the risk,” she said. “It has been the winter season, when more people are meeting indoors and when the air is dryer, which we believe has an impact on transmission.”
Nonetheless, she said, this increased transmission should push employers to take even more safety precautions in the winter months.
CAMM’s study was based on data collected by Region Stockholm to track which inhabitants tested positive for coronavirus, were admitted to hospital, or died, with the Stockholm database then linked with Statistics Sweden’s register of the individuals’ addresses, professions, birth countries, and income levels.
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The DN report found that those aged 50 to 64 living on incomes of less than 10,000 kronor a month were nearly seven times as likely to die of coronavirus in Sweden than those in the same age bracket living on incomes of more than 50,000 kronor a month.
There were 71.8 deaths per 100,000 among those earning less than 10,000 kronor a month compared to 10.9 deaths per 100,000 among those earning more than 50,000 kronor.
While it is not possible to say why this is, possible factors include lower earners being more likely to work in jobs that cannot be done from home or a correlation with living in more crowded housing, for example.
DN’s analysis also reconfirmed a disproportionate number of deaths among people born abroad, particularly in Somalia.
The death rate among 60 to 79-year-old’s born outside Sweden is 252.6 per 100,000, compared to 142.8 per 100,000 among those born inside Sweden. Among 60 to 79-year-olds born in Somalia, the death rate was 30.3 per 100,000.
The next most overrepresented birth nation was Finland, with 24.5 deaths per 100,000 within the age group reflecting the large number of Finns who came to work in Swedish factories in the 1960s.
Those born in Bosnia-Herzegovina and the former Yugoslavia, also had high death rates in this age group, at 23.4 per 100,000 and 22.3 per 100,000 respectively.
Anton Lager, a public health epidemiologist working for Region Stockholm, told DN that three-quarters of the over-representation of those born abroad could be explained by “over-crowded apartments, earlier illness, low income, profession, and age”.
“A large part of the explanation is also believed to relate to the area where the people live,” he added.