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How Denmark and Austria saw differing reactions to vaccine deal with Israel

Austria and Denmark’s leaders were in Jerusalem on Thursday to present an agreement with Israel for the development and production of future generation coronavirus vaccines. We look at the responses in Vienna and Copenhagen.

Published: 5 March 2021 17:47 CET

How Denmark and Austria saw differing reactions to vaccine deal with Israel

The Austrian and Danish government leaders with Prime Minister Benjamin Netanyahu during their visit to Israel to complete a Covid-19 vaccine deal. Photo: Avigail Uzi/AFP/Ritzau Scanpix

The three countries will launch “a research and development fund” and begin “joint efforts for common production of future vaccines”, Israeli Prime Minister Benjamin Netanyahu said at the Jerusalem news conference alongside his Danish counterpart Mette Frederiksen and Austrian Chancellor Sebastian Kurz.

Denmark and Austria are both EU members, and the Israeli partnership has been notable for being an apparent break with relying solely on the European Union for securing vaccines.

Kurz, the Conservative Austrian chancellor, had announced the alliance on Monday, saying the European Medicines Agency (EMA) was “too slow in approving vaccines”, leaving the bloc vulnerable to supply bottlenecks at pharmaceutical companies.

Frederiksen, who leads Denmark’s Social Democratic minority government, has been less forthright in citing EU shortcomings as a motive for the deal, but did say that Denmark must “make sure that we have enough vaccines in a year’s time, and in two, three, five and ten years”.

Despite critiquing the bloc’s vaccination approval process, Kurz sought to quell concerns about the Israel trip, telling Austrian media on Friday that the project “was not directed against the EU”.

Kurz lavished praise on the Israeli leader, saying Austria was simply trying to take advantage of Israel’s experience in “defeating the virus”.

“The world admires you because of the vaccination successes. You were the first country to decide to defeat the virus,” he told Netanyahu.

“Together we must now prepare for how things will continue after the summer, after the current vaccination program.”

Kurz said other EU countries were welcome to join the framework, with Czech Prime Minster Andrej Babiš set to arrive in Israel soon.

Kurz’s efforts to speed up Austria’s lagging vaccination process have been largely praised, although he faced criticism for his comments on the EU.

EU Internal Market Commissioner Thierry Breton welcomed the alliance.

“I’m absolutely not afraid that this is directed against anyone – it’s just about improving global cooperation,” Breton told Politico.

European MP Peter Liese, from the centre-right European People’s Party of which Kurz is also a member, said Kurz had the chance last Autumn to play a key role in the EU’s vaccination approval – a process the Austrian chancellor has now criticised.

“I’m pretty upset with my EPP friend Kurz,” Liese told German magazine Welt.

“It is not fair to criticise the EU now. Austria took a leading role in the (development of the EU vaccine steering group)”.

Sonja Hammerschmid, from the centre-left Social Democrats, criticised Kurz’s “staging tour” as a PR exercise, saying much more money than the planned €50 million needed to be pledged if the programme was to make a difference.

“While in Austria the failures of professional crisis management are visible to everyone, the Chancellor flew abroad and went on a production tour” she said.

“If you don’t add at least a zero to it (the figure), you can’t take the sum seriously for a second in the area of pharmaceutical production and clinical research.”

In Denmark, Frederiksen will have to fend off criticism from both the left and right for her decision to join the partnership, as well as for the visit to Israel itself.

Frederiksen’s government, ostensibly centre-left, is propped up by smaller left-wing parties but regularly works with the right wing to pass legislation, primarily on immigration. Much of the government’s response to the Covid-19 pandemic, particularly in its early stages, has also received broad parliamentary backing.

The leader of the opposition, centre-right Liberal party, Jakob Ellemann-Jensen, called the deal with Israel and Austria “inconcrete”.

Ellemann-Jensen also criticised Frederiksen for prioritising a trip to Israel over domestic talks related to the gradual lifting of Denmark’s Covid-19 restrictions and said the meeting with Kurz and Netanyahu could have taken place digitally.

“We have something urgent going on at home. The prime minister has chosen to turn her back to it. That’s something I have little understanding for,” he told the national broadcaster DR.

The sentiment was echoed by the centre-left Social Liberal party, whose foreign policy spokesperson Martin Lidegaard said he “couldn’t comprehend” the need to travel to Israel in person.

“She could have achieved the same things with a virtual meeting without getting herself mixed up in the Israeli election campaign, without sending a negative signal to the rest of Europe and without delaying negotiations about reopening Denmark,” Lidegaard said.

Another ally, the left-wing Red Green Alliance, said it was “deeply astonished” by “what the prime minister is running around and doing in Israel. This is not something she has agreed with parliamentary parties,” parliamentary group leader Peder Hvelplund said to DR.

A common criticism of Frederiksen’s government during the pandemic has been that it has sometimes failed to offer enough transparency over its decision-making process.

Hvelplund additionally called Israel a “controversial choice of partner”.

“This is a country which is not ensuring vaccination of parts of the population in the occupied areas which Israel has occupied in the West Bank and Gaza,” he argued.

“At the same time, an agreement was also made (by Israel) with Pfizer in which health data of the public is systematically delivered to Pfizer as a condition for being able to vaccinate,” he said.

For Frederiksen, the imagery of her proactively trying to boost Denmark’s vaccination programme — by teaming up with a country known for the rapidity of its own roll-out — may outweigh all of those criticisms.

She defended the trip during the Jerusalem press conference and called the deal “completely necessary” for Denmark.

As at Friday, March 5th, 6.5 percent of adults in Austria have received one vaccination dose – with 3.1 percent receiving both doses. In Denmark, those figures are 8.5 and 3.3 percent respectively.

Austria and Denmark on Friday both followed France and Germany in recommending the AstraZeneca vaccine for over 65s, reversing a previous decision not to approve the jab for seniors.

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FACT CHECK: Did Sweden have lower pandemic mortality than Denmark and Norway?

At one point in May 2020, Sweden had the highest Covid-19 death rate in the world, spurring newspapers like the New York Times and Time Magazine to present the country as a cautionary tale, a warning of how much more Covid-19 could ravage populations if strict enough measures were not applied.

“Per million people, Sweden has suffered 40 percent more deaths than the United States, 12 times more than Norway, seven times more than Finland and six times more than Denmark,” the New York Times reported in July 2020.

An article in Time in October 2020 declared Sweden’s Covid response “a disaster”, citing figures from Johns Hopkins University ranking Sweden’s per capita death rate as the 12th highest in the world.

So there was undisguised glee among lockdown sceptics when Svenska Dagbladet published its data last week showing that in the pandemic years 2020, 2021 and 2022 Sweden’s excess mortality was the lowest, not only in the European Union, but of all the Nordic countries, beating even global Covid-19 success stories, such as Norway, Denmark and Finland.

Versions of the graph or links to the story were tweeted out by international anti-lockdown figures such as Bjørn Lomborg, a Danish sceptic of climate action, and Fraser Nelson, editor of Britain’s Spectator Magazine, while in Sweden columnists like Dagens Nyheter’s Alex Schulman and Svenska Dagbladet’s opinion editor Peter Wennblad showed that Anders Tegnell, the state epidemiologist who led Sweden’s strategy had been “right all along”.

Excess mortality — the number of people who die in a year compared to the number expected to die based on previous years — is seen by some statisticians as a better measure for comparing countries’ Covid-19 responses, as it is less vulnerable to differences in how Covid-19 deaths are reported.

But are these figures legitimate, where do they come from, and do they show what they purport to show?

Here are the numbers used by SvD in its chart:

Where do the numbers come from?

Örjan Hemström, a statistician specialising in births and deaths at Sweden’s state statistics agency Statistics Sweden (SCB), put together the figures at the request of Svenska Dagbladet.

He told The Local that the numbers published in the newspaper came from him and had not been doctored in any way by the journalists.

He did, however, point out that he had produced an alternative set of figures for the Nordic countries, which the newspaper chose not to use, in which Sweden had exactly the same excess mortality as Denmark and Norway.

“I think they also could have published the computation I did for the Nordic countries of what was expected from the population predictions,” he said of the way SvD had used his numbers. “It takes into consideration trends in mortality by age and sex. The excess deaths were more similar for Denmark, Sweden, and Norway. Almost the same.”

Here are Hemström’s alternative numbers:

Another issue with the analysis is that the SvD graph compares deaths in the pandemic years to deaths over just three years, a mean of 2017-2019, and does not properly take into account Sweden’s longstanding declining mortality trend, or the gently rising mortality trend in some other countries where mortality is creeping upwards due to an ageing population, such as Finland.

“It’s very difficult to compare countries and the longer the pandemic goes on for the harder it is, because you need a proper baseline, and that baseline depends on what happened before,” Karin Modig, an epidemiologist at Sweden’s Karolinska Institute whose research focuses on ageing populations, told The Local.

“As soon as you compare between countries, it’s more difficult because countries have different trends of mortality, they have different age structures, and in the pandemic they might have had different seasonal variations.”

She described analyses such as Hemström’s as “quite crude”.

In an interview with SvD to accompany the graph, Tegnell also pushed back against giving the numbers too much weight.

“Mortality doesn’t tell the whole story about what effect a pandemic has had on different countries,” he said. “The excess mortality measure has its weaknesses and depends a lot on the demographic structures of countries, but anyway, when it comes to that measure, it looks like Sweden managed to do quite well.”

Do the numbers match those provided by other international experts and media?

Sweden’s excess mortality over the three years of the pandemic is certainly below average worldwide, but it is only in the SvD/SCB figures that it beats Norway and Denmark.

A ranking of excess mortality put together by Our World in Data for the same period as the SvD/SCB table estimates Sweden’s excess mortality between the start of 2020 and the end of 2022 at 5.62 percent, considerably more than the 4.4 percent SvD claims and above that of Norway on 5.08 percent and Denmark on 2.52 percent.

The Economist newspaper also put together an estimate, using their own method based on projected deaths.

Our World in Data uses the estimate produced by Ariel Karlinsky and Dmitry Kobak, who manage the World Mortality Dataset (WMD). To produce the estimate, they fit a regression model for each region using historical deaths data from 2015–2019, so a time period of five years rather than the three used by SCB.

What’s clear, is that, whatever method you use, Sweden is, along with the other Nordic countries, among the countries with the lowest excess mortality over the pandemic.

“Most methods seem to put Sweden and the other Nordic countries among the countries in Europe with the lowest cumulative excess deaths for 2020-2022,” said Preben Aavitsland, the Director for Surveillance and the Norwegian Institute of Public Health.

So if Sweden had similar excess mortality as the other Nordics over the period, does that mean it had a similar Covid-19 death rate?

Not at all. Sweden’s per capita death rate from Covid-19 over the period covered by the SvD/SCB figures, at 2,249 per million people, is more than double Norway’s 959 per million, 60 percent more than the 1,409 per million who died in Denmark, and more than 50 percent more than the 1,612 per million who died in Finland.

While Sweden’s death rate is still far ahead of those of its Nordic neighbours, it is now much closer to theirs than it was at the end of 2020.

“The most striking difference between Sweden and the other Nordic countries is that only Sweden had large excess mortality in 2020 and the winter of 2020-21,” Aavitsland explained. “In 2022, the field levelled out as the other countries also had excess mortality when most of the population was infected by the omicron variant after all measures had been lifted.”

So why, if the Covid-19 death rates are still so different, are the excess mortality rates so similar?

This largely reflects the fact that many of those who died in Sweden in the first year of the pandemic were elderly people in care homes who would have died anyway by the end of 2022.

About 90 percent of Covid-19 deaths were in people above 70, Aavitsland pointed out, adding that this is the same age group where you find around 80 percent of all deaths, regardless of cause, in a Scandinavian country.

“My interpretation is that in the first year of the pandemic, say March 2020 – February 2021, Sweden had several thousand excess deaths among the elderly, including nursing home residents,” he said. “Most of this was caused by Covid-19. In the other [Nordic] countries, more people like these survived, but they died in 2022. The other countries managed to delay some deaths, but now, three years after, we end up at around the same place.”

So does that mean Sweden’s state epidemiologist Anders Tegnell was right all along?

It depends on how you view the shortened lives of the close to ten thousand elderly people who caught Covid-19 and died in Sweden in the first wave because Sweden did not follow the example of Denmark, Norway, and Finland and bring in a short three-week lockdown in March and April 2020.

Tegnell himself probably said it best in the SvD interview.

“You’ve got to remember that a lot of people died in the pandemic, which is of course terrible in many ways, not least for their many loved ones who were affected, so you need to be a bit humble when presented with these kinds of figures.”

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