Sweden’s Covid-19 strategy caused an ‘amplification of the epidemic’

Sweden is famously one of the few countries to have opted against a lockdown to contain the spread of the coronavirus. But given that the country has a much higher death toll per million than its Nordic neighbors, many observers have suggested that the Swedish approach has failed.

While countries across the world have eased Covid-19lockdowns over recent weeks, Sweden stands out: it never imposed confinement measures to begin with. As billions hunkered down throughout the globe in late March, Swedish bars, restaurants, hairdressers, gyms and even primary and middle schools stayed open.

There have been some exceptions. Secondary schools and museums have been closed, sport fixtures cancelled and gatherings of more than 50 people banned. Swedes have been asked to stay at home if they are over 70 or are feeling unwell. Social distancing has been requested in public places. And on Thursday, the government urged Swedes to avoid unnecessary international travel and to limit car journeys within the country to two hours.

But even these measures – minimal by the standards of numerous other countries – have been laxly enforced. Police are unable to impose fines to enforce social distancing; they can only tell people to comply.

The Swedish approach has won praise from figures on the American right such as Fox News host Tucker Carlson, who have suggested that it provides a model for the US to follow.

‘People who think they can’t die’

In making the case for its unorthodox policy, Stockholm has pointed to high levels of trust in Swedish society, arguing that people could be expected to take precautions without being told to.

“There are people who are really diligent and are doing exactly what they should do, but there are too many who don’t,” said Elisabeth Asbrink, a Swedish author, freelance journalist and prominent critic of the government’s approach. In parts of Stockholm, “people are doing all the things they usually do, as if there’s no need to keep a distance”, she continued. “I’ve also visited Malmo (Sweden’s third-biggest city) and there’s a lot of people there who think they can’t die, somehow; they think they’re unapproachable by this disease.”

Figures compiled by data analysis website Statista show that the total number of confirmed Covid-19 cases in Sweden has been increasing steadily since the beginning of April – and now stands at more than 29,000.

Statistics suggest that Sweden has performed poorly compared to its Scandinavian neighbors, which imposed strict lockdowns. Experts say the other Nordic countries are the most apt points of comparison, given their similar healthcare systems, socio-political cultures and levels of connectedness.

Reported coronavirus deaths per million in Sweden stand at 358, according to Statista – even higher than the hard-hit US, at 267. The Swedish figure is dramatically worse than those of Denmark (93), Finland (53) and Norway (44). In Sweden, “we’re seeing an amplification of the epidemic, because there’s simply more social contact”, said Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University in the US.

In response to a comment in late April hailing Sweden’s performance, Nicolas Nassim Taleb – a professor of risk engineering at New York University, famous for his book on probability and uncertainty The Black Swan – tweeted back: “Stop the bullshit. Sweden did HORRIBLE [sic] compared to Norway Denmark Finland.”

‘They didn’t have time to take care of my mother’

Many Swedish experts have lambasted the government’s response to the pandemic. Twenty-two doctors and scientists demanded a change of tack in an editorial piece in the newspaper Dagens Nyheter, published on April 14. “The approach must be changed radically and quickly,” they implored. “As the virus spreads, we need to increase social distance […] Politicians must intervene, there is no alternative.”

As in many other countries, nursing homes have been a particular source of anguish. Although visits were banned on March 31, half of those 70 and older in Sweden who have died from Covid-19 were living in nursing homes, according to figures released at the end of April. Staff have warned that they lack personal protective equipment.

“They didn’t have time to take care of my mother,” one Stockholm resident – who claims his mother died of neglect in a nursing home while more than a third of its residents succumbed to the virus – told Agence-France-Presse last week.

“There are things which could have been done, and should be done, that would have altered the picture radically,” said Lena Einhorn, a Swedish virologist and critic of the government’s policy. If Sweden had implemented “a broad testing program, and especially in elder care”, she continued, the authorities would have “known who is infected, and now, with antibody testing, who was infected”.

Einhorn said two further policies would have made a significant difference, without necessitating a full-blown lockdown: “If Sweden mandated a 14-day quarantine for all household members of someone sick with Covid-19, we would not have had this picture”, and if the country “closed restaurants, there would have been less possibility of aerosol spread (airborne transmission) of the virus”.

‘Politicians are not taking visible responsibility’

The Swedish government has said that its policies are effectively decided by scientific officials such as the state’s chief epidemiologist Anders Tegnell, who has become a well-known and popular figure in the country since the start of the pandemic.

But Asbrink argued that this is having a negative effect on political debate in Sweden: “The decisions that they are making are of course political – they make choices – and I think it is a problem that Swedish politicians have not taken visible responsibility for the strategy, as they have in the other Nordic countries.”

The purpose of the country’s strategy has been much debated. Swedish Foreign Minister Ann Linde told FRANCE 24’s Clovis Casali in early May that “we don’t have a strategy of herd immunity” – referring to the phenomenon that occurs when a high proportion of a population contracts and thereby gains immunity from an illness, thus stopping the disease’s spread and indirectly protecting everyone else. “We don't want to stop all transmission; we want to flatten the curve,” Linde said.

However, Einhorn said that “they have denied it, but under their breaths they have acknowledged” a herd immunity strategy. She pointed to Tegnell’s comments in an interview with newspaper Aftonbladet in March: He said that the “basic idea” of herd immunity is “probably starting to become more and more relevant the more we see of this virus”.