
Passengers inside an underground train in Stockholm.
Photographer: Jessica Go / AFP / Getty Images
Photographer: Jessica Go / AFP / Getty Images
Sweden’s direct response to Covid-19, avoiding roadblocks while neighboring countries imposed restrictions, was controversial from the start. Despite rising death rates in early 2020, Sweden has kept shops, restaurants and most schools open. It banned public meetings of more than 50 people and some restaurants were forced to close temporarily, but most of the measures had little legal weight. Although many people initially agreed, they were less willing when the second wave arrived in November, forcing stricter measures.
1. What arguments did this raise?
Skeptics of the blockade saw the strategy as a way to avoid the negative side effects of restrictions to contain transmission and as a model to contain the virus without infringing on personal freedom. Critics labeled him deadly madness or a complete disaster. Government supporters point to countries like the UK, Italy and Spain, which have blocked, but have higher mortality rates than Sweden, while critics argue that the best comparison is with nearby countries, like Finland and Norway, which have densities similar populations and health coverage, but whose mortality rates and infection levels are well below those in Sweden.
2. Why did Sweden not block?
Anders Tegnell, a Swedish state epidemiologist and the main architect of the response, argued that all aspects of public health should be taken into account, including the adverse impact of restricting people’s movements. Tegnell said that Sweden followed tried and tested methods to deal with pandemics, while other countries were “crazy ”by imposing blocks. Instead, Sweden relied primarily on people’s willingness to voluntarily adjust their lives to help contain the transmission. There are also legal limits on the measures that Sweden can take; while one The temporary rule that allows the government to close stores is already in effect, Swedish law does not allow requests to stay at home or curfew.
3. Was the objective to achieve the herd’s immunity?
The Public Health Agency initially assumed that the population’s immunity would eventually stop the transmission of the virus, although it denies reports that his goal was to achieve collective immunity, allowing segments of the population to be infected. Herd immunity, which blocks transmission, occurs when a sufficient number of people in a community have been immunized, either through infection or vaccination. Early calculations overestimated the number of unreported cases, leading experts to misjudge the population’s level of protection. Tegnell said in early May that at least 10% to 20% of people in Stockholm were infected, while three weeks later the agency found that no more than 7% of the capital’s population had antibodies against the virus. When the second wave hit, Tegnell and his colleagues made it clear that Sweden he could not count on collective immunity to prevent the spread of the virus.
4. Was it more about politics or science?
In Sweden, authorities like the Public Health Agency have a great deal of autonomy and, although the government has the final say, it tends to rely heavily on its experience. When the pandemic hit Sweden for the first time in March, it was clear that Prime Minister Stefan Lofven’s center-left government would follow the approach outlined by the agency, and has continued to do so, even though initiatives taken since November have showed some signs of a crack. Although Lofven has said publicly that he continues to make decisions based on consultations with Tegnell and his agency, a number of measures since November indicate a more active role for the government.
5. Was the strategy abandoned?
Partially. Beginning in November 2020, Sweden began to introduce more significant restrictions, which in early 2021 included a ban on the sale of alcohol after 8 pm and allowing schools to teach seventh to ninth grade online. While the stores remained open, there were capacity limits. Most entertainment venues, such as cinemas and theaters, were forced to close due to a limit of eight people at meetings. The Public Health Agency also adjusted its recommendations, requesting people living with someone infected to be quarantined and making mask recommendations, although only on public transport during rush hour. Still, there was no formal block. Government response to Oxford Coronavirus Tracker, which analyzes data on policies around the world related to virus containment and blocking, health care measures and economic support, showed that Sweden, having taken the least stringent approach in Europe from late March to mid-April 2020, early 2021 for the middle of the package.
Not exceptional
Sweden’s Covid measures are now as strict as in most of Europe
Source: Oxford COVID-19 Government Response Tracker
6. How bad is the death rate in Sweden?
At the end of January 2021, more than 11,500 people in Sweden had died, or 113 per 100,000 of its population. This was above the EU average, three times the death rate in Denmark and 10 times that in Norway. The most affected countries in Europe, including the United Kingdom, the Czech Republic and Italy, recorded more than 140 deaths per 100,000. The pandemic exposed flaws in Sweden’s institutions and health system similar to those experienced elsewhere. Nursing homes were poorly prepared, the country had inadequate supplies of protective equipment, a lack of coordination impeded attempts to increase testing, and intensive care capacity was less than half the European average. Sweden was also one of several countries that underestimated the speed with which the disease spread and acted too late.
Deadly transmission
The death rate in Sweden is higher than the EU average, lower than in the USA
Source: Johns Hopkins University, Bloomberg
7. Was the strategy successful?
Supporters argue that Sweden has shown that it is possible to control the virus without taking measures that limit freedom and have a detrimental effect on health. The World Health Organization, while not supporting Sweden’s strategy, highlighted the benefits of measures based on trust between authorities and the public. The recommendations issued during the early stages of the pandemic affected people’s behavior, with restaurant sales in Stockholm falling between 75% and 80% in late March. After the December holidays, when many people stayed at home, there was a drop in infections, but authorities were warning that unless people followed the social detachment guidelines, Sweden could see a resurgence. There was also concern about new variants of the virus, which led the country to restrict the entry of the United Kingdom, Denmark and Norway.
The Reference Shelf
- Lionel Laurent of Bloomberg Opinion’s on how Sweden’s second wave offered a tough reality check.
- A Bloomberg Opinion column from Justin Fox on what it takes to get herd immunity.
- AN See why the mutant variants of coronavirus are so worrying.
- Swedish Public Health Agency regulations and guidelines for avoiding Covid-19 transmission.
- A June 2020 Bloomberg article on Tegnell’s strategy evaluation.
- THE October 2020 interview with Anders Tegnell about Sweden’s strategy.
- Correspondence in the Lancet by former state epidemiologist Johan Giesecke defending Sweden’s strategy. His assumption that between 20% and 25% of Stockholm’s population had been infected in early May was questioned by several critics.
- AN report from the Royal Swedish Academy of Sciences, contradicting the Public Health Agency’s view that there is no reliable evidence to support the use of face masks.
- AN report on how Sweden’s elderly care system handled the pandemic, compiled by a government appointed commission.