Sweden – an experiment gone terribly wrong?

30 Nov

Ever since Anders Tegnell, Chief Epidemiologist of Sweden’s public health agency, shunned the idea of a national lockdown to fight Covid-19, his country has been the subject of intense debate.

“Should we have done a Sweden?” fast became one of the most controversial questions to ask in the UK (and no doubt other countries). Sweden provoked opinions as divided as those on Brexit. Some felt that it had been dangerously relaxed about Covid-19, whereas others idolised its policy.

You only had to go to an anti-lockdown protest to see how fanatical some had become about Sweden. I observed one in London, where I photographed a young woman with a placard reading “SWEDEN DID IT RIGHT!” I wondered how my picture of her would age. Would she be vindicated as a brave revolutionary? Or proved wrong?

Right now, many would say the latter. Sweden has shown troublesome trends in its fight with Coronavirus. While its death rate (6,681) is low compared to many countries, the statistics are almost certainly going in the wrong direction, with cases and deaths steadily increasing. Shockingly, the European Centre for Disease Prevention says that in December, Sweden will surpass the peak death rates it suffered in April, with between 100 and 140 projected to die of the virus each day.

Furthermore, Sweden doesn’t compare well to its neighbours, which Tegnell once said would end up with lower levels of immunity. Whereas Sweden has seen 630 deaths this month so far, Norway, registered 30 deaths between October 28 and November 25.

Although Norway’s population is around half the size of Sweden’s, the difference is still stark, and in pursuing a more hawkish approach, Sweden doesn’t seem to have gained much economic benefit. Its GDP slumped 8.6 per cent in Q2, which was sharper than that of Denmark, Finland and Norway.

All of this has led many to conclude that Sweden has failed, and that someone is responsible for said failure. Newspapers are quick to point the finger at Tegnell, whom they suggest is being sidelined by the government because of his errors.

It certainly would seem that Stefan Löfven, the Swedish Prime Minister, wants more control over the pandemic. Sweden is unique in that its health agency, as opposed to the government, is in charge of health policies. But who knows for much longer…

In the fourth ever broadcast by a Swedish PM, showing just how urgent matters have become, Löfven warned that the Covid situation would get worse before it got better, and asked Swedes to call off, cancel or postpone non-essential meetings. The government has also banned public gatherings of more than eight people.

But does this make Tegnell and the whole of Sweden’s approach a disaster? It’s easy to say yes, but the reality – like everything in Covid-19 – is more complicated than headlines suggest.

For one, Sweden has never been as radical as made out, and actually had restrictions at the beginning of the Coronavirus outbreak. High schools and universities were closed, gatherings of more than 50 people were banned and the health authorities advised those over 70, as well as people who felt ill, to stay home.

Two, there are more favourable comparisons on which to place Sweden – only they do not always get the same media traction:

And three, not all of Sweden’s initial policies are thought of as incorrect by other governments. It kept schools for pupils up to 16 open throughout the crisis, in a decision that has now followed.)

The reality is that Sweden, like many other countries, has simply evolved its strategy in line with new data. In October, for instance, I wrote about the fact Sweden’s regional authorities would soon have their own ability to issue Covid-19 guidance, similar to Germany’s localised system. At a national level, the health authorities became more cautious – warning people to avoid shops, restaurants and public transport. Tegnell was especially vigilant about the elderly, as a large number of Covid-19 fatalities in the first wave of the crisis were care home deaths.

Far from being callous, which Sweden is often presented as, its initial system was always based around trust. It asked citizens to distance from one another, and to be careful, but it did not seek to legislate around their movements. There were also some logistical points Tegnell took into account when deciding Sweden’s policy, such as the fact it has a low number of multi-generational households compared to other nations.

And so, these nuances have to be taken in when assessing Sweden. Now that the vaccine has arrived, it’s tempting to decide what country “did best”, and to believe the “sit tight and wait for a vaccine” policy was correct.

But there remain so many unknowns, from whether the vaccine will work (we still don’t have approval) to the scale of the economic damage, to how every little decision will play out over years and decades. We are missing complex data, too, around population density, hospital capacity and other factors central to assessing a country’s performance. In short, the answer to the question “should we have done a Sweden?” is “who knows.”