Sweden. Once the outlier. But a new localised approach brings it closer to other countries.

14 Oct

Throughout the Coronavirus crisis, it could be said that Sweden has been the biggest outlier in terms of its pandemic strategy. While many countries quickly introduced lockdowns at the outbreak, and others implemented already-developed test and trace systems, Sweden pushed to keep society open as much as possible. 

Johan Carlson, head of its public health agency, justified this approach by saying that Sweden couldn’t take “draconian measures that have a limited impact on the epidemic but knock out the functions of society.” These words stunned members of the lockdown-loving press, as did the confidence of Anders Tegnell, chief epidemiologist, who refused to apologise for taking such a radical approach.

Hawkish Britons looked on with jealousy. As shoppers in this country were photographed frantically stockpiling Andrex, Sweden had more tranquil scenes of people going about their day. Bars and restaurants – as well as events of under 500 people were allowed to run. Seven months later, the debate still rages on about whether Britain “should have done a Sweden”.

There’s a libertarian romanticisation of it, and those with more interventionist instincts demonise it. It has become the axis on which people place arguments on whether to reopen, or close, the economy further.

The curious thing, though, is that the Swedish approach has actually changed a fair bit, making it not quite the radical experiment newspapers would have us all believe. It has, in fact, recently become closer to systems such as Germany’s, whereby local authorities get to decide what measures should apply to their area.

Indeed, next week Sweden will grant regional authorities the ability to introduce guidelines in their area to curb specific outbreaks of Covid-19. The National Board of Health and Welfare has set out what some of these could be, such as avoiding public transport; avoiding unnecessary travel; avoiding visiting people in a risk group, like elderly care homes, and avoiding physical contact with people who do not belong to your household. It remains to be seen how much councils will take up these instructions.

Furthermore, at a national level, Sweden has actually been quite cautious in many ways. Its health authorities encourage people to work from home if they can, avoid large social gatherings and keep a distance, as well as asking vulnerable people and over 70s to avoid shops, restaurants and public transport. 

Maybe the crucial difference about Sweden is that it has been a more consensual model than others’. Instead of introducing Emergency Powers, it has relied on people’s sense of personal responsibility to achieve a balance between keeping the economy open, and saving lives. 

Some of the more cautious move towards regional powers also reflects Tegnell’s fears about care homes – and his regret that they were not protected enough initially. It has been shown that a large number of the country’s 5,899 fatalities took place in such settings in spring, and he has since urged these places to “test staff very generously”.

In spite of Sweden’s evolving Covid strategy, the press still very much likes to sensationalise it. TIMES magazine recently called it a “disaster”, and focussed upon rising cases (never mind that daily deaths are relatively low and stable – as seen above).

But as with many other countries, the Swedish approach is changing. Perhaps that’s the biggest lesson from it. Nothing is known about this virus, not least how a government might – in future – choose to deal with it.

Sweden. Once the outlier. But a new localised approach brings it closer to other countries.

14 Oct

Throughout the Coronavirus crisis, it could be said that Sweden has been the biggest outlier in terms of its pandemic strategy. While many countries quickly introduced lockdowns at the outbreak, and others implemented already-developed test and trace systems, Sweden pushed to keep society open as much as possible. 

Johan Carlson, head of its public health agency, justified this approach by saying that Sweden couldn’t take “draconian measures that have a limited impact on the epidemic but knock out the functions of society.” These words stunned members of the lockdown-loving press, as did the confidence of Anders Tegnell, chief epidemiologist, who refused to apologise for taking such a radical approach.

Hawkish Britons looked on with jealousy. As shoppers in this country were photographed frantically stockpiling Andrex, Sweden had more tranquil scenes of people going about their day. Bars and restaurants – as well as events of under 500 people were allowed to run. Seven months later, the debate still rages on about whether Britain “should have done a Sweden”.

There’s a libertarian romanticisation of it, and those with more interventionist instincts demonise it. It has become the axis on which people place arguments on whether to reopen, or close, the economy further.

The curious thing, though, is that the Swedish approach has actually changed a fair bit, making it not quite the radical experiment newspapers would have us all believe. It has, in fact, recently become closer to systems such as Germany’s, whereby local authorities get to decide what measures should apply to their area.

Indeed, next week Sweden will grant regional authorities the ability to introduce guidelines in their area to curb specific outbreaks of Covid-19. The National Board of Health and Welfare has set out what some of these could be, such as avoiding public transport; avoiding unnecessary travel; avoiding visiting people in a risk group, like elderly care homes, and avoiding physical contact with people who do not belong to your household. It remains to be seen how much councils will take up these instructions.

Furthermore, at a national level, Sweden has actually been quite cautious in many ways. Its health authorities encourage people to work from home if they can, avoid large social gatherings and keep a distance, as well as asking vulnerable people and over 70s to avoid shops, restaurants and public transport. 

Maybe the crucial difference about Sweden is that it has been a more consensual model than others’. Instead of introducing Emergency Powers, it has relied on people’s sense of personal responsibility to achieve a balance between keeping the economy open, and saving lives. 

Some of the more cautious move towards regional powers also reflects Tegnell’s fears about care homes – and his regret that they were not protected enough initially. It has been shown that a large number of the country’s 5,899 fatalities took place in such settings in spring, and he has since urged these places to “test staff very generously”.

In spite of Sweden’s evolving Covid strategy, the press still very much likes to sensationalise it. TIMES magazine recently called it a “disaster”, and focussed upon rising cases (never mind that daily deaths are relatively low and stable – as seen above).

But as with many other countries, the Swedish approach is changing. Perhaps that’s the biggest lesson from it. Nothing is known about this virus, not least how a government might – in future – choose to deal with it.

Sarah Ingham: How so many gym-goers escaped Covid-19 is one of the great mysteries of this virus

22 Jul

Dr Sarah Ingham is a member of Kensington, Chelsea & Fulham Conservatives and launched the Gym-Goers’ Covid-19 survey.

On a spectrum of illness that runs from a mild cold to the Black Death, many of us have put Covid-19 at the fatal end of the range.

This is unsurprising. The initial images of the illness would not have been out of place in a disaster movie. People apparently lying dead in the eerily empty streets of Wuhan; the intubated patients in Italian intensive care units reminiscent of autopsy scenes, and the teams in hazmat suits.

That this particular Coronavirus may have been cooked up in a biological warfare lab in China has added to the apocalyptic nature of the threat. With the Steven Soderbergh film Contagion suddenly more like fact than fiction, many didn’t wait for the Government officially to order the lockdown on March 23.

By the second week of March they were already shielding themselves and their families. Children were pulled out of schools, essentials were stockpiled and events cancelled. The Government might have been following the science, but the great British public followed its gut instinct and stayed at home. It looked wise in the light of the prediction of 500,000 deaths, which it later transpired was instrumental in locking down the country.

Death at Teatime sounds like a cosy Agatha Christie mystery, but is in fact what the daily Downing Street press briefings became. This statistical ritual, with its rising death toll – first in hundreds, then in thousands, then in tens of thousands – reinforced initial impressions about the infectiousness and lethality of Covid-19.

When gyms and fitness studios reopen on Saturday, four long months will have passed since the lockdown was introduced. And it is surely in the context of the indoor sports sector that we can start questioning our current assumptions about Covid-19 and whether State-induced mortal fear promulgated by Government ministers is justified.

Among the mysteries surrounding Covid-19 – including when it actually arrived in Britain – is how any of the country’s gyms-goers and fitness studio fiends escaped it before the Government imposed the Lockdown.

Anyone who was a regular in one of Britain’s gyms, studios or indoor sports centres before their closure in March can testify that most were hardly operating-theatre sterile, particularly in city centres where space is at a premium.

Machines or mats crammed together, shared equipment, crowded changing rooms… Many working out got up close and personal with the heavy breathing and sweat of their fellow fitness fans whether they wanted to or not, in environments which were often strangers to anti-viral wipes.

Hot yoga fans relished classes in fetid, rammed studios heated to close to 100 degrees. Covid-19 was supposed to be dangerously infectious, justifying the emergency Coronavirus Act of March 25, which enabled the police, immigration and public health officials to detain “potentially infectious persons”.

Civil libertarians across the political spectrum have expressed concerns about the Act: the Institute for Economic Affairs states it imposes the “greatest restrictions on liberty in modern British history” while Liberty says it “strips away our civil liberties”. The enforced closure of gyms and studios follows a record-breaking year.

The 2019 State of the UK Fitness Industry Report by Leisure DB highlights that total UK membership broke the 10 million mark, with one in seven of us now members of a gym, while the number of fitness centres reached an all-time high. The industry is worth more than £5 billion a year.

Regulars to gyms, as well as yoga and pilates studios, are now getting updates about the measures that will be in place ahead of Saturday’s reopening. These might include screens around machines such as cross-trainers, fewer people in classes and more cleaning, making them very different places compared with the pre-lockdown era.

Whether regulars will return to their pre-Covid fitness regimes is the question that must be haunting the industry. With predictions about working from home, is working out at home also going to become the new normal?

And just as privately-owned centres might be soon feeling the financial burn, public fitness facilities, many funded by local authorities, are facing an uncertain future: reports last week from ukactive suggested that Britain is “sleep walking” towards losing many of them.

Like restaurants and cinemas, gyms can create a safe, socially-distanced environment, but it is not automatic that punters will have the confidence to return to them. Since March, the Government’s Project Coronavirus Fear has been relentless, putting Covid-19 at the Black Death end of the illness scale, bolstered by a media which has delighted in drinking the Corona apocalypse Kool-Aid.

But if Covid-19 were lethal and infectious enough to justify a four-month lockdown that was only supposed to last three weeks, then surely our indoor gyms and fitness studios would have been the places to find high rates of transmission?

Although the numbers dropped throughout the month, one boss of a leading high-end gym chain estimates there were at least 20 million gym visits in March, as peak virus was being reached.

Wouldn’t a London-based yoga teacher who was teaching 350 students a week have caught it, along with her colleagues and students?

She didn’t; they didn’t: why not?

Perhaps, as Roosevelt once suggested, most of us have nothing to fear but fear itself.