An outlier in Europe, Sweden's apparently relaxed approach to the coronavirus pandemic is an international subject of fascination, provoking controversy at home and abroad and becoming a cause célèbre among those who oppose strict lockdowns. As protesters rallied against a stay-at-home order in Minnesota last week, one demonstrator held up a poster among the American flags reading "Be like Sweden".
Pubs, restaurants, gyms and most schools remain open in the Scandinavian state, with the government relying on personal responsibility for compliance rather than strict enforcement. Official guidance states that citizens can still go out to a nightclub or go out for a meal with friends, as long as they stay at “arm’s length” from each other.
So far, the pandemic has killed 1,580 people in the country according to national figures, lower as a proportion of the population than in the United Kingdom, Italy or Spain. But when compared to neighbouring countries that did impose lockdowns, the Swedish death rate is nine times higher than Finland, nearly five times higher than Norway, and over twice that of Denmark.
Immunity
The man behind the Swedish strategy, state epidemiologist Anders Tegnell, told local media over the weekend that projections by the Public Health Agency indicated resistance was building in the population.
“According to our modellers, we are starting to see so many immune people in the population in Stockholm that it is starting to have an effect on the spread of the infection,” Tegnell said. “These are mathematical models, they’re only as good as the data we put into them. We will see if they are right.”
Tegnell’s assumption that people become immune to the virus is controversial. The World Health Organisation has warned that there is so far no proof of immunity in those who have recovered from Covid-19.
Sweden’s approach is also controversial at home: 22 leading doctors, virologists and researchers last week called on Swedish authorities to change course “radically and quickly” and close restaurants and schools. Over 900 teachers and school workers signed an open letter to say they were unable to protect vulnerable children and staff.
And despite the Public Health Agency saying that its priority was to protect the elderly, a third of deaths have been of residents of care homes, a fact that has also caused public blowback.
While the rules are less strict than elsewhere in Europe, those living within Sweden insist that the idea that life continues as normal in the country is far from the truth. In Stockholm, the amount of people moving around the city has been less than a third of its usual level since late March, according to statistics from transport app Citymapper. Residents describe traffic-free roads, quiet streets, and people careful to keep their distance.
“A lot of people think Sweden’s open for business and everything is open as usual, but Swedes are taking this very seriously,” said Cormac O’Brien, an IT worker living with his family in Gothenburg and originally from Malahide.
“The pubs are open, but I went to one on Saturday and it was empty. Would that be the case if they opened in Dublin? You can’t say if it works in Sweden you should do it elsewhere. Some of it is cultural.”
Advantages
The country has some natural advantages, including a health system that has not yet reached capacity from the pandemic. It is also more easily able to encourage isolation without strict measures: some 40 per cent of households in Sweden are made up of just a single person, and a large proportion of people are able to work from home.
Irrespective of whether immunity turns out to be a reality, or a vaccine can be developed, countries that slowed infection early will be better able to make decisions that save lives, according to Prof Devi Sridhar, chair of global public health at the University of Edinburgh.
“Even if we all end up being exposed to it, imagine if we could predict early on who would develop severe symptoms, and who would recover easily?” Prof Sridhar said. “Basically, regardless of where this goes . . . the countries that bought time by quick action and keeping numbers low are in a better position to create informed policy.”