In Sweden, herd immunity has tragically failed. Will there be a settlement?
This spring, when the coronavirus pandemic sharpened its grip all over the world, I wrote about Sweden’s controversially relaxed response to covid-19 and described it as more of a failure than a panacea. Still, I admitted, “the final assessment of Sweden’s unorthodox attitude can not be announced until the crisis moves into the history books”, although the actions of Swedish authorities “can ultimately be seen by future generations of Swedes as a shameful chapter in the country’s history.”
I was wrong. We do not have to wait until the end of the pandemic to know that Sweden’s strategy was a disaster that could be prevented. And I suspect that it will not take generations for Swedes to demand a calculation of what went so terribly wrong.
Today, Swedish healthcare professionals are fighting a catastrophic increase in coronavirus infections and deaths. Intensive care units in the Stockholm region, which the authorities predicted would be best protected by their lax approach, now exceed 100 percent of capacity. Hundreds of Swedes die every week, which adds to the more than 7,800 deaths in COVID-19 since the pandemic began. At the same time, across the border in Norway, the coronavirus has been kept well under control with the help of accepted public health methods such as locks and other restrictions. While 1,400 people died in Sweden in the last month, Norway counted 100 deaths. Norway’s total death toll in a pandemic is 383 people. The death toll in Norway from covid-19 is 74 people per million; it is more than 10 times higher in Sweden, at 770.
When Swedish hospitals struggle with patients, Björn Eriksson, Stockholm’s regional healthcare manager, appealed last week: “We need help.” Finland and Norway have now announced that they are on standby to offer assistance if Sweden so requests. It would mark a dramatic collapse from Sweden’s defiant self-confidence during the early days of the pandemic. As the architect behind Sweden’s hands-off strategy, chief epidemiologist Anders Tegnell, said in April, “Once you end up in a lockdown, it’s hard to get out of it. How do you reopen? When?” Other countries have struggled with that problem. Sweden has not.
There was cause for concern during the first days of the pandemic, when Sweden already had thousands more dead than its Scandinavian neighbors but refused to take any measures to slow down the spread of the coronavirus. When country after country introduced lockdowns, demanded face masks and restricted all kinds of gatherings, Sweden chose to go its own way.
Instead of what Tegnell called “draconian measures”, he recommended a light touch that he said was better suited to the country’s culture. Authorities advised the public to keep social distance and practice hygiene, but bars, restaurants and schools remained open – unlike in large parts of Europe – and there was no recommendation to wear masks.
The idea was to protect the elderly and allow younger people, less likely to become seriously ill with covid-19, to become infected and gain immunity – the so-called herd immunity strategy later pursued by President Donald Trump, his discredited adviser, Scott Atlas, and also a top-ranked Trump at the Department of Health and Human Services. However, herd immunity is a term used by epidemiologists to describe the time when enough people have been vaccinated to essentially stop the virus. Allowing people to get sick, without even realizing the immunity it provides, struck experts as a deadly and dangerous plan.
Tegnell confidently predicted that when the second wave of the pandemic hit Europe in the autumn and infected a large number of people outside Sweden’s borders, his country would be protected by high levels of immunity. He also insisted that the strategy was about saving lives, not the economy. But the companies loved it, and so did the Swedes.
Prime Minister Stefan Lofven wholeheartedly supported the strategy and his popularity soared. Tegnell became a superstar at home, and something of a global celebrity.
The “Swedish model” got very favorable news coverage, and right-wing politicians around the world used Sweden’s reputation to advocate and adopt similar strategies. “Sweden was right”, Florida’s Republican Gov., Trump ally Ron DeSantis, declared when he resumed his state.
When Swedish hospitals struggle with patients, Stockholm’s regional health director appealed last week: “We need help.”
Tegnell and his fans insisted that the high number of deaths was the sad result of the virus that affected the elderly care homes, and claimed that the early figures gave a misleading impression of the effectiveness of Sweden’s plan. After my column in May, I received messages from some worried Swedes who said that they felt that the government let people die. But my Swedish friends told me I was wrong. The plan worked, they said. Just wait.
Signs of failure soon became apparent. A government study found antibodies to coronavirus only in 7.3 percent of Stockholm’s population, well below the 60 to 70 percent required for herd immunity. In September, when the number of cases in Sweden began to tick up again, Lofven called it “worrying”.
Swedish authorities eventually recommended wearing masks, but the public health authority insisted that it did not back down. They seemed married to their idea and I have been told that the behavior did not change much among many Swedes.
By October, the country had entered a second wave, one much more deadly than its Scandinavian neighbors. Incidentally, the economy had not fared better than any of its neighbors before the urgent need for new measures became apparent.
In November, the Prime Minister made a dramatic announcement, banning gatherings of more than eight people, closing high schools for the remainder of the term and banning the sale of alcohol after 10 p.m. Unlike this spring’s laissez-faire proposal, this was a mandate. Offenders were fined and jailed. Lofven gave unequivocal instructions: “Do not go to the gym. Do not go to the library. Do not eat dinner. Have no parties. Cancel!”
Unfortunately, the government’s initial attitude seems to have stuck with Swedes, who seemed to take the orders as an easy proposal. As hospitals fill up and authorities try to do as their neighbors did eight months ago, Lofven’s popularity, which soared early on, has declined. A September survey already showed only one in three Swedes thought he did a good job handle the pandemic. Unsurprisingly, the failure has tarnished Lofven’s Social Democratic Party, whose support recently dropped to 29.4 percent.
After strongly supporting the herd immunity plan, Swedes have since changed their minds. A survey in November showed that 82 percent of Swedes worry about whether the country’s healthcare can cope with the crisis. A month later, it seems that their concerns are well placed.
Long before this pandemic ends, there is no doubt that the Swedish model has failed. It’s a tragedy for its people, but also for all the people around the world, in countries like the United States and Britain, who suffered after their leaders chose to imitate the Swedish government, although only partially in many cases.
An independent commission has already come to that conclusion the swedish government failed to protect the elderly, but the review does not end there. Whenever the public health crisis is over, one question remains. How long will it take Swedes to demand a calculation of their leaders and a fearless scrutiny of a misguided policy that cost thousands of lives, the country’s deadliest disaster since the Spanish flu a century ago?
Frida Ghitis is a columnist for world issues. A former CNN producer and correspondent, she is a regular contributor to CNN and The Washington Post. Her WPR column appears every Thursday. Follow her on Twitter at @fridaghitis.