Sweden’s coronavirus strategy has always stood out from the crowd. The distinctive approach is now coming to an end.
This week, the government proposed an emergency law that would make it possible to lock in large sections of society; the first recommended use of face masks came into force; and the authorities gave schools the opportunity to close to students over the age of 13 – any changes to its strategy to combat the pandemic.
“I do not think Sweden stands out [from the rest of the world] very much right now, ”says Jonas Ludvigsson, professor of clinical epidemiology at Karolinska Institutet in Stockholm. “Most things that made Sweden different have changed – either in Sweden or elsewhere.”
There has been no public outcry about its approach – which attracted much international attention for its lack of formal suspension and use of face masks. Instead, there has been a gradual change in various policies because the winter covid-19 wave has hit Sweden much harder than health authorities or politicians expected.
Sweden has reported more than 2,000 deaths of covid-19 in one month and 535 in the last eight days alone. This can be compared with 465 for the pandemic as a whole in neighboring Norway, which has half the population. As King of Sweden Carl XVI Gustaf said just before Christmas: “We have failed.”
Public confidence in the Swedish government and various authorities has been strained after several reports about ministers – including Prime Minister Stefan Löfven who has been criticized for Christmas shopping – seem to have violated their own guidelines on how to behave.
Dan Eliasson, head of the Civil Contingencies Agency, resigned this week after visiting his daughter in the Canary Islands over Christmas, despite authorities sending a nationwide text message just days earlier, warning of all unnecessary travel.
“It is a problem. What is special about this country is that they trust people. I think the government has not understood the seriousness of this disease,” said Claudia Hanson, senior lecturer in global public health at Karolinska. Ludvigsson added: “I am fear that it will reduce compliance with recommendations. “
Karin Tegmark Wisell, head of the microbiology department at the Swedish public health authority, which has played a large part in the country’s policy, insisted that it was “a hallmark of the strategy that when the degree of infection rises that we adapt our response”.
She added that the behavior of ministers, members of parliament and officials such as Eliasson was a “difficult issue” that could affect the confidence of individuals but also provoke a broader public debate about what was accepted or not.
However, there is little doubt that Sweden’s approach has changed subtly in recent weeks. On Monday, the center-left government in Stockholm adopted an emergency law that will enter into force on Sunday, which gives it the power to close shops, gyms and public transport if deemed necessary.
Hanson said that the mystery with Sweden was why the government was so reluctant to react, and largely handed over the policy to the public health authority. “They could have changed the law a long time ago. All countries had to introduce new laws to deal with the pandemic, she added.
Swedish health authorities also long opposed the use of face masks, claiming that there was little evidence that they helped reduce the degree of infection and some concern that they could make people relax on more important measures such as keeping their distance and hand hygiene. But from Thursday, face masks are necessary during rush hour on public transport, even if there will be no sanctions for not wearing them.
High schools for 16-19-year-olds that have closed since the beginning of December will remain so until at least January 24. This week, the public health authority gave upper secondary schools for 13-16-year-olds the opportunity to close if necessary – but added that the standard setting should be to remain open.
Ludvigsson said that it was not one-way traffic, with much of Europe moving towards Sweden’s position on certain issues, not least the importance of keeping primary schools open when many nations closed them during the first coronavirus wave. He added that most countries had also changed their goal from defeating the virus to mitigating it, which has always been Sweden’s official policy.
This is in line with the position Anders Tegnell, Sweden’s state epidemiologist, outlined for the Financial Times last month when he claimed that Sweden and Europe came to a unified approach. “We’re doing more and more of the same thing,” he said.
Far from everyone is convinced that Sweden’s distinctive approach completely explains its significantly higher death rate for its Nordic neighbors, who have similar population densities and cultures. Many in Sweden point to Belgium, which has closed twice but has far higher deaths per capita covid-19.
Ludvigsson said that more research is needed on why some countries were hit harder by the virus: “People have explained 100 percent of a country’s success or failure based on its policies. But I’m sure there are other underlying factors that affect how the virus took hold in some places more than others. ”