Sweden has so far avoided a COVID-19 lockdown: Has the strategy worked?
LONDEN – Sweden’s new approach to dealing with the coronavirus pandemic has aroused both praise and harsh criticism, not only in the Scandinavian country but in the entire western world. The country has so far resisted locking itself, unlike the rest of Europe, even during the peak of its second wave over Christmas.
Thus, Sweden has become a flash for those who are for and against stricter social distance measures. For some, its significantly higher deaths due to covid compared to its neighbors are proof that lockdowns are crucial in combating the spread, while for others, the comparative openness of Swedish society shows that a “balanced” approach to the pandemic is possible.
Now, a year into the pandemic, and with a vaccine expansion likely in the near future, their strategy continues to attract international attention. ABC News looked at the pitfalls and benefits of their approach in May last year, and a year later evidence shows that their unique approach now, as much as ever, offers invaluable lessons for the international community to live long-term with COVID -19.
The soft-touch method
For critics of the light touch method, such as Stefan Hanson, a Swedish expert on infectious diseases, such a high mortality rate is proof that an overall strategy has failed.
“The basic problem is that there are no clear plans,” he told ABC News. “From the beginning, it has never been the way it has been. Normally when you run a public health project, you have some goals and strategies, you have some goals and you follow up, you have a monitoring system to see how it goes. But in Sweden it has there has been no such thing. “
“It’s about having a low transmission. And Sweden has not presented it as a very important thing,” he added. In April 2020, Hanson left was the signer of a letter from several top Swedish researchers who criticized the approach to the pandemic, which they said would cause “many unnecessary deaths.”
But even during Europe’s “second wave”, which saw that Stockholm’s intensive care units almost ran out of beds during the Christmas period, the country has resisted the temptation to lock up, as it is the only country in Europe that does. In December, a very rare intervention came from King Carl XVI Gustaf, who said the country had “failed” in its approach. The strategy, which was groundbreaking by Anders Tegnell, Sweden’s state epidemiologist, has been heavily criticized, not only at home, but also abroad. False optimism that the capital, Stockholm, would reach “flock immunity” by the fall has exacerbated that criticism.
Herd immunity occurs when there are enough people who have either been vaccinated or exposed to the virus that it can no longer be spread in the population. Critics say there is an unnecessary risk of doing so by being exposed to the virus.
But as with so much of the information about COVID-19, proponents of the policy say reading data is a matter of perspective.
Sweden can feel better compared to more deaths – those that are greater than the usual number of deaths expected during a certain period of time. Experts say that excess deaths may indicate whether policies designed to combat the pandemic have unintended consequences, such as delaying treatment for other diseases and are an important measure of the overall impact of the policy.
While it still performs worse than other Nordic countries data from Eurostat, the official European Union statistical office and the University of Oxford, shows that Sweden registered 7.9% deaths last year compared to the years 2016-19, according to the independent health news Today’s Medicine.
This means that the country had the 23rd lowest annual death rate of 30 European countries – lower than the United Kingdom (15.1%), France (10.4%) and Spain (18.9%). Sweden also has a lower number of corona deaths per million than those countries, all of which have undergone severe shutdowns during the pandemic. Nils Karlson, an economist and political scientist, who together wrote a paper last year on foreign affairs, points to the latest studies of excess mortality. “Sweden’s Coronavirus strategy will soon be the world’s” is more optimistic.
“There were some new figures that show that if you count excess mortality, Sweden is one of the best countries in Europe,” he told ABC News. “And one of the reasons, of course, is that we did not get the flu, just the usual flu, because we washed our hands. We have social distance. We did not have many car accidents. You know, all the other things that affect us did not happen this year. ”
Opposition to lockdown, he said, is based on the idea that they are “unsustainable”, he said, and Sweden’s strategy takes into account not only economic factors, but all aspects of public life. While acknowledging that the death toll for COVID was too high, he said: “You have to keep society open not only for economic reasons, but also for important public functions to function, such as hospitals, schools and so on. Schools are still open to younger children … Otherwise it is distance learning. But I think it has worked quite well. ”
The nursing home crisis
One area where there has been agreement, however, is the crisis in Swedish old-age care, where the crisis has taken a terrible toll.
Nursing homes have accounted for about half of the country’s total deaths, and a further quarter of the deaths are seen among those over 70 who receive care at home.
“The big thing was that the whole pandemic we know that old people, just like in elderly care, were the people who were really the ones who would mostly die and the people who mostly went to the hospital”, Ingmar Skoog, a Swedish psychiatrist who specializes in study old age, told ABC News. “Even so, they did not bring in any seniority expert.”
The Swedish government introduced more protective equipment and testing, as well as other countries and limited nursing home visits.
A government-appointed commission concluded in December that high levels of infection in the general public, as well as a fragmented administration that made it difficult to develop a consistent policy, contributed to the crisis.
“We have found that elderly care was unprepared and poorly equipped when the pandemic struck and that this was based on structural deficiencies known long before the outbreak of the virus,” the report said. sa.
Although it is “obvious” that higher infection rates make it more likely that the virus will sweep through nursing homes, Skoog said, “part of the problem has been a fundamental misunderstanding about the large number of person-to-person contacts they receive in healthcare each day.” .
“They meet many people very intimately because they get help with the clothes, maybe food, clothing, hygiene, toilet and so on,” according to Skoog. “And people are very, very close. And that means they meet a lot of younger people … I think one of the first things that really should have been done was to talk to experts in the field and say, what are we going to do? ”
However, deaths in care facilities plagued even countries that carried out suspensions and took measures to protect nursing homes.
A report from the European Center for Disease Control in November was found that residents in long-term care accounted for 45% of the total deaths from coronavirus in France and 42.5% in Belgium – countries that both locked up and limited nursing home visits.
According to New York Times, 34% of deaths and 5% of US cases have been reported among nursing homes. In ten US states, the proportion of residents and employees who have died is more than half of all their deaths.
“I generally believe that the idea in Sweden to try to balance the risk of the virus and the risk of shutting down because there are health problems with it, I believe in a basic [level] that’s very good, he said. “But I think there’s a lot of ignorance about aging.”
Avoid lockdowns
Sweden has largely closed its international borders, including those to neighboring Norway, and left the internal society open. Although there are limits to the maximum amount of people in a social gathering, these come in the form of “recommendations” rather than strict laws that can be enforced with fines. The use of masks on public transport, for example, was only formally recommended in December.
Overall, the strategy, partly designed to be a holistic approach that took into account the pandemic-induced changes in society as a whole, has remained intact, according to Karlson.
“I think the public debate, the official debate, has largely argued that we have changed the strategy, that we have introduced more restrictions and so on,” he said. “I’m not really sure it’s true. I mean, it’s probably a shift. Now we have recommendations to wear masks, for example. There are stricter restrictions on public order and such. But we have no suspensions. These are basically recommendations. ”
The politicization of Sweden’s approach to American politics, in which prominent Republicans have often pointed to their lax approach to masks and lockdowns, was another point of contention.
“I think it worries a lot of people, you know, in Sweden because we love the welfare state and all that,” he said. “You know, right-wing groups in the US are starting to favor the Swedish strategy and that created some concern in Sweden.”
While the country has not come close to reaching “herd immunity” – according to the health magazine The Lancet described as their “de facto” policy of staying open – the lower mortality rate, psychological burden and economic performance mean that the policy can still survive another wave of coronavirus infections, which has increased in recent weeks.
Stockholm, for example, is about 15% immunity, but new variants have made the task more difficult.
The political consensus that saw the country end up behind its new COVID strategy last summer has broken down, Karlson said, and opposition parties have now called for shutdowns like those seen in other countries.
“We have tried in different ways, you know, depending on our culture and our history to adapt, you know, to minimize the consequences of this terrible disease,” Karlson said. “But I think Sweden has done everything well. I mean, it’s not as bad as it looks when you look at death rates, which are too high, of course. ”