All three Scandinavian countries – Denmark, Sweden and Norway – have completely lifted the COVID-19 restrictions and are mostly back to a “normal” way of life.
“We have returned to the lives we lived before the pandemic by 99%,” says Filip Knop, PhD, at the University of Copenhagen at Gentofte Hospital, to MedPage today. “You still see more disinfectants around, but you rarely see people using them. It’s such a relief.”
Denmark lifted all restrictions in mid-September, followed by Sweden and Norway, which ended the restrictions at the end of the month. Despite this, the virus seems to be retreating in all three countries. The most recent 7-day averages for falls were 552 (Denmark), 499 (Sweden) and 432 (Norway), with a 7-day average of one death in each country and fall.
Although all three nations have similarities that have contributed to their success – such as high vaccination rates and high confidence in the government – they have all taken slightly different approaches. In particular, Sweden has the highest number of cases (1.2 million) and deaths per million (1460), while Denmark (364,000 cases, 459 deaths per million) and Norway (194,000 cases, 159 deaths per million) fall far below it the brand.
In Denmark, the vaccination rate is excellent, 86% for all eligible (12 years and up) and 96% for everyone over 50, says Michael Bang Petersen, a political scientist who advised the Danish government on its pandemic approach.
No vaccine mandate was needed, he said, due to strong confidence in the authorities’ handling of the pandemic. “This confidence has been incredibly high and completely stable” in Denmark, Petersen said on Twitter.
Knop reiterated these sentiments, noting that Denmark’s relatively high tax rates (most Danes pay around 50% in income tax, he noted) and low levels of state corruption, along with its extensive provision of services and benefits to all citizens, such as free health care, education and care for the elderly, reduces inequality to a beneficial effect.
“This means that the differences between rich and poor are small, the level of education of the general population is high, the general standard of living is high and people trust each other and the authorities,” he said. “This, combined with a high degree of social solidarity, makes it logical for the vast majority of Danes to follow the government’s recommendations.”
He added that Danes rely on facts and “are not easily aroused by conspiracy theories”.
“In addition, government information has been transparent and we have a physical and digital infrastructure that provides an extremely effective framework for various types of interventional and preventive strategies, enabling everyone to monitor the effects of interventions,” said Knop. MedPage today. “And when you see that government-based recommendations are effective, you have to trust and follow them.”
Although Sweden also has a similar basic level for social equality and trust in the government, the latter during the pandemic has been lower there, Petersen said.
“What the authorities also do during the pandemic issues”, he noted and alluded to Sweden’s first decision to refrain from large-scale closures, at the expense of a higher number of deaths among the elderly, especially those in nursing homes. Knop also believes that a “different initial handling of the pandemic” led to the different results between the countries.
Still, life looks normal in Sweden nowadays. Mozhu Ding, PhD, epidemiologist at Karolinska Institutet in Stockholm, told MedPage today that people actually stopped using social distance and wearing masks (Sweden never gave a mandate to the latter) “long before the restrictions were lifted.”
Almost 80% of people in Sweden aged 16 and up are fully vaccinated, with about 84% receiving at least one dose, she said.
“Due to the great trust in government agencies and institutions, the Swedish population was massively vaccinated,” Ding added. “Lifting restrictions is simply keeping the government on its side.”
In Stockholm, many companies have returned to personal work, and restaurants “are now packed and people eat happily together and chat without worry. On the subway, the worm carriers are few and sometimes get the appearance because it can be assumed that a vaccinated person does not and therefore needs protection.”
Although confidence in officials’ first response to the pandemic may have faltered, so did confidence in the country’s vaccination program.
“Every Swede has the benefits of having free care and a solid welfare package that they can use if they fall ill,” said Ding. “Swedes have a genuine feeling that the social institutions work for them and do not use them. Trust in authorities and healthcare is a large part of Sweden’s vaccination efforts.”
“People are currently experiencing the freedom to get vaccinated,” she added. Although it may change “if there are frequent breakthrough infections that erode confidence in vaccines”, it is currently not observed and Sweden plans to introduce third doses to vulnerable populations.
In Norway, about 90% of eligible people are vaccinated, says Anne Spurkland, MD, professor of immunology at the University of Oslo.
While her university still relies on virtual learning and the amount of commuters is still smaller than it was before the pandemic, much of life is back to normal, with bars, restaurants and concert halls fully open. Schools are completely open, and rapid antigen testing among children is common.
“I agree with the idea that we need to reopen and start living our lives more like in pre-pandemic times, and just accept that COVID-19 exists and that we can have it sooner or later,” Spurkland said. MedPage today. “Since the majority of Norwegians are now vaccinated, the disease in Norway can now be compared more with the seasonal flu in terms of the disease burden. Hopefully it will remain so, but it remains to be seen.”
All three Scandinavian countries are prepared for the possibility that the virus may not be finished with them, and that a new variant could cause havoc if it comes around the high levels of vaccinated immunity. Even if that happens, Scandinavians seem to be confident that their governments will get them through.
“Will the lifting of restrictions go well? Who knows,” Petersen tweeted, noting that Sweden and Denmark did not have a third wave. “New variants may emerge and restrictions reappear. But from a behavioral perspective, I am optimistic about the future. Even with a third wave, mutual trust should be high enough to pull through.”