Sweden’s WHO figures must radically change the conditions for the Covid investigation
“Judge me in a year” said Anders Tegnell, Sweden’s state epidemiologist, in July 2020, when his country was attacked for sticking to its pandemic plan rather than adopting the new intervention with a lockdown. The latest figures from the World Health Organization complement the evidence that has been accumulated since the summer of 2021. Sweden handled the pandemic more successfully than most, with much less disruption to everyday life and economic activity.
The WHO has published estimates of surplus deaths globally for 2020 and 2021. This approach covers all deaths from Covid, whether or not they are formally diagnosed, along with side effects in deaths from other untreated conditions. If you look at Europe, where official data is usually robust, Sweden had half the mortality rate as the United Kingdom, Germany or Spain – and a quarter of it in many Eastern European countries.
In turn, the UK tends to be in the middle, in line with other major Western European countries, while Eastern European countries have had much worse experiences. There is a widespread perception that the UK has had a uniquely bad pandemic. The data simply do not support this.
Nor do they support the view that the results have much to do with the restrictions adopted by different governments, how soon they started or how strict compliance is. The question is thus how governments came to adopt a very restrictive policy in the first place. This must be the starting point for all national investigations. Why were the crisis planners’ experience and two decades of pandemic preparations abandoned everywhere except in Sweden?
Sweden ‘never lets it be torn down’. There were restrictions for large gatherings and for restaurants and some other entertainment venues. High schools and universities sometimes switched to distance education. Masks were never considered useful but social distancing was encouraged. The approach was based on the least possible intervention to manage environments with the highest risk.
Mistakes were made and acknowledged. In the first wave of the pandemic, Sweden had problems with Covid deaths in nursing homes, which tend to be larger than in the UK. Once the virus entered a home, it could circulate around a larger number of people than would be possible in British homes. When additional infection control was introduced, the inhabitants were as well protected as everywhere. Unlike the United Kingdom, where the elite assumed that people would know what was good for them, and then were forced or intimidated to do so, Sweden explained its public health thinking and invited citizens to cooperate.
Many problems in the UK can be traced to its top-down strategy. No one asked the academics who know the laws and regulations if they would work in this situation. Officials and politicians made these decisions based on their own, often simplified, beliefs. But rules are inflexible tools that invite confrontation and disputes. How can someone follow a law that can not distinguish between a party and a work-related gathering?
Sweden shows that there was another path that had not been taken, which could have led this country through the pandemic in much better shape, socially and economically. The investigation must not be diverted to the details of the arguments about whether we should have locked up a week or two weeks earlier. It must be free to examine the whole strategy – in particular why robust social science evidence for dealing with emergencies, and its contribution to pandemic planning since the early 2000s, was so hastily abandoned.
Robert Dingwall is Professor of Sociology at Nottingham Trent University