Opinion |

Sweden Is the Key Coronavirus Test Case in Preparing for a Second Wave

As is true of every country, Sweden has advantages and disadvantages in dealing with the coronavirus pandemic

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STOCKHOLM - In the final analysis the Swedes will disappoint everyone. Those who claim that their own government's reaction to the coronavirus pandemic was hysterical, because "in Sweden it's business as usual," have yet to discover how little they knew about business in Sweden. Even those who claim that countries that opted for a lockdown saved numerous lives, as opposed to the Swedes who are dying in the thousands, will discover that the numbers are misleading and confusing.

Both groups will be forced to find another source to prove their arguments. Last week, for example, headlines worldwide declared that the Swedes admit their mistake and that their model for dealing with COVID-19 has collapsed. The headlines were incorrect. The Swedish authorities are still adhering to their initial strategy, and the presumed admission of a mistake was a general statement that was taken totally out of context. But Sweden has long since become a punching bag for those justifying the lockdown policy as well as an exemplar for those who oppose it. Meanwhile, in the real world, the situation is more complex.

First it should be noted that it is not business as usual in Sweden – high schools and universities have switched to distance learning, most of the cultural, entertainment and sports venues are closed, and residents were asked to work from home, maintain social distancing and avoid traveling. Although most of the restrictions are only recommendations, it can be proven that most Swedes observe them meticulously,

Despite that, the elementary school and preschools did not close, no lockdown was imposed and there is no obligation to wear a mask. These are examples of controversial policies, which may turn out to be more damaging than beneficial. It is definitely possible that the Swedish government is wrong, but the claim that it is practicing “human experimentation” could be directed to all the other governments too. In times of coronavirus uncertainty steps such as isolating asymptomatic patients, prohibiting swimming in the sea and closing places of business are also a gamble. It’s clear to everyone that they all cause social, economic and health-related damage, but it is still unknown if and to what extent these steps limit the spread of the virus.

People enjoy the sunny weather at a garden cafe at Djurgarden in Stockholm, Sweden May 26, 2020.Credit: TT NEWS AGENCY/ REUTERS

As is true of every country, Sweden has advantages and disadvantages in dealing with the pandemic. The advantages include: an efficient public sector, a good health care system, a sparse population and a large number of single-person households (about 40 percent of households). And on the other hand, the Swedish population is very elderly (about 20 percent are aged 65 and above), the country has open borders and a cold climate, and about one fifth of the population was born outside the country – and therefore has less trust in the authorities and limited access to their directives.

There is therefore a limit to our ability to learn from the terrible figure – about 4,500 dead. Even if we ignore the differences in the way countries count their dead, and complex data such as overall and excess mortality – it is hard to compare young countries with elderly ones, hot countries with cold ones, and open and closed countries. Although Worldometer charts have become a morbid sport of body counts and patriotic wrestling matches, it is doubtful whether we can learn from counting the dead about the degree of effectiveness in a country’s handling of the pandemic, and especially the effectiveness of lockdowns.

Heading the charts are Belgium, Spain, Italy, England and France – countries which imposed a lockdown, and occasionally adopted tough measures to enforce it. They are followed by Sweden, without a lockdown and with a “soft policy.” And then come the rest of the countries, which have various ways of dealing with the problem. There are countries that imposed a lockdown and have a high mortality rate (Belgium), there are countries with a lockdown and a low mortality rate (Israel), countries without a lockdown and a high mortality rate (Sweden) and some without a lockdown and a low mortality rate (Iceland). And of course there are also differences between one city and the next in the same country.

People enjoying themselves in a park in Stockholm last month. Sweden never claimed it was striving for herd immunity.Credit: AFP

Why then have so many died in Sweden? At this point it seems that the failure is not related to the failure to impose a lockdown. There is no evidence of a significant contribution by schools or shopping centers to the spread of the pandemic. But there is evidence of a different failure – the treatment of the elderly. Although the handling of senior citizens’ homes was problematic all over the world, in Sweden the situation was especially grave. Recently it was revealed that due to power struggles among the authorities, the personnel were not prepared, there was a lack of equipment and the ban on visits was belated.

And yes, although Sweden is a developed welfare state, in the years when the seeds of the failure were sown it suffered from another plague: privatization, cutbacks and reforms in the public sector. Today, as opposed to the situation in the past, senior citizens’ homes in Stockholm lack work slots, equipment and skilled manpower. This is another example of the helplessness of the “invisible hand” when it comes to managing crises and protecting the weak.

Is it true, as has been claimed, that Sweden gave up on its elderly for the sake of the economy? Definitely not. First of all, public health is managed by an independent authority, which is not subject to economic considerations. Second, the Swedish economy is export-oriented. Initial investigations have shown that the blow to Sweden did not differ greatly from that of its neighbors.

In Sweden too there was a decline in consumption, growth was harmed and unemployment increased. Even if local businesses remained open, Volvo cannot manufacture vehicles when there is interference in the supply chains and demand plummets, and H&M cannot sell clothing when factories and malls the world over are closed. Not to mention the tourism industry. Policymakers knew that and did not waste time on attempts to prevent the blow, but instead channeled money to reduce the damage it caused.

Even more serious is the claim that the Swedes tried to save the economy by achieving herd immunity, because initial examinations demonstrated that Sweden is very far from that objective. But Sweden has never claimed that it was aiming at herd immunity – on the contrary, it vehemently denied that.

The objectives were to flatten the curve of the number of patients and to protect the populations at risk. The first objective was achieved: intensive care beds and ventilators were ready for use at all times – an impressive achievement, because there was no need for a ruinous lockdown. In the case of the second objective, the Swedes themselves admit failure. Those using the example of Sweden would do well to stop looking at the country for proof for their arguments, and to try to think what can be learned from the Swedish case. In the final analysis, this is not a theoretical exercise, it is an essential preparation for the second wave.