As an Irish person living in Sweden for much of the last year I have watched with sadness and concern what has been happening in both countries since the first outbreak of Covid-19 last year and since thousands of lives have been lost.
My interest here is similar to that of others, but also because both my husband’s parents, aged 85, are extremely vulnerable, live in an assisted living complex in Sweden, have carers enter their home four times daily and avail of regular respite in the local nursing home. In Ireland they would by now have had no other option but to enter a nursing home.
More liberal tack
Sweden’s approach to the Covid-19 pandemic has been very different to most other countries. The country has taken a more liberal tack, trusting its people to stay safe by adopting public health measures and only recently pursuing strategies of bans on large gatherings (until mid-November up to 50 people could still gather in public places) and some travel restrictions.
Sweden has not witnessed any nationwide lockdowns, rolling or otherwise. One reason for this is because the Swedish constitution has always banned lockdowns. Another is that public health recommendations in Sweden are made by health authorities and health officials – the equivalent of Nphet – and not directly by the government.
In Sweden, state epidemiologist Dr Anders Tegnell, who heads up the public health agency along with his team, have until now made all key recommendations regarding the suppression and elimination of Covid-19.
Swedish economy
Tegnell is revered by some for his success in keeping the Swedish economy ticking over in these most testing of times but condemned by others, for what is considered an irresponsible policy, going against all global and World Health Organization advice. Despite some protest and an earlier petition signed by more than 2,000 leading Swedish scientists to change direction, Tegnell has remained resolute, unflappable in his argument.
Nor is he unduly concerned that neighbouring Nordic countries, where strict lockdown measures have been applied, are reporting infection and mortality rates significantly lower than those witnessed in Sweden.
When asked why a lockdown was not introduced, Tegnell claims that if schools and creches were closed, the healthcare system would collapse as there would be “nobody there to mind the children”. Logical enough one would think in normal times, but these are far from normal.
He adds that at least Sweden will not have to face the difficult dilemma, confronting many other European countries, of easing lockdown restrictions. Face masks are still not mandatory in shops and as recently as some weeks ago, when other countries were debating the value of double masks and/or surgical masks, Tegnell was still calmly claiming that face masks may provide a false sense of protection.
Excess death rates
No measure is perfect in capturing the impact of an illness, but demographers argue that excess death rates offer comparable data. Between March and May 2020, excess deaths across Sweden ran at close to 3,500, meaning that almost 30 per cent more Swedes died during the pandemic period than would be normal for that time of year.
During roughly the same period, excess deaths in Ireland, a country, whose population is half that of Sweden’s, were at about 1,100 to 1,200, while excess death rates in Finland and Norway, countries similar in size population-wise to Ireland were fewer than 100.
As was the case in many other countries, those hit hardest by the pandemic have mainly been older people, resident in nursing homes, but the virus also been rampant in ethnic communities, especially in Stockholm with individuals born in Somalia, the Lebanon, Syria, Turkey, Iran and Iraq at heightened risk.
Nursing homes
In June a large-scale inquiry into the measures adopted in Sweden to suppress the pandemic started and a report was published in December. One in five Swedes is aged over 65 and this report was especially critical of Sweden’s failure to protect its older people, particularly those living in nursing homes.
In December, Swedish prime minister Stefan Löfven commented that the country had underestimated the deadliness of the virus and new and tougher recommendations and restrictions would be introduced.
These included the use of face masks on public transport and the closure of all public non-essential services. In early January 2021, a new pandemic law was passed that now allows the country to introduce lockdowns. However, to date no lockdown has occurred.
There is no doubt that within Scandinavia, Sweden has suffered more than the lion’s share of Covid-19, with more than 11,000 lives lost and the number of people infected running at over half a million.
In Finland and Norway where strict lockdown measures were enforced and borders closed off since early last year, the total numbers of deaths reported to date from Covid-19 are 655 and 550 respectively.
Nor has Sweden witnessed any major economic gain by avoiding lockdowns. For example, according to the Swedish central bank the country’s GDP will contract by 7 to 10 per cent this year, estimates comparable to the rest of Europe.
Cross-country comparisons are tricky: so many variables are at play, every human life is at stake and every country is doing its best. But it seems that Sweden has got it horribly wrong, partly because of its governance structures, partly because of the health authorities implicit trust in the public and their civic or personal responsibility to keep safe and partly because of the public’s own unquestioning confidence in the government.
But ask any Swede today and surprisingly most would say they are happy with the status quo and the freedom it allows.
And things are finally beginning to change in Sweden, infection rates and death rates from Covid-19 have come down, a nationwide vaccination programme is under way and, although where I live, bars, restaurants, ski resorts and gyms all remain open, restrictions have been introduced on numbers.
Also the health care assistants caring for my elderly parents-in-law have started to wear masks and due to a Covid-19 outbreak in the local nursing home, my father-in-law has, only since last week, had to stop using this service.
These are small developments in the right direction but a far cry away from a nationwide lockdown. An initiative that would hugely jar with the Swedish culture of “lagom” meaning moderation, personal responsibility and autonomy.