The architect of Sweden’s unusual coronavirus strategy admitted this week that the country’s approach had “potential for improvement” and that too many people had died. On Wednesday, Sweden reached the unenviable distinction of the world’s highest weekly number of COVID-19-related deaths per capita.
According to The Guardian, in an interview with Swedish Radio, the country’s top epidemiologist Anders Tegnell said, “If we were to encounter the same disease again knowing exactly what we know about it today, I think we would settle on doing something in between what Sweden did and what the rest of the world has done.”
At the start of the pandemic, Sweden startled the world by adopting a more relaxed attitude toward social distancing measures — an approach we noted had earned it some critics. Kids under 16 continued attending schools, gatherings of under 50 people were permitted, and bars, restaurants, and shops remained open, albeit with specific guidelines.
Tegnell’s concession was a step back from his confident response six weeks earlier when he told Nature he was satisfied with Sweden’s handling of the disease. Even then, he acknowledged the toll coronavirus had made on residents of nursing homes, which account for half of the deaths.
With a population of only 10.5 million, Sweden has had 4,500 deaths from coronavirus. By contrast, its immediate neighbors Finland and Norway, each with populations of about 5 million, have seen 322 and 238 deaths from the virus, respectively. The vast majority of deaths in Sweden have been among residents over 70 years of age.
Tegnell has denied that achieving herd immunity was ever a goal of Sweden’s coronavirus strategy, noting that the aim was to flatten the curve to prevent the health system from becoming overwhelmed. Yet he brought up herd immunity several times in April, including in the Nature interview. That month Sweden’s ambassador to the US also touted Stockholm’s march toward general immunity as a sign of a successful coronavirus approach.
In fact, experts say Sweden has achieved nothing close to herd immunity, and unlike elsewhere in Europe, its rate of infection curve is merely getting steeper. As a result, the countries closest to Sweden will maintain restrictions on travelers from Sweden, even as they ease up travel amongst themselves.
While it’s unclear whether support for Sweden’s more lax approach is beginning to erode within the country, voices of dissent are getting louder. In a local radio interview, Tegnell’s predecessor, former chief epidemiologist Annike Linde, critiqued the initial management of coronavirus as if it were the flu.
“It has been found that the coronavirus does not behave like the flu at all. It spreads more slowly and has a longer incubation time. This makes it more difficult to detect and to gain immunity in the population,” said Linde.
She also suggested the country had not done right by its oldest citizens, noting its lack of preparation. “There was no strategy at all for the elderly.”
In fact, some observers have noted that a failure to send elderly patients in nursing homes to hospitals is part of the reason for the staggering death rate among those patients. A BBC story featured nurses who said they were instructed not to send ailing seniors to the hospital.
In this week’s radio interview, Tegnell defended the decision not to impose a total lockdown, saying that in so doing countries could not determine which measures would be effective. He did say, though, that by “taking actions one by one” Sweden might have learned what measures could best slow the infection without imposing a total lockdown.
Yet Tegnell did not elaborate on what those actions could be, nor offer any indication of new or modified steps that could be expected in Sweden in the days and weeks to come.