With the world on pause with coronavirus, Sweden’s unique approach has drawn intense global scrutiny, not all of it complimentary. It refused to impose tough lockdown, kept primary schools and core economic activities functioning, issued clear guidelines and relied on voluntary social distancing plus personal hygiene practices to manage the crisis. Chief epidemiologist Anders Tegnell explained that lockdowns have no “historical scientific basis”. “Each country has to reach ‘herd immunity’ in one way or another, and we are going to reach it in a different way.” He told the BBC Sweden will be better placed than most European countries to face a second wave of the outbreak. In the past fortnight infections rose again across much of Europe, they stayed low in Sweden but the real test will be this coming winter.
The US media was harshly critical of Sweden’s approach: the New York Times (including a distortion-filled hit piece), Newsweek, USA Today, CBS News. Unlike bemused-cum-resigned Indians, Swedes are more used to being the cynosure of American attention than the object of censure. The media focussed on comparing Sweden’s Covid mortality rate to its better-performing Scandinavian neighbours, ignoring how Sweden was in the middle of the overall European pack. They refused to look at US states, including, in the case of the NYT, its home state/ city. As of Friday, Sweden’s death per million people was 576, compared to 557 for the US overall, with 14 states exceeding the Swedish rate including New Jersey 1,804, New York 1,696 (NY City 2,840), Massachusetts 1,296, Connecticut 1,252, Louisiana 1,048, and DC 857. Most of the mainstream media has been equally reticent about highlighting that 8 of the 10 US states with the highest mortality have Democratic governments.
For harsh lockdowns to be justified elsewhere, Sweden had to be discredited. Yet after six months without lockdowns, school closures and other tough-love measures widely imposed across the Western world, Sweden’s daily Covid deaths have stayed below 10 since July 19 and revived the debate over its herd immunity strategy. Its economy too has suffered, but less. In the first quarter, Sweden’s economy was the only one to grow, albeit by a modest 0.1%. In the second quarter, it contracted by 8%, against the EU-27 average of 12%. Meanwhile the US economy contracted by one-third on an annualised basis and the UK economy contracted by 20.4% in the second quarter, the biggest such drop ever recorded. Allister Heath, editor of the Sunday Telegraph, acknowledged that Sweden “has pulled off a remarkable triple whammy: Far fewer deaths per capita than Britain, a maintenance of basic freedoms and opportunities, including schooling, and, most strikingly, a recession less than half as severe as our own”.
According to Oxford University professor of epidemiology Sunetra Gupta, “There is no way lockdown can eliminate the virus … once you lift lockdown in areas it will flare up again.” That’s what we saw in Melbourne recently. Her views are supported by Harvard Medical School’s Martin Kulldorff: “The question is not whether to aim for herd immunity as a strategy, because we will all eventually get there. The question is how to minimise casualties until we get there.”
In June Tegnell acknowledged that in retrospect, they should have taken better precautions to protect the care homes with more than half of Sweden’s virus deaths. This “was spun pretty hard” in the international media as a mea culpa. It wasn’t. Knowledge about coronavirus is much better now and would be useful for improved mitigation, but “the fundamental strategy has worked well”.
The Swedish example teaches us three important lessons. First, be open and transparent, not dogmatic and totalitarian. Second, provide clear guidance to the people, including the limits of scientific certainty and the “known unknowns”, as then US defence secretary Donald Rumsfeld put it in 2009. Finally, transfer the responsibility for risk assessment and management back to the people: They are the ones best placed to make informed choices that directly affect their lives and livelihoods today and in the future.