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How Sweden Has Faced the Virus Without a Lockdown

‘Life Has to Go On’

Swedish public health officials expect that more than a quarter of Stockholm’s inhabitants will have been infected by May.

Yet last week:

  • Picnickers flocked to parks in Stockholm last week and were sun tanning at Sickla beach in Nackathe.
  • Sweden has not restricted park use.
  • Sweden has placed no limits on public transport.
  • Students in Stockholm celebrated the completion of their secondary education, though gatherings of more than 50 are banned.
  • Bars and restaurants have remained open, though five restaurants were closed on Sunday for failing to observe distancing requirements.

What gives?

The country was an outlier in Europe, trusting its people to voluntarily follow the protocols. Many haven’t, but it does not seem to have hurt them.

Trust is high in Sweden — in government, institutions and fellow Swedes. When the government defied conventional wisdom and refused to order a wholesale lockdown to “flatten the curve” of the coronavirus epidemic, public health officials pointed to trust as a central justification.

Swedes, they said, could be trusted to stay home, follow social distancing protocols and wash their hands to slow the spread of the virus — without any mandatory orders. And, to a large extent, Sweden does seem to have been as successful in controlling the virus as most other nations.

Sweden’s death rate of 22 per 100,000 people is the same as that of Ireland, which has earned accolades for its handling of the pandemic, and far better than in Britain or France.

While other countries were slamming on the brakes, Sweden kept its borders open, allowed restaurants and bars to keep serving, left preschools and grade schools in session and placed no limits on public transport or outings in local parks. Hairdressers, yoga studios, gyms and even some cinemas have remained open.

Museums have closed and sporting events have been cancelled. And at the end of March, the authorities banned visits to nursing homes.

There are almost no fines, and police officers can only ask people to oblige. Pedestrians wearing masks are generally stared at as if they have just landed from Mars.

“Throughout the crisis Sweden has had enough intensive care units to deal with Covid-19 patients”, the minister of health and social affairs, Lena Hallengren, said in an interview, referring to the disease caused by the virus. “We have 250 empty beds right now.”

This is not to say that Sweden has escaped Covid-19’s deadly consequences entirely. The authority announced last week that more than 26 percent of the 2 million inhabitants of Stockholm will have been infected by May 1. But even that figure was presented as something of a win: a number of infections that might limit future outbreaks, reached without suffering an inordinate number of deaths.

“The freer approach has not fully insulated Sweden’s economy, mainly because the country is dependent on exports”, the minister of finance, Magdalena Andersson, said. She said the economy was likely to shrink by 7 percent this year, “but of course hairdressers, restaurants and hotels are less affected compared to other countries.”

From the first signs of the pandemic, the Swedish Public Health Authority decided that a lockdown would be pointless. “Once you get into a lockdown, it’s difficult to get out of it,” the country’s state epidemiologist, Anders Tegnell, said. “How do you reopen? When?” Scientists like Mr. Tegnell, and not politicians, have driven the debate over the coronavirus response.

Political leaders rarely attend news conferences about the virus, and the Swedish Constitution prevents the government from meddling in the affairs of independent administrative authorities, such as the Public Health Authority.

While there was some early talk in Sweden of achieving “herd immunity,” which would mean infecting at least 60 percent of the population, Mr. Tegnell denies that was ever the government’s policy.

When responses are assessed after the crisis, Mr. Tegnell acknowledges, Sweden will have to face its broad failing with people over the age of 70, who have accounted for a staggering 86 percent of the country’s 2,194 fatalities to date.

That percentage is roughly on par with most other countries, but some critics here say the mortality rate among seniors could have been far lower with adequate preparation. In a letter to one of Sweden’s most prominent newspapers, Dagens Nyheter, 22 scientists accused the Public Health Authority of negligence.

In the absence of recommendations from the Public Health Authority, one Jewish care home near Stockholm unilaterally decided to ban visitors. The health authority even went so far as to order the “no visitors” signs removed. The home refused, but it was too late. The virus had already crept inside, and eventually killed 11 of the 76 inhabitants.

It was only after the home required employees to wear face shields and masks when working with all the residents, even those displaying no symptoms, that it managed to halt the spread of the infection.

The minister of health and social affairs, Ms. Hallengren, acknowledged that there had been a shortage of protective gear, though she also noted that “many people in the health care sector for the elderly aren’t used to working with P.P.E.”

Source: The New York Times