Sweden’s coronavirus strategy has always stood out from the crowd. This distinctive approach is now coming to an end.
The government this week proposed an emergency law that would allow it to lock down large sections of society; the first recommended use of face masks has entered into force; and authorities have given schools the option to close for students over 13 – all changes combat strategy the pandemic.
“I don’t think Sweden stands out [from the rest of the world] absolutely now, ”said Jonas Ludvigsson, professor of clinical epidemiology at the Karolinska Institutet in Stockholm. “Most of the things that made Sweden different have changed, whether in Sweden or elsewhere.”
There has been no public abandonment of his approach – which has garnered enormous international attention for its no formal locking and the use of face masks. Instead, there was a gradual change in various policies as the Covid-19 winter wave hit Sweden much more difficult that health officials or politicians have been waiting for.
Sweden has reported more than 2,000 Covid-19-related deaths in one month and 535 in the past eight days alone. That compares to 465 for the pandemic as a whole in neighboring Norway, which has half the population. As King of Sweden Carl XVI Gustaf said just before Christmas: “We failed.”
Public confidence in the Swedish government and various authorities was strained after several reports from ministers – including Prime Minister Stefan Löfven who was criticized for his Christmas shopping – appeared to violate their own guidelines on how to to behave.
Dan Eliasson, head of the Civilian Contingency Agency, resigned this week after visiting his daughter in the Canary Islands over Christmas, as authorities texted nationwide days earlier to warn against any unnecessary travel.
“It’s a problem. What’s special about this country is that they trust people. I think the government hasn’t understood the seriousness of this disease,” said Claudia Hanson, master of lectures in global public health in Karolinska Mr Ludvigsson added: “I’m afraid this diminishes adherence to recommendations.”
Karin Tegmark Wisell, head of the microbiology department at the Swedish public health agency which has defined much of the country’s policy, insisted that it was “a feature of the strategy that when the rate of infection increases, we adapt our response ”.
She added that the conduct of ministers, MPs and officials such as Mr. Eliasson was a “difficult issue” that could affect trust in individuals but also trigger a wider societal debate about what was accepted and what was not.
Nevertheless, there is no doubt that Sweden’s approach has amended subtly in recent weeks. Stockholm’s center-left government on Monday issued an emergency law that is due to go into effect on Sunday, giving it the power to shut down shops, gyms and public transport, among others, if deemed necessary.
Ms Hanson said the mystery with Sweden was the reason the government had been so reluctant to respond, leaving much of the politics to the public health agency. “They could have changed the law a long time ago. All countries have had to adopt new laws to deal with the pandemic, ”she added.
Swedish health authorities have also long held against the use of face masks, arguing that there was little evidence that they helped reduce infection rates and some fear they could cause people to relax on more important measures such as keeping a distance and hygiene hands. But as of Thursday, face masks are necessary during rush hour in public transport even if there will be no penalties for not wearing them.
The 16 to 19-year-old high schools closed since the beginning of December will remain closed until at least January 24. This week, the public health agency gave high schools 13 to 16 years old the option to close if necessary – but added that the default should be to stay open.
Mr Ludvigsson said it was not a one-way traffic, with much of Europe moving closer to Sweden’s stance on some issues, including the importance of keeping primary schools open when many countries shut them down during the first wave of coronavirus. He added that most countries had also changed their goal of beating the virus to mitigate it, which had always been official Swedish policy.
This fits with the position that Anders Tegnell, a Swedish state epidemiologist, put to the Financial Times last month when he argued that Sweden and Europe are coming to a unified approach. “We are doing more and more of the same thing,” he said.
Far from everyone is convinced that Sweden’s distinctive approach fully explains its much higher death toll to its northern neighbors, which have similar population densities and cultures. Many in Sweden cite Belgium, which has locked down twice but has many more deaths per capita in Covid-19.
Mr Ludvigsson said more research was needed to determine why some countries were more affected by the virus: “People have 100% explained a country’s success or failure on the basis of its policies. But I’m sure there are other underlying factors that affect how the virus has taken hold in some places more than others.