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The Truth About Sweden and Covid-19

This article originally appeared on nzherald.co.nz 11/05/2020 (and stats are as of this date), make sure you support the industry by subscribing.

As many of us start to get itchy feet as we look forward to coming out of level three, I’m hearing more and more New Zealanders say, “look at Sweden and the scientific model they’ve used, we could have done that too.” 

As a Swedish ex-pat, I have followed what has been happening in Sweden very closely, and I can tell you all is not as it seems.

Yes, Sweden has taken a very different approach to the rest of the world. But it is coming at a heavy price.

And while history will always be the best judge, there is mounting evidence that the Swedish strategy is not the success some claim. 

Sweden’s death rate is 10 times higher than that of its neighbours, Norway and Finland, and over five times that of Denmark. 

Over three thousand Swedes have died from Covid-19, compared to the 21 deaths we have experienced in New Zealand, a country with half the population.       

That is not to say that herd immunity is the wrong approach, I’m not a scientist after all. And, managed herd immunity might be a legitimate strategic approach to managing the long-term impact of the virus.

However, while there has been plenty of articles glorifying Sweden’s approach, I think it is important to understand the reasons why Sweden chose this strategy, which simply was that they seriously underestimated the virus.  

So, let’s talk about Sweden and all the factors at play. 

Rewind to 2018. The Swedish election was inconclusive, but it saw the alarming rise of the far-right Swedish Democrats, who captured 20 percent of the vote as issues like immigration and integration took centre stage.

Following the election, incumbent Prime Minister Löfven vowed to continue in his role, but he quickly lost a vote of no confidence, forcing him into a ‘caretaker’ role while negotiations continued. It took four months until he was able to negotiate an agreement that allowed him to continue in the role.  

Löfven’s second term got off to a challenging start. There was a rapid rise in gang violence, with shootings reaching record levels in 2019. A highly criticised interview by Löfven on the escalating violence in Sweden led to public confidence in the Prime Minister plummeting in December. 

It was against this backdrop that Covid-19 struck. Some might argue that this was the best Christmas present a struggling Prime Minister could ask for.  

Let me explain. 

Sweden did not “choose” herd immunity as a strategy. They went for herd immunity because it was the only choice left after a series of bad decisions. It was simply too late. 

Why? Let me introduce you to Anders Tegnell, the State epidemiologist. Depending on who you ask in Sweden, he is either a caricature or a hero. 

Approximately one week after the first reported case, Tegnell stated in early March that he believed Sweden was reaching the peak of its curve. This statement was repeated several times through March and early April. 

You read that right. Sweden’s leading expert on the spread of the disease thought the country had reached its peak one week after its first reported case, despite the virus having an incubation period of up to two weeks! 

Without doubt, it was this view that dictated the future strategy Sweden adopted and that has led to the high number of deaths across the country.    

This mistaken (and unbelievable) view that Sweden had peaked in early March, and an inability to admit that it got this wrong, is what has made Sweden different. 

While its neighbours, and the wider world, prepared to lockdown and take steps to protect those most at risk, Sweden stayed open.

Sweden prioritised its economy over its people. It placed the rights of the individual higher than the rights and health of the vulnerable (often immigrants/refugees) and elderly. 

For a country that has built its global brand on being a champion of a strong welfare state, this strategy is a startling abandonment of society-focussed approach. 

As the crisis deepened, we have seen increasing numbers of embarrassing mistakes that have only served to highlight the Public Health Authority’s incompetence. 

The tragedy is that there has been surprisingly little media commentary holding them to account, which has contributed to building a false narrative around Sweden’s success.

Statistics hailed by the Public Health Authority at an April press conferences as proving Sweden was reaching heard immunity has been terribly inaccurate. 

Claims that there was “1 confirmed case for every 1000 unconfirmed cases in Stockholm” were ridiculous at best. A simple calculation would show this would have meant Stockholm had 6 million cases, despite having a population of only 1.6 million.  

Cue facepalm. 

In early May another embarrassing error, the Public Health Authority published and presented the wrong data as they attempted to demonstrate they had an understanding and control of COVID-19, instead they proved the opposite.  

While this might have been a case of human error, it does nothing to build confidence that the Public Health Authority knows what it is doing.

This is compounded by the early decision to limit testing, which was reversed in late April. As tests have increased, unsurprisingly so have case numbers. 

In mid-April, New Zealand had done 10,000 more tests than Sweden. This is despite New Zealand having half the population and reporting its first case a month later than Sweden. To date New Zealand has reported 168,000 tests, compared to Sweden’s 148,500 tests. 

Worse still, early May saw confirmation that over 50 percent of Stockholm’s elderly care homes had had a diagnosis of Covid-19. 

Swedes can see what is happening around the world. Many, including friends of mine, are taking decisive and responsible action and self-isolating, despite the government’s inaction.

This is why, in late April, a group of Swedish scientists wrote a scathing public letter to Anders Tegnell asking for major changes to the strategy. In the letter they labelled Sweden’s approach “shameful”. 

A lack of process, clear communication (recommendations instead of regulation) and issues with personal protective equipment are all cited as issues that could have been prevented. 

Despite this, approval ratings for Prime Minister Löfven are soaring. Allowing the controversial State Epidemiologist Anders Tegnell to front communication has paid dividends for the Prime Minister’s public image.  

Only now are mainstream media beginning to grumble about the Prime Minister’s unavailability to front in-depth media interviews and questions are being asked as to whether he has been using his team to shelter him from negative PR. 

So what does all this mean? 

While there is some truth to the “only time will tell” mantra, there are some facts in which we can measure success. The key one is the number of preventable deaths each country experiences.

The death toll speaks to the levels of preparedness (or unpreparedness), as well as our willingness to put a price on life and our best attempt to try to help those most vulnerable. 

In Sweden for every 1 million people the death rate is currently 319 for COVID-19, not that much lower than the UKs 465 and a startling difference from New Zealand’s 4 and Norway’s 40.  

If New Zealand had adopted a similar strategy to Sweden, we could have experienced 1,500 deaths, and this number would likely continue to climb. 

Let’s be clear. Sweden will never admit that they failed in protecting their people. But the Prime Minister and Anders Tegnell have a lot to answer for.    

The global debate on herd immunity continues and if Sweden reaches it faster than other countries remains to be seen. But they will have reached it by mistake rather than by design.

Surely if you were planning a herd immunity strategy you would have ensured there was appropriate safeguards in place? Instead indications show that Sweden have failed to protect those most at risks e.g. immigrants and the elderly.  

So, do not believe the Swedish government spin “that all is well”. It is not. 

The Swedish narrative is being driven by a Prime Minister and a Public Health Authority who are working hard to escape the blame for a disaster of their own making. 

While spouting on a global stage how successful Sweden’s strategy has been, this is driven by the desire to save their own jobs and to improve public perception. No wonder former Prime Minister and highly respected Swedish Diplomat Carl Bildt called for the government to put a gag order on Anders Tegnell. 

Meanwhile, Sweden’s unemployment rate has risen to 8% and forecasts are into the double digits, so it is hard to argue that their approach has saved the economy, at least in the short-term. 

For New Zealand, I hope that we can look back at this period and say that we as a nation did everything we could to protect those most vulnerable. I doubt that Sweden can say the same.

That is why I am of the view that New Zealand has adopted the right strategy.

Yes, it has come with economic pain. But out of every great challenge comes an even greater opportunity. As a country, we need to take advantage of the opportunity we now have. 

Yes, it is possible we get hit by a second wave, but kiwis have now been educated on a pandemic response and are largely familiar with what the country needs to do to get through this crisis.  

In the interim, we need to get on with the hard work of rebuilding our economy, to support companies to innovate, create jobs and explore new opportunities. 

Now there must be reward for our sacrifices. 

And as we move into this next phase of lockdown, I urge our Government to think creatively about how New Zealand can use its new competitive advantage to truly make a long-term and positive financial impact for the people of New Zealand.   

Let us not just be the country that is applauded for its management of COVID-19, let’s be the country that embraces this challenge as an opportunity to grow and prosper in the years ahead.