People at the Grande Vegas online casino USA and around the world are watching Sweden to see how their approach to controlling the COVID-19 outbreak will pan out. Sweden’s strategy has been to keep everything open, as opposed to the majority of the world’s governments which have locked down.
Sweden’s policy was devised by scientists but has been consistently supported by the country’s leadership. The policy is being carefully watched by governments around the world which have been, for the most part, relying on social distancing to control the spread of the virus.
Sweden and COVID-19
In Sweden, there’s no lockdown. Life goes on as “normal” as schools stay open, people continue to go to work as usual and cafes and restaurants continue to serve. Sweden is relying on voluntary social distancing and their social experiment is drawing attention.
The government of Sweden has imposed no legal restrictions on gatherings or on the lives of Swedes. But most of the public seems to be doing their best to maintain isolation anyway – more people are working from home, fewer people are using public transportation, Swedes report that they are staying at least a meter away from others and the numbers at entertainment venues have dropped. The government has imposed a few restrictions -- no more than 50 people may gather together and no one may visit care homes for the elderly. They have also issued “recommendations” – work from home whenever possible and avoid travel.
Success?
The question on everyone’s mind is, is it working?
The Swedish Public Health Agency feels that the public has responded responsibly and that the strategy is sensible and sustainable. They point out that in Stockholm, coronavirus cases have plateaued and that any spikes detected are a result of increased testing. The health care system is not overwhelmed and Sweden seems no more at risk than countries where a lock-down is in place.
State epidemiologist Anders Tegell emphasizes figures. "To a great part, we have been able to achieve what we set out to achieve,” he says. “Swedish healthcare keeps on working, basically with a lot of stress, but not in a way that they turn patients away."
Most Swedes seem to agree with Tegnell and the Swedish Public Health Agency continues to enjoy high approval ratings from the public.
Different Drummer
Sweden has been marching to a different drummer throughout the crisis. As opposed to the rest of Europe, Sweden has left large parts of its society open. That strategy is based on Tegnell’s projections which, in opposition to most other scientists, demonstrate that the virus has a smaller impact relative to population size.
The Swedish Public Health Agency is also promoting their belief that the majority of COVID-19 cases are likely to be mild. The Agency denied that the strategy was based on the notion of herd immunity. They believe that less-stringent restrictions are more likely to be maintained for a longer period of time.
In Sweden, schools have remained open, as has day care. Parents are working, the economy is moving and life is almost like normal.
Numbers
Yet, when looking at the numbers, it’s not clear that Sweden’s approach is the right one. Figures from John Hopkins University report that the death rate in Sweden is one of the highest in Europe – more than 22 per 100,00 people. Other Scandanavian countries report less – Norway and Finland have less than four deaths per 100,000 people and Denmark has 7 deaths per 100,000.
On the other hand, countries such as Spain, Italy and the UK have a higher death rate than Sweden. Italy and Spain have a death rate of approximately 45 and 51 deaths per 100,000 while in the UK, there are approximately 32 deaths per 100,000. Swedish epidemiologists who support the government’s current policy point out that the numbers don’t tell the whole story. In Italy, for example, many households are multi-generational, the population is older and there are more smokers.
Still, many Swedish researchers, scientists and academicians are calling for the government to comply with the World Health Association (WHO) guidelines. In a March 28th petition, they wrote, "The measures should aim to severely limit contact between people in society and to greatly increase the capacity to test people for Covid-19 infection…..These measures must be in place as soon as possible, as is currently the case in our European neighboring countries. Our country should not be an exception to the work to curb the pandemic."
Herd Immunity
Critics of Sweden’s tactic said that the Swedish strategy involves trying to create a herd immunity. Herd immunity involves a situation that occurs when the majority of a population is immune to an infectious disease. This provides an indirect protection for those who are not immune.
Many researchers, both in Sweden and elsewhere, say that the idea of herd immunity isn’t supported by scientific research and are opposed to the tactic. Lena Hallengren, Sweden’s Minister for Health and Social Affairs, denies that creating a herd immunity is her government’s goal. "There is no strategy to create herd immunity in response to Covid-19 in Sweden. Sweden shares the same goals as all other countries -- to save lives and protect public health."
Professor Jan Albert of the Department of Microbiology, Tumor and Cell Biology at the Karolinska Institutet, believes that Sweden’s present strategy is the correct one. "What's the strategy of the other countries?" he asked. "It [herd immunity] was already the only thing that will eventually stop this, unless there is a vaccine in time, which is quite unlikely. The truth is that no one, no one in Sweden, no one elsewhere either, knows what the best strategy is. Time will tell."
Albert believes that strict closures "only serve to flatten the curve and flattening the curve doesn't mean that cases disappear -- they are just moved in time…..and as long as the healthcare system reasonably can cope with and give good care to the ones that need care, it's not clear that having the cases later in time is better."
Health Care System
Albert says that the healthcare system in Sweden is coping. The statistics show that the number of coronavirus patients who have been treated in the country’s intensive care units has been stable over the past few weeks. The failure, as in other countries, has been in protecting elderly residents living in care facilities. Ann Linde, Sweden’s foreign minister, admitted that the high number of deaths occurring in homes for the aged is the “one area where we have failed.”
State epidemiologist Anders Tegnell was asked whether Sweden’s death count would have been lower if Sweden had introduced stricter restrictions. He replied, "That's a very difficult question to answer at this stage. At least 50% of our death toll is within the elderly homes and we have a hard time understanding how a lockdown would stop the introduction of the disease into the elderly homes."
To Lock Down or Not
Hallengren, the Swedish health minister, notes that the absence of a full lockdown doesn’t mean that it’s “business as usual" in Sweden. There is a measure of social distancing and there are restrictions in place. Foreign Minister Linde said that "There's been a lot of misunderstanding. We have pretty much the same goals as every other government ... And as we have always said, we are perfectly ready to go with more binding regulations if the population does not follow."
As of late April, the Swedish Public Health Agency was forecasting that the peak of the spread of infections Stockholm County had passed. According to Tegnell, in the second wave of coronavirus infections, the country will be better able to withstand the onslaught. "It will definitely affect the reproduction rate and slow down the spread."
Tegnell said, if and when Sweden sees a second wave, it still won’t achieve "herd immunity." "We know very little about the immunity of this disease, but most of the experts in Sweden agree that some kind of immunity we definitely will have because a lot of people that have been tested so far have produced antibodies ... We hope this will make it easier for us in the long run."