@ Cynthia Adina Kirkwood
Lies About Sweden in COVID-19 Crisis
Social distancing at a city park entrance in Gothenburg (By Adam Ihse/Reuters)
Sweden has been misunderstood and, in some cases, downright lied about in its response to the COVID-19 pandemic.
Foreign leaders, including Alberto Fernandez of Argentina and United States President Donald Trump, have put forth Sweden as a cautionary tale in defending their own strict policies. Also, those who oppose surrendering their civil liberties in mandatory shelter-in-place orders sometimes point to Sweden for its respect of individual freedom.
Some of the harshest criticism has been from the Chinese newspaper, Global Times, which is linked to the Communist Party. The paper said that Sweden has capitulated to the new coronavirus and is in a black hole, where the virus can now thrive and attack other areas. It called on the international community, especially the European Union, to condemn Sweden’s actions of limiting testing to high-risk groups and health-care workers, according to Sveriges Radio on March 14. Long before now, Swedish-Chinese relations reached bottom when Hong Kong bookseller and Swedish citizen, Gui Minhai, was imprisoned in China. Gui went missing in 2015, and, in February, was sentenced to 10 years for illegally providing intelligence overseas, according to the BBC on February 25.
The first falsehood about Sweden’s response to COVID-19 is that it is following a herd immunity strategy.
United States President Donald Trump said in a televised coronavirus briefing in April that Sweden, “a very disciplined country,” is following the “herd” approach and is “suffering greatly”. Trump was referring to “herd immunity”, which is a form of indirect protection from an infectious disease that occurs when a large percentage of a population has become immune, whether through vaccination or previous infections, according to “Herd Immunity” by Paul Fine, Ken Eames and David L. Heymann.
Sweden Foreign Minister Ann Linde said in a televised CNN interview on April 10 that it was “absolutely false” that Sweden was using herd immunity. Linde also rejected the idea that Sweden had taken a radically different approach to other countries.
“We are doing roughly what most other countries are doing, but we are doing it in a different way,” said Linde. “No lockdown, and we rely very much on people taking responsibility themselves.
“We are suffering like many other countries, but there is a lot of myth going around about so-called Swedish strategy. . . . We have a combination of recommendations and legally binding measures that are followed by many of the people. For example, we can now see at Easter that there is a 90 percent decrease (in travel) from Stockholm to some of the most popular Easter travel places. And we also have more than 90 percent of the people who are more than 70 years old who stay at home and follow the recommendation.
“Then, we also have legally binding measures like, for example, it is forbidden to go and visit any elderly at a home. We have that no more than 50 people can (gather).”
The second falsehood is that business has gone on as usual in Sweden.
Although shops and businesses remained open, many shops have closed due to a lack of patrons, said Health Minister Lena Hanegren in a Bloomberg interview on May 1.
The third falsehood is that schools remained open.
Universities closed on March 16 and shifted to online learning. Secondary schools also closed their doors. On March 13, the spring Swedish Scholastic Aptitude Test was canceled for the 70,000 students who registered for it. On March 23, the Swedish National Agency for Education canceled national examinations.
Primary schools remained open, although principals could decide to close its schools after consultation with virologists. Education Minister Anna Ekstrom said that closing all the schools would cost more than it would give as carers would have to stay with children of health-care workers. There was much criticism within Sweden of the decision not to close all primary schools, according to Aftonbladet on March 13.
The fourth point is not a falsehood so much as a cultural misunderstanding about the term “recommendation”, which in English, means a suggestion of what should be done. However, a recommendation issued by a Swedish public authority is stronger than a suggestion but, if not followed, is not subject to a fine or prison.
The CNN interviewer attempted to understand the Swedish “recommendation” as he talked with Foreign Minister Ann Linde. He observed that there seems to be a basis of trust among all parties:
“You’re trusting the population to do the right thing without mandating some draconian shutdown. At the same time, the population is trusting the government to provide adequate health care for when they become sick.”
Linde agreed, saying: “The system we have had for 300, 400 years is that we have rather small ministries and rather big authorities. For example, the Public Health Agency is one such authority. There is a high level of trust between the people and the authorities toward the politicians, but also the other way around. When there is a recommendation from the Public Health Agency, there is a very, very strong urge to follow it from the population. So that is why in our case, and I have to say this is our way of doing it, we don’t need the legally binding measures because we can trust people to follow the recommendations to a very big degree.”
The Swedes are invested in their government. Voter turnout is one barometer. The voter turnout in the 2018 general elections was 87.18 percent, according to Valpresentatation (Election Authority). The country has the world’s second-highest voter turnout among the Organization for Cooperation and Development (OECD) countries, said Pew Research Center in “U.S. Trails Most Developed Countries in Voter Turnout” (May 21, 2018). Belgium has the highest, but unlike Sweden, Belgium has some form of compulsory voting. By comparison, the United States’ voter turnout in the 2016 presidential election was 55.7 percent, according to the Office of the Clerk of the United States House of Representatives and the Institute for Democracy and Electoral Assistance (IDEA). The U.S. ranked 26 out of 32 OECD countries in voter turnout of recent national elections.
In the CNN interview, Foreign Minister Linde said: “We have also made it possible for people to stay at home. We have taken away the qualifying days for sick leave. We have raised the money you get when you are unemployed.”
In mid-March, the Swedish government proposed a 300 billion Swedish kroner (SEK) (€27 billion) emergency package to reduce the economic impact of the crisis, according to The Local SE on March 17. The legislation reduced work hours where the government will pay half the salary, aiming to help businesses avoid layoffs. Also, the government will pay the employer’s expenses for sick leaves, which is normally shared between the employer and the state. Employer contributions also have been temporarily discontinued for small business owners, which will save small businesses about 5,000 SEK per employee each month but will result in a loss of tax revenue of 33 billion SEK, according to Dagens Nyheter on March 25. The emergency package was supported by all parties.
Those with minimal symptoms that could be caused by COVID-19 have been asked to stay at home. Also, the length of time one can stay at home without a doctor’s note has been increased from 7 to 21 days.
In the CNN interview, Foreign Minister Linde said: “We also have seen that the health-care system gets what it needs.”
On March 25, Bjorn Eriksson, the director of health care in Stockholm, appealed to anyone with medical education or experience in health care to volunteer. By the next day, 5,100 people had registered, according to Dagens Nyheter on March 27. Also, the increasing number of cases in densely populated areas such as Stockholm has resulted in the cancellation or postponement of 90 percent of scheduled surgeries, reported SVT Nyheter on May 7.
The Swedish response to the coronavirus pandemic has been heavily debated within the country. However, for the most part, criticism has been by academics. Opposition parties in the Riksdag, or parliament, with one exception, have avoided criticizing the government as have parties not represented in government in what often is called a “borgfred”, or truce, where the opposition supports the government in times of crisis.
On April 14, a statement criticizing the Swedish Public Health Agency strategy was signed by 22 academics and sent to Swedish newspapers. It called for stricter measures and said that the present strategy would lead to chaos in the healthcare system, according to Sveriges Radio on the same day. Moreover, it said that there was no transparency regarding the data used in the models made by the agency. Anders Tegnell, chief state epidemiologist and a central figure in the crisis responded that there was no lack of transparency.
The critics’ statement also compared death rates among the Nordic countries. In Sweden, there were 10 times as many new coronavirus deaths than in Finland, taking into account the number of deceased per million inhabitants.
As of May 17, there was 6.7 percent as many COVID-19 deaths in Sweden as compared with Finland, according to the Johns Hopkins University School of Medicine Coronavirus Resource Center. In Sweden, there were 3,674 deaths (36.08 per 100,000) compared with 297 deaths (5.38 per 100,000) in Finland. In Sweden, there were 29,677 confirmed cases compared with 6,286 in Finland. In the United States, there were 88,754 deaths (27.13 per 100,000) and 1,467,820 confirmed cases.
Many countries promote or require the use of face masks in public. Not Sweden. The Swedish Public Health Agency says:
“Face masks are not needed in everyday life. The best way to protect oneself and others is to keep at a distance from other people and to maintain good hand hygiene.”
Face masks in public spaces do not provide any greater protection to the population, Johan Carlson, of the Public Health Agency, said at a press conference on May 13, according to The Local SE.
There is concern that wearing masks would make people follow distance and hand hygiene guidelines less strictly.
Prime Minister Stefan Lofven said at the same press conference: “There is a risk of a false sense of security, that you believe that you can’t be infected if you wear a face mask.”
Much of the recent literature advises that wearing a face mask may stop the wearer from spreading the virus to others, not so much the other way around.
There was a reported shortage of personal protective equipment (PPE), including masks, for healthcare staff on March 13, when hospitals in Stockholm were forced to reuse disposable PPEs after sanitation, said Bjorn Eriksson, director of health for Stockholm, according to Expressen on March 15. Eriksson warned about the shortage in early March, and government agencies have waived temporarily the public procurement law in order to get more supplies quickly. The National Board of Health and Welfare confirmed that there was no preparedness storage and nothing to distribute to the health-care sector.
A Public Health Agency poster advises people on how to protect themselves and others from infection: Wash your hands frequently! Cough and sneeze into your elbow! Avoid touching your eyes, nose and mouth! Stay at home when you feel unwell!
Elsewhere on the Public Health Agency website, people are advised: “to keep at (an unspecified) distance from people in public places”.
As of May 10, diagnostic tests had been administered to only 177,000 in a country of 10 million, according to the Public Health Agency.
As more and more countries reopen, Sweden walks down the same road, which it believes makes it more likely for people to adhere to its few laws and many recommendations for a long period of time.
As Foreign Minister Ann Linde said in the CNN interview: “Our goal is the same goal as in other countries. We want to save lives. We want to hinder the spread of the virus.”