As COVID-19 infections and deaths surge across many European countries, Sweden’s case count, and most notably death count, remain low.
Sweden did not impose a mandatory lockdown or mask-wearing, unlike Italy, Spain, France, and the United Kingdom. Instead, it encouraged its citizens to cut down their movement, properly social distance, and avoid large gatherings.
At the beginning of the pandemic, Sweden did experience high death rates at nursing homes but managed to reverse course by providing more targeted protection to those facilities. The country has resisted broad-based lockdowns recognizing that such measures could have greater, far greater costs.
“Locking people up at home won’t work in the longer term. Sooner or later, people are going to go out anyway,” Sweden’s chief epidemiologist, Anders Tegnell stated in April.
Tegnell made his comment on a bit of a limb. In March, the Imperial College of London predicted that Sweden would have 96,000 deaths from COVID-19 by the end of July 1, 2020. As of November 5, 2020, Sweden has 6,002 deaths. This represents a percentage error of 94 percent.
Underestimated Success
Despite the low numbers of deaths in Sweden and the ability to continue with relatively normal life, Sweden is largely ignored by other countries and the media.
The U.S. would be smart to follow Sweden’s lead, says Edward Burton, an economist at the University of Virginia. Burton shared an email to friends, colleagues, and former students with Health Care News, expressing his thoughts.
“Sweden, with a total population a bit over 10 million has had fewer than 6,000 deaths from the COVID-19 virus,” Burton stated in the email. “That’s a lot, but it is well below the European average and well below the U.S. average. If one looks at the numbers in Europe and the U.S. overall, deaths are continuing apace and there is no indication that any real progress on the virus has occurred from the shutdown and social distancing policies over the past several months.”
Since July, the daily death count in the United States has hovered around 1,000 per day.
“The U.S. has 33 times the population of Sweden but has 500 times the number of per-capita daily deaths from COVID-19,” Burton wrote. “It is clear that Sweden’s situation is many times better than that of the U.S. and Europe—500 times better.”
Coercion, the Wrong Prescription
Tegnell told the New Statesman on October 19 that one of the most effective courses in tackling the death rate was getting the nation to comply with mitigation, without coercion.
“I think it’s very important to have trust, and I think it’s been shown over time, with Ebola in West Africa, with many big outbreaks in the work, you need to have a public trust to stop the disease,” Tenell stated. “It’s important that the public understand what you are trying to achieve and work with you. I think that is what we’ve managed to achieve in Sweden so far.”
Sweden’s approach is a lesson for all policy-makers, says Jeffrey Singer, M.D., a surgeon and senior fellow with the Cato Institute.
“They gave the people consistent and accurate advice on how best to social distance and prevent spread,” Singer told Health Care News. “When people are not coerced, receive rational recommendations, and get good information, they tend to cooperate. Sweden also asked people to work from home when possible, and many Swedes did so.”
Sweden also considered the short-term and long-term impact lockdowns can have on families and children. It chose to keep schools open.
“Evidence shows the young children have a very low risk for contracting or spreading the disease, and if they contract it, they generally do quite well,” Singer said. “These very young children require in-person education or they can suffer developmentally. By keeping the schools open, that also allowed parents to go to work.”
Lockdown Laboratories
The United States is in a unique position because there was not a national lockdown; the U.S. system is largely state-based. As such, some governors in the United States followed Sweden’s example while others followed a response similar to the United Kingdom, Spain, Italy, and France.
“For example, Florida and South Dakota have largely followed Sweden’s example. And Arizona, Nebraska, and several other states have policies that are something similar if not exactly like Sweden’s,” Singer said.
Other countries continue to impose lockdowns, including most recently second lockdowns in the U.K, France, and Germany.
These countries will continue to grapple with the effects of prolonged lockdowns on the health of their citizens, Singer says.
“Economic lockdowns are causing people to miss necessary preventive health care, cancer screening, and treatments, and are leading to delays in diagnoses of serious medical problems, thus resulting in poorer non-COVID health outcomes,” Singer said. “They are also causing increased rates of substance use, depression, overdoses, and suicides.”
Kelsey Hackem, J.D. (khackem@gmail.com) writes from Washington State.
