The Swedish experiment continues to be one of the most interesting things happening in the world right now. Pretty much every other country in the world, including Sweden’s neighbors Denmark and Norway, have adopted similar types of government-ordered social distancing. But in Sweden, the country is merely asking people to be sensible and hoping that’s enough to slow the spread of the virus.
Anders Tegnell, the head epidemiologist at the semi-independent agency that is managing the Swedish response has denied that he is pursuing a herd immunity strategy but has previously said in an interview “We will not be able to control it in any other way.”
The Swedish response appears almost libertarian at first glance, but it isn’t based on trusting individuals so much as it is on trusting that most Swedes will do what the government recommends without being forced.
The government was clear, though, that Swedes should adopt the usual social distancing measures to flatten the curve. And experts told me the population typically trusts what officials say and abides by their guidelines, allowing officials not to have to impose strict measures.
Top Swedish officials say that two-way trust is paying off. “It is a myth that life goes on as normal in Sweden. Many people stay at home and have stopped traveling,” Sweden’s Minister of Health and Social Affairs Lena Hallengren told me. “There is no full lockdown of Sweden, but many parts of the Swedish society have shut down.”
In addition to this high level of trust in government, the Washington Post reports that “public health nationalism” has taken hold with many Swedes.
In the past few weeks, the country has experienced a bizarre nationalistic wave dubbed “public health nationalism” (”folkhälsonationalism”), which celebrates Sweden as an island of common sense in a sea of panic and resistance to science. According to this narrative promulgated by authorities and media alike, cultural exceptionalism — such as high public trust –– makes Sweden particularly well-equipped to manage the pandemic. When asked why Sweden’s strategy deviates from other countries’, Sweden’s influential former state epidemiologist Johan Giesecke quipped, “That is because everyone else is doing it wrong.” He went on to explain how he could be so confident: ”I think we will manage the epidemic without destroying the economy more than necessary. The absolutely most important thing is to protect the elderly from getting infected. I think we succeed quite well in that. It lies in the Swedish national character to do as one is told.”
And to be clear, the Swedish approach may still have some long term advantages. There simply isn’t enough data to draw conclusions at this point about what the trade-offs will be. It’s entirely possible that if we’re still locked in our homes three months from now and U.S. unemployment is above 30 percent, the Swedish approach may come to look like the wiser choice to some people.
But in the short term, it’s starting to look as if the Swedish approach will result in an increased death toll and overwhelmed hospitals, i.e. the very thing the U.S. and other countries are trying to avoid:
A head doctor at a major hospital in Sweden says the current approach will “probably end in a historical massacre.” He says healthcare workers at his hospital who have tested positive for the virus but are asymptomatic have been advised to continue working. He asked to remain anonymous because “it is frowned upon to speak of the epidemic or to go against the official vision” but said he felt a need to speak out from an “ethical and medical point of view.”
The Swedish legislature will meet this week to discuss whether tougher measures restricting business and travel should be implemented. Söderberg-Nauclér says it’s already too late to prevent chaos in Stockholm but that preventative lockdown measures could still be taken throughout other parts of the country.
“If they are right and we are wrong, I will open a bottle of champagne,” Söderberg-Nauclér says. She notes that, based on the modeling she’s seen, the healthcare system in Sweden will collapse if stricter measures are not adopted immediately. “But I will not give up the fight until the government shows us evidence for their strategy.”
A Swedish virologist told Vox, “I didn’t sign my informed consent for this experiment.” That’s really what this is: A nationwide experiment that we’re all watching play out in real time. The legislature may decide to clamp down this week and put an end to the experiment but it may already be too late to avoid a disaster. As of today, Sweden has 9,141 confirmed cases and 793 deaths. Denmark has 5,830 confirmed cases and 237 deaths.
This PBS report, published yesterday, gives some good insight into the Swedish approach including resistance to it from within Sweden: