Coronavirus: Sweden Update

Sweden has gotten a lot of attention in the press recently regarding coronavirus/COVID-19. They are one of the few countries that have taken a softer approach than the vast majority of countries. Other countries that I would argue are following Sweden's approach is Brazil and Iran. I put up a blog post on Sweden on April 2nd. Per Worldometer, Sweden had 308 deaths at the time and 5,568 cases. This will post on April 14th, but I'm doing most of the writing on April 9th. As of April 9th, there were 793 deaths and 9,141 cases. So in 7 days, the number of deaths have more than doubled. Sweden is also 20th for most reported cases while they rank 91st on the country population ranking (10 million). Admittedly, a country like India may actually have far more cases than Sweden, but the testing isn't all that good. I could see Sweden staying in the Top 20 for a little bit longer as they could easily pass South Korea and Israel by the time I post this blog.

Bloomberg wrote a piece about Sweden on April 4th:

There are signs that the death rate in Sweden is growing faster than elsewhere in Scandinavia, raising pressure on the government to abandon its controversial hands-off approach in tackling Covid-19 . . . But after a week of sobering data, [Prime Minister Lofven] now seems to be striking a darker tone. In an interview published on Saturday by Dagens Nyheter, he warned that Sweden may be facing “thousands” of coronavirus deaths, and said the crisis is likely to drag on for months rather than weeks. Meanwhile, criticism from across the political spectrum forced his Social Democrat-led government to back down on a proposal to bypass parliament when implementing sterner measures to fight the virus, according to local media reports on Sunday.

. . . Visits to retirement homes for the elderly are banned, and Lofven has made clear stricter instructions may follow. But it remains a far cry from measures taken elsewhere. In neighboring Denmark, citizens face hefty fines and even prison sentences for breaking new coronavirus laws. Controversially, the government has also made it easier to expel immigrants as part of the freshly minted legislation. 



Sweden's government is now expecting thousands of deaths. As Sweden has a population of 10 million, every 10,000 deaths equals 0.1% of the population.

Though I haven't spent time search the Internet on this topic, one has to wonder if the Sweden Democrats (the far right political party in the country) are gaining (or will gain) in the polls (especially if this crisis gets out of hand).

On April 5th, Forbes looked into the government's reasoning for their hands off approach:

The crux of the argument put forth by Anders Tegnell, Sweden’s Chief Epidemiologist, and other leaders is essentially that nobody really knows what approach works best for a virus like this, and that the difference in outcomes between draconian lockdowns and a more relaxed approach may not be all that different in the end. As long as Swedish hospitals aren’t overrun, they say, there’s no reason to panic. They seem to be accepting that the virus will make its way through a certain portion of the population. “Flattening the curve” is important, yes, but taking more extreme measures to slow down its spread is not worth the pain and complications it would cause, at least for the moment. That is partly based on simulations run by the government (link in Swedish) that predict a lower number of hospitalizations per 100,000 people compared to other models that have been drawn up. 

I would be interested in learning more about what the journalist means by "compared to other models that have been drawn up?" Is Sweden really saying that if they went into a lockdown similar to other countries that the number of hospitalizations would end up being higher? That just doesn't seem to make sense.

Another interesting wording in the article is that more extreme measures don't need to take place "at least for the moment." That almost feels like the Swedish government isn't forecasting into the future and isn't assuming that this virus won't spread exponentially.

OPPOSITION GROWING

Will Sweden continue to take this type of approach? Yahoo on April 7th via Business Insider looked into what potential sterner measures might take place in Sweden in the near future. This would be done via the legislature, which might be showing some lack of confidence in the strategy being used by Lofven (Prime Minister) and Tegnell (Chief Epidemiologist):

Sweden's parliament may also introduce more restrictive measures, which could include shutting transport links, closing shops and restaurants, and putting new limits on public gathering.

Other than the legislature, doctors and scientists are also questioning the wisdom of this hands-off approach. Time writes:

At the end of March, 2,300 doctors, scientists and academics signed an open letter to the government calling for stricter measures.

“We think there is no scientific evidence for their strategy,” says Cecilia Söderberg-Nauclér, an expert in microbial pathogenesis who signed the letter. 

. . . A head doctor at a major hospital in Sweden says the current approach will “probably end in a historical massacre.” . . . 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.” 

Hmm. That last part is interesting. Some doctors are worried to speak out on the topic as his point of view is different from the official vision. Strangely, that sounds like how China dealt with those who spoke out about the virus earlier on. Admittedly, 2,300 doctors, scientists and academics did sign an open letter to the government, but there does appear to be fear among others.

IMPACT ON IMMIGRANTS

In the United States, as discussed by President Trump, Dr. Anthony Fauci and Dr. Deborah Birx, African Americans are being especially hit hard by COVID-19. On April 8th, Yahoo via the Huffington Post had similar thoughts about what was happening in Sweden:

While the government has not reported a breakdown by ethnicity, local researchers noted “an astonishing high rate” of deaths among the Somali population in late March, and recent statistics suggest a disproportionate number of infections in areas of the capital and national center of the outbreak, Stockholm, with many residents from foreign backgrounds. 

Some of the reasons provided are:

1. Sweden only provided information on the virus in Swedish.

2. Cultural differences such as many native Swedes live alone, this is not the case with the minority population.

This potential higher impact on the minority population versus native Swedes could be one reason why top government officials aren't ready to lock down the country. They're focused on native Swedes and the impact the virus is having on that population and over-looking the impact on immigrants.

PRAISE FROM US CONSERVATIVES

Sweden's approach has drawn praise by conservatives in the United States. On April 6th, Yahoo had an article from National Review:

Sweden has courageously decided not to endorse a harsh quarantine, and consequently it hasn’t forced its residents into lockdown. “The strategy in Sweden is to focus on social distancing among the known risk groups, like the elderly. We try to use evidence-based measurements,” Emma Frans, a doctor in epidemiology at Sweden’s Karolinska Institute, told Euronews. “We try to adjust everyday life. The Swedish plan is to implement measurements that you can practice for a long time.”

. . . If social isolation worked, wouldn’t Sweden, a Nordic country of 10.1 million people, be seeing the number of COVID-19 cases skyrocket into the tens of thousands, blowing past the numbers in Italy or New York City? As of today, there are 401 reported COVID-19 deaths in Sweden. 

Though this was published on Yahoo on April 6th, the 401 reported deaths are as of April 5th. As of April 9th, the number of deaths has risen to 793, almost double the deaths in 4 days.

I really think that sometimes strategies are praised or panned too soon into the process. As Sweden's infections and deaths seem to be rising much quicker now, I think we should wait a month or so before praising or being overly harsh on Sweden's approach.