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Jury still out on Swedish coronavirus strategy In the race to condemn the Swedes for their approach to coronavirus, critics are missing the bigger picture

A restaurant in central Stockholm advertises its easter menu (Photo by Narciso Contreras/Anadolu Agency via Getty Images)

A restaurant in central Stockholm advertises its easter menu (Photo by Narciso Contreras/Anadolu Agency via Getty Images)




April 14, 2020   5 mins

Over the past few weeks, a huge amount of energy has been spent trying to prove Sweden’s more lenient approach to the coronavirus a failure.

Liberal news outlets in the US have commissioned opinion pieces from Right-wing Swedish commentators accusing the country of a pivot to national chauvinism; President Trump has talked about the Swedish “herd” approach and how “they are suffering very, very badly“; and Twitter is full of apocalyptic charts that are shared thousands of times and which seem to prove beyond doubt that the Swedes should have locked down better, and sooner:

But hold on a sec. That chart is carefully designed to look bad for Sweden — the timeline is extended in a way that makes the curve appear more dramatic, and the countries it features are only those which have lower deaths per million. Here’s the same exact chart, from the same source, compared with a different set of fully ‘locked down’ European countries:

Suddenly the Swedish curve looks the best — and flattening out rapidly.

The truth is, the Swedish epidemic is far from the out of control disaster its critics would like to believe. Yesterday, there were 12 deaths from Covid-19; the previous day there were 17; the day before that there were 77 and the day before that there were 106. We could expect levels to catch up after this Easter weekend, but it can hardly be described as exponential growth.

A clearer way of looking at death numbers, also courtesy of the excellent Our World in Data, is the daily trend of deaths per million. Here you get a good sense of the trajectories. All of the countries listed below, except Sweden, have full national lockdowns. And yet Sweden is roughly in the middle of the pack. This is quite remarkable in itself, when set against the dominant narrative that lockdowns are the only thing capable of ‘flattening’ these curves and preventing tragedies that are many times worse.

More immediately useful than the death figures (which are three weeks or more out of date by the time they are published) is the chart which monitors daily new admissions into Swedish critical care with Covid-19. How many seriously ill people are presenting every day? Again, the chart depicts a far from exponential increase. It looks to have been roughly flat for the past couple of weeks:

New daily admissions into Swedish critical care wards

New admissions to Swedish critical care, daily, since 6th March

This is why the Swedish state epidemiologist Anders Tegnell remains calm: he is not seeing the kind of rapid increase that might threaten to overwhelm the Swedish health service, and unlike policymakers in the UK, he has been entirely consistent that that is his main objective.

At first that was also the stated objective of the UK lockdown — to “buy time for the NHS” and prevent it being overrun. But with the 4,000-bed Nightingale hospital still lying near-empty, not a single hospital so far reporting as being overwhelmed, that objective is apparently being met. But it is no longer clear what the goal is, other than to ‘get past the peak’; so, worryingly, there is now no obvious metric on which to make decisions about lifting the UK lockdown.

Comparing Sweden with other countries produces a mixed picture: it shows that very early, very extreme lockdowns in smaller countries such as Denmark can be effective in arresting the virus completely. If numbers of deaths are the only measure of success, Denmark is “doing better” than Sweden here. By this measure, which many British commentators seem to consider the most important metric, the sign of good government simply becomes who can impose the strictest lockdown and reduce the number of Covid deaths closest to zero for as long as possible — but there is no sense in this discussion of a viable long term policy looks like, or what the trade offs or secondary effects might be.

Anders Tegnell explicitly worries that the Denmark lockdown has been too effective, and that they will struggle to find a way out of it. The moment they start releasing the lockdown measures, there could be a panic as cases start rising again. Modelling released by the Danish government factors in an increase in transmission, and therefore cases, and therefore deaths, when they bring schools back after Easter. But they are still going ahead and there aren’t headlines of ‘blood on their hands’ because of it.

The comparison of Sweden with other European countries also suggests that in those places where the virus was already widespread, such as the UK, the severity of the lockdown doesn’t necessarily correlate with a flatter curve. Belgium, which is fully locked down, has a much more worrying trajectory than Sweden, with no lockdown. The severest and most disastrous epidemics so far have been in Italy and Spain, the countries with the strictest legal lockdowns.

In any case, it’s unclear whether the ‘Danish option’ would even have been available to the UK, with a city like London at its heart. The worst epidemics have been seen in global hubs such as London and New York — another reason why it is a fallacy to say that the size and extent of different national epidemics is simply the effect of differing government policies.

That’s why it is important that some of the simplistic thinking surrounding this crisis needs to be challenged. If the only moral and virtuous policy is to minimise Covid deaths at all costs, as parts of the media imply with the endless game of ‘look how badly Britain is doing compared to X other country’, there can be no argument for releasing any part of the national shutdown at any point. The refrain at every point will be the same: why take a risk with people’s lives? And the Government will find itself backed into a corner.

A better definition of success would surely be: which governments are getting the balance right between protecting their people as reasonably as possible against this new threat while not destroying too much of their country in the process? Death rates per million is not the only datapoint in this difficult equation; and right now, it is far too early to judge how successful Sweden, or the UK, will be.


Freddie Sayers is the Editor-in-Chief & CEO of UnHerd. He was previously Editor-in-Chief of YouGov, and founder of PoliticsHome.

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tommy1979
tommy1979
4 years ago

Well its not such a big mysteri for us Swedes…
1: we trust FolkhÀlsoinstitutet (people’s healt institutet) and their guidlines how to tackel a pandemic of this sort

2: THE Swedish government trust us citizents to act and take the precautions needed to keep the most wonurable as safe as they can be and act om their recomendations who they get from the FolkhÀlsoinstitutet, how collects as much sientific evidens and solutions as possible

3: we report ALL cases of death where traces of Covid-19 is found, even patientes whos already terminal I’ll from other decisces, there is country’s right now in Europe who don’t even register eldery who dies even of traces of Covid-19 is found as Covid-19 victims. That is also a reson why we hade/have a high mortality rate but Still only om the middle as you could read in the charts

I do do apologise for my Spellings ðƾ˜Ơðƾ‘

melandrabethell
melandrabethell
4 years ago
Reply to  tommy1979

Yes, I agree with you 100 percent!

Mark Bishop
Mark Bishop
4 years ago

It’s entirely possible that two countries could pursue wholly different strategies and both be right. Sweden’s population density is much lower than the UK’s, and therefore its R0 (transmission rate) would be lower, if both pursued the same (or no) mitigation strategy. Less change is therefore needed to get R0 below one, the point at which new cases decline, or to hold it around one, enabling it to pass through society at a rate that allows hospitals to provide suitable care to those infected while working toward herd immunity.

The unstated question for the UK is whether we recognise the vast differences in population density across the British Isles by varying the degree of lockdown across the country. Encouraging the good people of Dartmoor or the Fens to meet friends at the pub while closing down the London Underground seems inconsistent but may be the optimum strategy, if we believe it can be communicated clearly and that people won’t game it by moving around the country (think furloughed London couple retreating to one set of parents’ holiday cottage in the Scottish Highlands).

mshwartz
mshwartz
4 years ago

Unfortunately, policy can not be made retrospectively. A choice had to made before the data was available, and the conservative option had to be taken. I don’t think the government had a choice. Large parts of the media have been going with the ‘UK didn’t act quick enough to enter lockdown’ narrative and ‘country x did this, why aren’t we’ – Imagine the hysteria and the accusations towards the government if death rates were similar in the UK with a no lockdown policy. We have to learn from the data and outcomes, but let’s not play policy by hindsight.

Fraser Bailey
Fraser Bailey
4 years ago
Reply to  mshwartz

Yes, I don’t particularly blame the government for anything. They were in an impossible situation, not helped by the hysterical media you refer to. And I blame the NHS and PHE for the lack of PPE. They have plenty of money for countless unnecessary managers, diversity consultants and communications people, so they have money for PPE. All that said, Sweden does seem to have been the only country that has acted calmly and rationally.

reluctantmlungu
reluctantmlungu
4 years ago

Excellent, Freddie. Your simple, evidence-based (how ‘progressives’ love using that term against their opponents) arguments shows just how much of an agenda the ‘mainstream’ media seem to have with their constant, extreme alarmism.

Mark Corby
Mark Corby
4 years ago

A brilliant analysis of the media hysteria and bovine Government policy that has dominated this synthetic ‘crisis’.
Was it not HMG that extolled us to bin our petrol cars in favour of wonderful clean diesel ones, only to rapidly reverse that decision and penalise diesel owners? Yet we are still expected to have faith in Government scientific advice?
Perhaps in a nation that seriously believes that a man ‘rose from the dead’, and has just finished celebrating that preposterous notion, it is hardly surprising.
No, we should swallow our pride, forget that we invented Penicillin and the Spitfire and follow the example of Sweden, the inventors of the Aga and Volvo amongst many other wonders.

Jerry W
Jerry W
4 years ago
Reply to  Mark Corby

I see you are a man with an agenda .. the Aga for example is a wasteful Victorian oven that is hard to control and gives off heat as if there is no tomorrow. Volvo is Chinese and has been for years. Diesels are not in any way clean if you look at particles. I love Sweden and have many friends there, but they are no more an exemplar for the UK than say, Germany which is notably being more successful in dealing with coronavirus. Hysteria is bad, no matter who is spreading it 😉

Mark Corby
Mark Corby
4 years ago
Reply to  Jerry W

Apologies for the rapid response, but gardening finished earlier than expected.
You misunderstood my point about Diesels. I am not claiming they are ‘clean’ it was the bovine behaviour of HMG and it’s subsequent volte-face on the subject that I found irritating.
I personally like my kitchen to be as hot as the boiler room of the late, lamented, H.M.S. Hood (commissioned 1920) and the Aga (invented 1922) is perfect, if you know how to handle it/her.
Volvo was sold to the Chinese in 2010. The only other Chinese thing about it is the Pangolin carrier in the boot.
Given Germany’s history, I think I, and many others would rather be guided by Sweden. Need I say more?

Mike Hall
Mike Hall
4 years ago
Reply to  Jerry W

You’ll need more evidence from Germany to make the claim it has been more successful dealing with the current plague. Daily score sheets are not enough. We’ll not know until later this year when proper studies start to get released (from serious sources) which practices proved most effective and limiting what? spread?/ deaths?/ re-bounds, etc.etc.

Juilan Bonmottier
Juilan Bonmottier
4 years ago

I agree with so much of this article -thank you for articulating a viewpoint that is hard to find in the mainstream -disgraceful though it is that such a thing should be true to say.

As you write, ‘some of the simplistic thinking surrounding this crisis needs to be challenged’.

In terms of ‘the government being backed into a corner’ however, it seems to me it’s doing a fine enough of a job of this on its own and without the need for any assistance. Today Sunak was making the plaintive case that given the choice between ‘people’s health’ and the ‘economy’ he would choose people’s health every day -bathing in virtuous self regard and moral sanctimony. This is not just in all probability, an outright lie (I’m sure he could be pretty Machiavellian with some economic decision making) but it’s an utterly false choice making out that the government in some way had its hands tied when it came to competent decision making by its moral duty. This government has messed up – but they need a narrative which will obfuscate the ineptitude of their fight/ flight response to date -and the ‘saving lives’ and ‘protecting the NHS’ will do.

By the way, in terms of ‘protecting the NHS’ the vast majority of NHS staff are currently doing far less than they have ever had to do thanks to this lockdown. Almost all appointments have been cancelled, no referrals, no consultations, nothing! I imagine the NHS has collectively never been so unproductive in its entire history. Once the data is in -we can assess just how much harm this branch of inactivity has conferred on patients.

And the media are meanwhile lapping it all up faithfully and feeding us stories about OAPs running around in circles in their back gardens ‘for the NHS’. A metaphor if you will for the aimless blind panic of the response to this crisis.

Adrian Smith
Adrian Smith
4 years ago

Thanks for a well researched and balanced article. Your multi country logarithmic graph is the best presentation of daily death figures I have seen. Using a 7 day rolling average sorts out the weekend under reporting and consequent Monday surge effects. We used to see something similar at daily No 10 briefings, but it changed about a week ago for a cumulative which makes it impossible to see the peak – I wonder why?

I doubt the Swedish approach would have worked in UK – we are just not that obedient or sensible. There is no doubt in my mind that it has worked brilliantly in Sweden with them “peaking” before us – may not be sustained, but clearly in a downtrend at the moment. It seems clear to me that whilst CV 19 is more dangerous than normal flu, it is nowhere near as deadly as people believe and Sweden shows the spread can be controlled by taking quite mild, simple and commonsense measures.

The damage done to our economy already is bad enough to kill more people than the virus ever will. We need to lift the lock down, get the kids back to school and get back to work. Sensible restrictions can be put in place to allow shops, bars and restaurants to reopen and, having been through lock down, the majority should now respect them. I think the restriction on mass gatherings needs to remain eg football matches and concerts etc. Most of all I believe failing to grow herd immunity gradually over the summer months risks a far worse resurgence in autumn / winter when ordinary flu will be back to compound the problem and that really will overwhelm the NHS , as it often does already. We have built additional capacity which is not being used, we need to start using it and get all those cancelled operations back on.

Joe Smith
Joe Smith
4 years ago

“A better definition of success would surely be: which governments are getting the balance right between protecting their people as reasonably as possible against this new threat while not destroying too much of their country in the process?”

In short: we don’t want a victory over Covid-19 to be a Pyrrhic one, which it could well be if lockdown goes on much longer.

Benjamin Dyke
Benjamin Dyke
4 years ago

Great article. I’m a Brit living in Sweden in the 10th largest city (i.e. not Stockholm or Gothenburg or Malmö!) and the response in Sweden seems proportionate to the threats faced here! Lives are very much being affected by both the disease and the response but it feels all very adult…I as an example have had my work hours reduced by 40% due to the economic impact and to take advantage of the government scheme for employers, most of my organisation are working from home, people are not going to restaurants or cafes like they are used to, nor out to the shops, there is little to no journeys being taken for work or leisure, most people are resisting the urge to hug when we meet up and keeping a distance.

Mike Hall
Mike Hall
4 years ago
Reply to  Benjamin Dyke

Sweden provides an alternative study. The most interesting comparison will be with Norway, same people / DNA / culture / attitudes / pattern of living, but Norway went into lockdown. I doubt this will be the last pandemic we suffer and such comparative study will be quite instructive to how we deal with this in the future.

Madeleine Moback Neil
Madeleine Moback Neil
4 years ago
Reply to  Mike Hall

I would not say that Sweden and Norway are as comparable as we generally believe. Though languages are virtually the same, we have quite different cultures, different attitudes, and very different socio-economic structures.

mariamgrandinlindmark
mariamgrandinlindmark
4 years ago

Hi, as a Swede, do you base your assumptions on the official numbers or the actual numbers (that are bad enough for the leadership to withhold from the public?
Israel’s population is more or less the same as Sweden’s, but Israel tracks and maps cathode contagious and sick and have a tenth of the mortality compared to Sweden. And in Sweden the authorities count only hospital cases and so far not those who died or are dying at home or at the nursing homes, of which approximately 100 are infected. That makes excellent statistics. At the same time Swedish authorities boast about having an 80% success rate at the ICU’s. That means they admit those expected to recover, not that they admit those who are really in bad condition. There’s a selection underway where doctors are made to choose which ones to save. Those over the biological age of 80 are not admitted.
However, illegal aliens are – despite the fact that the former have paid hefty taxes most of their lives in order to ensure that they get to live their lives fully, with the care they are entitled to – something which they under this pandemic, are not granted.
In acting quickly many lives are saved – dragging it out, waiting “to see what will happen” and them doing the opposite of others with by now more experience, not encouraging people to take safety measures, selling all the field hospitals, military and crisis supplies so the Swedes stand unprotected at the mercy of a government who is paralysed and too afraid to act now but instead hiding the actual extent of the crisis. In the meantime hospital staff make their own protective gear and the staff at the nursing homes in general wears none whatsoever. Just the other day Tegnell, the elected head epidemiologist, admits that maybe, just maybe one can be contagious without showing symptoms – while doctors from all over the country rage at this blatant system of misinformation. If you break the back of the healthcare system (which was at breaking point even before there even existed something called Corona) chances are that not even people of the “right” age will have somewhere to turn. This is what happens when you let loose this disease, which, by the way is said to be 10 times as deadly as the swine flu. Don’t think Sweden has any form of control – they don’t. The numbers they serve are made to look good and they are falsified, just like the information given to the public.
The mouth cover is not for your own protection, but others’ – so don’t be selfish.
If you want more information on this, just contact me and I’ll show you where to go, in order to get to the bottom of this.
Stay healthy!

mats.ronne
mats.ronne
4 years ago

In a similar way that London and New York are more severely hit, Stockholm is (so far) quite different from the rest of Sweden. Greater Stockholm has just under 25% of the population of Sweden, but around 2/3 of the Swedish corona virus deaths.

jason whittle
jason whittle
4 years ago

Much needed article. The media’s silence on 3 great days in Sweden, in terms of CV19, was deafening. Now the Swedish government reported just 5 deaths on 14th April, the same as Norway and 1/3 of Denmark. Instead of celebration and enquiry into the validity of lockdown, an anonymous hack put 114 deaths on the most visited site on the virus http://www.worldometer.com. This number was then immediately picked up by a journalist and posted on Forbes as proof of the disaster of Sweden’s policy. Just 5 new people also went into intensive care. spread the word, lock down was an economic disaster with very limited or quantifiable benefits to the safety of the community.

Fraser Bailey
Fraser Bailey
4 years ago

Actually the jury is increasingly ‘in’ on the Swedish strategy, and it seems that Sweden has had no more deaths per million than anywhere else.

melandrabethell
melandrabethell
4 years ago

This is why I go directly to data sources myself, rather than relying on shared charts. I put in the countries and parameters that I want to check against. Replying to the Swedish guy below, I wish the infamous Neil Ferguson (aka Professor Lockdown) who’s non-peer-reviewed study (which he later proved that he did not believe in by flouting his own rules) pushed our government to enter a Draconian lockdown, would take a good long look at this latest in a line of predictive failures and learn something. If only that outdated computer modelling is unreliable. The Swedes have got it right!

KristjĂĄn ArngrĂ­msson
KristjĂĄn ArngrĂ­msson
4 years ago

What exactly is the point of this article? Surely the author is not implying that Sweden is somehow a similar society as the UK and thus the cases of Sweden and the UK are directly comparable?
Or is the author®s point that the lockdown in UK is unnecessary and an infringement on liberties? Why would we not want to curtail our liberties for a short while if that might help protect the vulnerable? How narcissistic can you be?

Benjamin Dyke
Benjamin Dyke
4 years ago

The point was quite clear from the title surely?

dibakarghoshurol
dibakarghoshurol
4 years ago
Reply to  Benjamin Dyke

Sweden could have kept the next Nobel on Medicine and Physiology for themselves,only if Tegnell would have thought about the Care Home inhabitants and insulated them before declaring his Novel Experiment.

Mike Hall
Mike Hall
4 years ago

Who are the vulnerable? Men in their 50s, ex-smokers, with over weight issues? So sketchy research has so far illustrated. Or is it self-employed people on thin margins who find their livelihoods wrecked or alternatively people with mental health issues who find isolation and lack of normal support destructive – both cases suffer strikingly from this lockdown.

KristjĂĄn ArngrĂ­msson
KristjĂĄn ArngrĂ­msson
4 years ago

“If the only moral and virtuous policy is to minimise Covid deaths at all costs, as parts of the media imply with the endless game of ‘look how badly Britain is doing compared to X other country’, there can be no argument for releasing any part of the national shutdown at any point.”
Talk about “simplistic thinking”. But seriously, this is surely a straw-man. Does anyone actually hold this position?

Mike Hall
Mike Hall
4 years ago

I think the decision to upgrade to lockdown was less to do with the touted Imperial College model but more that govt saw that people were rapidly locking down themselves, so the plan to choose the timing of lockdown (and the limited supposed toleration of it) was no longer an option. I suspect the “metric” used to release lockdown will be the same. When mass people start meeting up again / nerves about personal economics / children’s development/ patience wearing thin / sense the threat is less than it was, the govt will be unable to stem the return to social normality and “we may as well” allow shops etc to open up again.

Michael Hadley
Michael Hadley
4 years ago

It’s easy to understand why some don’t search out or trust articles like this. When THEY have an agenda in which we are not allowed to doubt you will notice both SIDES agree about the lies being spread. Lies about how evil China is or what actually makes this virus deadly. For truth about China I advise folks to watch youtube videos made by Brits, Aussies, and Americans that were and are living in China during these times. For truth about what will actually help you survive the ðƞŠ  I advise researching the works by Dr Ron Rosedale. He has some great books and a recent youtube video directly related to the virus. Also there is an Irish doctor who wrote The Oxygen Advantage with great advice about breathing through the nose at all times. I don’t recall his name … maybe Patrick McGowen or something like that. He also has a recent youtube video with great advice about this. I new there had to be an article about Sweden like this but I truly had to dig. I’m now a proud member. Keep up the good work.

Daren Austin
Daren Austin
4 years ago

You’re looking at plots the wrong way. Take the interactive plot of cases/1M embedded in the page. Show it on a LOG scale, then look again. You will see clearly that France, Sweden and UK are completely PARALLEL, but Belgium crosses the others with a steeper ascent. Now imagine they are rebased in time to 0.1 cases/M and start from there – they will sit on top of each other. The explanation is not RATE of spread (which is largely constant), but time of introduction of the epidemic. From that data, there is little evidence that Sweden has better or worse outcome than UK and France. The real question is why is Belgium looking worse with disproportionately more rapid increases in deaths?

j flood
j flood
4 years ago

The real reason that “experts” are mounting an all-out war on the swedish approach.., is that they don’t want there to be any counter-examples of the strategy they have forced us to adopt.

If the sweden ends up having more or less the same outcome as countries that have adopted draconian lockdowns.., the “experts” will have a lot to answer for – including, potentially, many unnecessary deaths – the victims of the the cure.