This time a year ago, the discussion around Covid changed. In an interview with UnHerd, Johan Giesecke, advisor to the Director General of the WHO, former Chief Scientist of the EU Centre for Disease Control, and former state epidemiologist of Sweden came out forcefully against lockdowns. The world was shutting down and he was the first voice to speak out so bluntly early in the pandemic.
He contended that the difference in infection and death rates between countries would come out in the wash, regardless of their lockdown policies and promised to return in a year’s time to review the evidence.
But he makes no bones about his mistakes. When I remind him of his prediction that countries would end up with similar results after a year, he readily concedes he was mistaken. “One of the things I got wrong a year ago is the rate of spread of this disease. I thought it would spread quicker. And I also thought it would be more similar in different countries. We can see now that there are big differences in the rates of spread in between countries. It may have to do with lockdown, it may have to do with cultural things in these countries. But there is a big difference between countries.”
The difference that is most commonly cited in the ‘case for the prosecution’ against the Swedish strategy is the following chart showing Sweden’s deaths per million dramatically exceeding its neighbouring Scandinavian countries. This is generally considered solid proof that the Swedish strategy failed.
Johan Giesecke disagrees: “The differences between Sweden and its neighbours are much bigger than people realise from the outside — different systems, different cultural traditions…If you compare Sweden to other European countries [such as the UK, France, Spain, Italy, Belgium] it’s the other way round. On the ranking of excess mortality, Sweden is somewhere in the middle or below the middle of European countries. So I think it’s really Norway and Finland that are the outliers more than Sweden.”
Explaining what he means by cultural differences, he mentions among other factors that “they’re more sparsely populated. There are less people per square kilometre in these two countries. There are also much fewer people who were born outside Europe living in these two countries.”
So, crucially, if Sweden had instituted a hard lockdown and shut the border earlier, would its death rate have been closer to its Nordic neighbours? “Maybe not,” he says, “I think we would still have more deaths than they have.”
He is also fairly dismissive of charts currently showing that Sweden has the highest level of infection in Europe:
“I don’t think you should compare countries now, while we are still in the pandemic. You should wait until the pandemic has receded before we start comparing countries. If you did that chart a month ago it would be very different. And a month from now? I don’t know but it would be very different. These snapshots may not show the whole truth.”
Compared to the UK, Sweden ranks 23 in the world in terms of Covid deaths per million, and the UK ranks 11 —so on the most important measure of all, Sweden has had a better result. In fact, as the above chart shows there are strikingly similar patterns of deaths over the past 12 months in the two countries.
“They’re very similar,” says Gieseke, “And yet one of the countries has had three severe lockdowns and the other has only had voluntary or mostly voluntary measures. That tells us something I think.”
What does it tell us?
“That lockdowns may not be a very useful tool in the long run.”
Swedish expert: why lockdowns are the wrong policy
In our first interview, the Professor speculated that the Infection Fatality Rate (IFR) could be as low as 0.1% and that over 50% of people would shortly be revealed to have already had the virus once antibody testing became widespread.
We now know that the IFR for countries like the UK and Sweden is between 0.5% and 0.9% and that antibody testing has persistently revealed disappointingly small prevalence. Even now, after tens of millions of people have had Covid in the UK and a further 32 million have been vaccinated, antibodies are only estimated to be present in 55% of people.
“Two things I really got wrong (there are probably more things, but two big things). One is that the vaccine came so fast. I had no idea that we would have a vaccine within a year… The other thing is the rate of spread — I overestimated it, I thought it would spread much faster than it did.”
Giesecke was critical, last year, of Prof Neil Ferguson’s forecasts of up to 510,000 deaths in the UK from an unmitigated epidemic, 250,000 from a mitigated epidemic and as few as 20,000 with a suppression strategy. But with over 130,000 deaths in the UK, I ask, Ferguson’s numbers don’t look so wrong any more, do they?
“You may be right,” he concedes. “There is quite a difference between half a million and 130,000 — but, yep.” Put together, I suggest, these errors — a wrong estimate of the fatalities, the wrong percentage of people infected and an overly pessimistic expectation of the vaccine roll out — add up to getting the overall picture very wrong. So does that mean that his rejection of lockdowns at that stage was wrong, too?
“No. Sweden has had rather severe restrictions, but we based them on voluntary participation by the inhabitants instead of using laws and police. A lot of people in the world seem to think that Sweden did nothing about the Covid pandemic. That’s wrong. The entire population changed their way of living and it had profound effects on daily life for millions of Swedes, even though you weren’t fined if you were in the wrong place at the wrong time. So I would still advocate the Swedish model, even knowing all that.”
Although he concedes that some lives may have been saved, he believes that the successes of the Swedish approach over the past year should be considered in the balance:
“Look at the good things with the Swedish system…. One is the schools: we are not destroying the future for classes of children. Another is that Sweden kept to its international agreements — for example in the EU you are not supposed to close your borders with other countries, but that has happened in several countries in Europe. We have made it possible for small businesses like cafes or bicycle shops to survive the pandemic. We have kept democracy. We have trusted people. I think there are a number of benefits from not having a severe lockdown and more of them will come as we do research on this in the future.”
A year ago, Giesecke predicted that inhabitants of a democracy would swiftly tire of lockdown, and that long-term house arrest was not a viable option. But as it turned out, the policy remained highly popular among the majority across Europe for most of the period.
“People were willing to give up more freedom than I thought they would. It worries me — there are many democratic rules and freedoms that have been curtailed. I think that may be one of the dangerous results of this pandemic.”
He regrets the recent legislation in Sweden that makes lockdowns constitutionally possible for the future. “There is a new law — a pandemic law — which gives the Government more power than it had before, and curtails part of the freedom of the Swedish population… It’s shifted power away from parliament to some extent, which is a new thing in Sweden at least in peacetime.”
Looking to the future, Giesecke can see various scenarios playing out:
“The virus may mutate so it becomes less pathogenic than it is now. It may be that it comes back in a new shape every autumn. And it may be that we’ll all have to take a new coronavaccine every year, tailored for that strain. But it is here to stay — we won’t get rid of it.”
Which is not to say the pandemic heralds the beginning of a “new normal”, or is part of a “great reset”. In fact, he is confident that the old normal will return. Once vaccinated, he believes people should return to normal:
“If you are vaccinated with two doses and wait the right number of weeks, then… you should be able to live like you did before the pandemic. This disease is sometimes seen as something supernatural, mystical, mythical — but it’s a viral disease like all other diseases. More dangerous than some of them, but it’s not unique, Covid. So a proper vaccine used correctly protects you and means that you don’t infect other people as well…. No vaccine is 100% effective, but we don’t have this discussion about any other vaccine.”
He has been vaccinated with the AstraZeneca jab, and would be happy for everyone to take it: “If we really want to get down to small numbers — we won’t eradicate it, but to small numbers — then I think even children should be vaccinated… I can’t see why not.”
Giesecke had a long and prestigious career at the top of international medicine. Does he regret joining the debate so publicly, and becoming such a controversial figure?
“I hope I have done some useful things for the Swedish population. If it has been useful for me or not… the discussion in Sweden has been very politicised and very divisive.”
He believes that history will judge him kindly.
“I think I got most of the things right, actually.”