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.”

Watch the original interview

Did Sweden get Covid wrong?

By UnHerd

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.”

More from this author

Which epidemiologist do you believe?

By Freddie Sayers

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.”

It was not really until David Hume, writing during the Scottish Enlightenment, that an attempt was made to reconcile Scepticism with the real world. Frustrated at the “insipid raillery” of those who claimed mankind could know nothing, he dismissed their obscure thought experiments as “mere Philosophical Amusement”, and instead chose to reclaim Scepticism as a critical mindset. To put it simply, for Hume it was important to be “a philosopher; but, amidst all of your philosophy, be still a man”.

At the end of last year, Edinburgh University renamed its David Hume Tower because the philosopher — at least according to those who demanded the change — “wrote racist epithets”. Whether or not that is true is an argument for another day. But this erasure of Hume – the Enlightenment philosopher who reclaimed the meaning of scepticism more than 200 years ago – is symbolic of something far more significant. For it seems to me that the term “sceptic,” and the attitude it represents, is once again in urgent need of rehabilitation.

More from this author

Why the new inquisition came for David Hume

By Giles Fraser

On paper, that shouldn’t be too difficult. As Hume put in his Enquiry Concerning Human Understanding, to be sceptical is “to begin with clear and self-evident principles, to advance by timorous and sure steps, to review frequently our conclusions, and examine accurately all their consequences”. At the time, this was radical. It encompassed everything progressive about the Enlightenment and the emergence of the scientific method. But it also seems eminently sensible. Who wouldn’t want to be a sceptic today?

Apparently, quite a lot of people. Scepticism is suddenly perilously out of fashion. More than that, it is now deemed dangerous. The reason? The rise of the “lockdown sceptics”, who in recent weeks have taken a battering for having made claims about the virus that turned out not to be true.

In a sense, this is what should happen in the scientific method — commentators and experts being held to account for predictions they make. But the ferocity of the attacks has left us at a place where all questioning groups are subjected to the same moral condemnation. Whether they are pundits peddling conspiracies, credentialed scientists recommending alternative approaches, or intellectuals worried about the political implications — “Lockdown sceptics” is used interchangeably for them all. Any dissent will mark you out as part of the global “anti-science” movement. So sceptic has become a dirty word.

In our own LockdownTV interview series, which kicked off early in the pandemic, we put the scientific method into action. We featured eminent scientists from all sides of the debate sharing their views: advocates for a stronger response such as Profs Neil Ferguson, Nathalie Dean, Devi Sridhar and Fredrik Elgh put forward their arguments alongside advocates of a more liberal approach such as Johan Giesecke, Anders Tegnell and the Great Barrington scientists. As you might expect, some statements aged better than others; some voices became more credible and others fell away, but it was all conducted in a spirit of civility and respectful enquiry.

More from this author

Which epidemiologist do you believe?

By Freddie Sayers

When Nobel prize-winner Michael Levitt’s prediction that the American epidemic would end in August failed to materialise, we had him back on the show to account for himself. Both Giesecke and Tegnell have also pledged to return to discuss their learnings later this year.

But the treatment of some of these scientists is troubling. Oxford Professor Sunetra Gupta is now bracketed with out-and-out cranks by MPs and columnists in national newspapers. I know her to be a kind, intelligent and accomplished person who cares deeply about saving lives. Perhaps she shouldn’t have speculated so specifically about the Infection Fatality Rate in her UnHerd interview so early in the pandemic; perhaps she should have caveated her theory that the epidemic was “on the way out” with the likelihood that it could come back again in the winter.

But she was a scientist giving her interpretation of the data at the time, not a trained politician stiffly parsing every word. The attacks on her fellow signatories of the “Great Barrington Declaration” by academic colleagues at Harvard and Stanford, as well as the “blood on their hands” rhetoric they regularly receive in the British press, sets a disturbing precedent for the next scientific controversy. Who would be a dissenting scientist now?

Creative thinking should be encouraged, not penalised. If new variants or developments extend this lockdown period beyond the spring, a more differentiated approach closer to the one the GBD posited — offering better protection to the vulnerable and letting others get on with their lives — may yet become relevant. At the briefing Boris Johnson received from Gupta, Carl Heneghan and Anders Tegnell, he rejected their proposals and continued with a lockdown strategy regardless — fair enough. But the Prime Minister should surely be praised rather than condemned for wanting to test and retest his assumptions?

More from this author

From Covid to crime: how media hype distorts risk

By Tom Chivers

At the level of government policy, the effect of the pandemic on attitudes should also give us pause. In the relentless comparison of different countries’ outcomes, the recipe for success on Covid-19 policy appears to be something like: presume new risks are worst-case scenarios and act immediately, and dramatically, rather than waiting for more evidence. Countries which acted in the opposite way to David Hume’s “timorous and sure steps” and swiftly imposed border controls and restrictions have generally had the best Covid-19 outcomes; “dithering” Western nations are unfavourably compared to their more commanding Asian counterparts. But while this may have been effective in the context of the pandemic, as a general lesson for government it would represent a terrifying new direction.

Many people might feel that we are in a wartime situation with this virus, and that something closer to martial law is therefore appropriate for this exceptional period. But as human rights lawyer Adam Wagner made clear in yesterday’s UnHerd interview, if history is any guide, emergency measures have a way of becoming permanent — most of the powers taken by the government during 9/11 are still there. We have now been governed in a “Napoleonic” style for almost a year, with new updates coming by ministerial decree on average every four and a half days and with very little oversight. Can anyone confidently say that none of that attitude will stick?

When it comes to the inevitable next virus or pathogen to be identified somewhere around the world, the playbook has surely now been written. As Wagner told me, “the danger is that if Covid never leaves us, or it mutates or a different virus arrives with a similar dynamic we’ll be in a semi-permanent state of “this is what we do” — when this happens, we have lockdowns, we have emergency laws, we take away parliamentary niceties like scrutiny, debates, votes, that sort of thing… And I think that is a danger that doesn’t come out of the fringes of the lockdown sceptic movement. That’s the real deal as a worry.”

At times of crisis, scepticism can be unnerving and the temptation to try to silence dissenting voices is understandable. But which is the bigger danger? That people are allowed to question the orthodoxy and potentially get things wrong but are held accountable in an open debate? Or that sceptical voices are censored for  “misinformation”, and no one dares dissent? Everyone loses when doubt becomes a vice once more.