The world of Swedish epidemiology is small. Fredrik Elgh is a Professor of Virology at Umeå University in Northern Sweden and a clinical physician, but earlier in his career, heading up a department at the Swedish Institute for Infectious Disease Control in Stockholm, a certain Anders Tegnell was in his staff, and Johan Giesecke was another department head. From our 45-minute conversation, I think we can surmise that they are no longer on speed dial.
Professor Elgh has been one of the most outspoken critics of the Swedish response to Covid-19, calling for more dramatic action as early as March 2nd in an op-ed in the main Swedish broadsheet. Since then, he has been shocked by what he sees as inaction by the Swedish government. “In the early days, the information was ‘this was nothing to worry about,’ week after week after week,” he says.
From the start of the epidemic, he says there was no serious attempt to quarantine arrivals from infected areas in Europe — much of the Stockholm infection is thought to have arrived from returning skiers from the Alps in February — and even contacts of known cases were not required to isolate. As Professor Elgh puts it, “there was no will to stop this, no will to put people in quarantine that came from these places, no will even to put people in quarantine that had been in contact with people who came down with the disease, no will to stop pupils going to school who had come back from infected areas.”
He targets Johan Giesecke and Anders Tegnell for particular criticism. “They have not really told us what the exact strategy was, but it must have been that it should sweep through the community rapidly,” he says. “I will say to the day that I die that this was a huge mistake.”
Once the summer arrived and cases and deaths fell to a very low level, due to seasonal effects, he believes that the country should have been preparing for a second wave. “We could have prepared ourselves in a number of ways during the summer. I was really upset when it was like everything was over and we had done a fantastic job. That was not okay with me.”
Professor Elgh says that right now, dramatic action is required. “We have to save lives. We have to save health. In Sweden, we need to save our health system because that is almost full… In a fortnight we will have a tremendous amount of cases in our hospitals.”
“I would install a very tough lockdown for four weeks. First two weeks of lockdown so you get rid of the contagion from the streets and the shops and everywhere, then another two weeks to make sure that spread within families comes down to as near zero as possible.”
I put it to him that what that practically means is on-off lockdowns all the way until the vaccine has been very widely distributed. “Yes, it might be like that. That’s probably what we are going to see in the other European countries… and we just have to do that… Look at our curve – where is it going? We cannot accept that… The current measures are not enough. If we go on like this, week after week, waiting for the curve to come down, we will be in a disastrous situation.”
Our thanks to Professor Elgh for a lively discussion, and for sharing his views.