Sweden’s Outlier Response To COVID-19, And Its Results So Far

While most of the world has gone into some version enforced social distancing and quarantine mode with the rise of COVID-19 — closing schools, banning public gatherings, shutting down all non-essential businesses like restaurants and shops and requiring that anyone who can work from home do so — Sweden has been an outlier. Shops in Sweden remain open, as do bars, restaurants, schools and offices. Citizens are encouraged to stay home if they feel ill, and to wash their hands, stay at least three feet away from other people when possible and on the whole be more conscientious about their movements and how they might be spreading the coronavirus. But other than a recent ban on gatherings of more than 50 people, there are no official hurdles to life proceeding as normal in Sweden.

Which means, according to reports on the ground, that life is more or less normal, albeit with somewhat lower density.

As of early April, around half the Swedish workforce is now working from home, and public transport usage has fallen by roughly 50 percent. The streets in the nation’s capital, Stockholm, are 70 percent less busy than usual.

But Swedish students under 16 are in school, restaurants are less full but still operational and haircuts are still an available service. People are even still going to nightclubs, according to club owner Oscar Tornell. The guests, he told NPR, are mostly respecting social distancing guidelines while they are there — or at least they are early in the evening. But by the end of the evening, several drinks in, Tornell did admit he occasionally has to intervene to remind people about the personal space guidelines.

“It’s a struggle. It’s a pretty funny struggle in this mayhem of the world right now,” Tornell said.

Lapses in social distancing among the amorous and intoxicated aside, however, Sweden’s decision to make social distancing guideline purely voluntary as opposed to enforced — as nearly all of its Northern European neighbors have — has been less amusing than controversial.

Particularly the choice to leave primary schools open, as parents and educators have complained school is an infeasible environment to practice social distancing of any sort, and thus a public health liability for students, educators and families. Reports have also emerged that parents keeping healthy students out of school due to health concerns have been threatened with referral to social services, which itself seems to run a bit counter to the message from Sweden’s Chief Epidemiologist Anders Tegnell that the nation’s COVID-19 strategy is rooted in a “long tradition of respecting free will.”

But, inconsistent national approaches to the concept of free will to the side, Tegnell has defended Sweden’s more relaxed approach to combating the coronavirus as both sufficient to protecting the public health and more realistically sustainable over the long term than the measures its European neighbors have put in place. School closures, forcing businesses to shut their doors, he told NPR, can’t be carried on indefinitely. Sweden’s approach, he says, is far less disruptive to people’s lives and to businesses.

“These are measures we could keep on doing for months, maybe even years if we had to,” he said, “while ensuring a slow spread of infection and that the health services are not overwhelmed.”

Some experts have also noted that Sweden — given its unique demographic factors such as the fact that 50 percent of the population lives alone, or that its population density is approximately one-tenth that of the U.K or Italy — might be unusually well suited to a more hands-off, less socially and economically disruptive approach to social distancing.

But as both public health numbers and economic data are rolling in from Sweden, those claims are becoming more hotly debated.

Sweden’s COVID-19 death toll officially crossed the 1,300 mark as of Thursday (April 16), according to Johns Hopkins data. Compared to the United Kingdom with over 13,000 deaths, or Italy with over 20,000 deaths, that number sounds low — and taken against the European average it is.

But compared to its demographically similar Scandinavian neighbors Denmark, Norway and Finland, the difference is quite striking. Denmark has had 321 deaths; Norway has had 150 and Finland has had 75. Sweden, in fairness, has the largest population of the four, with roughly 10 million citizens to about 5 million in the other three nations.

But at roughly twice the size, it has more than four times the number of COVID-19 fatalities as Denmark. And while Denmark is smaller, its population density is a much more virus-friendly 347 people per square mile to Sweden’s 64 people per square mile.

Despite the disparate figures, however, Anders Wallensten, the nation’s deputy chief epidemiologist, reported as of mid-week that Sweden’s cases were starting to show signs of decline and that he was “cautiously positive” that the country is at or approaching a peak. Official reports also indicate that the health system has not had any difficulties in managing the rapid upswing in patients.

As for the lessened economic and social effects of Sweden’s approach, again the early data is a bit murky. Sweden has not shut down, but all of its neighbors in Europe have, which is placing a drag on its economy. As of mid-week, Finance Minister Magdalena Andersson estimated that the nation’s GDP could shrink by as much as 10 percent this year, and that unemployment could reach as high as 15 percent.

But for now, the plan remains popular with Swedish citizens, the majority of whom reflect a desire to carry on with voluntary social distancing measures as opposed to leveling up to the more extreme measures their neighbors in Europe and around the world are experimenting with.

And, as Sweden’s chief epidemiologist Tegnell keeps noting, the world is in uncharted territory as it formulates a response to COVID-19. What will work in the long term — or even what the long-term definition of “working” will be? That, we imagine, will be a work in progress worldwide for some time to come.