How Sweden’s herd immunity strategy has backfired

As the country’s Covid-19 death toll has spiralled, support for the government’s unique approach has frayed.

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As Europe’s citizens emerge from months of lockdown to count the cost of the Covid-19 pandemic, one country continues to stand out. Sweden’s refusal to lock down has been both vilified and lauded across the world, but as the death toll mounts so do questions at home.

Every country has developed its own coronavirus rituals. In Sweden, the defining event is the daily Covid-19 press conference. Unlike in the UK, this is fronted not by the prime minister, Social Democrat Stefan Löfven, but by an official: Anders Tegnell, state epidemiologist at the country’s Public Health Agency. Tegnell has become so ubiquitous in the Swedish media that he is sometimes jokingly referred to as the new landsfader” or “father of the nation”.

When Tegnell was pictured recently enjoying a socially-distanced beer outside a bar in Stockholm, it seemed to embody the unique Swedish approach to the virus. Visits to care homes and events for over 50 people were banned, but schools, shops and restaurants remained open. Voluntary social distancing was preferred over forcing people to stay at home.

Tegnell said his purpose was to slow the spread of the virus to prevent the healthcare system being overwhelmed: he argued it wouldn’t be possible to suppress Covid-19 completely until a vaccine was available. He speaks frequently of “herd immunity” as a hopeful by-product of the strategy, though not its aim. In April, Tegnell said he hoped herd immunity would be achieved by May.

The policy has been watched closely from abroad. Swedes, used to being the whipping boys of the populist right in Britain and the US, have attracted support from unusual places. Anti-lockdown protesters in the US held “Be like Sweden” placards. On Fox News, commentator Tucker Carlson praised the country for not shutting down society. In the UK too, Sweden has won plaudits from right-wingers such as Toby Young, for persisting with herd immunity when Boris Johnson’s government changed course

But after three months, Sweden’s critics are feeling vindicated by events. By 10 June, Sweden had recorded 46,814 confirmed cases and 4,795 deaths from coronavirus, putting it among the worst hit countries in Europe. Ninety per cent of deaths have occurred among the over-70s, and half were in care homes.

The contrast with the other Nordic countries is particularly stark, with deaths in Finland and Denmark numbering in the hundreds rather than thousands. In Norway, where just 239 people have died after testing positive for the virus, authorities say there was no excess mortality at all in the country this spring, as coronavirus deaths were cancelled out by a fall in the number of deaths from flu. By contrast, excess deaths at the height of the crisis in Sweden peaked at 46 per cent.

Extend the comparison to countries beyond the Nordics, however, and the picture is more mixed. Sweden’s excess mortality figures pale by comparison with the UK’s, where deaths at the peak of the epidemic were 109 per cent higher than a normal week, as well as countries including Spain (100 per cent) and the Netherlands (74 per cent). 

And even within Sweden, the picture defies easy explanations: Stockholm has been badly hit, while Malmö has had few cases. This is attributed by some to Stockholm’s half-term break occurring a week later than Malmö’s and therefore coinciding with the explosion of cases in the Alps. Malmö has also been less badly affected than neighbouring Copenhagen, where a lockdown was enforced.

But as a whole, Sweden has fared worse than most countries. Moreover, as death rates have plunged in countries that imposed lockdowns, Sweden has often in recent weeks been the country with the highest per capita daily death toll. There is now fear that Swedes might be excluded as pan-European travel returns: Norway, Denmark and the Netherlands have told Swedish tourists they are not welcome, even as they open their borders to others.

The refusal to lock down has not even spared Sweden’s export-oriented economy. With much of the world shut down, demand for exports has fallen and supply chains have been disrupted. Truck maker Scania suspended production in mid-March before restarting at far lower levels at the end of April.

Sweden’s central bank, the Riksbank, has warned that in a worse-case scenario, GDP this year could fall by as much as 10 per cent. In April’s budget, the government suggested unemployment would rise from 7 per cent last year to 9 per cent this year, or 13.5 per cent at worst. 

And despite the grim death toll, there are few signs that herd immunity is within reach. A study released on 20 May showed only around 7 per cent of people in Stockholm had developed antibodies by early April, far from the 60 per cent thought necessary to provide protection.

Sweden’s strategy has been criticised from the outset by a few high-profile researchers and editorialists. Their arguments are now finding favour among a growing constituency. Annika Linde, one of Tegnell’s predecessors as state epidemiologist, now says Sweden should have imposed a month-long lockdown to buy time to protect care homes. A lack of consistent testing for care home staff, a failure to provide protective equipment and a dearth of training all contributed to the high number of deaths, she said.

As the death toll has spiralled and herd immunity has failed to materialise, the domestic consensus around the Swedish strategy has started to fray. Confidence in Löfven’s government’s ability to handle Covid-19 fell to 45 per cent in early June, down 18 points since April. Confidence in the Public Health Agency was also down, although at 65 per cent it remained comfortably in positive territory.

Opposition politicians now question why Sweden failed to test and isolate all those returning from virus hotspots such as the Italian and Austria Alps in late February. The Centre Party, a small liberal party that supports the Social Democratic government in parliament, recently issued a list of demands including a restart of the test-and-trace programme. The Sweden Democrats, a hard-right party and the third largest in the Swedish parliament, are demanding Tegnell’s removal.

Now, the government has promised that an independent commission will be appointed to evaluate Sweden’s handling of the crisis. Tegnell acknowledges that lessons will be learned: “If we were to encounter the same disease again, knowing exactly what we know about it today, I think we would settle on doing something in between what Sweden did and what the rest of the world has done,” he told Swedish Radio last week. 

But after journalists interpreted his comments as a mea culpa, he issued a clarification: "There's nothing to indicate that we would have had a totally different outcome if we had implemented more drastic measures,” he told news agency TT. “Britain did that but did not have a good outcome," he added.

To date, most Swedes have been willing to give this view the benefit of the doubt. But as deaths mount, the question is how long that support will last.

James Savage is publisher and CEO of The Local

This article appears in the 19 June 2020 issue of the New Statesman, The History Wars

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