Sweden does not have a herd immunity strategy, and it is irresponsible for The BMJ to perpetuate this myth. Similarly,the decision not to “lockdown”is only “controversial” because the media have framed it as such. It is time for the word lockdown to be replaced with precise, non-sensational language that describes the measures taken.
Most of the media coverage has focused on country level data, which is misleading. Stockholm county has 91 deaths per 100 000, whereas Skåne county, including Malmö, has about 15; Blekinge has the lowest, with 4.4 deaths per 100 000. I am still waiting for an article on what we can learn from Blekinge’s approach to covid-19.
Sweden does not have a single approach to covid-19; its response is a mixture of policies at national, regional, and local levels and in sectors outside of the health system such as public transportation. Although a strategy might be set nationally, the responsibility for implementation can be regional or local. In Sweden social care, including care homes for the elderly, is run by municipalities, whereas healthcare is run by the county. Municipalities are also responsible for public health education campaigns and for enforcing physical distancing in public and commercial spaces. In practice, the balance of responsibilities is blurry and can differ depending on the county and municipality. Much of the “public” sector in Sweden is privatised, which raises further questions of responsibility (and blame).
Compulsory physical distancing measures exacerbate social and health inequalities to a greater extent than voluntary ones. With some exceptions, people in Sweden have continued to have access to regular and specialist care, and children have had access to education. The importance of a semi-normally functioning society cannot be overstated.
Sweden, and the Swedish approach, is much more multilayered than portrayed in the media, and this hinders serious policy evaluation.
Rachel E. Irwin, Researcher
My comment: the US is the same only more so. Virtually all the detailed coronavirus response measures are at the State level, then county, then city. The federal government has very limited mandate. A national mask law, for example, would be unconstitutional. So, when it’s time to toss bouquets or hurl brickbats, the targets must be state governors, and on down the line.
On this point, to repeat: the ten worst performing states in America, are all run by democratic governors. The narrative is the opposite, of course. According to CNN, NYT, etc, it’s the red states that performing badly. The opposite is the truth, if one goes by figures. That’s not to say that anyone has figured out the single best way to handle this disease. Because they haven’t. Researcher Irwin, above, is saying as much.
Related: from “The Swedish Economic Model”:
Progressive politicians love to wish that America’s economy could be more like Sweden’s. After Wednesday’s economic-data release there, we share the dream, albeit for different reasons.
The Nordic country suffered an 8.6% decline in GDP from April to June, which sounds bad until you remember the eurozone economy contracted 12.1% in the same span with some European countries doing much worse. The U.S. economy shrank nearly 10%, or 33% on an annual basis.
Sweden fared better because, unlike the rest of Western Europe or much of the U.S., Stockholm hasn’t imposed a total lockdown in response to the coronavirus. Schools, shops and restaurants remained open through the spring. The economic decline results partly from a fall in trade as other countries shut down and partly because Swedes took individual responsibility for moderate social distancing, as their government
