Did Sweden with its minimal restrictions really get it right in fight against Covid?

Swedish woman Karin Lindström will never forget the moment when she had to break the news to her father, living with dementia in a care home, that her elderly mother had died suddenly in 2020. Shouting from the car park below, she told him: “Mum’s dead!”

Her story will chime with many, kept away in the pandemic from loved ones during their last moments or when tragedy struck. Two years on, she is infuriated by the lack of debate in her homeland about why Sweden did a solo run on Covid-19.

Why, she wonders, in its rush to limit disruption and protect the economy, does no one today call out what she believes is the lie at the heart of its stated public health priority: that the elderly would be protected from the ravages of the pandemic.

While Lindström was refused access to her father, her cousin – a grounded flight attendant – was retrained as a care-home assistant and allowed into homes to visit other people’s elderly fathers and grandfathers, with no testing and no protective equipment.

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“No one wants to remember any of this now. I suspected before that we Swedes were spoiled and naive and even a bit arrogant. But I never realised that we could be so shallow,” she told The Irish Times.

Each country had its own pandemic experiences, the virus finding and exploiting weaknesses in our bodies – and societies – but a leading Swedish Christian group described later the treatment of older Swedes in the pandemic as “structural euthanasia”. Others called it a modern-day revival of the medieval Nordic ritual of Ättestupa, where the old and infirm were reportedly encouraged to leap off cliffs rather than become a burden on their families.

When Covid-19 reached Europe in early 2020, Sweden emerged as an outlier with a looser approach to restrictions than its European neighbours. Lockdowns never happened, travel and working-from-home guidelines were voluntary and masks were effectively non-existent. Daily life continued, shops and primary schools never closed, testing and tracing – in particular of arrivals to the country – was rejected as “too complicated”.

The first shock came on March 19th, 2020, when its Nordic neighbours, alarmed by Stockholm’s light-touch response, closed their borders to Sweden for the first time since the second World War. Four days later, some 2,000 scientists at Swedish universities signed a petition protesting the strategy – but it was widely ignored by Swedish media.

‘Herd immunity’

Instead, all eyes were on chief epidemiologist Anders Tegnell, a uniquely powerful and popular figure who on April 4 explained his pandemic approach: “Herd immunity is the only way to stop the spread in any reasonable way,”

While he enjoyed huge public support, drawing on Swedes’ traditional high levels of trust in their authorities, British medical journal The Lancet denounced his “futile and cynical” approach. As cases surged, some restrictions were introduced – a ban on larger gatherings and closures of secondary schools and university. But when a doleful King Carl XVI Gustav delivered his Christmas 2020 message, he said that, collectively, Sweden had “failed”.

Critics say Sweden’s performance is only average if compared with densely populated European countries such as Germany and Switzerland. A more realistic comparison, they say, is neighbouring Norway

So has it failed? Sweden recorded much milder subsequent pandemic waves in 2021. A final government commission report from February 2022 counted 13,000 deaths and, in its top line, concluded: “Sweden has come through the pandemic relatively well and is among the countries with the lowest excess mortality over the period 2020–2021.″

That has been challenged by furious critics, many of whom have contributed to a new book, Sweden’s Pandemic Experiment, (published by Routledge and available to download for free). They say Sweden’s performance is only average if compared with densely populated European countries such as Germany and Switzerland.

A more realistic comparison, they say, is neighbouring Norway with a similar population density and a restrictive, mainstream pandemic response. In Norway, with half the Swedish population, just 2,500 people died. Rather than “averages”, critics of Sweden’s approach speak of “avoidable deaths”. “One can assume that between 10,000 and 12,000 lives were lost in Sweden due to the Swedish government’s inaction,” write authors Sigurd Bermann and Martin Lindström in Sweden’s Pandemic Experiment.

After a positive top line, Sweden’s state Corona Commission report tore apart the country’s approach, saying its measures were “too few and should have come sooner”. “Sweden should have opted for more rigorous and intrusive disease prevention and control measures,” it summarised. There was no plan to protect older people or at-risk groups and “additional steps should have been taken to try to slow community transmission of the virus”.

This would have bought the government time, it said, but government showed a “one-sided dependence” on Sweden’s powerful public health agency (PHA) and Anders Tegnell. Basing national policy on one individual’s decisions was “not a satisfactory arrangement”.

From early on, Sweden’s pandemic was a through-the-looking-glass experience. Those most energetically attacked, in public and in the media, were those arguing for masks and lockdowns

The report’s message was clear: Sweden was unprepared for the pandemic, its politicians did too little for the wider population, nothing for the vulnerable and were too deferential to unelected experts. Sweden’s Social Democratic government refused to accept the findings of the report – even after they were echoed in a second report by the Royal Swedish Academic of Sciences. “There are many reports and many expert groups and I believe that the report is that group’s opinion,” said Lena Hallengren, Sweden’s ex-social affairs minister.

Energetically attacked

Swedish officials insist many of their moves had proven correct: despite fewer mandatory restrictions, more than 80 per cent of Swedes said they had voluntarily restricted their social lives and observed social distancing. Sweden’s youngest schoolgoers avoided the struggle of their peers elsewhere caused by vital classroom years lost: not just teaching hours but developmental and social skills.

From early on, Sweden’s pandemic was a through-the-looking-glass experience. Those most energetically attacked, in public and in the media, were those arguing for masks and lockdowns. In February 2021, Swedish public radio devoted a 20-minute report to a private Facebook group challenging the state pandemic narrative, run by Ireland-born Swedish resident Keith Begg. His 200-member group was presented on the radio as clandestine organisation threatening national security.

For Begg, from Limerick, the report, and a hostile response of threatening messages, the experience was “like something from an authoritarian state”. Leaving Sweden for good, he told The Irish Times: “Sweden has put itself on such a pedestal of exceptionalist arrogance.”

Since February’s critical commission report, Sweden has rolled up its exceptionalist Covid tent. The public health authority chief as well as Sweden’s chief epidemiologist, Anders Tegnell, have moved on. (The Public Health Authority did not respond to repeated interview requests.) There have been no political consequences and Covid-19 was ignored in the recent election campaign. For for good reason, says Swedish political scientist Andrej Kokkonen: centre-right opposition parties, now in power, backed the government’s pandemic approach while in opposition.

“No one has an interest in pursuing this debate, it would not look good for anyone,” said Prof Kokonnen of the University of Göteborg. “As well as that, I think people enjoyed being a bit freer than elsewhere. Today they are more worried about the cost of living.”

The elderly comprised 90 per cent of Covid deaths but were of no further economic ‘use’ to society. The second group hit hard were Swedes with a migrant background, often frontline workers

One of Sweden’s most popular books about its pandemic is The Herd by journalist Johan Anderberg. In its fast-moving narrative – a television version is coming soon – Anderberg argues that the rest of Europe focused too much on death toll and too little on the knock-on effects of lockdowns: on mental health, domestic violence and sexual abuse in the home, missed development goals, medical check-ups and surgery, all of which are now becoming visible.

“Sweden more or less went in the opposite direction yet its results were not noticeably different from those of other countries,” he insists. While he says Sweden embraced “freedom” in 2020, and is celebrated by libertarians worldwide, Anderberg sees an embarrassed silence in pro-lockdown countries over how their restrictions “were of limited value”.

That has sparked outraged counter-claims in Sweden that its exceptionalism was based on utilitarianism and racism, given the cost of Sweden’s approach was disproportionately borne by two groups. The elderly comprised 90 per cent of Covid deaths but were of no further economic “use” to society. The second group hit hard were Swedes with a migrant background, often frontline workers who care for the elderly, drive buses, clean offices and wait tables.

‘Massacre of the elders’

Intercultural studies expert Tobias Hübinette points out how in the September election, Sweden’s far-right decried the “massacre of the elders” who built the postwar welfare state – but no one mentioned deaths in the immigrant communities that keeps Sweden running today. “These people don’t have a voice in Swedish society and their deaths must not be acknowledged,” said Dr Hübinette, a lecturer in migration and intercultural studies at Karlstad University. “If you acknowledge you have failed them, you have to admit so much more failure on integration and everything falls apart.”

Three years after it arrived in Europe, the legacy of Covid-19 in Sweden is of how the majority of the population had the lightest pandemic in the western world by forgetting – or ignoring – vulnerable minorities, now left alone with their suffering. Like all opportunistic viruses, Covid-19 found – and exploited – the weakest spot and has left an awkward question: just who belongs in today’s multicultural Sweden?