As It Happens

Swedish virologist says her country's COVID-19 strategy has failed, but nobody will admit it

Sweden's health authority maintains its approach to COVID-19 was a success. But our guest says the data speaks differently, and that new measures announced Monday are insufficient.

Sweden allows regions to institute local lockdowns 8 months into the pandemic

People walk on Stranvagen in Stockholm on Sept. 19. The country has had no lockdowns or mask policies during the coronavirus pandemic. (Jonathan Nackstrand/AFP/Getty Images)

Eight months after the start of the global pandemic, Sweden is changing its COVID-19 strategy — but virologist Dr. Lena Einhorn says it's far too little, too late.

Last spring, as other countries went into lockdown, Swedish citizens were mostly living as usual. The government issued advice and guidance in place of rules and restrictions. School and work went ahead. Many businesses stayed open. 

But as of Monday, Sweden's per capita death rate from COVID-19 was the 15th highest in the world, or 13th if you exclude the tiny countries of Andorra and San Marino, according to data from Time magazine and Johns Hopkins University

Now Sweden is shifting its policy. According to the Telegraph, starting Monday, the government has empowered regional health authorities — in consultation with the federal public health agency — to instruct citizens to stay away from crowded spaces like shopping malls, museum, gyms, and concerts, and avoid taking public transport or visiting the elderly. However, there will be no legal or financial consequences for non-compliance.

Einhorn, a virologist, author and filmmaker in Sweden, is one dozens of medical experts who have been critical of the country's COVID-19 response from the start. Here is part of her conversation with As It Happens host Carol Off. 

Is the Swedish government finally willing to admit that its approach to tackling COVID-19 has failed?

I haven't seen any such signs, no.

Do you think they'll just continue as they are?

There have been incremental changes in the recommendations. There has never been, and I doubt there ever will be, any kind of admission of having made mistakes.

Dr. Lena Einhorn is an author, filmmaker and virologist in Sweden. (Submitted by Lena Einhorn)

If you were to describe Sweden's approach to tackling the coronavirus, what words would you use?

Stubborn is probably the best word I can come up with.

When they started, their initial assumptions were fair. They assumed that this would be like SARS; it would never sort of be a major problem in Sweden or outside of Southeast Asia. They were convinced it's only spread from symptomatic people, so like SARS, you could isolate the symptomatic people and stop the spread that way.

That was fair, you know, sometime in January. It was not fair in April or in May. So they stuck to that. And one could say that when the spread really … hit Europe and Sweden, they did the opposite of our Scandinavian and Nordic neighbours who went into lockdown, and we did not.

There was an idea that we heard from coming from Sweden in the spring, and I guess it continued, that Sweden would attempt something called "herd immunity," that if enough people were to contract the virus, that eventually there would be a general immunity enough within the population that it would have a better effect than locking things down and keeping people from getting it. Is that what happened?

It has been assumed that they were going for herd immunity, but they've been speaking through two sides of their mouths. On the one hand, they've been denying it. On the others, on the other hand, they said it would be a bonus.

They said that come fall, and the second wave, we will be much better protected than our Scandinavian neighbours who had 10 times less deaths than we did in relation to population. But it became very clear once broad testing of antibodies was being done that there was nothing close to herd immunity.

And so, of course, they realize that they can't go for herd immunity. It's going to kill too many people. I mean, it's already killed almost 6,000 people in a population of 10 million. So they are no longer going for herd immunity, which doesn't mean that they're prepared to say, "we were wrong and we're going to change our recommendations."

Anders Tegnell of the Public Health Agency of Sweden attends a news conference updating the country about COVID-19 on Oct. 9. (Claudio Bresciani/TT News Agency/Reuters)

At the centre of all of this, as we have followed what's going on in Sweden, is a man named Anders Tegnel, Sweden's chief epidemiologist, and he seems to be a bit of a rock star in your country for the decisions he made. People have tattoos of him on their bodies. So why is he so popular?

This is a combination of factors, and this deserves a long discussion. Part of it, I'm sure, is that when there's a national crisis, people want to believe in authority.

The other aspect is that he has a very calming demeanour. Even when the numbers were going through the roof, he kept saying that we're flattening out, we're hitting the peak. He had a way of sounding extremely calming.

And also, you know, 90 per cent of the deaths were in the elderly, so … most people didn't see it.

And what do you think of Anders Tegnel?

I have no opinions about him personally, but I think he has not handled this well and he keeps on not handling this well.

Just as an example, Sweden is [one of the only countries], together with Somalia, Yemen, Eritrea, Syria, Greenland and some Pacific islands, who have still no recommendations for face masks whatsoever. So, you know, he hates face masks. He says they don't help. He keeps saying there's no support for them.

In the spring, that could have been a fair assumption. But by now, there's the studies are overwhelmingly showing the benefit of face masks, especially when it's used in the whole population, because it protects against someone who is sick.

So if everybody wears it, face masks are extremely efficient. But if only 50 per cent wear it, it's not at all sufficient. But he will not even say that they're good. I mean, you have to understand, in the Swedish hospitals, the doctors and nurses do not wear face masks.

Well, it seems that [U.S. President] Donald Trump and the people around him would agree with Anders Tegnel. But the rest of the world, at least in countries where they have policies, they are not doing that. So somebody is right and somebody is wrong.

The interesting thing is that in Sweden, we have a social democratic government dominated by the Social Democrats, so … it's more of a left-wing policy. Whereas in the rest of the world, it's very much a right-wing laissez faire policy to have herd immunity, or to try to have herd immunity, or to not wear face masks. Freedom, you know?

A sign promoting physical distancing is pictured in the Gallerian in Stockholm, Sweden, May 12. (Henrik Montgomery/TT News Agency/Reuters)

There was a freedom of information [request, and] a bunch of emails that have been published by journalists in your country that show that Mr. Tegnel said that at one point that when it was suggested that 10 per cent of those who would get the disease would be the elderly and maybe they would die, 10 per cent might be "worth it," he apparently said. How much of the decisions are being driven by this idea that, well, maybe we have to keep Sweden moving, keeping the businesses open, and that's part of the motivation?

They will never admit that the economy is an aspect. By the way, Sweden's economy has not fared any better than its Nordic neighbours. Rather, it's more at the bottom than at the top among our neighbours. So it hasn't benefited from it, and it has certainly not benefited from the herd immunity.

Today we saw the announcement that citizens in Sweden should avoid places like shopping malls, museums, gyms, concerts, and avoid public transportation or visiting the elderly. So is there a shift perhaps in perception?

There are policies. You know, it's not a completely laissez faire. I mean, people are advised to stay to work from home if they can. People are advised to not fill up the public transportation, the busses and the subways. There is still a maximum amount of people gathering of 50.

It's not a complete "let's live as normal" — but it's all recommendations and advice.

I would say that incrementally, Sweden has has gotten closer to other countries. I mean, we do a lot of testing now. We do, you know, about as much as Canada per capita. So it's not like in the spring, where nobody was tested outside of the hospital.

But it still is always too little.


Written by Sheena Goodyear. Interview produced by Jeanne Armstrong. Q&A has been updated for length and clarity. 

Corrections

  • An earlier version of this story incorrectly identified the countries of Andorra and San Marino as islands.
    Oct 20, 2020 9:12 AM ET

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