Empty streets in Stockholm

Is Sweden’s coronavirus strategy a cautionary tale or a success story?

Streets in Stockholm’s Old Town were nearly empty in April because of the coronavirus pandemic

IBL/Shutterstock

Sweden was one of the few European countries not to impose a compulsory lockdown. Its unusual strategy for tackling the coronavirus outbreak has been both hailed as a success and condemned as a failure. So which is it?

Those who regard the strategy as a success claim it reduced the economic impact, but it isn’t clear that it did. What is clear is that so far Sweden has had a more protracted outbreak with far more deaths per capita than its neighbours.

While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people.

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“Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.

This appears to be true, in Sweden at least. The measures did work nearly as well in getting people to change their behaviour. Adam Sheridan at the University of Copenhagen in Denmark, for instance, has used data from a bank to compare spending patterns up to April in Sweden and Denmark. Denmark introduced a compulsory lockdown on 11 March, one of the first in Europe.

Sheridan found that spending – an indicator of behaviour as well as economic activity – fell by nearly as much in Sweden as in Denmark: 25 per cent compared with 29 per cent.

Similarly, data from the Citymapper phone app, which helps people plan their travel routes, suggests that travel in Stockholm fell to 40 per cent of the normal level. “That’s a substantial reduction,” says Martin McKee at the London School of Hygiene & Tropical Medicine, whose team did the analysis. However, there were even bigger falls in other major European cities during compulsory lockdowns, to 20 per cent on average.

So there was a substantial voluntary lockdown in Sweden – yet it wasn’t nearly as effective in reducing the spread of the coronavirus as the compulsory lockdowns in neighbouring Denmark and Norway. Cases and deaths rose faster in Sweden and have been slower to decline.

Sweden has about 8200 confirmed cases per million people as of 12 August, compared with 1780 in Norway and 2560 in Denmark. (For the UK it is 4600 and the US 15,400.)

Sweden has had 57 deaths per 100,000, compared with five in Norway and 11 in Denmark. (For the UK it is 70 and the US 50.)

Sheridan’s analysis suggests that young people – whose spending makes little contribution to the overall economy – were least likely to change their behaviour and might have undermined the voluntary lockdown. Among people aged between 18 and 29, spending dropped far less in Sweden than in Denmark.

Tegnell, meanwhile, says the high death rate in Sweden was related to the failure to prevent infections in care homes. Matters have now been improved, he says. Half of Sweden’s deaths were in care homes up to mid-May.

What about the economy? “This has never been done to save the economy. It’s been done to save public health,” says Tegnell. And that means public health in a broad sense, he adds, not just the coronavirus.

That said, Sheridan’s spending comparison suggest that the economic impact was only slightly reduced by not imposing a more effective compulsory lockdown. “It’s very little in economic costs for saving a larger number of lives,” he says.

What’s more, recent data released by another bank suggests that spending in Denmark has recovered faster than in Sweden, says Sheridan.

Others have claimed that Sweden suffered less of an economic decline on the basis of initial estimates of GDP for the second quarter of 2020. Sweden’s fell by 8.6 per cent, less than the estimated average of 11.9 per cent for the European Union as a whole.

However, those making such claims fail to point out that several countries that did impose compulsory lockdowns did as well or better. GDP fell 8.4 per cent in the Czech Republic, for instance, and just 5.1 per cent in Lithuania, the lowest in the EU.

What’s more, many of the countries that fared worst, including the UK, Spain and Italy, rely heavily on tourism, unlike Sweden. A more telling comparison would be with Norway and Denmark, but these figures aren’t available yet.

What all the researchers agree on is that it isn’t over yet. There might be second waves in Denmark and Norway that Sweden avoids because so many people there have already been infected, although it is too soon to compare figures, not least because it is the summer holidays in Sweden during which time the country all but shuts down anyway. Comparisons are further complicated by the fact that Sweden hasn’t relaxed its approach at all, unlike the other countries.

Achieving herd immunity was one of Tegnell’s original aims – but antibody surveys suggest only about 20 per cent of people in Stockholm have been infected, similar to levels in London and New York. That is far short of near the 70 per cent level estimated to be needed.

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