Did Sweden’s Controversial COVID Strategy Pay Off? In Many Ways It Did – but It Let the Elderly Down

In this light, the Swedish strategy has gone from being called “a disaster” and “cautionary tale” to a “Scandinavian success”. But to draw any relevant conclusions, it’s crucial we dig a little further into how Swedes navigated the pandemic.

Notably, any perceptions that people in Sweden went on with their everyday lives during the pandemic as if nothing had changed are untrue.

In a survey by Sweden’s Public Health Agency from the spring of 2020, more than 80% of Swedes reported they had adjusted their behavior, for example by practicing social distancing, avoiding crowds and public transport, and working from home. Aggregated mobile data confirmed that Swedes reduced their travel and mobility during the pandemic.

Swedes were not forced to take action against the spread of the virus, but they did so anyway. This voluntary approach might not have worked everywhere, but Sweden has a history of high trust in authorities, and people tend to comply with public health recommendations.

It’s also difficult to compare Sweden’s results to those of countries outside of Scandinavia that have very different social and demographic conditions.

Strengths and Weaknesses
Despite the benefits of avoiding lockdown, the Swedish response was not flawless. In late 2020, the Corona Commission, an independent committee appointed by the government to evaluate the Swedish pandemic response, found the government and the Public Health Agency had largely failed in their ambition to protect the elderly.

At that time, almost 90% of those who had died with COVID in Sweden were 70 or older. Half of these people were living in a care home, and just under 30% were receiving home help services.

Indeed, numerous problems within elderly care in Sweden became evident during the pandemic. Structural shortcomings such as insufficient staffing levels left nursing homes unprepared and ill-equipped to handle the situation.

In its final report on the pandemic response, the Corona Commission concluded that tougher measures should have been taken early in the pandemic, such as quarantine for those returning from high-risk areas and a temporary ban on entry to Sweden.

The commission did, however, state that the no-lockdown strategy was fundamentally reasonable, and that the state should never interfere with the rights and freedoms of its citizens more than absolutely necessary. The commission also supported the decision to keep primary schools open.

By comparison, the Corona Commission in Norway, one of the few countries in Europe with lower excess mortality than Sweden, concluded that although the handling of the pandemic in Norway was generally good, children were hit hard by lockdowns and the authorities did not adequately protect them.

The focus of Sweden’s strategy was to reduce the spread of the virus, but also to consider other aspects of public health and protect freedom and fundamental rights. While the Swedish strategy remains controversial, today most countries are taking similar approaches to the continuing pandemic.

Looking back, it seems a bit unjust that the country that followed its pre-pandemic plan was the country accused of conducting an experiment on its population. Perhaps Sweden instead should be considered the control group, while the rest of the world underwent an experiment.

Emma Frans is Senior research specialist, C8 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. This article is published courtesy of The Conversation.