COVID-19: The Swedish Model
In the spring of 2020, Sweden chose a different path to many other countries, one based on a voluntary approach and personal responsibility rather than more intrusive measures. The majority of other countries, by contrast, made greater use of lockdowns or other intrusive regulatory interventions. Whether Sweden’s choice of path was reasonable, or whether it would have been better to introduce other types of measures to limit the spread of the virus, is a question the Commission will return to in its final report. To address that question, it is necessary to gain a better understanding of what information key decision-makers had as a basis for their assessments regarding disease prevention and control measures during the various phases of the pandemic. Several other aspects of Sweden’s handling of the crisis, moreover, remain to be investigated and assessed. These include, in particular, the impacts of the emergency on the economy and personal finances, and what capacity the Swedish machinery of government and its institutions had to manage a crisis. Only after that will the Commission be able to assess whether the path chosen by Sweden represented a reasonable balance between effective disease prevention and control and other interests. With answers to these questions, it will also be possible to better assess questions of responsibility.
The Commission has initiated a research program – A Research Program on COVID-19 in Sweden: Spread, Control and Impacts on Individuals and Society – in collaboration with researchers at Stockholm University. The program is based on very extensive gathering of data on medical and socio-economic outcomes, gene- Summary SOU 2021:89 2 rally at the individual level, from a large number of sources. It currently involves some thirty external researchers at various universities and other institutions, a number of whom have written background reports to this report. We have also engaged the services of several independent experts, who have likewise provided us with background reports.
The Commission’s most important overall conclusions based on the review carried out to date and presented in this report are:
• Sweden’s handling of the pandemic has been marked by a slowness of response. The initial disease prevention and control measures were insufficient to stop or even substantially limit the spread of the virus in the country.
• The path chosen by Sweden has placed the emphasis on disease prevention and control measures based on a voluntary approach and personal responsibility, rather than more intrusive interventions.
• Sweden’s pandemic preparedness was inadequate.
• Existing communicable diseases legislation was and is inadequate to respond to a serious epidemic or pandemic outbreak.
• Sweden’s system of communicable disease prevention and control was and is decentralized and fragmented in a way that makes it unclear who has overall responsibility when the country is hit by a serious infectious disease.
• The health care system has been able, at short notice, to adapt and to scale up care for people with COVID-19. This is largely thanks to its employees. Adaptation has been achieved at the price of extreme pressure on staff and of cancelled and postponed care. We will therefore live with the consequences of the pandemic for a long time to come.
• In several areas there is a problematic lack of data, making it harder to monitor the pandemic while it is in progress and to satisfactorily evaluate its management when it is over.
