Often denounced as a counter-example, but praised by opponents of containments, Sweden’s “flexible” approach to COVID-19 has sparked heated debate since the start of the pandemic.
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What is the “Swedish strategy”?
Deeming it practically impossible to prevent the virus from circulating, the Swedish authorities have set themselves the goal of specifically protecting the elderly and at risk, and) as elsewhere (avoiding the saturation of health services, while tolerating a certain level of contagion.
Fearing too heavy an impact on society, Sweden has not confined its population or closed schools for children under 16.
Almost global singularity: the country has never recommended the use of masks, judging them ineffective and favoring calls for distancing.
Another specificity: apart from a few bans, the strategy is essentially based on “recommendations” having the value of an official rule, but not coercive.
What are these recommendations?
In addition to the classic handwashing and physical distancing, recommendations include teleworking where possible and self-isolation in the event of symptoms.
In the spring, two bans were applied: no visits to retirement homes and no more than 50 people in public events. High schools and universities have also been closed.
With the arrival of a second wave in October, the Public Health Authority and the government have tightened the recommendations in the affected regions, then at the national level since December 14.
In particular, the Swedes have been called upon to frequent only members of their households. During events, the public is now limited to 8 people.
On the other hand, bars, restaurants or stores have never had to close. But distancing measures must be applied and there can currently not be more than eight at the same table.
Why this strategy?
The Scandinavian country can rely on high trust in its authorities, with recommendations generally well followed even when they are not mandatory.
Sweden has always sworn that its strategy was not dictated by the goal of saving the economy.
But, legally, the country has no emergency law allowing it to shut down parts of society in peacetime.
A three-month temporary law passed in April, which required the green light from parliament for each new measure, was never used.
A new law is now promised, which should allow certain stores and establishments to be closed, but only in March 2021.
Did Sweden seek collective immunity?
The strategy has often been described as targeting collective immunity, when a part of the population that has contracted the virus and developed antibodies is high enough to stop the contagion, which authorities have always denied.
“It has never been part of our strategy”, denied the chief epidemiologist Anders Tegnell to AFP in September. “Collective immunity that completely stops the virus will only happen with a vaccine,” he also said in May.
But the architect of the Swedish strategy has repeatedly said that he does not take a dim view of contained contamination.
“It’s good to have high immunity in the population, we are seeing the effects” on the drop in the number of cases, he told AFP in June.
Internal emails from the health authority revealed by the press also showed that collective immunity was indeed discussed in March.
What assessment?
Against the backdrop of heated debate and despite growing criticism, Sweden has so far refused to qualify its strategy as a failure, calling for a long-term judgment.
With more than 75 deaths per 100,000 inhabitants in mid-December, it has a record up to ten times heavier than its neighbors, Finland (8), Norway (7) or Denmark (16).
But it is doing better than several European countries that have taken containment measures such as Belgium (157), Italy (109), Spain (104) or France (87).
The government admitted in May that it had failed to protect nursing homes, where nearly half of the first wave deaths were recorded.
“The strategy to protect the elderly has failed,” lashed an independent commission Tuesday in a preliminary report.
As for the respect of the instructions, it is difficult to be categorical: almost 90% of Swedes say they follow them, according to a recent survey. But government and health officials deplore in recent weeks that they are not yet sufficiently respected.