Too Casual with COVID-19 The High Price of Freedom in Sweden

Many Europeans suffering under lockdowns view Sweden as a role model for how the Scandinavian country has dealt with the COVID-19 pandemic. But the price of Stockholm's lax approach has been high.
By Dietmar Pieper in Stockholm
City residents in Stockholm's Södermalm neighborhood on May 7

City residents in Stockholm's Södermalm neighborhood on May 7

Foto: Stefan Bladh / DER SPIEGEL

At Stockholm's Nytorget Square, the coronavirus crisis feels far away. Groups of people sit outside, soaking up the spring sunshine. The cafes that skirt the square are full and there's not a face mask in sight. In front of one restaurant, a small sign reminds people to keep their distance from one another. But many of the people waiting for a table don't appear to care. The din from a nearby school echoes across the square. The children run around the playground, kicking soccer balls and twirling hula hoops.

From across the Baltic Sea, Germans gaze upon Sweden with a mixture of admiration and envy. The German avant-garde theater director Frank Castorf believes "citizens there are treated with greater care." The writer Daniel Kehlmann puts it this way: "When I think about what the future could look like, my mind rests on the Swedish model." What's even more astonishing is how many conservative American hardliners are suddenly fans of Sweden, like Tucker Carlson, one of Fox News' most prominent personalities. Completing this strange alliance, the World Health Organization (WHO) has also chimed in.

Michael Ryan, the executive director of the WHO's Health Emergencies Program, has been downright effusive with his praise for the country. "Sweden represents a future model," he said in April, a way to keep the virus under control without paralyzing society with a lockdown. Others countries could learn something, he added.

The Swedes' approach consists of giving people a choice to follow guidelines rather than compelling them to do so. Many measures that were mandatory elsewhere have remained recommendations in Sweden. Daycare centers and schools have even stayed open, pupils in upper secondary schools have not been allowed to attend classes. The same has been true for restaurants, which are subject to minor restrictions. Groups of up to 50 people are even permitted. Since April 1, only visits to old people's homes have been prohibited. Otherwise, people are supposed to conduct social distancing, avoid traveling, work from home if possible and observe basic hygiene rules.

A Much Higher Death Rate

Data has also shown that many Swedes are adhering to the recommendations. Indeed, they have voluntarily imposed on themselves a "lockdown light." Public transportation use, for instance, was down by a third in mid-April. (In Germany, it's down by half and in France, it has fallen by more than 80 percent.)

But Sweden has also paid a high price for the liberal route it has taken. More than 3,313 people have already died from the coronavirus there. That's a lot for a country with 10.2 million inhabitants. Many of the deaths were in and around Stockholm, home to 2 million.

In front of parliament, bereaved relatives have erected an improvised memorial for loved ones lost to the coronavirus. It's decorated with bouquets of flowers, candles, letters and signs: "Mikael Twilling, 62. You were healthy before the coronavirus took your life."

For weeks, Sweden has been among the 10 countries with the highest number of COVID-19-related deaths in relation to its population. The difference between Sweden and its neighbors is dramatic. In Finland and Norway, the death rate has been less than a sixth of what it is in Sweden.

The Swedish strategy against the coronavirus was conceived in a brick building on the edge of the city center that houses the Public Health Agency. The Swedish constitution gives considerable power to government experts. Indeed, politicians there are much more closely bound to their guidelines than in other countries.

Johan Carlson (right) is the head of Sweden's Public Health Agency.

Johan Carlson (right) is the head of Sweden's Public Health Agency.


The head of the agency is Johan Carlson, a scientist with white hair who speaks calmly and deliberately. His course has been heavily criticized both at home and abroad. It was no wonder that he was so pleased about the WHO's praise. "It's not unproblematic if you are looked at as the only one that is diverting from the main road" Carlson says.

Did he make mistakes? No, looking back, he wouldn't say that. He attributes the many deaths in old people's homes to the fact that hygiene regulations were not observed. "Those responsible are working on fixing the problems."

Good for People, Bad for the Economy

Carlson and his team, which includes state epidemiologist Anders Tegnell, consult with the administration every day. So far, politicians have made only one decision: to introduce an upper limit for gatherings. "We were consulted beforehand and we agreed," says Carlson.

Has he ever considered a lockdown for his country? Carlson shakes his head. In April, however, the government of Prime Minister Stefan Löfven had parliament grant it special powers to impose more stringent measures. "I didn't perceive this as mistrust, but as a way of insuring when the worst comes to the worst," Carlson says. But that's not what happened: "The spread is now slowing. We had expected to hit the peak earlier, in mid-April, but our prediction has been rather correct."

Despite the loose regulations, the pandemic has walloped the Swedish economy. Unemployment is on the rise and the government has said it's possible GDP will drop by 10 percent. The GDP of the eurozone, of which Sweden is not a member, is expected to contract by 7.75 percent.

Jonas Frycklund of the Swedish employers' association shares a graph that depicts just how adversely the consequences of the pandemic are affecting Swedish companies. Hotels and restaurants are the worst hit. Ninety-three percent say they have financing or liquidity problems. Frycklund now thinks Sweden's special approach will hurt its competitiveness. "The time it will take us to control the virus will be prolonged. It's not good for the economy." The economy could "bounce back more quickly" after a stricter lockdown like the ones in other countries.

Nevertheless, most Swedes are satisfied with how the government has handled things. Prime Minister Löfven's approval ratings are higher now than they've ever been in his six years in office, according to the latest polls. But what's behind this broad consensus?

A Perfect Storm for the Elderly

The view from Lars Trägårdh's study extends far over Stockholm and its harbors, magnificent town houses and parks. Trägårdh is a historian and has a sharp, analytical view of the present. The pandemic is exposing "the underlying structure of social relations," he says. "The strengths of a society are put into relief as much as its weaknesses."

One of the more positive aspects of society is trust. "The citizens trust each other. They trust their institutions. And the government and the authorities trust the citizens. That's very important." He said that's why it was wise to introduce anti-coronavirus measures on a voluntary basis. "Citizens feel that they can use their intelligence and make their own decisions." Why would they protest against something they think is right?

Closing the daycare centers and schools would have been "a serious mistake," Trägårdh says. "The government has taken care to keep our societal fabric as intact as possible." He adds: "Gender equality can only exist if women can do their jobs as well as men."

But Trägårdh is also aware of the dark side of Sweden's coronavirus response: Old people and migrants are suffering disproportionately from the disease. The virus has been raging through Stockholm's nursing homes for weeks.

Lots of cuts have been made to elderly care since the '90s, Trägårdh says. Nearly all of the work in the sector is done by migrants nowadays. They often lack the proper equipment and sometimes don't even speak the language well. They didn't follow the rules properly, Trägårdh says. "For our elderly it was kind of a perfect storm."

'We Are Not in a Hurry'

For Lena Einhorn, there's a bigger problem. "Sweden is poorly run at the moment," she says. She blames Johan Carlson's administration and the government. Einhorn is a virologist and author. She belongs to a group of critics who publicly oppose Sweden's course. In mid-April, she and 21 other scientists and doctors called for the government to impose stricter measures.

But this, too, is a peculiarity of Swedish culture. If the vast majority of people in the country are convinced of something, dissenting opinions hardly stand a chance. To date, Einhorn says, no government representative has responded to her or any of the other scientists.

There are plenty of good reasons to make Sweden's handling of the coronavirus a matter of public debate. For one, if what several doctors at the Karolinska hospital anonymously told the newspaper Dagens Nyheter is true, then COVID-19 patients weren't treated due to controversial guidelines.

"We were forced to let people die before our eyes," one of the doctors claimed. These included "60- to 70-year-olds with relatively mild pre-existing conditions," whom he had to deny artificial respiration, according to another doctor. Nurses were bursting into tears, they said.

The hospital's management has rejected the accusations. Meanwhile, an investigation has begun at the Karolinska hospital and has been extended to other hospitals.

Not much will change in everyday life. There is little discussion about loosening the regulations in the country. "We can take our time," says Carlson, the head of the public health authority. The first thing that comes to his mind is an end to the government's recommendation that people work from home. "But we are not in a hurry."

Editor's note: This article went to press on Thursday, May 7. On Tuesday, May 12, the Swedish government announced it would spend 2.2 billion kronor (around 207 million euros) to improve health and elderly care in response to the COVID-19 outbreak.

Mehr lesen über