Abhayjeet Singh Sachal

By the end of May, Sweden had the highest rate of COVID-19 deaths (per million population) in the world. This is hardly what one would expect from a country with stable leadership and a strong healthcare system. The story of the Swedish government’s response to the pandemic involves seemingly lax restrictions and an open-for-business approach. A majority of Swedes continued their socially distant lives as normal while the most vulnerable were left susceptible to the deadly virus.

While neighbours Denmark and Finland implemented lockdowns in mid-March, Swedish officials flirted with the idea of herd immunity. Despite little scientific evidence, the government promoted the idea that widespread exposure to the virus through natural transmission would allow the economy and normal life to continue. Chief epidemiologist Anders Tegnell soon retracted his statements about herd immunity but affirmed that the goal of retaining normalcy was central to Sweden’s response. These mixed messages downplayed the severity of the virus among citizens, leading some to ignore social-distancing suggestions.

In March, the Swedish government closed secondary schools and universities, banned visits to long-term-care homes, and recommended social distancing for the elderly. However, daycares, elementary schools, and most businesses remained open in an effort to avoid the adverse economic impacts of a full-scale lockdown.

These relaxed restrictions were premised on the country’s strong social capital and unique norms. Given the high level of trust that Swedes have for their government, officials were confident that citizens would adhere to voluntary distancing measures. For example, cell phone data from Easter weekend found that travel to popular holiday destinations was down 90 percent, highlighting how most Swedes seemed to be complying with recommendations. Even before the pandemic, Swedes were already among the most socially distant societies in the world. Over 50 percent of Sweden’s population lives in single-person households, most have access to high-speed Internet, and many work from home. Combined with paid sick leave and strong social security, there was reason to believe that Swedish societal structure could help mitigate viral spread.

Sweden experienced some minor payoffs from this strategy in April, specifically regarding its decision to keep elementary schools open. Given the country’s high percentage of two-working-parent families, Tegnell argued that school closures would force too many parents to stay home. Recent estimates suggest that closures could have overwhelmed the healthcare system because up to 43,000 doctors and nurses—10 percent of the nation’s healthcare force—would have had to stay home.

Despite more or less containing viral spread within the majority of the population, Sweden has faced major challenges because of the government’s failure to prevent the virus’s transmission into long-term-care homes, where almost three-quarters of Swedish deaths have occurred. An April study found that about 90 percent of all deaths related to COVID-19 occurred in people over the age of seventy. Protective clothing for nurses arrived weeks too late, and some staff at care homes may have gone to work despite showing COVID symptoms at the onset of the crisis. These blunders were compounded by national guidelines suggesting, in an attempt to avoid overcapacity, that elderly COVID patients should not be automatically taken to hospitals for treatment.

Structural inequalities have also been exacerbated with immigrant populations among the hardest hit. Densely populated Somalian and Iraqi suburbs have three times more cases than other communities. Somali Swedes, who account for around 0.5 percent of the total population, make up nearly 5 percent of COVID hospitalizations. Immigrant workers are overrepresented as taxi and bus drivers who are inevitably more susceptible to COVID infection because the government provided only minimal aid to reduce transmission in those settings. Compounding such issues, the government has had poor communication with non-Swedish speakers, who tend to have less familiarity with government sources and national news outlets. Sweden’s public health agency has largely been unable to translate the linguistic nuances of public health recommendations, resulting in a lack of access to reliable information about COVID-19.

By 1 June Sweden had 39,758 cases and 4,403 deaths. Trust in Tegnell has fallen, and Sweden has been excluded from a Scandinavian travel “bubble.” Although the relaxed approach to lockdown was implemented to prevent irreparable harm to the economy, early reports indicate that the Swedish economy will likely suffer as much as those with stringent lockdowns. The European Commission has forecasted a 6.1 percent decline in Swedish GDP compared to an average European decline of 7.7 percent. The Swedish Central Bank has predicted a more ominous contraction of up to 10 percent, largely as a result of the halted global supply chains’ effect on Sweden’s export-driven economy. However, other observers have argued that Sweden is in a better position to rebound than other European nations because of lower unemployment rates.

The Swedish government did not lock down and failed to protect the most vulnerable. Its strategy worked for the average Swede but failed many. Time will tell the nation’s ultimate tale.

Part of the COVID Comparative Project. View the complete series.