Sweden and Covid-19: Sensible or suicidal?

I’ve been getting a lot of questions from abroad on what is going in Sweden, and why it’s swimming against the current in fighting Covid-19. I have translated an interview with a Swedish historian explaining the cultural reasons for why Sweden is facing this crisis so differently than other countries.

A couple of additions from personal observations:

  • A majority, around 60-70%, agree with the current way of doing things. At the same time, a very vocal minority is very upset and feels that this is reckless. There is constant debate around this in Sweden. So, while this article describes a general point of view, it is not universal.

  • Sweden has some of the best domain knowledge in the world. Stockholm is home to the ECDC, and its founding director and former Swedish chief epidemiologist Johan Giesecke has strongly supported the Swedish course of action in the media.

  • Ironically, I think we are also being protected by a pathology in Swedish society that I have spent a lot of my time trying to counter – our individualist and socially distant lifestyle.

I have not posted this because I agree with everything this historian is saying, I don’t endorse all of his views on “Swedish exceptionalism” but I do believe that he captures well why Sweden is behaving differently than the rest of the world. I thought I would post it here to provide another data point for to integrate into the sense-making.

Sweden stands out as the world’s only major industrialized country that handles the new corona virus without tough restrictions, coercion and isolation requirements. Countries are amazed and appalled by the Swedish solitary position in the viral crisis. “The picture that is given is a kingdom of invincible Vikings,” writes the newspaper Le Monde.

A dozen other media in the world report similarly, according to a review by SvD. “People over the age of 70 are simply asked to stay home,” France Info notes with surprise. Corona-affected Italy goes a step further. “Sweden swims against the current in an irresponsible way. Nordic modelling is a dangerous mistake, ”according to La Repubblica.

The British Financial Times calls Sweden’s road a “unique public health experiment” while The Guardian reports that Sweden “plays Russian roulette with its citizens”, and Swiss Le Temps amazes that “in Sweden life goes on as usual”.

The Swedish line is also noticed in Argentina, China and the Middle East. “Sweden seems to live in a different world, and believes that the virus can be eliminated by giving citizens some simple instructions,” writes Argentine newspaper Clarin Mundo. China Daily reports on “unexpected cultural differences” between Sweden and the Nordic neighboring countries, and Al-Jazeera is completely in awe of that gyms are open as usual in Sweden.

The prestigious American magazine Foreign Policy has an in-depth article about the “business as usual”, in Sweden. “Almost all Western countries have come to the conclusion of shutting down their communities - but one big exception stands out: Sweden. The Swedes seem to expect that their national culture can cope with public health threats that other countries cannot, ”it says. It is aghast at that Swedes who have just returned from skiing in the virus-infected Alps are now planning to travel to Åre. The New York Times also writes about global wonder over the relaxed Swedish line.

Rarely has Sweden and Swedish politics received so much attention in the outside world and been challenged so brutally for a public health strategy. International inquiries now rain over the Public Health Authority. Everyone has the same wonder: why does Sweden go against the current?

Swedish historian Lars Trägårdh is a specialist in Nordic welfare models and Swedish social values. He says that Sweden’s actions are based on deep-rooted traditions and social structures.

– First, there is a deeper trust in public institutions in Sweden than in other countries. It is not blind faith that make us obedient citizens but the belief in expert authorities who in turn trust the citizens. It is a matter of mutual trust.

Therefore, Swedish authorities believe that it is enough to make recommendations such as staying inside if you feel ill and avoid large crowds. “Use your brains,” says Lars Trägårdh. In other words, classic Swedish freedom under responsibility. May also be called common sense or sense of duty.

Secondly, he thinks, the Swedish exception can be explained by the ban on “ministerial rule”. It is a deeply rooted rule that goes back to Axel Oxenstierna’s time in the 17th century when the foundation was laid for the Swedish state apparatus. This means that Sweden is governed, de-facto, by expert authorities and not directly by the government. Politicians who want to show strength in tough times should keep their paws away from unpolitical institutions whose decisions are based on skills and expertise.

– This runs very deep in Sweden. Elsewhere in the world where one does not have this strict rule, many politicians now take the opportunity to prove themselves as strong leaders and impose harsh prohibitions, especially if it is an election year.

This rule is also stronger in Sweden than in neighboring countries. This may partly explain the difference in virus strategy with, for example, Denmark being “given a more populist political culture”.

Thirdly, the answer lies deep in Swedish culture, says Lars Trägårdh. In principles that can be summed up in two words: trust and care.

– In Sweden, there is trust between people. When I go outdoors, I assume that others have taken their responsibility and do not go out with a fever or spit and cough on the street. You keep a decent distance. You self-regulate and at the same time create degrees of freedom.

– Trust is good but control is better in many countries. In Sweden, on the contrary.

Right now, the Swedish population is undergoing a stress test. It then returns to the typical Swedishness that is sometimes considered a bit boring and mellow, says Trägårdh.

– Conscientiousness. It sounds a bit old-fashioned, but if you look at the deep structures in society, this word always pops up. And it is exaggerated in crisis situations.

He takes the example of provocative “corona parties” organized in some parts of the world.

– It is seen as idiotic in Sweden, and nothing that gives any plus points. There is no party price mentality here with people spitting each other in the face to show how tough they are. Some may misbehave, but the majority act well.

– People also do not run around and are careless in Stockholm. It is calm and quiet. People are careful and considerate. We do this in the context of allowing for greater freedom without breaking institutions and closing schools - a typical Swedish line.

At the same time, extensive work is going on behind the scenes before the pandemic worsens, he says.

– Students are carefully prepared for things to be tougher. They are trained to work remotely, given passwords and access to online teaching platforms. At the same time, we are preparing people to step into full time child care and help in a deeper crisis.

There is no naive hope that Sweden will get away, says Lars Trägårdh.

– But here is another balance between taking care of individual sick people and our institutions and the economy. That discussion feels calmer and more mature in Sweden. In many other countries it is more hysterical and people are horrified by “talk about protecting the economy when old people die”. That doesn’t sound right in Sweden.

In addition, a completely different atmosphere is created in society when one assumes that people themselves can manage responsibility in critical situations, he adds.

In the outside world, Sweden is known for relatively strong state control from the cradle to the grave. Then why not control with a stronger hand in the corona crisis?

– During the cholera epidemic in the late 1800s and the AIDS epidemic in the 1980s, Sweden was the worst in the class. We took the most draconian and almost horrific measures to deal with these epidemics. People were imprisoned and there was no talk of regard for freedom and individual rights.

– Now there is a need for a greater freedom in society. But at the same time, people’s need for a firm hand remains. In this way, there is something unexpected about the Swedish virus strategy.

And if other countries are right that Swedish action is irresponsible and can lead to a virus bomb that kills thousands and also strikes the outside world?

– We don’t know. I cannot say whether Sweden is doing right or wrong. Time will tell.

– But in the criticism of Sweden there is also a trail of jealousy. Sweden should not get away, be able to have children in schools and go to restaurants when others do not. Unfortunately, there seems to be a bit of pleasure in almost hoping that things are going to go bad in Sweden in the future, says Lars Trägårdh.

On the other hand, it is perhaps as the radio channel France Info points out: “the belief in collective responsibility may work for a while but will become increasingly complicated”. Possibly, restrictions will increase over time.

– The Swedes are like everyone else and the pressure is increasing. The schools and restaurants are admittedly open. But fewer are coming and classes are being emptied by parents who prefer to keep their children at home.

– Sweden may eventually come to the same conclusions as all of us. But they have taken a different path.

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Accounts of people partying in bars in the capital are somewhat exaggerated it seems…

Some of the reservations I have heard have been about lack of transparency about the basis for selection of this self-responsibility strategy. More specifically lack of publicly accessible data, with a comparison made to Norway; https://www.dn.se/debatt/folkhalsomyndigheten-maste-sluta-hemlighalla-fakta/

Well, yes and no. I went out for a beer and food with a friend last night at a local restaurant after a long walk where we saw plenty of people out. It was a lot more empty than usual on a Sunday, but there were still maybe 20 people there. Plenty of safety precautions like staff wearing medical gloves.

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Excellent work, thanks for doing it.

Many of my friends in Italy are very, very worried of the corporate-state surveillance that SARS-CoV-2 is helping being introduced. Self-regulation and responsibility looks very good to me. Even if it is a rosy picture of actual Sweden, it is still something to aspire to.

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I also wanted the thank you Hugi! this helped me to understand the situation here a bit better. When following mainly international media, it can be confusing to see Sweden going in this different direction.

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Found this article that gives some historical context as to why it seems we are underresourced when it comes to disaster preparedness. With a comparison to how Finland has managed this:

Is it working? Are people keeping their distance?

Speaking of going in the wrong direction, Hungary just handed Orban almost unlimited dictatorial power.

It makes sense, people get used to everything. If you always give them more responsibility, trust and freedom to choose they will consider that a natural state and get used to acting like that. If you regulate everything and communicate in a way “you must do it, or else we will infinitely punish you through fines etc” people get used to being assisted in many ways and don’t follow the guidelines unless there is a big consequence (usually affecting their pockets and yes, money is god so hit them where it hurts).

Comparing your relationship with the ones in Belgium or any Balkan country with “screw them (the government) or they will screw you” attitude…we have a long way to go to reach that level of personal development.

Interesting how you describe the institutions/people relationship, I noticed the same thing in Denmark and Finland seems to have the same dynamic between the two. I had a Finnish mentor and that was one of many things I made sure to remember so that one day maybe I get to apply them in Balkans.
Discussed it with a close friend of mine last time I visited Copenhagen and she said something similar. She said she thinks people are very happy in Denmark because of the general feeling of trust they have. Trust in institutions maybe less but trust in each other for sure. I could feel it.

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It’s not even the recommendation to keep 3 feet at all times. People are hanging out in restaurants and going for walks. Schools are open, and so are many workplaces, although a lot of people are working from home. It’s not business as usual, as my brother who works in the restaurant industry will tell you, there is a massive change in behaviour which is affecting business like nothing we’ve seen for a very long time. Still, compared to other countries, it’s still reasonably relaxed.

This picture is from a few days ago, and is reasonably representative:

Pictures in this article are reasonably representative.

Still, people are very aware of what is happening around Europe and the world. But there is this feeling among a majority that Sweden can somehow navigate this with common sense and stoicism. I have no idea how this will turn out. It sort of feels like we are the non-interventionist arm of a huge randomised controlled trial.

Whatever happens, I agree with @alberto and his friends:

What is happening around Europe and the world is far scarier long term IMO. These transgressions on liberties and rights will not be rolled back. Lex Patriot act. We are going into a very scary new normal. And the EU just got its first dictatorship…

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Well I wish you all goof luck. But I would add this cautionary tale from a Los Angeles Times newsletter:

With the coronavirus quickly spreading in Washington state in early March, leaders of the Skagit Valley Chorale in Mount Vernon debated whether to go ahead with weekly rehearsal. The virus was already killing people in the Seattle area, about an hour’s drive to the south. But Skagit County hadn’t reported any cases, schools and businesses remained open, and prohibitions on large gatherings had yet to be announced.

Sixty singers showed up. A greeter offered hand sanitizer at the door, and members refrained from the usual hugs and handshakes. Nearly three weeks later, 45 have been diagnosed with COVID-19 or ill with the symptoms, at least three have been hospitalized, and two are dead.

The outbreak has stunned county health officials, who have concluded that the virus was almost certainly transmitted through the air from one or more people without symptoms.

This was a choir. So they were not just standing together but the whole time there were many tiny droplets coming out of singing mouths. But still…

I think also relevant to look at some photos of the choir. They are predominantly white-haired people, many of whom look like they are well into retirement. This is not uncommon among community choirs. So people should not make the mistake of thinking this was a cross-section of society. This was a group of the more at-risk demographic. That’s the reason that I am surprised they took the decision they did. If it had been a youth choir, there would most likely have been no such tragedy.

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Probably right. Still, there is a new study of the Seattle area that indicates that social distancing definitely helps slow the spread, but does not stop it. In this case social distancing is the 6 foot rule. But suppose you are in a store or walking down the street and someone coughs or spews some mist out of their mouth and you walk into it?

I am going to have to go to the store either today or tomorrow. I have not left my house since last Wednesday. I’m not looking forward to going…

Looks like it might not be going so well in Sweden…

That depends what the rate of infection is in Sweden vs. Norway. If the rate of infection in Norway is 6 times lower than in Sweden, then Norway is likely to have the same number of deaths, just drawn out over time before getting to herd immunity. We need serology tests to be able to make sense of that.

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