Today, Explained - Why Sweden stayed open

Episode Date: May 6, 2020

The Kingdom of Sweden watched the world lock down and decided to do the opposite. Swedish journalist Nathalie Rothschild explains. Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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BetMGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly. If you have any questions or concerns about your gambling or someone close to you, please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Did you hear the one about Sweden? The whole world was shutting down to deal with the pandemic,

and Sweden went the other way. So the biggest difference is no lockdown and no quarantine. And obviously that means, you know, schools have stayed open, bars and restaurants, gyms, hairdressers, what have you. Natalie Rothschild is a freelance reporter based in Stockholm. She's been covering the country's response to the pandemic, but she's also been living it. So the other week, it was a very sunny weekend, and I looked out my window where I see bus stops and I see cafes and restaurants and a kind of little shopping centre and that kind of thing, and it was bustling, lots of people everywhere,

and you would not know that there was a pandemic on. But then the next day, equally sunny Sunday, I took a ferry that's usually cram with people. It was empty. There were about nine people on that ferry. I went to a zoo with my mom and my son and there was hardly anyone there. We walked through the city center. It was dead. No one was out shopping, even though there are big sales on. Lots of stores that are normally open on a Sunday had closed because lots of stores have limited their opening hours. We walked through the old town, which is usually bustling with tourists on a sunny Sunday.

It was empty. Stores are shuttered. And at the same time, in another part of the cities, it's, you know, bustling with people. So it really depends where you look and where you point the camera, so to speak. And I think it's perhaps better to look at the figures. The data does show that Swedes are limiting their movement. Obviously not to the same extent as in countries where there are lockdowns where you need a special permit to go out or you're limited to take you know one jog a day or one walk a day or something like that but they have reduced their mobility. So yeah obviously on a sunny day

sort of sun-starved Swedes will rush out of their homes and, you know, go for ice creams and picnics and what have you. But it's not like life is exactly like it was before the pandemic. How exactly did Sweden respond to this pandemic? I mean, no lockdown, but certainly the country did something? Actually, in the roughly six weeks or so between the first confirmed case and the first confirmed death, so between the end of January and mid-March, roughly, not that much happened by way of response. I mean, I'm sure there was a lot of work going on behind the scenes, so to speak, but in terms of requirements for changing behaviour and new laws and so on, not much happened. So the foreign ministry issued a few travel advisories, the risk level of a community

spread was raised, and the government classified the virus as dangerous to public health. Some flights were halted and so on. But actually throughout February, when schools across different parts of Sweden closed for one week for winter breaks, lots of Swedes were traveling to and then back from the Alps, especially the Italian Alps. It's a popular winter destination for Swedes. And that's how the virus really took hold to start with in Sweden. Okay, so you know you've got all of this community spread. You know people in Sweden have traveled to Italy and brought it back. What does the Swedish government do once it has a thousand cases and knows, okay, the concentration that's kind of front and center of the Swedish strategy and effort to combat the virus, at an early stage they said that there were three phases to their approach. So the initial phase is that you have a situation where the virus has not entered the

country, as far as you know, and that's when the strategy is focused on keeping it out. Then once there is a domestic spread, you move into phase two, which is containment. And then the third stage is a pandemic. And when the WHO confirmed a pandemic on March 11th, you could see the government and the health authorities kind of spring into action. Before that, there was contact tracing going on also and testing of the initial cases. But once the community spread was confirmed, the testing got limited to patients and elderly home residents with symptoms and to some medical staff,

and they stopped doing contact tracing. But then from March, there were a set of measures put in place. And what were they? So since then, basically, the government made some changes to the social security system to make it easier for people with symptoms to take sick leave. And anyone who was able to work from home was advised to do so. Public gatherings were limited. Initially, it was 500 people.

Then it was lowered to 50. The government has also imposed a ban on visits to elderly homes. And they closed down high schools and universities, which have had to move to online teaching. But preschools and schools remain open. Restaurants are now only able to offer table service or takeaway. And then there are also a set of recommendations that the public health agency issues. These recommendations include keeping good hygiene, so washing your hands regularly, keeping a distance to other people,

staying home at any sign of a cold. Elderly people should self-isolate, but they should also go out to take fresh air and exercise. You should only travel if necessary. I mean, breaking any of these recommendations, going against them doesn't carry any legal sanction. Is part of the strategy here maybe to just let the virus get out there and work its way through the lesser vulnerable people in the country, something called herd immunity? The idea that Sweden's strategy is premised on herd immunity, or that that is the goal

or the basis of Sweden's strategy, is something that's been denied many times by the government and by the public health agency. Well, we don't have a strategy of herd immunity. We know that that is a state that will come eventually, but it's not in our strategy. But what is in our strategy is that we don't want to stop all transmission. We want to flatten the curve. And that we have managed with. So the idea that Sweden's conducting some massive experiment in herd immunity is a misconception? Yes. I'm glad we could clear that up.

Yeah. I'm sure it will still be a theory floating about. And why do you think Sweden chose to go about it this way? No lockdown? I think it's a complicated question, but at least part of the answer lies in Swedish history and form of governance. It's enshrined in the Swedish constitution that public agencies should be free from ministerial rule, meaning they should be politically independent. So a public agency like the public health agency is, I mean, influenced by the government in that the government sets the remit, the budget, it appoints the head of the agency and so on, but it's not allowed to meddle

in the day-to-day affairs of the agency. So they sort of leave it to the experts to formulate, in this case, Sweden's public health approach. And then there's a kind of expectation that the government will rely on their advice and formulate policies along the lines of that advice. That's one kind of distinctive characteristic, let's say, of Swedish society and governance and the other element is that Sweden along with other Nordic nations is what's called a high trust society this is something that has been measured for instance in the world values survey there are different

elements to that so there's a high level of mutual trust between agencies and citizens, and also a high level of interpersonal trust between citizens. And so the public health agency has relied on that trust. The tradition in Sweden when it comes to healthcare and public health has very much to work with voluntary measures, to have a dialogue with our population, to give good advice and tell people what we're trying to achieve, not telling them exactly what you should do in every situation. To understand this, I think a parallel can be drawn,

and the Public Health agency has drawn this parallel as well to the national vaccine program which is also based on voluntarism in that there's no legal requirement to get vaccinated or to or for parents to have their children vaccinated but there's a near universal uptake anyway and so the same ethos kind of underlies this strategy, and not everyone thinks that's a good thing, because it's a very new, unprecedented public health emergency. I'm a scientist.

I don't trust authorities. I trust data, and I don't see transparency of data that makes me calm to say that the strategy chosen is the best way forward. How Sweden's experiment is working out after the break. Support for Today Explained comes from Ramp. Thank you. Ramp says they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained, ramp.com slash explained, r-a-m-p.com slash explained.

Cards issued by Sutton Bank, member FDIC, terms and conditions apply. Okay, Natalie, so we have this sort of remarkable absence of a lockdown in Sweden, even so things are certainly different. Social life has slowed. Outdoor activity has slowed. But I wonder, without an official lockdown and a legally enforced lockdown, and even without public schools being closed, how is it going in Sweden? How does it compare to, I don't know, Sweden's neighbors?

And is that a fair comparison? Sweden's neighbors have lower figures, a lot lower. For Sweden and Denmark, the number of COVID-19 deaths was fairly equivalent at first, but then Sweden saw a surge in April. Sweden's death rate is 24 per 100,000 people compared with the UK's at 39, though Sweden looks poor compared with neighboring Denmark at over seven and Norway at under four. But obviously, you know, there's an element of cherry picking when you look at other countries, if you compare it to Belgium, for instance. Here in Sweden, it's 283 dead per million. In Belgium, it's 692. There's also the public health agency is keen to stress that

different countries have different ways of counting and recording deaths and that different countries are at different stages of the pandemic and so on. And testing as well, right? Yeah. So Sweden has tested about 120,000 people so far. And there's been promises of greatly extending testing for quite some time that haven't really been realized. So there's a lot of discussion about that now in Sweden. How are different groups in Sweden doing? I mean, in the United States, we're definitely seeing the elderly are more vulnerable,

and we're seeing more, quote--unquote essential workers being affected by this because they're out there every day taking buses, taking public transit, and on the sort of front lines of this. Yeah, there's a huge problem in care homes or nursing homes. Fatalities in care homes count for a third of Sweden's deaths from the coronavirus. In the Stockholm region, which is the hardest hit area, that figure rises to 50 percent. And so both the government and the public health agency have been very keen to defend the Swedish strategy, but they've also admitted that this has been a major failure. What we can say is that we have a large amount of the deaths

are connected to the elderly homes and that we are now investigating very thoroughly what we can do with the elderly homes to prevent the contagion from entering into those places. As the infection and death rates climb, care workers and union representatives have also shared stories in the media and in reports of poor routines, of a lack of protective equipment, bad communication from management teams and kind of working conditions in the elderly care system.

That means workers have been very vulnerable and have also exposed potentially elderly people to the virus. There's not been a will to test us systematically, at least in places where I've worked. Even if there are people with symptoms, they're not being tested. What about the economy? Has not locking down spared Sweden from the crises we see all over the planet? I mean, of course, in a globalized world, the Swedish economy doesn't exist in isolation. Of course, a lot of industries and sectors are

affected, not least tourism, hospitality, and unemployment is soaring here as well. I know 183 businesses within the hotel and restaurant industry filed for bankruptcy in the first three weeks of April alone. So obviously a lot of individuals, a lot of companies and a lot of sectors are feeling the impact of this pandemic. I know I saw figures the other week that the IMF, the International Monetary Fund, predicted that the Swedish economy would shrink by 6.8%. So by comparison, the 2009 financial crisis are very tame compared to other countries. It still is the case that life has radically changed in terms of how you move about and how you spend your money and the caution, obviously, that people are taking with their personal finances at a time of uncertainty.

So it's not as if Sweden is booming financially at the moment. So what does that mean for this approach that the government took, this approach to avoid a lockdown? I mean, it sounds like it didn't necessarily save the economy, and it didn't necessarily stop the spread of this virus. Correct me if I'm oversimplifying it, but was it a smart approach, you think, or is it too early to say? I think it's too early to label any approach of any country as either right or wrong at this point. I mean, I think we have to wait for some time to make a sort of conclusive judgment on that. But I also think, considering that this is a global crisis, it would be impossible for Sweden to not be impacted. I mean, both in terms

of health and deaths, and in terms of the economy. But I think the argument from the authorities here in defense of avoiding a lockdown, it also means that Sweden is not in the situation that other countries find themselves in now in terms of debating how to open up. You know, the big issue for many other countries right now is the exit strategy. And Sweden in many ways needs an exit strategy as well, because we're not living as we did just a few months ago. But obviously the transition back to normalcy is not as complicated as in other countries. There's always going to be differences in opinion as to whether the strategy is right or wrong,

but I also think we're still in the midst of it, and perhaps a year from now or even further away, the debate will sound completely different. I mean, who knows? But I also think that it there's a very legitimate concern and worry and and disappointment I guess for someone who perhaps has an elderly relation in a care home and sees what's going on there and there's there's a lot of frustration among care workers and a lot of people are being

affected obviously by the pandemic so people are going to have very different experiences of this whole situation. Natalie Rothschild reports on the Kingdom of Sweden from Stockholm. You can find her work at natalierothschild.com or on Twitter at n underscore Rothschild. I'm Sean Ramos-Firm. This is Today Explained.