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Why Sweden Is Going Rogue In Its Response To COVID-19

Sweden has taken a conspicuously different response to the pandemic, with life largely continuing as normal and the government trusting in the public to adopt softer, voluntary measures.

Unlike its Nordic neighbours Denmark, Finland and Norway, Sweden has chosen not to close its borders or its schools.

Non-essential businesses continue to stay open, and the Swedish government also hasn't put an end to gatherings of more than two people, unlike the U.K. and Germany.

To What Extent Has Sweden Been Impacted?

Some may assume that Sweden is taking a more relaxed approach to the coronavirus outbreak because the nation does not have many confirmed cases, but this is not so.

There are currently more than 5500 confirmed cases of coronavirus in Sweden and 308 deaths,  according to Johns Hopkins University. Sweden also has the fifth highest death rate per capita, following Italy, Spain, France and the UK.

Yet Sweden's chief epidemiologist Anders Tegnell says the country's relatively permissive policies are more sustainable in protecting people's health amid the pandemic.

What Are Swedes Still Allowed To Do?

The streets of Stockholm are quiet but not deserted. People still sit at outdoor cafes in the centre of Sweden's capital and vendors still sell flowers.

Although the government has now banned gatherings of more than 50 people, this excludes places like primary schools, restaurants and gyms which remain open. Restaurants, bars, cafés and nightclubs have been told to offer seated table service only.

Sweden’s government has advised working from home if at all possible, avoiding non-essential travel and the elderly are advised to stay home.

How Do Experts Justify This Approach?

Prime Minister Stefan Löfven has said: "We all, as individuals, have to take responsibility. We can’t legislate and ban everything. It is also a question of common sense."

Chief epidemiologist Tegnell said that while Sweden's strategy to tackle the virus was different, the end goal is the same.

“Sweden has gone mostly for voluntary measures because that’s how we’re used to working,” Tegnell said.

An elderly woman wears a mask as she attends a service in central Stockholm amid the coronavirus outbreak. (Image: Getty)

Tegnell said the country has a long tradition with the 'voluntary approach' and  "that it works rather well”.

He argued that Sweden's policies are more sustainable and effective in protecting the public's health rather than "drastic" moves like closing schools for four or five months.

"Sweden is an outlier on the European scene, at least," the country's former chief epidemiologist Johan Giesecke said.

"And I think that's good."

Is There Much For Support For A More Relaxed Approach?

Sweden has amassed criticism for what some experts say is too “relaxed” a response to COVID-19.

In late March, more than 2,000 Swedish university researchers published an open letter questioning the government’s response.

"We’re not testing enough, we’re not tracking, we’re not isolating enough -- we have let the virus loose," virus immunology expert Professor Cecilia Soderberg-Naucler said.

"They are leading us to catastrophe," she said.

This week, epidemiologists highlighted the growing concern among Swedish medical experts over the government's laissez-faire approach.

"People now are taking sides, with some arguing that publicly criticising the authorities only serves to undermine public trust at a time when this is so badly needed," Professor Paul Franks and Professor Peter Nilsson from Lund University wrote.

"Others are convinced that Sweden is hurtling toward a disaster of biblical proportions and that the direction of travel must change."

BUT... Is It Working?

Sweden has a considerably higher number of COVID-19 fatalities than neighbours Denmark and Norway, despite having a similar number of confirmed cases. Using this data as a measure, it would suggest that it is not working to date.

However Franks and Nilsson argued that a long-term lockdown will have major economic implications and could cause even greater death and suffering in the longer term.

"Ultimately, given the uneven and relatively modest spread of the virus in Sweden at the moment, its initial strategy may not turn out to be reckless," they wrote.

Swedish authorities also say they know the worst is yet to come.

"Of course, we’re going into a phase in the epidemic where we’ll see a lot more cases in the next few weeks, more people in the ICU, but that’s just like any other country -- nowhere has been able to slow down the spread considerably,” Tegnell said.

Tegnall has said the authorities had explained to the population why voluntary social distancing was needed, “and so far, it’s been working reasonably well”.

In terms of fear and panic, Swedes are coping the best in a poll of 26 nations around the world. Less than one third of Swedes say they are “very” or “somewhat” scared that they will contract COVID-19. This is in stark contrast to other countries where fear is much higher.

Image: YouGov poll

While Sweden is doing an outstanding job in terms of managing fear, it is yet to be known whether its health outcomes will be as successful.

"So when we probe the lessons learned from the COVID-19 pandemic in the future, there will likely be a lot of focus on the success or failure of Sweden’s relatively relaxed initial approach.

This would take into account not just the loss of lives from the pandemic, but also longer-term social and economic negative consequences and the deaths they may cause," Franks and Nilsson said.

Contact the author alattouf@networkten.com.au