Sweden stayed open while other countries locked down — with 5,800 dead, critics are questioning if the gamble went horribly wrong

  • Sweden chose not to lock down after the coronavirus pandemic hit, and suffered many more deaths than its neighbors Denmark and Norway.
  • Thousands of Swedish people over the age of 70 died, around half of whom lived in care homes.
  • The Swedish economy is also expected to shrink by around 6% this year.
  • Critics are now questioning whether Sweden's hands-off approach to the pandemic has gone horribly wrong.
  • View more episodes of Business Insider Weekly on Facebook. 

As the coronavirus sent much of the world into lockdown in March, Sweden was a clear outlier.

In the Scandinavian country, restaurants, schools, and gyms stayed open, and images of smiling Swedes enjoying a near-normal life outside cafes and bars seemed to taunt those in other countries living under strict stay-at-home orders.

Sweden attracted global attention and criticism for its hands-off approach to the pandemic, which it hoped would allow the virus to circulate until the majority of the population became naturally immune.

But by April it was becoming clear that Sweden was in trouble. The death rate began rocketing upward, and for one week in May, the country had the highest number of deaths per capita in the world, according to research by the Financial Times.

Meanwhile, its European neighbors employed strict lockdowns and suffered far fewer casualties. To make matters worse, the Swedish economy also suffered as many Swedes took it upon themselves to stay home.

Now, as many of its neighbors have now reopened, observers in Sweden are questioning whether their country's gamble had gone horribly wrong.

Sweden's strategy resulted in thousands of unnecessary deaths, critics say.

It was out of sight and away from Sweden's apparently care-free cafes and bars that the real damage of the coronavirus pandemic was being done.

The vast majority of the 5,800 people in Sweden who had died by the end of August were over 70, and according to the Sweden's national health board, almost half had been in residential care homes.

"We didn't have the logistics to handle this pandemic at all and the price is paid by the elderly," said Jon Tallinger, a Swedish doctor who left his post as a general practitioner in May to campaign for better treatment of the elderly.

"They are letting people who get severely sick and are above 80 in care homes for instance, die instead of receiving oxygen."

Tallinger believes it was a mistake to keep so many people with COVID-19 in care homes rather than transfer them to intensive care units, where they would have stood a far greater chance of survival.

While Sweden greatly expanded its ICU capacity, many of the beds remained empty. A large field hospital hastily constructed in Stockholm in April was dismantled without taking in any patients.

Tallinger said facilities like this should have been used for the elderly.

"There was oxygen all along. This has nothing to do with the lockdown at all," he told Business Insider Weekly. "We could have had just as much freedom, so to speak in Sweden right now and saved thousands of people."

ICU treatment for the elderly could indeed have saved lives, said Peter Kasson, a professor of molecular physiology and biological physics at the University of Virginia's School of Medicine.

"Many, many more people were dying than were ever seeing the inside of an ICU. Our data suggests that provision of more intensive care would have obviously improved survival," he said.

"I certainly believe that earlier use of more extensive, personal protective equipment in the care homes would have also had an impact."

Swedish authorities also stand accused of closing down access to care homes too late, and of being slow with tracking and tracing cases.

Prime Minister Stefan Löfven has admitted some fault in that regard.

"Of course we are painfully aware that too many people have lost their lives due to COVID-19," Löfven said at a recent press conference. "Just like several other countries, we did not manage to protect our most vulnerable people, the most elderly, despite our best intentions."

Sweden's state epidemiologist Anders Tegnell is seen as the chief architect of the nation's mitigation strategy. In spite of the alarming number of deaths from COVID-19, he has insisted the policy is the right one.

"There are always aspects where we could have handled this situation even better than we do today. We are still very happy with the basic strategy. It works well. We have a low level of spread in society," he said. "We have an unfortunately very high death toll, but we are working on that, and we see that it's diminishing rather quickly."

Sweden's hands-off strategy stands in stark contrast to those of its neighbors.

Sweden's strategy stands in stark contrast to that employed by Denmark, just 30 kilometers from the Swedish west coast.

But during the COVID-19 pandemic, it may as well have been a world away. Denmark locked down early into the pandemic, closing schools, restaurants and shops.

By the end of July the country of nearly 6 million had recorded 615 deaths — that's almost 10 times fewer than its neighbor, according to figures from Our World in Data.

Denmark also closed its borders to Sweden in March — and kept them closed as their case numbers continued to diverge.

"People have been in wonder," said Søren K. Villemoes, a Danish journalist with the  Weekendavisen newspaper. "How can they continue this strategy, which for people in Denmark have been obviously flawed from the beginning?" 

Compared to its northern European neighbors, Sweden's policy stands out as a failure. Yet many suggest it could have been far worse. 

Authorities did close some schools and banned large gatherings — while advising the elderly to stay at home — but analysts feel that without the vigilance of ordinary Swedes, the pandemic could have spiraled out of control.

"I think Sweden was hit a lot harder than it could have been, but also spared a lot of the sickness and death that it would have likely experienced if not for the action of individual citizens," Kasson said.

Despite resisting a lockdown, Sweden's economy may still shrink anyway.

While there were no stay-at-home measures in place, mobile phone data from Google Mobility Trends suggests a significant drop in movements as many Swedes self-isolated. As a result, the economy, which should have benefitted from the stay-open approach, has also been hit.

As an export dependent country, Sweden's fortunes are very much tied to those of their neighbors and the wider global economy.

"So whatever we do in Sweden, the effects of our policies, our national policies, will be limited," Erik Wengström, professor of economics at Lund University, told Business Insider Weekly. "If other countries close down, that affects demand. So in some sense in the globalized economy, we are in this together."

Wengström predicted that Swedish GDP will fall between 4.5% to 6% by the end of the year — exactly the type of downswing Sweden wanted to avoid by keeping the country open.

A loss of that size may be less than that of Italy, Spain, the United Kingdom, and the United States, but it's similar to the figures of its Scandinavian neighbors who did lock down.

Unemployment in Sweden, according to Wengström, is likely to reach 10% by the end of the year.

The businesses that did stay open saw a noticeable drop in customers. Maria Persson, the operations manager for the Friskis & Svettis gym in Malmö, said she kept her doors open, but that didn't mean avoiding a financial hit. She now predicts losing about a quarter of her income this year.

"It's been really like a hurricane," she told Business Insider Weekly. "The first weeks after everything was closing down, we were really, really, just thinking every day that this will be the last day we will be able to keep it open. We could see really huge drop-downs in visitors, no new clients at all in the beginning."

"But it's still a struggle. So it's been really up and down."

In spite of a bruised economy, its high death rate, and no clear evidence to suggest that Sweden has achieved anything close to herd immunity, it's nevertheless too early to write off Sweden's experiment.

And while far worse than its neighbors, it suffered fewer deaths per capita than the likes of the UK, Italy, and Spain, all of whom locked down their populations.

The Swedish government insists that lockdowns are unsustainable as a long-term solution, and maintains its lighter touch will be proved right in the continuing fight against COVID-19.

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