Back in February, as the coronavirus started rapidly spreading worldwide, Sweden’s state epidemiologist didn’t see the need to lock down the country. A lot of Swedes started to fly all over Europe for their annual winter break. The country’s public health leaders insisted on keeping businesses and primary schools open while the rest of the world shut them down. Face masks were constantly discouraged. Months later, Sweden now has one of the highest death rates from the coronavirus in all of Europe. Its hands-off approach to COVID-19 has been disastrous, and shockingly, it’s still unclear whether Sweden’s policy will change course.
On Tuesday’s episode of What Next, I spoke with Lena Einhorn, an author, filmmaker, and former medical researcher, about how Sweden screwed up and what to think about what’s happening there now. Our conversation has been edited and condensed for clarity.
Mary Harris: Let’s go back to the beginning. Sweden was very slow to respond to the virus. But I remember that this was kind of seen in the United States as almost fresh thinking. I remember seeing articles saying the country is an outlier in Europe, trusting people to voluntarily follow protocols. Even though many did not, that seemed to not affect them. Do you remember that?
Lena Einhorn: Sure. The problem is that it wasn’t only an issue of trust—it was an issue of recommendations. The recommendations were different in Sweden. The restaurants were kept open. Experts were advocating against face masks. It’s different from most countries today.
Reporting shows that the Public Health Agency of Sweden pushed back hard against research showing that people who seemed healthy could be contagious. And for all the additional data we have, the Public Health Agency hasn’t substantially adjusted its claims.
In the beginning, the agency wrote on its website that there is no precedent for dramatic spread from those who are asymptomatic. Today, it will still say, It’s possible, but it will not drive the epidemic. And so the agency still has the same recommendations: Wash your hands and stay at home if you feel sick. Its webpage still says, if someone in your household has COVID-19, you go to work or school as usual.
The Public Health Agency may be refusing to admit it made a mistake because that means admitting that you caused a lot of people’s deaths. It’s a very difficult thing to admit.
The country’s policy has been shaped by state epidemiologist Anders Tegnell, who talks about immunity in this kind of funny way. He denies that his strategy is to make the population immune to the coronavirus. But at the same time, he puts forward these numbers that suggest otherwise. He said a while back, “We think that up to 25 percent of people in Stockholm have been exposed to coronavirus and are possibly immune.” I don’t know what his evidence was for that. But to even put that forward, it hints that maybe that’s something you’d like to be true.
And in the beginning, he was very open. He believed the only way we’re going to solve this is through herd immunity—he actually said that. Then the next time he denied that. At the same time, the agency overstated the antibody prevalence. It’s acting as if officials want younger people to get infected, because they’re very, very strict on people ages 70 or older staying at home or not associating with people.
They clearly recognize that there’s a vulnerable population.
Absolutely. But the problem is that so many people have died in elder care, both in the facilities and in the home. That goes back to pre-symptomatic and asymptomatic spread. Swedish epidemiologists don’t believe that that drives the pandemic, and they do not advocate using face masks in elder care facilities unless people are working with somebody who is sick. But a lot of the people who were working in the elder care facilities came from areas of Stockholm where there was a lot of spread, like in the suburbs. People were saying, oh, they came to work sick. No, they didn’t come to work sick. They came pre-symptomatic. They had no symptoms. But since they were told not to wear face masks, they probably gave it to the elderly. And that’s how it spread.
With a death rate and an infection rate that are so much higher than those of surrounding countries, it’s hard to think about why the population in general hasn’t risen up and said, “We want more restrictions, we want more control of this virus.”
There are a few answers to that. One aspect has to do with wishful thinking or desires—we want this to turn out well. Another one is, we want to be able to live as we always have. The third one is, we want to believe that our country is good and is doing the right thing.
There is another aspect, and that is that the Public Health Agency and the state epidemiologist had a press conference every day during the week at two o’clock. Now, in the summer, it’s only twice a week. But until recently, they had this every day during the week and everybody was watching it. And they basically always said: This is looking good. We know it’s hard on the hospitals, but we’re going in the right direction—
They’d say that even as the numbers were going up?
Yeah. It was always, The numbers are going up, but it’s flattening, it’s not going up as steeply anymore. And in the beginning, they said, We’re going to reach the peak tomorrow. And then the next day they said, maybe in two days. There was always a positive message at those press conferences. When somebody whom you want to trust says those things in such a calming way, people want to believe it.
Did you notice any kind of change in the Swedish perspective on this approach as the death numbers climbed, as the infection rates climbed?
The support for the Swedish policy lessened. It used to be very high. It’s not as high anymore. I would still say the support is pretty strong, but it’s definitely much more polarized compared with how it was. Also, the newspapers, their editorials started getting much more critical. But what hasn’t changed in the least is the policy of the Public Health Agency and the government. They’re sticking to their guns.
In some ways, it seems like Sweden is doing deliberately what the U.S. has done, with incompetence and neglect.
Yeah, and I don’t know how successful you could call it when we overall have higher death numbers per million inhabitants than the U.S. does.
Right now, coronavirus cases are actually on the decline in Sweden. Last week, Sweden’s daily COVID count dipped to its lowest point since May. The country’s health agency director said, “We are beginning to approach levels that other countries find acceptable.” What does it mean to you that Sweden’s numbers are going down now? Does that mean that there’s been some kind of success?
Well, they’re not at all going down as radically as they are in countries that had lockdowns. I mean, Sweden still has higher rates than surrounding countries and many other countries. But it is going down. There could be different explanations for this, because it’s still spreading a lot among the young. I’m speculating that one of the reasons it’s somewhat going down is that health care facilities’ routines are much better worked out, so it’s not striking the elderly to the same extent.
Another reason it’s going down is because you have to know what happens in Sweden come midsummer. From June 20 until Aug. 1, Sweden is a summer vacation place. That means people are in the country houses, they are not working. There is much more social distancing for natural reasons right now. So that’s another aspect.
What are people thinking about school? About businesses? Is it just back to normal?
Our schools were open, except for high school and universities. Which was really scary for some people because they maybe had parents with risk factors. But the kids were forced to go to school. If parents kept the kids home, they were threatened with social interventions. And now high schools will be open again too. So people will be going back.
Does that worry you?
Of course! Now what we are wondering is, will they finally change the policy in the fall? Will they say, please wear a face mask? I’m not only worried, but also curious about what will happen in September.
