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What Happened to Sweden’s Strategy for COVID-19?

The King of Sweden has admitted that Sweden's strategy “failed.” What happened to herd immunity? It didn’t work! What is the new strategy?

Many people around the world are fed up with restricted activities, masks and quarantines. Everyone wants to get back to normal. But Sweden’s strategy may be an example of why it’s too early to let down our guard. As we explain below, Sweden followed a different course from its Nordic neighbors last year. Instead of a lockdown, public health authorities urged prudence. People were allowed to go to restaurants, bars and outdoor events.

What Happened in Sweden?

Then Sweden was hit with a second wave that was much worse than its neighbors’. This spring, Sweden appears to be entering a third wave. New cases have increased by 10% for each of the last three weeks and ICUs are once again under stress. The government has instituted reduced hours for gathering places like bars, cafes and restaurants. Face mask requirements have also been upgraded along with recommendations about working from home and socializing with limited numbers of people.

Those who develop symptoms are being encouraged to get tested and isolate themselves. The national Public Health Agency warns that they may need to impose even stiffer restrictions if Swedes don’t follow recommended guidelines.

What Was the Swedish Model?

Back in the spring of 2020, Sweden followed a very different path from its Nordic neighbors and most of Europe. First, there were no widespread lockdowns. Restaurants, cafes and bars stayed open. There were lots of photographs of Swedes enjoying outings together with no masks or social distancing.

Offices remained opened, though people were encouraged to work from home. Schools stayed open for children under 16. Gatherings of over 50 people were discouraged, but there were no mandates.

In essence, the government took a hands-off approach.

Anders Bjorkman, a professor of infectious diseases at the renowned Karolinska Institute in Stockholm, was quoted (BMJ, June 12, 2020): 

“They did not want to put it bluntly, but seeking herd immunity was always inherent in the Swedish strategy.”

Many Americans Loved Sweden’s Strategy:

We heard from lots of visitors to our website:

Lillian thought that Sweden’s strategy was a model for the future:

“The former Swedish head epidemiologist, Dr. Johan Giesecke has explained that he could not see a way to back off a complete lockdown without creating new waves of illness. It is his bet that while Sweden may experience more deaths up front, countries locked down will experience more deaths later. He said the difference in numbers of deaths overall will be negligible and Sweden will have avoided a lot of the economic and social costs of locking down.

“I am rooting for them because this will not be our last pandemic and they have likely provided us with a model for the future.”

Wayne offers this comment about Sweden’s strategy:

“In the long run, all countries will have roughly the same mortality rate. Sweden has not delayed it but let the disease run its natural course. Sans vaccine, all measures to ‘flatten the curve’ are merely delaying tactics.”

Julie is adamant that Sweden’s strategy is the one to follow. This is what she wrote in August:

“If you want real data, look at Sweden. No lockdowns, no masks, kids in school and most importantly, NO RESURGENCE because they achieved herd immunity. And yes, they had deaths, but not as many as Spain, Italy and the UK. All the countries that locked down and wore masks are now having severe second waves and initiating more lockdowns and intensified mandates.

“Are we willing to spend the rest of our lives in lockdowns and fear? That is where this all leads. When will we learn? This was predicted by world renowned scientists from the beginning. As long as we continue to hide, we will not achieve herd immunity and repeated infection waves will occur. All we are doing is delaying herd immunity and perpetuating the recurrences.”

Some U.S. government advisers also loved the idea of herd immunity.

What Actually Happened with Sweden’s Strategy?

The state epidemiologist, Dr. Anders Tegnell, told his countrymen that the hands-off approach would reduce the likelihood of a fall surge in COVID cases. He was wrong!

Sweden is experiencing a staggering surge in cases that is overwhelming hospitals in Stockholm. Sweden’s King, Carl 16 Gustaf, has admitted that the country has fared poorly.

He said:

“The Swedish people have suffered enormously in difficult conditions.”

At last count, Sweden has had roughly 400,000 cases of COVID-19 with more than 8,200 deaths. Norway has had 45,500 cases and less than 500 deaths. Finland has had just over 34,000 cases and 524 deaths.

To be fair, we have to take into count the populations of each country. Sweden has 10.3 million people compared to 5.5 million in Finland and 5.3 million in Norway. So, Sweden has roughly twice the population of these nearby countries. But Sweden has almost 10 times the number of cases and roughly 16 times the number of deaths compared to its Nordic neighbors.

Here is how the Lancet (Dec. 22, 2020) describes Sweden’s strategy and its per capita death rate: 

“In the second wave of the COVID-19 pandemic, the Swedish national response continues to be an outlier with cases and deaths increasing more rapidly than in its Nordic neighbours. On Dec 20, 2020, COVID-19 deaths in Sweden had reached more than 8000 or 787 deaths per 1 million population, which is 4·5 to ten times higher than its neighbours.”

Sweden’s Strategy Has Failed!

That is not our conclusion. That is the word Sweden’s King Carl XVI Gustaf has used to describe the Swedish model.

The Corona Commission of the Swedish government has also concluded that the laissez faire attitude of public health authorities was a failure (Lancet, Dec. 22, 2020): 

“On Dec 15, 2020, the Corona Commission concluded that ‘the single most important factor behind the major outbreaks and the high number of deaths in [elderly] residential care is the overall spread of the virus in the society’. In addition to the failure of the COVID-19 strategy, there are other unresolved structural factors related to the organisation of the care of older people in Sweden.

“The Royal Swedish Academy of Sciences independent review of the available evidence validates WHO’s recommendations to keep a physical distance, wear a face mask, keep rooms ventilated, avoid crowds, and practise good hand and respiratory hygiene. However, not until Dec 18, 2020, did the government give directives to start to translate more of these recommendations into practice including the use of face masks, as the trajectory of rapidly rising cases and deaths continues and intensive-care facilities and the health-care professionals are stretched to the limits in many regions in Sweden.”

Sweden’s Strategy Today vs. Herd Immunity:

The government is now encouraging citizens to wear masks on public transportation. Non-essential workers are urged to stay home. The prime minister, Stefan Lofven, has told his countrymen to cancel all social engagements. Gyms, libraries, pools and similar gathering places will be closed until the end of January.

And what about herd immunity? Dr. Anders Tegnell now says that:

“No it’s never been part of the strategy.”

Except an investigative report tells a different story (FP or Foreign Policy, Dec. 22, 2020): 

“Sweden’s botched coronavirus response is no longer news: Even the country’s king, Carl XVI Gustaf, admitted in his annual Christmas address that the Swedish government had ‘failed.’ But private emails seen by Foreign Policy, some of which have been previously reported in the Swedish press, reveal that Sweden’s health authorities were resigned to mass infections—so called herd immunity—all along, and no matter the costs. Throughout the pandemic, Sweden’s health authorities have said one thing publicly and something different in private about nearly every aspect of their management of the crisis. There were repeated public denials from the government that it deliberately sought to achieve herd immunity, even though that was the strategy pursued behind closed doors.

“And the result has been deadly. While countries such as the United States, Brazil, and India have made headlines for recording the highest number of coronavirus-related fatalities, Sweden’s death rate of over 80 per 100,000 people is among Europe’s highest and is around 10 times as great as those of Norway and Finland, and over four times Denmark’s.”

Is there a lesson here for the United States?

We will let a commenter have the last word on Sweden’s strategy:

In November, Ben added this comment to our website:

“I lived in Sweden for a few years, and my family visited there for two weeks last August (2019). I have many close friends there, and I am in weekly contact with them. Just from observation from afar, from what I have read in Swedish papers, and from articles like this it seems evident that it was a bit of an experiment (unfortunately with people’s lives) that maybe did not turn out as planned.

“Of my three best friends there, two of them were directly impacted and contracted COVID-19. Of my many more U.S. contacts and family, only one I know of has contracted COVID-19. All wear face masks and social distance, although the U.S. has a hodge-podge /imperfect plan. Hopefully, we will all apply Lessons-Learned for the next time.”

What Do You Think?

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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