Sweden’s government is drawing up new legislation to allow it to take “extraordinary steps” to combat Covid-19, local media have reported, amid concern that its relatively soft approach may be leading to a higher death rate than in other Nordic countries.
Denmark and Norway are among the many countries to have imposed tough lockdowns, closing borders and shutting schools and non-essential stores, and Finland has isolated its main urban area around Helsinki. But Swedes are still able to shop, go to restaurants, get haircuts and send children under 16 to class.
On Sunday Sweden reported a total of 401 deaths so far from Covid-19, up 8% from Saturday and greater than the totals of its three Nordic neighbours combined. Sweden’s toll per million inhabitants is 37, compared with 28 in Denmark, 12 in Norway and 4.5 in Finland.
The state broadcaster SVT said on Sunday that after an outcry by opposition parties, the Social Democrat-led government had abandoned plans reported earlier in the weekend to rule by decree, bypassing MPs.
Under legislation to be tabled next week, the Riksdag, Sweden’s parliament, will now be consulted before the government takes any new emergency steps such as shutting airportsor train and bus stations, closing shops and restaurants, further limiting public gatherings or requisitioning medical equipment, according to SVT.
Anders Tegnell, Sweden’s chief epidemiologist, has described the country’s coronavirus strategy as an attempt to ensure “a slow spread of infection and that the health services are not overwhelmed”, arguing that it is important for a part of the population to acquire immunity.
Tegnell has denied trying to build rapid “herd immunity” to the virus, a strategy originally adopted by the UK and the Netherlands before projected soaring death numbers prompted those countries to change course, but he has conceded that such a policy is “not contradictory” to Sweden’s objectives.
“It is important to have a policy that can be sustained over a longer period, meaning staying home if you are sick,” he said recently. “Locking people up at home won’t work in the longer term. Sooner or later people are going to go out anyway.”
Tegnell acknowledged last week that Sweden’s infection curve was “starting to become somewhat steeper” but insisted that overall it was still “fairly flat”. Amid a sharp rise in cases in Stockholm, however, the capital is soon to open a field hospital with 140 beds, rising eventually to 600, in a convention centre.
There are also growing concerns for the country’s older population after a third of Sweden’s municipalities reported confirmed or suspected cases of the virus in nursing homes, where distressed staff have warned publicly of a lack of protective equipment. One third of Stockholm’s nursing homes are affected.
Although Sweden has closed senior high schools and banned gatherings of more than 50 people, the prime minister, Stefan Löfven, has preferred to rely on Swedes’ sense of civic responsibility, asking rather than ordering them to avoid non-essential travel, to work from home and to stay indoors if they are over 70 or are feeling ill.
“Everyone is responsible for their own wellbeing, for their neighbours’ and for their own local community,” the foreign minister, Ann Linde, said last week. “This applies in a normal situation and it applies in a crisis situation.”
The approach has so far proved popular among voters, with 44% of respondents in a survey published last week saying they trusted Löfven, compared with 26% in February. But while Stockholm is estimated to be 70% less busy than usual, an analysis of smartphone location data showed that while visits to public places had fallen steeply in most European countries, Sweden was bucking the trend.
The strategy has come under increasingly heavy fire from some of the country’s health experts. Stefan Hanson, a Swedish infectious diseases expert, said the situation was not lost in the whole country, with large parts of the south and north so far displaying low infections rates.
“But in Stockholm it is fast becoming critical,” Hanson said. “There is a real risk now that cases will rise so high that the hospitals cannot cope. Treatment choices are already having to be made by biological age.”
He said this was due to a “very confused and unclear policy, with no clear objectives beyond trying to protect the over-70s and imposing some rather mild physical distancing measures.”
Cecilia Söderberg-Nauclér, a professor of microbial pathogenesis and one of about 2,300 academics to sign an open letter to the government at the end of last month calling for tougher measures to protect the healthcare system, said the government had “no choice” and should now lock down Stockholm.
“We must establish control over the situation; we cannot head into a situation where we get complete chaos,” Söderberg-Nauclér said. “No one has tried this route, so why should we test it first in Sweden, without informed consent?”
Sten Linnarsson, a professor at Sweden’s Karolinska Institute, said the concern was that “there is really a lack of scientific evidence being put forward for these policies”. He compared the approach to letting a kitchen fire burn but intending to put it out later: “The danger, of course, is that it burns the whole house down.”
A letter to the Swedish newspaper Dagens Nyheter from 14 scientists last week asked why Sweden had stuck with its policy when others, such as the UK, had followed the rest of Europe with tough measures. “Different countries have different conditions but we struggle to see why the Swedish context is so different from the British,” they wrote.
In an interview published by Dagens Nyheter on Saturday, Löfven said the country could be facing thousands of coronavirus deaths and the crisis was likely to drag on for months rather than weeks.
“We have chosen a strategy of trying to flatten the curve and not get too dramatic a process, because then the healthcare system probably will not cope,” he said. “But it also means that we will have more seriously ill people who need intensive care, we will have significantly more deaths. We will count the dead in thousands.”