A Brief Discussion of Sweden’s Approach to the COVID-19 Pandemic
By: Joe Giacalone
Imagine you are a director of a movie about the ongoing coronavirus pandemic in the year 2040.[1] You open your film with an overhead shot of a town’s main street, with people walking down the street, most not wearing masks, most businesses open, and the only visible social distancing seems to be done voluntarily by the people on this street, without traffic cones, taped reminders on the street or in the floors of buildings reminding people to stay socially distanced, or physical barriers set up to make it more difficult for people to be physically close to one another. If you are an American, perhaps you think that this is some area of the United States where college students have gone back to a college campus and are seeing an increase in cases.[2] If you thought this, then you are wrong. This is actually a common sight in Sweden as of August 2020.[3] It’s an alternative way of approaching the coronavirus pandemic that is worth a discussion as to its successes, its failures, and lessons that can be extrapolated from the experiment in whether the Swedish Model of coronavirus (anti)lockdowns effectively deals with the medical costs to Sweden, which in turn influence economic, legal, and social costs going forward.
1. Sweden’s (Relatively) Permissive Restrictions
Compared to many countries in Europe, and its Nordic neighbors, Sweden followed a more permissive plan when it came to locking itself down.[4] In late March, after many countries around the world had already instituted strict lockdown measures, Sweden followed suit in a less restrictive way, instituting national bans on public gatherings of more than fifty people in the following places: gatherings that constitute demonstrations, lectures and speeches held for the purposes of teaching or for public or civic education, gatherings for religious practice, theatres, concerts, and other artistic purposes, and other gatherings at which freedom of assembly is exercised.[5] Unlike jurisdictions that shut down restaurants, bars, cafes, or pubs, Sweden let most of these venues continue to operate, provided that they enforce social distancing guidelines of keeping patrons at least one meter from one another.[6]
2. Sweden Kept and is Keeping its Schools Open
Despite all of the above actions, Sweden never fully locked down its country to the same scope that many of the other European countries did. In particular, Sweden never shut down its school systems, did not institute mask mandates in schools, and continues to operates its schools in person throughout the country today.[7] This approach has not led to a mass outbreak of coronavirus cases in Swedish schools. In fact, the percentage of coronavirus cases in Sweden as a total number of overall coronavirus cases is lower than in neighboring Finland.[8] Scientific evidence suggests that the overall transmission of coronavirus cases for children age 0-18 is lower than adults, as the possibility of decreased susceptibility to infection, along with a lower probability of showing disease on infection, or a combination of both exists.[9]
3. A National Ban on Visiting Nursing Homes
One major action that Sweden took at the beginning of the coronavirus pandemic was to institute a national ban on visiting retirement homes throughout the country.[10] In instituting this ban, Sweden tried to protect the oldest members of its country from the transmission of the disease, thereby protecting one of its most vulnerable populations from a disease shown to most strongly lead to death in the elderly and those with high levels of co-morbidities.[11] Sweden’s approach from the initial onset of the coronavirus pandemic was focused on protecting its most vulnerable population, statistically speaking, while allowing the members of its society to that do not bear the same risk burden, statistically speaking, to interact and potentially develop a herd immunity commonly associated with communicable diseases.[12]
This approach – protecting, statistically, the most vulnerable members of society, while allowing those in society who are statistically shown to be significantly less likely to die or be hospitalized and develop herd immunity associated with communicable diseases – questions why certain high-infection areas around the United States, now the global leader in deaths from COVID-19, chose to allow covid-positive patients into nursing homes in the first place, or why state policies have generally become split on whether covid-positive patients should continue to be allowed back into the general populations of nursing homes.[13]
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[1] You could be a fan of special effects and huge explosions like Michael Bay, or perhaps you prefer a more gritty, meticulous style like Martin Scorsese. Compare The “Transformers” franchise (Bay), and “Goodfellas”, “Gangs of New York”, or “The Irishman” (Scorsese).
[2] Rachel Treisman, University Of Alabama Reports More Than 560 New COVID-19 Cases In 1st Week (Aug. 25, 2020, 8:06 PM ET),https://www.npr.org/sections/coronavirus-live-updates/2020/08/25/905992043/university-of-alabama-reports-more-than-560-new-covid-19-cases-in-first-week (last visited Aug. 30, 2020, 8:28 PM ET); see also Kim Kozlowski, 38 COVID-19 cases linked to Central Michigan University (Aug. 22, 2020, 5:29 PM ET), https://www.detroitnews.com/story/news/local/michigan/2020/08/22/38-covid-19-cases-linked-central-michigan-university/3421218001/ (last visited Aug. 30, 2020, 8:29 PM ET).
[3] Alahna Kildred, ‘WE’RE DOING FINE’ Sweden is beating coronavirus because of widespread immunity after refusing to lock down, country claims, The Sun UK, (updated Aug. 24, 2020, 9:30 PM ET), https://www.thesun.co.uk/news/12481469/sweden-coronavirus-herd-immunity-pandemic/ (last visited Aug. 30, 2020, 8:33 PM ET).
[4] Ronald Bailey, Did Sweden Accidentally Blunder into COVID-19 Herd Immunity?, Reason.com (Aug. 14, 2020, 3:50 PM ET), https://reason.com/2020/08/14/did-sweden-accidentally-blunder-into-covid-19-herd-immunity/ (last visited Aug. 30, 2020, 8:36 PM ET).
[5] Krisinformation.se, Restrictions and Prohibitions (hereafter Restrictions) (updated Jul. 25, 2020), https://www.krisinformation.se/en/hazards-and-risks/disasters-and-incidents/2020/official-information-on-the-new-coronavirus/restriktioner-och-forbud (last visited Aug. 30, 8:39 PM).
[6] See Restrictions, supra at note 5.
[7] Connor Parker, No face masks and no closures: How Sweden kept schools open throughout the pandemic (hereafter No face masks), Yahoo News UK (Aug. 27, 2020), https://uk.news.yahoo.com/no-evidence-parents-and-teachers-are-much-more-infected-how-keeping-schools-open-affected-swedens-pandemic-140117335.html?ocid=uxbndlbing&guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuYmluZy5jb20v&guce_referrer_sig=AQAAAB4-f3WEjRhTrZgqMW9zvbk7thwDRlzBr0QeAcRHckfUEodgFA6T4q-VXNYkehInEro8m9ULdgSGqDOQaYDfq3oCbjw9glEZVLGmHBn6xaz6rc6GrrybMpPMPSqhl16ZnYbO8saAYy49j9ixh0_PjV-7Sr3jXbAd8emdgw48Ey4v (last visited Aug. 30, 2020, 8:42 PM ET).
[8] See No face masks, supra note 7.
[9] Nicholas G. Davies et. al., Age-dependent effects in the transmission and control of COVID-19 epidemics, Nature Medicine, Nat. Med. 26, 1205, 1205-1211 (2020) (Apr. 16, 2020), https://www.nature.com/articles/s41591-020-0962-9 (retrieved August 30, 2020, 9:05 PM ET).
[10] See Restrictions, supra at note 5.
[11] Zunyou Wu, MD, PhD and Jennifer M. McGoogan, PhD, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention, Journal of the American Medical Association (Feb. 24, 2020), https://jamanetwork.com/journals/jama/fullarticle/2762130 (retrieved Aug. 30, 2020, 9:13 PM ET); see also No face masks, supra note 7.
[12] See No face masks, supra note 7.
[13]Anna Wilde Matthews, New York Sent Recovering Coronavirus Patients to Nursing Homes: ‘It Was a Fatal Error’, The Wall Street Journal (May 14, 2020, 11:39 AM ET), https://www.wsj.com/articles/new-york-sent-recovering-coronavirus-patients-to-nursing-homes-it-was-a-fatal-error-11589470773 (retrieved Aug. 30, 2020, 9:18 PM ET).