The Swedish government finally gave in at the end of November. The country had attracted global attention earlier this year for ignoring calls to impose a lockdown during the first peak of the COVID-19 pandemic as the government advocated recommendations for tough regulation. But in the face of a dangerous second wave of coronavirus cases, the Swedish government finally introduced its first trade ban: bars and restaurants would close after 10:30 p.m.
After many overseas viewers watched Sweden with confusion – and sometimes horror – they saw the move as the final judgment on whether governments should implement bans or just recommendations if the pandemic rages on. Even Sweden, they thought, had finally been told what to do. Granted, the foreigners’ disdain for the country’s approach was not unjustified: my Swedish compatriots have ignored the government’s loose guidelines all along. With no bans, they still huddle in malls and sit knee to knee in bars (before 10:30 p.m. now) as the death toll in a nation has risen from 10 million to nearly 8,000 – a number higher than that of all other neighboring countries combined.
Criticism of the authorities is also increasing within the country. Here, however, the conversation is more nuanced. What people are asking is no longer restrictions or a lockdown, but simply what the Swedish government promised from the start: clarity. When Sweden was preparing for its first COVID-19 outbreak in February, the health department, led by state epidemiologist Anders Tegnell, stressed the importance of giving clear instructions to the public. These guidelines should allow Swedes to make responsible choices while still being able to lead their daily lives – and keep the economy going – while the health department adjusted the recommendations as the situation evolved.
Instead, of course, a lack of clarity in national response has become the norm, and what has been termed a “trust-based” approach by health authorities has become a source of confusion. Two things in particular have dysfunctional and made it all too easy for Swedes to ignore official recommendations: First, there are too many guidelines – from shopping and dining to going to church – that vary across the country’s 21 regions. Second, there is a growing gap between the recommendations of the ruling party and those of the health department, which acts constitutionally independently of the government.
The best example of how confusing the Swedish guidelines have been is the debate over masks. Wearing masks has been a constant problem since the beginning of the pandemic: The health department advised against the “general” use of masks, but claimed that masks could be “useful” in certain places, for example on public transport – with the caveat that Masks this too could be counterproductive as they can give people a “false sense of security”. During the pandemic, Tegnell in particular has stressed the lack of evidence that masks are effective and warned Swedes of the alleged risks of people wearing masks incorrectly. Finally, on December 18, the health department announced that the updated guidelines would actually include the wearing of masks on public transport during peak hours.
It is true that the understanding of scientists and policymakers about making mask mandates has evolved, and politics around the world has changed as the pandemic has progressed. However, Sweden could have benefited from stricter recommendations at an earlier stage. By August, 4 in 10 wanted masks to be mandatory on public transport, compared with 3 in 10 in May. But the authorities did not give in. In Stockholm – where buses were full due to reduced public transport (and sick drivers) – commuters were still not advised to wear masks. Instead, they were encouraged to “avoid crowded places”. Obviously unrealistic for people who commute to work, this begs the question: if the problem was mask abuse, why not make a nationwide recommendation on wearing masks on public transport with clear instructions on how to use them? correct?
Tegnell fended off criticism by saying: “If you want, you can wear a mask.” That may be, but the individual decision to wear a mask is at the top of a long laundry list of other choices Sweden has to make on a given day. This list contains information on whether and how to shop for unneeded goods (the largest shopping center in the city of Malmö had to be temporarily closed because shoppers neglected national social distancing guidelines on Black Friday), whether to visit relatives in nursing homes ( Regulations and / or recommendations depend on (region and / or relationship) and whether you should eat out in restaurants (Prime Minister Stefan Lofven says he should stay at home while Tegnell approves of eating Christmas buffets in restaurants as long as the guidelines are followed will).
Mixed news, especially between Lofven and Tegnell, has only further confused the public. When the pandemic began, the health department under Tegnell set the tone. But when opposition parties have now cracked down on the ruling center-left coalition and accused them of botched the pandemic response, that coalition has started taking action without consulting the health department.
At the end of November, she made the first unilateral decision to ban gatherings of more than eight people. When asked about the reasons for this policy, Tegnell replied that it was a government move and that “it is certainly not the public health agency that is setting foot”. After the announcement, the companies remained without a clear policy. For example, Sweden’s largest cinema chain, Filmstaden, said it would temporarily close, but it overturned the decision later that day because Tegnell said the ban did not apply to cinemas. It was then reinstated a few days later after the government announced that “Tegnell is wrong”.
It is no coincidence that Lofven wants to step out of Tegnell’s shadow at this very moment. A recent poll found that people expressing “high confidence” in the health department fell from 68 percent of the population in October to 52 percent in December. Meanwhile, the government has come under renewed criticism as a special coronavirus commission recently concluded that the many deaths in nursing homes across the country were due to longstanding government neglect. (Nearly 90 percent of coronavirus deaths in the country were among people age 70 and over, and half of those were in nursing homes.)
Lofven has now admitted that his government is partly to blame, but continues to stress that health care is primarily the responsibility of regional authorities. However, his explanations have not appeased a population that increasingly feels part of a failed experiment. If the strategy doesn’t work, the Swedes ask, why didn’t the rulers change it?
Yet the reality is that even if the ruling party wanted to introduce stricter regulations, its powers are quite limited. During the height of the first wave of coronavirus in April, Parliament granted the government a temporary license to close restaurants, shopping malls, gyms and public transport if the pandemic worsened. However, the law was never applied, and after it expired in late June, the government failed to expand the emergency law as health officials forecast that herd immunity would protect Swedes from a major second wave.
Of course, the prediction has proven hugely wrong and Sweden now has one of the highest per capita mortality rates in Europe. Although the government is drafting new emergency laws, it is unlikely to come into effect until March 2021 at the earliest – two months after vaccinations are expected to arrive in the country.
It is now hard to imagine that the world will remember Sweden’s handling of the pandemic as anything other than a fatal mistake. Aside from the many lives lost, there is an added tragedy as the Swedish voluntary model could have been at least a partial blueprint for other countries if the authorities hadn’t fumbled it so hard. Sweden could have done without a lockdown if, for example, the government had completely closed nursing homes to visitors before the virus spread. The ruling party could also have better prepared for a second wave and the Swedish people ready for it, even if health officials thought another large-scale outbreak was unlikely.
Indeed, it was Sweden’s execution. The model was supposed to protect the old, but the authorities failed to take into account that nursing homes would be hit by decades of neglect and lack of resources. The plan was to give people freedom in exchange for responsibility, but the authorities did not provide clear enough guidance for people to be accountable in the first place. If the government had valued clarity – and if it had put its political arguments aside to come up with a unified response – criticism of Sweden might have turned into praise for not bending over under misplaced international condemnation.