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Health Care

Sweden, Lockdowns, and New Zealand’s Maginot Medicine

A street with less pedestrian traffic than usual as a result of the coronavirus outbreak in Stockholm, Sweden, April 1, 2020. (TT News Agency/Fredrik Sandberg via Reuters)

There hasn’t been quite so much talk of late about how Sweden has been doing — a land that (heresy!) decided to keep calm and (to varying degrees) carry on through the pandemic.

Could this be why?

Richard Orange in The Daily Telegraph:

It’s the start of the new school year in Sweden, and the highly infectious delta variant is starting to hit the country hard, with cases having doubled since the end of July.

In a lot of countries that would mean one thing: lockdown. But not in Sweden. Instead, at Sorgenfri school in central Malmö, the only visible anti-Covid measure is a ban on parents entering the school building . . .

Sweden’s decision to eschew lockdown and leave pubs, restaurants, shopping centres and primary schools open throughout the pandemic generated furious discussion internationally.

Millions of people across the world have been confined to their homes, watched businesses go under, and struggled to stay on top of their studies amid wave after wave of restrictions to prevent the spread of coronavirus . . .

That is not to say the virus has not taken its toll – nearly 15,000 people have died in total, around 1,450 per million. But that death rate is lower than the average for the European Union as a whole (1,684), and well below those of France, Spain, Italy and the UK.

In fairness, it should be noted that the numbers are much lower in Sweden’s Nordic neighbors (Sweden’s per million rate is around three times higher than that in Denmark and some nine or ten times the rate in Norway and Finland) — differences that can be partly be explained by a badly botched handling of the position in Swedish nursing homes during the early stages of the pandemic, and some other local factors, but only partly. The relatively relaxed approach taken by the Swedish authorities has undeniably taken a toll. (I’d stress that “relatively.”) The Swedes were never so laissez-faire as was sometimes claimed. Some restrictions were introduced from the beginning. These were tightened by quite some measure following a second wave last winter, a turn that has not been fully reversed and is unlikely to be for a while. What the Swedes have been trying to do is devise a balanced response to the pandemic, a response that recognizes that managing a pandemic will involve some hard trade-offs. More contentiously, particularly after initial hopes were dashed, they have been — however much they may or may not admit it — trying to reach a level of herd immunity that delivered widespread and lasting, well, immunity.

Nevertheless, Orange quotes Samir Bhatt, professor of public health at the University of Copenhagen, and one of the team at Imperial College who pushed the U.K.’s lockdown strategy:

“Many times I would have thought that the situation would have gone a different way, but it worked for Sweden. . . . They achieved infection control; they managed to keep infections relatively low and they didn’t have any health care collapse.”

Some of this can be attributed to, I suspect, high rates of voluntary compliance — thanks to what Dr. Bhatt, in an elegant turn of phrase, referred to as “a reliance on the intricacies of what makes Swedish culture Swedish culture.” Bhatt added that “if the UK had adopted what Sweden did, I have no doubt . . . that it would have had an absolute disaster.” I’m not so sure if that would have been true in the end. An instinct for self-preservation is something humanity shares across all cultures, even if it kicks in in some places rather more rapidly than in others, and is always vulnerable to the appeal of the irrational. Hello, anti-vaxxers!

Richard Orange:

The real benefits of Sweden’s radical policy, however, can be seen in the economy, the psychological impact, and in schools.

At the end of the first wave last year, the IMF predicted that Sweden’s economy would contract by 7 per cent in 2020. In the end, GDP shrank by just 2.8 per cent, significantly lower than the EU average of 6 per cent and the UK – a staggering 9.8 per cent.

Sweden’s economy has also bounced back faster than any other country in Europe. By  June, GDP had overtaken where it was before the pandemic struck and the economy is estimated to grow by 4.6 per cent this year.

The government avoided splashing out on costly financial-support packages, spending just $22bn (£16bn) – 4.2 per cent of its GDP – on wage subsidies and other measures.

As a result, in 2020, the country recorded the second-smallest budget deficit in the European Union after Denmark, and its national debt has come through the crisis almost unscathed.

“The public finances have been hit relatively lightly compared to most countries, probably due to the fact that we have used less draconian measures,” Urban Hansson Brusewitz, Director General of Sweden’s National Institute of Economic Research  told the Telegraph.

The psychological toll of the pandemic also appears to have been less dramatic in Sweden.

The National Board of Health and Welfare reported a continuation in the decline in the number of people seeking treatment for anxiety and depression, particularly among children and young adults.

A large part of this is likely down to the decision to keep primary and lower secondary schools open throughout. Even in upper secondary schools, only children who test positive or have been formally contact-traced are asked to stay home.

Entire schools and classes were quarantined very rarely and only in exceptional circumstances if advised by a local infectious disease doctor. That’s a marked contrast to the UK, where as many as a million children were sent home from school during the “pingdemic”.

“We are very happy that we kept our schools open. I think that that is very important,” explained Sara Byfors, unit chief at the Public Health Agency.

An analysis of national grades published by the Swedish National Agency for Education last month found no evidence that the pandemic had negatively affected children’s educational attainment.

As we have now discovered, COVID-19 has a way of hanging around. One wave was not enough, two waves were not enough, herd immunity has proved frustratingly elusive, and variants (for now Delta, with the troubling Lambda waiting in the wings) are a painful reminder of the powers of mutation. This is a disease, it seems, that we are going to have to learn to live with if we wish to preserve our society in some sort of good order, and that is going to take that balanced approach. “Live with” and lurching from lockdown to lockdown are not the same thing.

And nor (even if it were possible in a country such as the U.S.) is the Maginot medicine pushed in New Zealand by the government of the wildly overrated Jacinda Ardern. Ardern continues to pursue the fantasy of “COVID-elimination,” something that risks severely harming her country in order to save it.  And a fantasy is what it is.

Reuters (August 19):

New Zealand’s coronavirus cases jumped on Thursday, as questions grew about the government’s response to the pandemic given the slowest vaccination rate among developed countries and the economic pressures of prolonged isolation.

Eleven new cases were reported on Thursday, taking the total to 21 in the latest outbreak that ended the country’s six-month, virus-free run.

Those six months do not appear to have been used wisely.

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