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In the Coronavirus Fight in Scandinavia, Sweden Stands Apart In the Coronavirus Fight in Scandinavia, Sweden Stands Apart
(about 16 hours later)
STOCKHOLM — When the coronavirus swept into the Scandinavian countries, Norway and Denmark scrambled to place extensive restrictions on their borders to stem the outbreak. Sweden, their neighbor, took a decidedly different path.STOCKHOLM — When the coronavirus swept into the Scandinavian countries, Norway and Denmark scrambled to place extensive restrictions on their borders to stem the outbreak. Sweden, their neighbor, took a decidedly different path.
While Denmark and Norway closed their borders, restaurants and ski slopes and told all students to stay home this month, Sweden shut only its high schools and colleges, kept its preschools, grade schools, pubs, restaurants and borders open — and put no limits on the slopes.While Denmark and Norway closed their borders, restaurants and ski slopes and told all students to stay home this month, Sweden shut only its high schools and colleges, kept its preschools, grade schools, pubs, restaurants and borders open — and put no limits on the slopes.
In fact, Sweden has stayed open for business while other nations beyond Scandinavia have attacked the outbreak with various measures ambitious in their scope and reach. Sweden’s approach has raised questions about whether it’s gambling with a disease, Covid-19, that has no cure or vaccine, or if its tactic will be seen as a savvy strategy to fight a scourge that has laid waste to millions of jobs and prompted global lockdowns unprecedented in peacetime.In fact, Sweden has stayed open for business while other nations beyond Scandinavia have attacked the outbreak with various measures ambitious in their scope and reach. Sweden’s approach has raised questions about whether it’s gambling with a disease, Covid-19, that has no cure or vaccine, or if its tactic will be seen as a savvy strategy to fight a scourge that has laid waste to millions of jobs and prompted global lockdowns unprecedented in peacetime.
By Saturday, Norway, population 5.3 million, had more than 3,770 coronavirus cases and 19 deaths; Denmark, population 5.6 million, reported 2,200 cases and 52 deaths; Sweden, with 10.12 million people, recorded more than 3,060 cases and 105 deaths.By Saturday, Norway, population 5.3 million, had more than 3,770 coronavirus cases and 19 deaths; Denmark, population 5.6 million, reported 2,200 cases and 52 deaths; Sweden, with 10.12 million people, recorded more than 3,060 cases and 105 deaths.
A recent headline in the Danish newspaper Politiken, encapsulates the question ricocheting around Europe, “Doesn’t Sweden take the corona crisis seriously?”A recent headline in the Danish newspaper Politiken, encapsulates the question ricocheting around Europe, “Doesn’t Sweden take the corona crisis seriously?”
There is no evidence that Swedes are underplaying the enormity of the disease rampaging across the globe. The country’s leader and health officials have stressed hand washing, social distancing and protecting people over the age of 70 by limiting contact with them.There is no evidence that Swedes are underplaying the enormity of the disease rampaging across the globe. The country’s leader and health officials have stressed hand washing, social distancing and protecting people over the age of 70 by limiting contact with them.
But peer into any cafe in the capital, Stockholm, and groups of two or more people can be seen casually dining and enjoying cappuccinos. Playgrounds are full of running, screaming children. Restaurants, gyms, malls and ski slopes have thinned out but are still in use.But peer into any cafe in the capital, Stockholm, and groups of two or more people can be seen casually dining and enjoying cappuccinos. Playgrounds are full of running, screaming children. Restaurants, gyms, malls and ski slopes have thinned out but are still in use.
The state epidemiologist, Anders Tegnell, said in an interview that Sweden’s strategy is based on science and boiled down to this: “We are trying to slow the spread enough so that we can deal with the patients coming in.”The state epidemiologist, Anders Tegnell, said in an interview that Sweden’s strategy is based on science and boiled down to this: “We are trying to slow the spread enough so that we can deal with the patients coming in.”
Sweden’s approach appeals to the public’s self-restraint and sense of responsibility, Mr. Tegnell said. “That’s the way we work in Sweden. Our whole system for communicable disease control is based on voluntary action. The immunization system is completely voluntary and there is 98 percent coverage,” he explained.Sweden’s approach appeals to the public’s self-restraint and sense of responsibility, Mr. Tegnell said. “That’s the way we work in Sweden. Our whole system for communicable disease control is based on voluntary action. The immunization system is completely voluntary and there is 98 percent coverage,” he explained.
“You give them the option to do what is best in their lives,” he added. “That works very well, according to our experience.”“You give them the option to do what is best in their lives,” he added. “That works very well, according to our experience.”
Sweden’s method flies in the face of most other nations’ stricter strategies. India is attempting a lockdown that affects 1.3 billion people. Germany has banned crowds of two or more people, except for families. In France, residents are asked to fill in a form stating the purpose of each errand when they leave their homes; each trip requires a new form. Britain has deployed police officers to remind residents to stay home.Sweden’s method flies in the face of most other nations’ stricter strategies. India is attempting a lockdown that affects 1.3 billion people. Germany has banned crowds of two or more people, except for families. In France, residents are asked to fill in a form stating the purpose of each errand when they leave their homes; each trip requires a new form. Britain has deployed police officers to remind residents to stay home.
Still, while Sweden may appear to be an outlier in Scandinavia and in much of the wider world, it is too soon to say whether its approach will yield the same results as other countries’. And the Swedish authorities could still take stronger action as coronavirus hospitalizations rise.Still, while Sweden may appear to be an outlier in Scandinavia and in much of the wider world, it is too soon to say whether its approach will yield the same results as other countries’. And the Swedish authorities could still take stronger action as coronavirus hospitalizations rise.
In explaining Sweden’s current strategy, experts point to other underlying factors: The country has high levels of trust, according to the historian Lars Tragardh, and a strict law in the Constitution prohibits the government from meddling in the affairs of the administrative authorities, such as the public health agency.In explaining Sweden’s current strategy, experts point to other underlying factors: The country has high levels of trust, according to the historian Lars Tragardh, and a strict law in the Constitution prohibits the government from meddling in the affairs of the administrative authorities, such as the public health agency.
“Therefore, you don’t need to micromanage or control behavior at a detailed level through prohibitions or threat of sanctions or fines or imprisonment,” Mr. Tragardh said in a phone interview. “That is how Sweden stands apart, even from Denmark and Norway.”“Therefore, you don’t need to micromanage or control behavior at a detailed level through prohibitions or threat of sanctions or fines or imprisonment,” Mr. Tragardh said in a phone interview. “That is how Sweden stands apart, even from Denmark and Norway.”
The government has deferred to the agency’s recommendations to fight the virus, which has infected more than 600,000 people and killed more than 27,000 worldwide by Saturday. If the health agency were to say that closing borders and shutting down all of society was the best way to go, the government would most likely listen.The government has deferred to the agency’s recommendations to fight the virus, which has infected more than 600,000 people and killed more than 27,000 worldwide by Saturday. If the health agency were to say that closing borders and shutting down all of society was the best way to go, the government would most likely listen.
Mr. Tragardh said Swedes’ level of trust was manifested in other ways: Not only do citizens have confidence in public institutions and governmental agencies and vice versa, but high social trust exists among citizens, as well.Mr. Tragardh said Swedes’ level of trust was manifested in other ways: Not only do citizens have confidence in public institutions and governmental agencies and vice versa, but high social trust exists among citizens, as well.
That is evident in the country’s approach to the virus. Norway did not completely shut its 1,000-mile land border with Sweden, but most people returning from abroad must enter a two-week quarantine (Reindeer herders and daily commuters are exempt.) Finland closed the borders of its most populous region — which has 1.7 million people and includes the capital, Helsinki — for three weeks to fight the outbreak there.That is evident in the country’s approach to the virus. Norway did not completely shut its 1,000-mile land border with Sweden, but most people returning from abroad must enter a two-week quarantine (Reindeer herders and daily commuters are exempt.) Finland closed the borders of its most populous region — which has 1.7 million people and includes the capital, Helsinki — for three weeks to fight the outbreak there.
Norway limited groups outdoors to no more than five people, and those indoors must keep a distance of more than six feet (except relatives). Denmark closed its borders, sent public workers home with pay and encouraged all other employees to work from home. It shut nightclubs, bars, restaurants, cafes and shopping centers, and banned gatherings of more than 10 people outdoors.Norway limited groups outdoors to no more than five people, and those indoors must keep a distance of more than six feet (except relatives). Denmark closed its borders, sent public workers home with pay and encouraged all other employees to work from home. It shut nightclubs, bars, restaurants, cafes and shopping centers, and banned gatherings of more than 10 people outdoors.
Sweden initially banned gatherings of 500.Sweden initially banned gatherings of 500.
Early in the outbreak, some event organizers suggested they would try to get around the crowd limit by allowing precisely 499 ticket holders into their venues. (That stopped when cases of Covid-19 were confirmed among staff members.)Early in the outbreak, some event organizers suggested they would try to get around the crowd limit by allowing precisely 499 ticket holders into their venues. (That stopped when cases of Covid-19 were confirmed among staff members.)
Mr. Tegnell, the state epidemiologist, said that is why bans don’t work: “People find ways around the rules.”
He also said he did not believe Sweden was a maverick and did not understand its neighbors’ strategy. “Closing borders at this stage of the pandemic, when almost all countries have cases, to me does not really make sense,” he said. “This is not a disease that is going to go away in the short term or long term. We are not in the containment phase. We are in the mitigation phase.”
He also said that closing schools had not been ruled out.
The Netherlands, which reported more than 9,700 cases of the virus and 639 deaths by Saturday, is taking a similar approach to Sweden’s. On March 16, Prime Minister Mark Rutte said his country of 17.1 million was opting for a “controlled spread” among groups at the least risk of getting seriously ill. He argued that it was too late to shut down the country “completely.”
Updated June 22, 2020Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Mr. Tegnell, the state epidemiologist, said that is why bans don’t work: “People find ways around the rules.”
He also said he did not believe Sweden was a maverick and did not understand its neighbors’ strategy. “Closing borders at this stage of the pandemic, when almost all countries have cases, to me does not really make sense,” he said. “This is not a disease that is going to go away in the short term or long term. We are not in the containment phase. We are in the mitigation phase.”
He also said that closing schools had not been ruled out.
The Netherlands, which reported more than 9,700 cases of the virus and 639 deaths by Saturday, is taking a similar approach to Sweden’s. On March 16, Prime Minister Mark Rutte said his country of 17.1 million was opting for a “controlled spread” among groups at the least risk of getting seriously ill. He argued that it was too late to shut down the country “completely.”
A majority of Swedes, 52 percent, support the measures to contain the virus, according to a survey conducted by the newspaper Svenska Dagbladet and published on Tuesday. But 14 percent said that too little consideration was being given to public health in order to benefit the economy.A majority of Swedes, 52 percent, support the measures to contain the virus, according to a survey conducted by the newspaper Svenska Dagbladet and published on Tuesday. But 14 percent said that too little consideration was being given to public health in order to benefit the economy.
There is growing concern as Swedes prepare to travel to their country houses and to the ski slopes for Easter, even though the public health agency has asked citizens to reconsider such trips. (Norway announced a “cabin ban” to prevent residents from going to their country homes.)There is growing concern as Swedes prepare to travel to their country houses and to the ski slopes for Easter, even though the public health agency has asked citizens to reconsider such trips. (Norway announced a “cabin ban” to prevent residents from going to their country homes.)
Even Prime Minister Mette Fredriksen of Denmark issued a warning about its neighbor on Monday: “Don’t go on a ski vacation in Sweden!”Even Prime Minister Mette Fredriksen of Denmark issued a warning about its neighbor on Monday: “Don’t go on a ski vacation in Sweden!”
Last week, a cluster of Covid-19 cases was traced to an après-ski party at a Swedish alpine center, Are, prompting officials to close an aerial tram and gondola and shut bars and nightclubs. Hundreds of Covid-19 cases in Scandinavia have stemmed from vacationers returning from ski trips in Italy — which has the most cases in Europe — and in Austria.Last week, a cluster of Covid-19 cases was traced to an après-ski party at a Swedish alpine center, Are, prompting officials to close an aerial tram and gondola and shut bars and nightclubs. Hundreds of Covid-19 cases in Scandinavia have stemmed from vacationers returning from ski trips in Italy — which has the most cases in Europe — and in Austria.
Now, there is a petition on social media to close the ski slopes.Now, there is a petition on social media to close the ski slopes.
Some Swedes have suggested that their country is deviating from most other nations’ response to hasten herd immunity, risking lives unnecessarily.Some Swedes have suggested that their country is deviating from most other nations’ response to hasten herd immunity, risking lives unnecessarily.
The public health agency denies this.The public health agency denies this.
In the meantime, the infection curve in Sweden has started to rise sharply, and on Friday the government tightened the limit on crowds to no more than 50 people.In the meantime, the infection curve in Sweden has started to rise sharply, and on Friday the government tightened the limit on crowds to no more than 50 people.
Some residents like Elisabeth Hatlem, a hotelier, are of two minds about the Swedish approach. She is grateful that she can keep her business open. But she and her partner do not like sending their six children to school amid the pandemic.Some residents like Elisabeth Hatlem, a hotelier, are of two minds about the Swedish approach. She is grateful that she can keep her business open. But she and her partner do not like sending their six children to school amid the pandemic.
“For us, a total lockdown is a disaster,” she said. “But I am worried Sweden will explode at some point. I feel like I’m living in a huge experiment, and I was never asked if I wanted to sign up.”“For us, a total lockdown is a disaster,” she said. “But I am worried Sweden will explode at some point. I feel like I’m living in a huge experiment, and I was never asked if I wanted to sign up.”
Christina Anderson reported from Stockholm, and Henrik Pryser Libell from Oslo. Follow Ms. Anderson on Twitter @candersonSTO and Mr. Libell @hlibell.Christina Anderson reported from Stockholm, and Henrik Pryser Libell from Oslo. Follow Ms. Anderson on Twitter @candersonSTO and Mr. Libell @hlibell.