Blog Post

What Sweden's lockdown U-turn means for the global fight against Covid-19

November 24, 2020

    By Miles Cottier and Paul Trigonoplos

    In a world where most of us have been subjected to some form of restriction due to Covid-19, Sweden had remained an enigma. In spring, when most of the world was heading into various degrees of lockdown, Sweden infamously decided to adopt a 'light-touch' approach: Schools were closed for children over the age of 16 and large gatherings were discouraged, but public spaces remained open, and neither masks nor social distancing were mandated.

    How 9 countries responded to Covid-19—and what we can learn to prepare for the second wave

    But that has begun to change.

    A second wave of Covid-19 continues to bite across Europe, and Sweden hasn't escaped its grip. On Nov. 17, Swedish leaders discouraged Swedes from using public transport, going to shops/gyms, and eating at restaurants, and they announced that they will lower the public gathering limit from 50 people to eight beginning on Nov. 24. Although the move doesn't go as far as mandating a full lockdown, it is a significant departure from Sweden's initial strategy.

    What made Sweden change its course?

    To understand why Sweden is locking down now, we must first understand why it hadn't done so previously. The rationale behind its light-touch approach was grounded on three concepts.

    1. The high level of trust between the public and the government in what is known as 'folkvett' (common sense of the collective) prompted Sweden to take a less stringent approach. Indeed, the government trusted the public to adhere to social-distancing recommendations and that trust was reciprocated: One survey showed 73% of respondents said they trusted the strategy. Trusting people to make the right decisions would ideally make a lockdown unnecessary and help ensure economic stability.

       

    2. Swedish leaders resisted strict lockdowns so long as the health care system did not reach maximum capacity. If you recall, most countries, when defending their decisions to lock down during the first wave, said they were trying to flatten the curve so as to not overwhelm the health system. Sweden's system never did quite reach capacity during the first wave, and thus harsh lockdowns weren't seen as a necessity.

       

    3. While chief epidemiologist Anders Tegnell has adamantly stated that Sweden's approach wasn't in direct pursuit of herd immunity, he and other experts were expecting that, come this fall, a sizeable number of Swedes would be immune to the virus after contracting it earlier in 2020. This 'benefit' of a lighter approach throughout the year theoretically would have prevented Sweden from the foreboding winter that many experts anticipate countries will face.

    Fast forward to now, and the second and third points above look a bit different. The number of daily Covid-19 cases is well beyond Sweden's peak of 1,066 from June, reaching almost 7,000 on Nov. 12 and now standing at about 4,000 per day and rising. Positivity rates are up from 3.6% during the peak of the first wave to now 12.6%. Daily ICU admissions have been increasing since September, and death rates remain high. This rapid surge in new infections and hospitalisations is disproving the hypothesis that a lighter touch now would mean more immunity later. And the recent boom in case rates is a harbinger of potential pressures that will hit the health system this winter.

    What Sweden's new strategy means for other countries

    On one hand, Sweden's departure from its original strategy is big news for the rest of the world. Sweden is considered the flagbearer for the herd immunity approach by many (especially lockdown sceptics), so this a major step in the global abandonment of herd immunity aspirations that aren't achieved through a vaccine. The change also implies that public trust can only get you so far and, like many other countries across Europe have already seen, social restrictions (coupled with mask wearing) are the only effective way to contain the virus before a vaccine is available.

    But on the other hand, Sweden's U-turn does little to change our thinking on what the world should be taking away from the country: There are too many factors unique to Sweden to make a comparison to the country worth your time. Over 50% of households in Sweden are single person, guaranteeing a moderate level of social distancing. There are also higher than average work from home rates. Sweden's social safety net is also generous compared even with other European countries. And as mentioned above, Swedes are more inclined to trust advice from the government to socially distance than residents in other countries might be. So, unless your cultural profile is extremely similar to that of Sweden, you should view any conclusions from the country with a healthy degree of scepticism before importing those lessons into your local context.

    Global edition: Covid-19 scenario planning guide

    Global edition

    Learn about 10 potential scenarios that could unfold in a community outbreak with moderate to severe infection rates.

    Each of these scenarios—which cover impact on capacity, clinicians and staff, finances, and the broader ecosystem—includes a set of questions that leaders can use to engage preparedness planning leaders, taskforces, partners, and other executives to identify potential gaps in strategy.

    Download Now
    X
    Cookies help us improve your website experience. By using our website, you agree to our use of cookies.