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COVID-19

Swedish government inquiry to rule on ‘no-lockdown’ Covid-19 strategy

Sweden's government, health agencies, and regional health authorities are braced for criticism later today, when the Corona Commission tasked with assessing the handling of the pandemic gives its final conclusions.

Mats Melin, chairperson of Sweden's Corona Commission delivering the second part of his report last October.
Mats Melin, chairperson of Sweden's Corona Commission, delivering the second part of his report last October. Photo: Christine Olsson/TT

The commission’s long-awaited final report is expected to answer the big remaining question around the country’s handling of the pandemic: the choice of strategy, and in particular whether Sweden was right to go its own way and avoid the compulsory “lockdown” measures imposed in most other European countries.

“Whether Sweden’s choice of path was reasonable, or whether it would have been better to introduce other types of measures to limit the spread of the virus, is a question the Commission will return to in its final report,” it wrote in October. “The big question we must ask ourselves is why the start [of pandemic handling] and the path chosen became as it was.” 

The commission is also expected to examine the problems caused by the way Sweden’s system of pandemic handling speads responsibility between the government, Public Health Agency and other agencies, and the regional health authorities. 

The report will also include a section on how Sweden’s choice of strategy and financial measures taken impacted on the country’s economy.

To do this, it will seek to understand what information the key decision-makers in central government and in the Public Health Agency had access to when they set Sweden’s strategy.

In its earlier reports, the commission, and its chair Mats Melin, have used unusually harsh language for a Swedish government inquiry, denouncing the government, regional health authorities, and health agencies as  “tardy”, and attacking aspects of their handling of the pandemic as a “let-down”, and even a “car-crash” or “disaster”.

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The first report, issued in December 2020, concentrated on the impact on elderly care and the second, issued in October last year, focused on the spread of infection, testing, protective equipment, and the response of the healthcare system. 

The months running up to the release have seen strained relations between the commission and Sweden’s government and government offices, with the commission’s investigators complaining in January that they had been denied access to documents they had requested.

In the end, the commission was given an enormous release of documents, leading some sources in Sweden’s government offices to speculate that they would not be able to read or understand them before this week’s publication date.

Ahead of the report’s release, Anders Tegnell, the state epidemiologist seen as the architect of Sweden’s strategy, said he was looking forward to any constructive criticism. 

“We look forward to anything which helps us get better,” he told the Dagens Nyheter newspaper in an interview published on Wednesday. “For this type of inquiry to be really good, it needs to be able to point out ways to be better next time. That’s the whole point. To just point fingers is rarely very helpful.” 

He said that he believed the Public Health Agency needed to improve its contacts with some other parts of Sweden’s system.  

“We already had good connections to the healthcare system, but we have now learned how to connect with the elderly care system and other actors, which means we can be faster next time. But we are only one agency out of many.” 

Sweden’s health minister, Lena Hallengren, also said that she hoped the commission took a forward-looking view, and looked at lessons to be learned, rather than imply pointing fingers at the mistakes made over the last two years. 

“I expect the Commission to lift its gaze so that we can benefit from all the conclusions,” she told TT newswire. “We will suffer more crises in the future and they are not going to look like Covid-19 2.0.”

 

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COVID-19 RULES

Sweden’s pandemic strategy ‘fundamentally correct’: Coronavirus Commission

Sweden's Covid-19 response was "fundamentally correct", but the government should have taken the lead, and brought in earlier and tougher measures, the country's Coronavirus Commission has concluded.

Sweden's pandemic strategy 'fundamentally correct': Coronavirus Commission

“It was fundamentally right to rely on issuing advice and recommendations,” Mats Melin, the commission’s chair said at a press conference after issuing the report. “The state should not limit the freedom of the individual more than is necessary to limit a dangerous sickness.” 

In addition, he noted, countries which had imposed greater restrictions had not necessarily had better outcomes. 

“We are not convinced that long-lasting and repeated lockdowns are necessary element in the response to a new, serious epidemic outbreak,” he said. 

Sweden made headlines early on in the pandemic by not introducing a lockdown, instead issuing recommendations on home-working, social distancing and good hand hygiene.

But tougher measures should have been introduced in February-March 2020, Melin said, with the measures that were imposed “too few” and coming “too late”. 

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While the commission hailed Sweden’s decision to keep most schools open during the first wave, it said that by March 2020 there “should have been temporary closures” of indoor places where people gather, such as shopping centres, restaurants, sport events and so on.”

In particular, it criticised the fact that it took until the end of March 2020 for the limit on public gatherings to be lowered to 50 people. 

It also said that those returning from ski trips in Italy at the end of February and the start of March should have been asked to quarantine, while incoming travel should have temporarily been stopped for all but the most necessary journeys, as happened in Denmark and Norway.   

In an interview with The Local, Sweden’s health minister Lena Hallengren welcomed the commission’s conclusion that the fundamental strategy had been correct. 

“That the commission concludes that the overall strategy based on non-invasive recommendations and a non-lockdown policy, that they think that was the right choice. I think that’s good,” she said. 

At later stages of the pandemic, Sweden eventually introduced stricter measures, including bans on elderly home visits, earlier closings at bars and restaurants, and vaccine passes for indoor events.

The commission also said the government should have assumed leadership of all aspects of Covid crisis management, despite the Public Health Agency’s large degree of autonomy and a healthcare system managed by self-governing regional councils.

“The government had too one-sided a dependence on assessments made by the Public Health Agency”, it said.

It was not until the end of October that the government began to try to take a leading role, with documentation obtained by the commission showing the then Prime Minister Stefan Löfven trying to take more precedence over the Public Health Agency. 

The government, it concluded, should also have sought to get alternative views from other infectious disease and public health experts, rather than relying solely on the Public Health Agency’s expertise.   

Hallengren told The Local that she rejected this aspect of the report. 

“The government has been the one leading and deciding, and we are responsible,” she said. 

She also rejected the claim that the government had been over-reliant on the agency’s experts. 

“They can have their opinion about that, but the fact is, that the Public Health Agency is not an expert, it’s hundreds of experts, who are working with infection control and working with public health issues all the time,” she said. “It would be very strange if I, as minister for health, or the government, relied on specific or unique experts instead of this very big expert authority when it comes to epidemiological knowledge.”

An earlier partial report by the commission had also criticised the country’s slowness is setting up adequate testing measures.

With more than 17,000 fatalities so far, Sweden’s death toll is slightly better than the European average but is far higher per capita than those of neighbouring Norway, Finland and Denmark.

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