Coronavirus, “in Sweden without obligations and more natural distancing, a method that would not have worked in Italy”

“In relation to the population, the Sweden is the fifteenth in Europe by number of contagion and seventh by the number of deaths. It had a different approach than other countries, focused on sustainability of measures and responsibilities individual. But beyond the mistakes in the retirement homes, which were the main cause of this high mortality, so far there has not been a special criticality in intensive care ”. Gaetano marrone, associate professor of global health Karolinska Institute of Stockholm, among the most important medical research institutes in the world, takes stock of a ilfatto.it about the situation COVID-19 in Sweden, that at emergency shutdown He preferred a strategy based on “recommendations” rather than on coercion. To date, the country is experiencing an increase in infections, but not a massive second wave as is happening in Europe, Italy even. However, he had the history of victims in Scandinavia. Let’s look at the figures: out of a population of 10.2 million, there were 5,900 victims and 103,000 cases. To make a comparison with neighboring countries, in Denmark the dead were 677 (population of 5.8 million inhabitants), 278 in Norway (population 5.4 million) and 351 in Finland (population 5.5 million).

Why so many deaths?
One of the reasons is undoubtedly the high mortality rate in nursing homes due to errors admitted by the Swedish authorities themselves. For the rest, it is difficult to make comparisons at this time because today many countries are at different times on the epidemiological curve.

The victims in nursing homes were many.
Initially, due to the unknown nature of the disease, the staff did not have adequate training. In addition, the material and protective equipment were not sufficient and the rules for maintaining hygiene were not clear.

And how is the risk of contagion now managed in senior facilities?
The situation has now improved significantly.

Do you think that the approach that Sweden took, without blocking and fully relying on individual responsibility also for self-isolation, would have been possible in Italy?
In Sweden, there is a strong relationship of trust between the population, the government and the public health agency in charge of managing the pandemic. In general, the population follows the government’s instructions and Swedish philosophy focuses on the concept of recommendation, trying to avoid formal impositions as much as possible. However, the recommendation is seen by the population as a duty, without the need for sanctions if it is not followed. In Italy, however, the population perhaps tends to follow more specific directives, considering the “recommendation” little more than advice, in the absence of sanctions. I believe that this approach would not have been possible in Italy for this reason and for the fact that Italy had a sudden and serious exponential increase in Covid-19 cases at the beginning of the pandemic, with the healthcare system rapidly collapsing, and had to make drastic decisions in no time.

Sweden has been at the center of controversy in Europe and the world for its handling of the pandemic.
At the base was precisely the belief that the population should have learned to live with the virus: Sweden, therefore, faced with the hard blockade, has opted for a more sustainable intervention in the long term, avoiding closing everything and focusing on raising awareness among the population. . Let’s talk about washing your hands, staying out if you have the slightest symptoms, keeping a safe distance, and avoiding crowds. On this there were specific guidelines that established the maximum limit of people in public places and other rules of distancing in closed places, then distance lessons for universities and public secondary schools and promotion of smart work.

State epidemiologist Anders Tegnell has repeated mea culpa, saying they could have “done better,” and even doctors and scientists have criticized the government’s decisions.
There has been and continues to be a broad debate about the management of the pandemic. The truth is that nobody knows which is the best option. Many countries have implemented different strategies and to understand the reasons well, it is necessary to study and know their history in depth. The best option in a social and economic context may not be the best in other contexts. I believe that the comparison should not be made between nations but inside the same nations: each has learned how to better handle the health crisis, albeit in a different way, and it is hoped that if there ever is another, all will be better prepared.

Sweden’s strategy pursued herd immunity, which, however, was not achieved.
Sweden has never officially stated that its goal is herd immunity, although it was initially more or less legitimately believed that that was its line. The guideline is to sensitize the public to implement correct behaviors that may contain infections, within the threshold of what the health system can support.

In mid-September, the WHO praised Sweden because, contrary to what was happening in Europe, it was able to contain the cases.
In reality, Sweden is also registering an increase in positives in recent weeks, as is the case in many other European countries, also thanks to a greater number of tests carried out. An increase in cases that, for the moment, is not followed by an increase in places occupied in intensive care or mortality.

What is the procedure for inserting a tampon?
A citizen can do this for free in case of symptoms. However, in recent months, some countries have required a negative PCR for travelers arriving from Sweden, with a medical certificate in English. These tests and documents, in the absence of symptoms, are issued primarily by private entities, for a fee.

Is the containment of infections when they increased in Europe is also linked to a kind of “natural distancing” given by the lower population density?
There are many differences with Italy: we can certainly mention a lower population density, but also a different family structure: here, as soon as they come of age, children often go to live alone, kindergartens and schools They work full time and therefore there is not that indispensable interaction between children, parents and grandparents that often occurs in Italy when both parents work. Furthermore, the sense of individual responsibility, even in the presence of recommendations alone, has favored the containment of the pandemic within the capacities of the health system.

In the rest of Europe, the worrying thing is the arrival of the cold season and its influences. Is this also the case in Sweden?
There is certainly much more awareness than in spring. People are very attentive to social distancing and they know what to do to avoid contagion. There is awareness but no panic among public opinion or less in the newspapers: browsing online daily, Covid-19 is not always among the first news, following the classic approach moderate – balanced, ed – Swedish.

Have schools and offices returned to normal?
High schools are free to decide whether to teach online or remotely. Kindergartens and primary schools teach face-to-face, with the strong recommendation not to send children to school even in the slightest cold. As for the offices, there is a slow return to normality, but the government invites you to work from home.

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