The example of this country is discussed almost widely in the world: the Swedish strategy had serious arguments

At the request of Laurynas Kasčiūnas, parliamentary member of the Group of Christian Democrats of the National Union-Lithuania (TS-LKD), the analysis of the situation in EU countries by the Research Division of the Department of Information and Communication of the Seimas Chancellery asks the question: has the Swedish model been successful?

“It is too early to answer this question at the moment (if we want to answer it honestly), because not only is there a lack of data, but the pandemic itself has not ended. However, it is already possible to compare the indicators of the last few two months with the neighbors of Denmark, Norway and Finland, where the COVID-19 management measures were much stricter than in Sweden, ”the document states.

The researchers noted that according to the Oxford University Government Austerity Index, which compares the severity of management measures introduced by different countries in the context of COVID-19, Sweden stands out not only as one of the most lenient measures in Europe but also worldwide.

The index is calculated by evaluating 8 types of measures: school closings, workplace closings, cancellations of public events, collection restrictions, public transport restrictions, household arrangements, national travel restrictions, and international travel restrictions. Gravity is rated on a scale of 1 to 100 (1 for the freest mode, 100 for the strictest mode).

May 11 According to the data, the Swedish index is 47.35, Norway 63.22, Finland 74.33 and Denmark 79.49, according to the document.

The researchers noted that for all measures, with the exception of meeting restrictions, Sweden only applied guidelines or none.

Meanwhile, for the other three Nordic countries: 1) school closings have been ordered in Denmark and Finland, 2) workplaces have been ordered to close to some extent in all countries, 3) public events have been canceled in all countries, 4) collection restrictions apply in all countries, 5) stopping public transport is recommended in all countries, 6) staying at home in Denmark and Finland is recommended, 7) limiting domestic travel is recommended in all countries, 8) borders are closed in all countries.

May 12 Data shows that in the first 2 months. Sweden is a clear leader in both COVID-19 infection and deaths. 1 million There are 2,641 cases of COVID-19 in Sweden, with 1,815, 1,495 and 1,080 respectively for Denmark, Norway and Finland, according to the report.

The same day, 1 million. There are 322.4 COVID-19 deaths in Sweden, more than Denmark, Finland, and Norway combined, with 92, 49, 41 deaths per million, respectively. population.

The document notes that Sweden is also a clear leader in terms of mortality among people diagnosed with COVID-19, at 12.21%. mortality, with mortality rates in Denmark, Finland and Norway of 5.07% and 4.53% respectively. and 2.76 percent.

“Finally, Sweden is also a leader in terms of the ratio of COVID-19 tests positive to negative, with 1 positive close to 6.84 negative tests (per million inhabitants), while in Denmark, Norway and Finland, 1 positive is close to 31.8, 25, 35 and 22.72 negative tests. Furthermore, it should be noted that Sweden, unlike other Nordic countries, has a more specific testing policy that focuses exclusively on risk groups, “the report states.

The researchers note that a brief comparison of the figures for the first two months in these Nordic countries allows limited conclusions to be drawn as to whether the Swedish model has worked.

“This question can only be answered after the end of the pandemic and by estimating a greater number of variables than just the number of infections and deaths and by revealing the potential for the pandemic to recur.” However, one fact is already clear: although Sweden has a risk-based management policy, it is that it has exceptionally high death rates compared to the other three countries, the measures of which are aimed at society as a whole. Furthermore, as Sweden applies the tests to the target groups, the results of its policy are not entirely clear to the rest of society, which should be clarified in order to know the results of the chosen path for the country as a whole ”, says the document.

Officially denied the desire for the widest possible immunity to society

Tum Beinort, a physician at Cambridge University Hospital, a member of the Evidence-Based Medicine Group, said the Swedes themselves denied that their strategy was based on allowing as many people as possible to contract coronaviruses while protecting the most vulnerable .

“Swedish epidemiologists have said that this is not true. Their model was not based on the idea of ​​developing immunity as soon as possible. The strategy was based on the idea that people’s liberties should be restricted as little as possible and that the system of health care should not be saturated so that all people could receive the necessary medical care. At least officially, they mention it everywhere, but of course, if we do not introduce really regulated restrictions, then the disease is expected to be greater, and that side effect would be indirectly the development of immunity, “said Beinort.

According to the researcher, the development of immunity to COVID-19 remains an open question.

“There are no direct clinical data. There is some evidence from the basic sciences that the amount of antibodies produced is correlated with the deadly effect of the virus, but this has not been clinically demonstrated at the human level, that is, if a person becomes ill if they have those antibodies, “said Beinort .

The doctor noted that an antibody test in Stockholm (where most people in Sweden are sick) three weeks ago found that only 7.3 percent people have them.

“It just came to our attention then. The epidemic is not over and we will see its effects for a long time. If in Sweden, where everything was done so freely, just such a result, then in Lithuania the prevalence of antibodies among people would be very, very low, “said T. Beinort.

The problems are the same, the reasons are different.

Looking at the comparable death rates for COVID-19, it is easy to succumb to the temptation and quickly draw conclusions that the Swedes have come to terms with the liberal measures. However, not everything is so simple.

Paulius Gradeckas, an epidemiologist who worked on the team of Prime Minister Saulius Skvernelis, noted that these numbers were primarily determined by the morbidity of people at risk and not by indicators in the general population. In Sweden, as in Lithuania, Italy or any other country, most of the problems arose in nursing homes and care institutions.

Drawing attention to the fact that nurses are also going to work in Lithuania to Sweden, one of the possible reasons why there may be problems in nursing and care institutions in that country, the specialist mentioned the possible shortage of staff.

“It could have been that they couldn’t assign one or more separate groups of staff to work with themselves,” Gradeck said.

At the same time, he noted statements by the country’s current and former leading epidemiologists, Anders Tegnell and Johan Giesecke, that the Swedes emphasize publishing data on general mortality that other countries do not.

“The Delfi commentator is still told by specialists that we have not yet estimated how many additional people have died as a result of the closure, not from COVID-19, but for other reasons. And they say that we have total mortality, we are transparent:” give all deaths and it will be possible to compare them, “Gradeck said.

Three things are important in decision making.

The expert pointed out that political, cultural and social aspects are very important in decision-making in any country. The epidemiologist referred to the circumstance, which is also mentioned by the analysts of the Seimas Chancellery, arguments that are mentioned in the country’s Constitution.

Gradeck noted that the Swedish legal framework was slightly different from that of continental Europe. Its constitutional laws are more similar to those in force in the United Kingdom or the United States. The country’s Constitution consists of several documents. The focus of these documents also differs.

“The politicians or the people working alongside the politicians are aware that some measures, even if they are effective, would not be implemented because the politicians would not.” The rule of law must be the first principle of a democratic state.

Contrary to what most of our Seimas sometimes think, Swedes do not believe that the Constitution is simply a written document that can be amended. For them, it is more than a written document, it presupposes a lifestyle for them, ”said P. Gradeckas.

The specialist also drew attention to the fact that Sweden had its last military conflict in the 19th century. In the beginning (with Russia).

“This is a country where generations and generations have not seen a state of emergency, and the government needs to think very seriously before saying ‘look, we will restrict your freedoms,'” Gradeck said.

At the same time, the epidemiologist also drew attention to the cultural context: in Sweden, all institutions, without exception, are highly reliable.

“In Lithuania, we see a division: trust in the Fire Protection and Rescue Service. Police trust has grown. Trust has never been proven in some institutions, such as the Center for Communicable Diseases and AIDS, the Institute of Hygiene, the National Center for Public Health (NVSC).

There were surveys on how they assess the quality of services, but NVSC also theoretically includes decision makers in Vilnius, but also people like Telšiai, where an NVSC employee smuggled. This can seriously undermine trust in the institution, “Gradeck said.

The specialist noted that in Lithuania, politicians, rather than professionals, often speak on behalf of the public, simply because politicians have confidence at the individual level.

“The prime minister or minister may be criticized, but they have confidence in some sectors of society,” Gradeck said.

The epidemiologist also agreed with assessments that Swedes did not have to take part in the restrictions after these neighbors to the country applied them.

“If your neighbors: Finland, Norway, Denmark close their borders, you don’t have to close your borders, because they are closed anyway,” Gradeck said.

Some of the measures applied elsewhere are not permitted by the Constitution

According to the analysis, in Sweden until May 17. 209,900 tests were performed, of which COVID-19 was confirmed in 29,677 cases, of which 3,674 deaths were confirmed. The Swedish government is currently the EU’s national authority that has implemented the most lenient restrictions. Many of the measures taken by Sweden to manage the pandemic are more advisory than binding.

“Measures such as movement restrictions, curfews or other restrictions on leaving the home, which have been widely used in many EU countries, are not possible in Sweden because they are prohibited by the country’s constitution. The constitution of the The country also prohibits the legislature, both locally and nationally, from influencing the executive and gives a wide margin of discretion to expert public agencies. In the case of the COVID-19 pandemic in Sweden, the priority was to initiate actions in the Epidemiology Department of the Public Health Agency, headed by the State Epidemiologist A. Tegnellis ”, points out the analyst of the Seimas Chancellery.

According to them, although the powers of the agencies are mainly recommendations, they traditionally have considerable authority, so politicians in Sweden cannot ignore the recommendations of scientists and experts. The government tends to follow the agencies’ instructions, and the public criticizes politicians who do not follow them. The COVID-19 case confirmed the rule that the government-approved pandemic management strategy was largely proposed by the state epidemiologist.

According to the Public Health Agency, the Swedish strategy has as its main objective to protect the elderly and other citizens at risk of a pandemic, which slows down the spread of the virus in the most vulnerable groups and avoids overloading the health system.

The law requires the Public Health Agency to base its decisions and recommendations on scientific arguments. April 17 agency advisor prof. Mr. Giesecke argued that, unlike, for example, hand hygiene, universal measures such as social isolation, border closures and educational establishments were not scientifically justified. Therefore, many of the government-approved pandemic management measures in Sweden are of a recommending rather than binding nature, making Sweden an exception not only in the EU but also globally, the analysis explains.

The recommendations promoted social isolation.

The Seimas Chancellery specialists, who prepared the analysis, pointed out that the Swedish recommendations mainly promote social isolation. March 16 recommendation issued:

(a) limit contact with other people over the age of 70 and avoid overcrowding, such as shops, public transportation, and public spaces;
(b) employers are asked to recommend that their employees work from home;
(c) The Public Health Agency recommended that high schools and universities across the country switch to distance education.

The document also notes that, unlike many European countries, including neighboring Denmark and Norway, Sweden has not closed preschool and primary education institutions.

According to the Public Health Agency, on the one hand, this decision lacks scientific arguments, and on the other hand, it would have negative consequences for society, since many parents, including health professionals, would have to stay home to care for their children. The agency estimates that the closure of elementary and preschool schools could lead to a shortage of up to 43,000 health professionals, including doctors, nurses, and nursing assistants, that is. and. about 10 percent of total industry employees, according to the analysis.

It also notes that on March 11. The Swedish government, following the recommendations of the Public Health Agency, passed a new law that restricted freedom of assembly by prohibiting all meetings of more than 500 people. Failure to comply with the order was punishable by a fine or imprisonment.

March 27 The government has announced that the restriction on meetings has been tightened, prohibiting all meetings of more than 50 people.

The ban applies to cultural, artistic and entertainment events, including theater, cinema and concerts, religious events, demonstrations, conferences, sports, amusement parks, fairs and markets. The ban does not apply to meetings in schools, workplaces, public transportation, supermarkets or grocery stores, health clubs, or private events. This is currently the only non-recommended insurance in Sweden.

March 18 The Public Health Agency recommended avoiding traveling not only abroad but also nationally. The recommendation was recommended that with ongoing internal migration, the virus could spread to all regions, which would increase the number of pandemic outbreaks and require increased logistical capacity in the health care system.

As Easter approached, the public was urged to reconsider all planned vacations and outings. Agency experts and government officials, including Prime Minister Stefan Löfvén and King Carl Gustaf XVI, repeated the calls multiple times to avoid travel and social contacts over the Easter weekend, according to the document.

Swedes asked for recommendations

As noted in the study, surveys and studies showed that Swedish society tended to follow the recommendations. At the end of March, 93 percent. People over the age of 70 said they followed government recommendations to a certain extent and reduced contact with friends and family. The report establishes the following facts:

• a month after the recommendations were issued, statistics showed that about half of the Swedish workforce performed their tasks from home.
• Most schools, following the recommendations, started the educational process remotely.
• April Public transport administrations in various parts of the country reported around 50 percent. reduced use of public transport.
• In Stockholm, the streets were remarkably empty: the number of cars was reduced by 30% and the number of pedestrians by 70%.
• Swedish mobile network operator Telia, which analyzed mobile network data during Easter week, found that most Swedes followed the recommendations to avoid unnecessary travel during the Easter holidays. Overall, travel from the Stockholm region has decreased by 80-90%, and the number of Stockholm citizens traveling to popular vacation destinations like Gotland and ski resorts in Ara has decreased by more than 90%.
• Ferry operator Destination Gotland, urging customers to postpone their planned trips over Easter, said 85 percent. All orders have been changed.

Adopted a new law

The document prepared by specialists from the Seimas Chancellery draws attention to the fact that on April 16. The Riksdag passed a law to temporarily amend the Communicable Diseases Act.

The new law gave the Swedish government more decision-making power to avoid voting in the Riksdag. However, the Riksdag would have the option to withdraw any measure imposed after its entry into force. The law would only apply in the fight against the COVID-19 pandemic and only for a limited time.

The law went into effect on April 18. and valid until June 20. It allows the government to impose measures such as traffic restrictions, closings of bus and train stations, ferries and ports, closings of companies such as restaurants, health clubs or supermarkets, libraries and museums, or schools.

The law would also allow the government to make decisions about the distribution of drugs and other health care equipment, such as personal protective equipment, among different health care providers, including private companies.

However, the law would prevent the government from introducing measures that would restrict people’s ability to leave home, would introduce a curfew, as this would restrict people’s constitutional right to free movement, according to the document.

Vaccine and drug research is ongoing

In many parts of the world, decision makers are turning to the question of when an effective drug or vaccine will be available against COVID 19.
Intensive investigation is underway.

“The vaccines are five or six first-phase studies that measure both human side effects and the primary immune response. They are carried out in China, the United States, Europe. I know more about the vaccine that is being developed at the University of Oxford The study is already halfway through the first phase of the study, and perhaps in the second half of the summer we will have results, “Beinort said.