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A train arrives at the Odenplan metro station in central Stockholm, where morning commuters without masks get off or board before settling in to read their smartphones.
Whether on trains or trams, in supermarkets or shopping centers, places where face masks are commonly used in much of the world, Swedes live without them.
When most of Europe locked up its populations at the beginning of the pandemic by closing schools, restaurants, gyms and even borders, Swedes continued to enjoy many freedoms.
The relatively low-key strategy captured the world’s attention, but at the same time coincided with a much higher per capita death rate than in other Nordic countries.
Stina Stjernkvist / AP
While most of Europe locked up its populations, Sweden has continued to enjoy many freedoms.
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Now, as the number of infections rises again across much of Europe, the country of 10 million people has one of the lowest numbers of new coronavirus cases, and only 14 virus patients in intensive care.
However, it is still highly uncertain whether Sweden’s strategy is succeeding.
Your health authorities, and in particular the chief epidemiologist, Dr. Anders Tegnell, keep repeating a familiar warning: it is too early to tell and all countries are in a different phase of the pandemic.
That hasn’t stopped a World Health Organization official in Europe from saying the continent could learn broader lessons from Sweden that could help fight the virus elsewhere.
“We must recognize that Sweden, at this time, has avoided the increase that has been seen in some of the other Western European countries,” WHO’s European Emergency Officer Catherine Smallwood said last week. “I think there are lessons for that. We will be very interested in working and hearing more about the Swedish approach. “
Claudio Bresciani / AP
Sweden’s chief epidemiologist, Dr. Anders Tegnell, says it is too early to know whether the Swedish strategy is succeeding.
According to the European Center for Disease Control, Sweden has reported 30.3 new cases of Covid-19 per 100,000 inhabitants in the last 14 days, compared to 292.2 in Spain, 172.1 in France, 61.8 in the UK and 69.2 in Denmark, all of which imposed strict closures early in the pandemic.
Overall, Sweden has reported 88,237 infections and 5,864 deaths from the virus, or 57.5 deaths per 100,000 inhabitants since the start of the crisis.
How Sweden’s out-of-country strategy was viewed appears to depend largely on the stage of the pandemic that the observer was experiencing at the time. Initially, many abroad were incredulous at the images of Swedes dining with friends in restaurants or sipping cocktails on the Stockholm waterfront. Some were envious that Swedish companies were not forced to close.
Then came the shock when the virus swept through the country’s nursing homes and hospices.
By mid-April, more than 100 deaths were reported every day in Sweden, while death rates were falling in other parts of Europe.
Andrés Kudacki / AP
As infection numbers start to rise again in Europe, Sweden has one of the lowest numbers of Covid-19 cases.
On Monday, as fears of a second wave grow in Europe, it is fashionable to praise Sweden, and journalists from France, the United Kingdom and elsewhere travel to Stockholm to inquire about its success.
But a Swedish government commission investigating the handling of the pandemic will undoubtedly have tough questions to answer: Did authorities wait too long to limit access to nursing homes, where about half of the deaths occurred? Were they too slow to provide personal protective equipment to staff in those homes when shortcomings in the elderly care sector were long known? Why did it take so long to set up the large-scale tests?
Tegnell also refuses to rule out a second wave of coronavirus infections in Sweden. Of particular concern is the return of students to high schools for the first time since March.
“We have to be very careful and find the first sign that something is happening so that we can do everything we can to prevent it escalating,” he told The Associated Press.
Localized outbreaks are expected, but instead of fighting them with national rules, officials plan to use targeted actions based on evidence, contact tracing, and patient isolation quickly.
“It is very important that we have a rapid and local response to combat the virus without imposing restrictions for the entire country,” Health Minister Lena Hallengren said last week.
From the start, health officials argued that Sweden was pursuing a sustainable approach to the virus that the population could adopt, for years, if necessary. “This is a marathon, not a sprint,” became a slogan that ministers repeated at every opportunity, since there is still neither a vaccine nor a cure.
While the rest of the world watched with envy the freedoms that Swedes enjoyed amid closures elsewhere, there were not as many as people assumed. Meetings were limited to 50 and gathering in bars was prohibited.
Most of the changes involved voluntary actions by citizens, rather than rules imposed by the government.
Andrés Kudacki / AP
Although Sweden enjoyed more freedoms than some European countries, gatherings were still limited to 50 and for a time congregating in bars was also prohibited.
This trust given to the population to take personal responsibility in the pandemic puts Sweden at odds with most other countries that used enforcement measures such as fines to force compliance.
This is often attributed to a Swedish governance model, in which large public authorities made up of experts develop and recommend measures that smaller ministries are expected to follow. In other words, people trust experts and scientists to develop sensible policies, and the government trusts people to follow the guidelines.
Swedes were asked to work from home when possible and maintain a social distance, and they did so willingly. While people now ride public transport without masks, there are also far fewer commuters than before.
Unlike most European countries that have mandated the use of face masks in public spaces, Sweden does not recommend their widespread use and people largely follow that recommendation.
Health officials say that masks worn outside health care facilities by untrained personnel can provide a false sense of security that could cause sick people to leave home and ignore social distancing. Instead, they believe that simple but non-negotiable guidelines provide clear rules that can remain in place for long periods of time: stay home when Covid-19 symptoms are displayed, maintain good hand hygiene, and maintain social distancing. .
In a country the size of California with only a quarter of that state’s population of 41 million and low levels of transmission, most Swedes believe wearing masks makes little sense.
Carol Rosengard, 61, who runs a center for disabled youth, has seen people use masks incorrectly or take them off to smoke a cigarette or drink water.
“This is not how they should be handled,” Rosengard said, explaining his support for not imposing mask rules on the population.
Hallengren, the Health Minister, echoes that opinion, which does not totally rule out the effectiveness of the masks and sees their usefulness in cases of serious local outbreaks. At the same time, it rejects the general rules for the whole country.
“People will not wear masks for years,” he said.
Associated Press reporters Jan M Olsen in Copenhagen, Denmark, and Vanessa Gera in Warsaw, Poland contributed.
