21 October 2020

AAAS Science: “Critics of Sweden’s lax pandemic policies face fierce backlash”

The Swedish approach has its fans. Protesters against coronavirus-related restrictions in Berlin in late August waved Swedish flags. In the United States, a prominent member of President Donald Trump’s coronavirus task force, neuroradiologist Scott Atlas, has cited Sweden as a model to follow. The policies also have widespread public support in Sweden, where consensus is prized and criticism of the government is rare.

But within Sweden’s scientific and medical community, a debate about the strategy has simmered and frequently boiled over—in the opinion pages of newspapers, within university departments, and among hospital staff. A group of scientists known as “the 22” has called for tougher measures since April, when it published a blistering critique of the country’s public health authority, the Folkhälsomyndigheten (FoHM). The group, which has grown to include 50 scientists and another 150 supporting members, now calls itself the Vetenskapsforum COVID-19 (Science Forum COVID-19).

The group’s criticism has not been welcomed—indeed, some of the critics say they have been pilloried or reprimanded. It has been so, so surreal, says Nele Brusselaers, a member of the Vetenskapsforum and a clinical epidemiologist at the prestigious Karolinska Institute (KI). It is strange, she says, to face backlash even though we are saying just what researchers internationally are saying. It’s like it’s a different universe.

Gretchen Vogel

For people loudly defending Sweden’s distinctive approach to the pandemic – even though it resulted in high casualties, especially among the old – this article should make it clear that it is not without opposition inside the country. Weirdly enough, the policy and its main proponent, Dr. Anders Tegnell, remain popular with the Swedish public, despite several changes and backtracking along the way. As the article notes, Sweden’s consensus culture could partially explain this situation, where citizens refrain from criticizing the government and view those who publicly speak against it in a negative light.

Excess mortality was far higher in Sweden than in neighboring countries
One measure of COVID-19’s impact, excess mortality, was far higher in Sweden than in neighboring countries and Germany, but not as high as in England and Wales. (Graphic) X. Liu/Science; (Data) The Human Mortality Database, U.K. Office for National Statistics

But I suspect it also has to do with how the pandemic was presented to the public, by omitting critical data such as the extent of excess mortality caused by the disease, the treatment of severely ill patients at the height of the first wave, and refusing to test children to hide the fact that they are spreading the virus despite showing little to no symptoms. No one should support a public authority that knowingly lets sick people die and refuses them treatment, after doing very little to prevent the situation, but apparently too many people are content believing convenient stories instead of accepting harsh truths.

By late March, more than 30 COVID-19 patients were being admitted to ICUs every day. By early April, Sweden was recording about 90 deaths from the virus daily—a significant undercount, critics say, because many died without getting tested. Hospitals did not become as overwhelmed as those in northern Italy or New York City, but that was in part because many severely ill patients weren’t hospitalized. A 17 March directive to Stockholm area hospitals stated patients older than 80 or with a body mass index above 40 should not be admitted to intensive care, because they were less likely to recover. Most nursing homes were not equipped to administer oxygen, so many residents instead received morphine to alleviate their suffering. Newspaper reports told stories of people who died after being turned away from emergency rooms because they were deemed too young to suffer serious COVID-19 complications.

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