Sweden-with its extensive government regulation and social engineering-used to seem to me to be like the world's largest prison, a sort of real-life version of that 1960s British TV series, The Prisoner, about a make-believe, contrived village where everyone had a designated role. Sweden, I thought, was even worse than the Australian Capital Territory. Well, having now read Anderberg's new book recounting the Swedish 'experiment' during the pandemic I was clearly wrong. Anderberg is a Swedish journalist whose book highlights from beginning to almost the end of the pandemic what Sweden did, the key public health officials involved who called the shots, the internal debates, the international attacks and the interactions with Sweden's politicians, and the nation's highly decentralised government.
The Herd: How Sweden chose its own path through the worst pandemic in 100 years by Johan Anderberg. Scribe, 2022. 336pp
This is no dreary chronological historical account, but rather is more like a whodunnit or an expose like All the President's Men concerning the Watergate Hotel break-in that eventually brought down US President Nixon in 1974. We are taken from the beginning into the meetings and disagreements among the experts and officials. It is like a television documentary without the pictures.
During the pandemic, Sweden was one of the few countries that adopted what must be regarded as a liberal, light-touch approach in response to the unfolding pandemic. It relied on people making their own choices on whether to go to work or wear masks. It avoided major lockdowns. Compulsory schools (primary) were kept open (but not secondary schools or universities). Restaurants and many public facilities, sporting venues, playgrounds, parks, and beaches remained open. No Swede was prevented from leaving their home. Borders remained mostly open. There was no mass vaccinations or testing. Sweden resisted the draconian and authoritarian approaches of most other countries including Australia, and especially Victoria, where police were given extra arrest powers. Moreover, even after some restrictions were introduced, Sweden, like some of the other Nordic countries such as Denmark and Norway, dropped their restrictions quickly while other countries persisted unnecessarily with theirs! Don't we know that so well in Australia?
Its key public health authority, the Public Health Agency, under the country's leading epidemiologist, Anders Tegnell, early on rejected the nightmare predictions of experts such as the UK's expert Neil Ferguson from Imperial College London, being fully aware of earlier grossly inaccurate predictions of death from mad cow disease and bird flu. The book highlights just how wrong these were, and also how forecasts of UK's COVID losses were also wide of the mark.
Sweden resisted the overreaction and hyperbole.
Sweden also resisted the overreaction and hyperbole that was a feature in other countries. Anderberg explains how in public policy when confronted with a crisis 'diffusion' occurs-this is "political interventions spread without closer analysis". What made Sweden's response different from most other countries, including Nordic ones, was that Sweden, under Tegnell's direction, previously had instigated mass vaccinations when confronted with the Swine Flu-but that flu turned out to be a furphy.
Sweden's pandemic response was dominated by its key health body, the Public Health Agency that called the shots and its leader, Tegnell, did most of the public announcements rather than by politicians as in Australia. For this approach, Sweden, a country that likes to keep its head down in international affairs, found itself in the odd position of being viciously attacked by other countries, international experts, and mainstream media, for the sin of not conforming to the international conventional wisdom. Sweden was attacked by the international community-just like individuals are attacked for not agreeing to the latest wokeism.
L: Anders Tegnell during his daily press conference in Stockholm, April 2020. Photo: Frankie Fouganthin. R: Daniel Andrews Covid press conference.
Sweden is known to have a rational, technocratic, and consensus model of policy development and decision making. It looks to the evidence-so one criticism of Sweden's Public Health Agency pandemic strategy was that it waited too long for data before initiating actions and should have adopted the 'precautionary principle' earlier, given they were dealing with a new flu variant.
The other issue is that in Sweden there was an appreciation about the trade-offs, as in all public policy, between costs and benefits including those concerning deaths. Swedish authorities appreciated the need to look beyond just health issues in responding to COVID-19-issues such as the impacts of lockdowns on mental health, educating children, and the economy.
The Swedish Commission of Inquiry into the country's response (which was appointed with bipartisan support as the pandemic started and made several interim reports) largely endorsed Sweden's action, with some important caveats. Earlier action should have occurred. Masks should have been used in certain limited close-contact situations. Death rates among the elderly could have been avoided. The 'precautionary principle' should have been followed.
So how did Sweden perform overall? Anderberg points out that Sweden in terms of registered deaths outperformed 56 other countries-many European ones, that had engaged in severe repressions. Later figures from other sources highlighted that in terms of excess deaths per million inhabitants-10 other countries performed better-including NZ, Japan, Denmark, Australia, and Norway. Nevertheless, Sweden actually experienced a mortality deficit during the pandemic.