Swedish children continued to pour through the gates of their schools and kindergartens on Thursday as the Nordic nation stood increasingly alone in Europe in its approach to tackling the coronavirus pandemic.
Shops and restaurants also remained open across the country, with parks and recreational areas packed with groups enjoying the spring sunshine.
Despite a surge in Covid-19 patients and growing dissent among epidemiological experts, the Swedish government’s medical experts were last night standing by their decision not to follow almost all other EU nations by instituting economic and social lockdowns.
Anders Tegnell, Sweden’s state epidemiologist, said the different approach reflected the independence traditionally enjoyed by government agencies like the Public Health Agency of Sweden and the reluctance of politicians to override expert advice.
“I might look like the figurehead, but agencies in Sweden are very much working as a whole,” he told the Daily Telegraph. “These are not decisions I take on my own in my little office.”
He conceded, however, that if infection rates do start to soar and Sweden ends up in a similar situation to that Italy or Spain has faced, he would face criticism.
“Of course, I and the agency will be to blame, for sure. I’m quite aware of that,” he said. “But I would feel a lot worse taking a lot of decisions I don’t believe in and for things to go wrong, than to take decisions I and the agency very much do believe in and for things not to work out.”
Unlike Denmark and Norway, which both shut schools and kindergartens at the start of last week, and where, in Denmark at least, any gathering of more than 10 people is banned, much of life in Sweden remains unchanged.
The government has only banned events with more than 500 participants, issuing a recommendation that those who visit pubs and restaurants should be seated at a table rather than mingling at a bar, and that people taking public transport should “think carefully” about whether it’s necessary. Those who fall ill with coronavirus-like symptoms need only wait two days after they feel well again before returning to work or school.
The advice has not changed despite a surge of cases in Stockholm in recent days which led the city’s health chief Björn Eriksson to call for any help he could get handling the influx of coronavirus patients.
“The storm is here,” Mr Eriksson said, announcing that 18 patients had died in the region in the preceding 24 hours, doubling its total death tally in a single daily update.
“We don’t know how far we’ve come yet in this storm, but it’s going to get worse.”
At the school gates, opinion was mixed as the wisdom of the Swedish government’s outlier approach to the pandemic.
“I do think it’s a bit irresponsible,” said one father picking up his daughter from Västra Skolan in Malmö, contrasting Sweden’s open approach with the strict lockdown imposed in his native Denmark across the Öresund straits in his native Denmark.
“I think they should be doing more.”
Even children whose parents he knew were home sick with coronavirus-like symptoms, he complained, were still allowed to come to classes, so long as the children themselves were symptom-free.
“In my opinion, they are very relaxed,” said Rosaline Abugiche, and she picked up her daughter Ellen Ruth. “Almost all places are still open and it’s getting worse and worse. Everybody’s worried about it.”
Johan Heander, another parent, was more relaxed.
“I think Sweden and the UK were the only country’s being sensible about the whole thing, and then the UK got scared and closed down.”
Sweden has decided not to close schools because in a country where stay-at-home parents are almost unheard of, the country’s health agencies believe it would remove at least a quarter of the workforce, and an even higher share in the health sector. Closing schools would also put more children on the streets, increasing the risk of vulnerable elderly people becoming infected. If grandparents are called in to help out with childcare, it could even increase the infection exposure of the most at-risk group.
Mr Tegnell also argues that there is little evidence for the shutdown measures seen across Europe.
“The only studies they have done are on flu and flu is quite different, and even with flu, it should be done at a later stage,” he said.
“The other thing is that you cannot keep schools closed for very long. That would have huge negative effects on the children, not only their education, but also on their health. So if you do close schools, you really need to do it at the most crucial time.”
Mr Tegnell also noted that, unlike in Italy and Spain, it is very rare in Sweden for several generations of a family to live together under the same roof, making it much easier to isolate the vulnerable older generation.
“We have age segregation in Sweden, which is certainly quite different to most other countries,” he said. “Elderly people meet mostly elderly people and younger people meet mostly younger people. And I think that gives us a reasonable chance to actually protect our elderly.”
But expert opinion has been divided. As early as March 10, a group of doctors and researchers wrote a joint opinion piece in Sweden’s leading medical newspaper warning of a potential “disastrous impact” on Sweden’s health service if tougher actions were not taken.
On Tuesday, more than 2,000 eminent Swedish researchers and university professors sent an open letter to the government calling for tougher measures.
“I get the feeling that they want to spread the infection to get an immunity, but it’s pretty cynical because it will be at the price of hundreds, if not thousands of lives,” said Olle Kämpe, a professor at Sweden’s leading medical university the Karolinska Institutet, who was among the authors.
For now it is too early to say how the pandemic will play out. Sweden has recorded 2,806 confirmed cases of infection, which at 281 cases per million people puts it below Denmark and Norway, and just slightly ahead of the UK.
After Wednesday’s surge in Stockholm, it has recorded 66 deaths, which at 6.5 deaths per million inhabitants, remains below that of locked-down Denmark (7.3) and only fractionally above that of the UK (6.2).
So far, the healthcare system is starting to feel under pressure in Stockholm, but is still just about managing, and if the strain gets too much for existing hospitals, the Swedish army has erected a field hospital on the site of the city’s biggest conference centre.
Mr Tegnell conceded his strategy was not without risk.
“We are just trying to slow it,” he added, “because this disease will never go away. It will come back. If you manage, like South Korea to get rid of it, even they say that they count on it coming back.”
“Stopping it might even be negative, because you would have a pent-up possible spread of the disease, and then once you open the gates, there is a possibility that there would be an even worse outcome.”