Sweden's Public Health Director Explains Why Lack of Lockdown Was a Success

The director general of the Public Health Agency of Sweden has said the lack of lockdown was a success because it meant messages to the public were clear and consistent, and placed emphasis on personal responsibility. This approach, he says, meant people understood the guidelines and personal actions they needed to take in order to help stop the spread of COVID-19.

Sweden's decision not to implement a nationwide lockdown to halt the spread of the coronavirus was seen as highly controversial when initially announced towards the start of the pandemic. Since then it has been widely debated whether this approach was successful or not. Death rates from coronavirus are far higher in Sweden compared with other Nordic countries. However, they are also lower than some other European countries that implemented strict lockdowns. It is thought the lack of a lockdown in Sweden helped protect its economy, compared with other countries that took more extreme measures.

"The purpose of our approach is for people themselves to understand the need to follow the recommendations and guidelines that exist," Johan Carlson, head of the Public Health Agency of Sweden, is quoted by Reuters as saying. "There are no other tricks before there are available medical measures, primarily vaccines. The Swedish population has taken this to heart."

Throughout the pandemic, experts have warned mixed public health messages have the potential to dampen efforts to reduce the spread of COVID-19. In the U.S., the polarization of the pandemic has led to confusion among the public on a wide variety of topics, including schools reopening and mask wearing. In the U.K. on Wednesday, the government changed its policy on how many people could meet up socially as a result of an uptick in cases—one of many changes that have been made since the outbreak began.

"Our strategy has been consistent and sustainable. We probably have a lower risk of spread here compared to other countries," Jonas Ludvigsson, professor of epidemiology at Sweden's Karolinska Institutet, told Reuters.

Susann Järhult, senior lecturer emergency medicine at Uppsala University Hospital, Sweden, returned to Sweden in June after having been in Australia under lockdown. She said that after arriving back, the international news coverage appeared out of sync with what was happening in Sweden.

"It soon became obvious that the 70+ population were self-isolating and/or taking high precautions," she told Newsweek in an email. "Others made efforts to adhere to given guidelines on a daily basis. Shops, restaurants, cafés, public transportation as well as other public places had made COVID adjustments."

Järhult said people were actively following daily updates and taking responsibility for minimizing the spread, such as limiting social contact and meeting with others at a safe distance. "Public awareness and responsibility was clearly visible—and audible—people of all ages and settings were engaged in discussions and thoughts on the chosen strategy. The possible number of non-clinical infections and immunity among the lower age-groups was debated. Pros as well as cons to the chosen strategy were transparently broadcasted in the media."

According to Reuters, on Tuesday Sweden's health agency announced its test positivity rate—the percentage of positive tests compared with tests taken—had fallen to 1.2 percent. This is the lowest it has been since the pandemic started.

Järhult said Sweden is now anticipating "some kind of" second wave, despite cases being low and testing having increased. She also said that at the start of the pandemic, it was impossible to know whether opting not to lockdown was the right course of action.

"In hindsight, for the Swedish population I believe the chosen strategy was the best choice considering the social, economic as well as mental health issues now to be addressed globally," she said.

Criticism of Sweden's strategy remains. Over 5,800 people have died from the disease in the country, with many saying this many deaths cannot be deemed a success.

However, Prime Minister Stefan Lofven last month defended the country's decisions. "The strategy that we adopted, I believe is right," he told the newspaper Dagens Nyheter. "What has been discussed most, and what we did differently in Sweden, was that we did not close schools. Now there are quite a few people who think we were right."

Johan Carlson
Johan Carlson, director general of the Public Health Agency of Sweden. Sweden's decision not to implement a lockdown to stop the spread of COVID-19 was viewed as controversial by many at the start of the pandemic. SOREN ANDERSSON/TT News Agency/AFP via Getty Images