Sweden's 'Herd Immunity' Mastermind Gets Promoted by WHO

One of the people behind Sweden's "herd immunity" plan for managing the COVID-19 pandemic has been promoted by the World Health Organization. Johan Giesecke has been given a senior advisory position as vice-chair of the Strategic and Technical Advisory Group on Infectious Hazards.

He was voted into this position, which was then confirmed by WHO. In this role, Giesecke will advise the WHO Director-General Tedros Adhanom Ghebreyesus on pandemic response.

Towards the start of the pandemic, which has now affected over 25 million people worldwide, Sweden made the controversial decision to avoid a complete. While many other countries put mandates in place to have people stay at home and avoid social contact, Sweden did not impose such measures. Instead, it relied on voluntary restrictions—for example, asking people to work from home where possible and to avoid public transport.

These measures were in an apparent bid to achieve "herd immunity." This phrase is normally used in the context of vaccines, where if a certain proportion of people are vaccinated, it helps protect unvaccinated people from the disease. With COVID-19, where there is no vaccine currently available, herd immunity involves letting the virus spread through the population so the population builds up natural immunity—at least in the short-term.

Giesecke was Sweden's state epidemiologist between 1995 and 2005. He is considered a mentor to Anders Tegnell, who took on the role in 2013.

In August, emails between the two men from as early as March show how they discussed herd immunity to limit the spread of the virus in Sweden. First reported by thelocal.se, one email from Giesecke said: "I believe [that] the virus is going to sweep like a storm over Sweden and infect basically everyone in one or two months...I believe that thousands are already infected in Sweden... it will all come to an end when so many have been infected and become therefore immune that the virus has nowhere else to go (so-called herd immunity)."

Writing in The Lancet in May, Giesecke said he believes that "everyone will be exposed" to the virus at some point and that "most people will become infected"—but many will have weak or mild symptoms. "There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in one year from now, the figures will be similar, regardless of measures taken."

His article was met with a response by a collection of scientists, who raised several issues with Giesecke's assertions. They said the idea that stopping the spread of the coronavirus was "futile" and fails to take into account countries where this has been done successfully, such as New Zealand. They also said it was "cynical" as this suggests the efforts to develop drugs and treatments would amount to nothing.

Replying, Giesecke said the way out of the pandemic is through vaccines. "If an efficacious vaccine is developed, mass produced, and distributed worldwide, then the crisis will be over," he wrote. "The same goes for a preventive or truly curative antiviral therapy, so that there will be no severe cases or deaths. I hope for one or both of these, and soon."

Whether Sweden's lack of lockdown has or will lead to some form of herd immunity is still unknown. It is also unclear whether a lack of lockdown helped prevent other public health problems, such as increased cancer deaths, now being faced by some countries.

Recent analysis of Sweden's COVID-19 response shows that a lack of lockdown did result in an increase in deaths. However, it also fared better than many expected, with researchers largely attributing this to the collective actions of individuals across Sweden.

Speaking about his new role at WHO in an interview with UnHerd, Giesecke said media coverage about Sweden's response to the pandemic has become more favorable since it took hold at the start of the year. "Back then they thought we were crazy," he is quoted as saying.

He told the website he does not think the appointment is a "political statement," but that they liked his experience. He also said it is too early to say whether Sweden was right in its coronavirus strategy: "You should wait one year or maybe five years before comparing strategies. We still have a long way to go in this pandemic."

Johan Giesecke
Johan Giesecke has been promoted to vice-chair of the Strategic and Technical Advisory Group for Infectious Hazards. BERTIL ERICSON/SCANPIX SWEDEN/AFP via Getty Images