Most countries in Europe haven’t gone into the kind of tight stay-at-home conditions seen in Italy, Spain, and even some localities in the United States. Instead they’ve moved to what might be seen as a medium level of social distancing: closing schools and restaurants, limiting gatherings, and restricting some businesses. But Sweden has essentially placed a large cup on the national sidewalk, and asked its citizens to drop in a little of their normal freedoms … voluntarily.
Here’s how that’s working out so far.
Comparing Sweden to any of its neighbors, what’s immediately obvious is that they have more confirmed cases. What’s equally striking is that those nations which imposed social distancing rules only did so about three weeks ago—not long before their paths and that of Sweden began to diverge. In the last week, neighbors Norway and Denmark, despite starting from a nearly identical number of cases and having similar outcomes before distancing was imposed, have genuinely “flattened the curve.” In Norway the number of active cases has been essentially flat over the past week as recoveries reached a rate near that of new cases.
But there’s more at stake here than bragging rights over case counts. As of Friday, Sweden had 887 deaths from COVID-19, compared to 260 in Denmark, 117 in Norway, and just 49 in Finland. It’s not just that Sweden’s deaths are higher than all its neighbors combined, but it’s also running a considerably higher case fatality rate.
Part of this may be that Sweden is also failing at another basic aspect of fighting the pandemic: testing. Sweden has so far tested at a rate of about five tests per 1,000 citizens. That’s worse than even the United States, and nothing close to the 23 per 1,000 that have been completed in Norway.
Strong social distancing paired with a high rate of testing means that Norway has held its case fatality rate to 1.8%. It has also identified more cases with light symptoms, allowing it to isolate the individuals most likely to spread COVID-19. That combination has allowed better planning, provided better outcomes, and put Norway in a position where it’s genuinely on the way to controlling the coronavirus outbreak within its borders.
On the other hand, Sweden’s idea of locking away the old folk and leaving everyone else to follow their own judgement has simply failed. Cases aren’t just continuing to rise, they’re continuing to rise faster. Paired with limited testing, Sweden has also identified few of the light-symptom cases most likely to spread the disease, and is instead essentially notching up COVID-19 patients as they report to the hospital.
Sweden is far from the only nation that is still suffering from flirting with the “herd immunity” approach. After all, the United States didn’t run up the worst numbers in the world by mere chance. It took active mismanagement and a profound failure of federal response to kill 20,000 Americans without even beginning to bring the epidemic under control. The U.K. is still going up rapidly for a similar reason, as is the Netherlands. Both nations spent days pondering if they really needed to impose social distancing long after the answer was clearly “yes.” The cost to both nations is numbered in the thousands—so far.
In a way, Sweden has done the world a service: it has demonstrated what does not work. But it needs to stop before the price is higher than it’s already proven to be.
1. You might notice that I’ve said relatively little about Finland here. In large part that’s because while the numbers there are much lower, they’ve bounced around as the government decides whether to count suspect cases rather than just confirmed cases. They’e even been deflected by some errors in basic math. The result has been a couple of days of negative numbers I’ve tried to smooth over in the chart. These negative cases do not mean zombie outbreaks (as far as I know).
2. In addition to Sweden, there is one other nation conducting a “low social distancing” experiment that is genuinely interesting. That nation is also Scandinavian, at least in origin; It’s Iceland, where the government has decided to keep everything running while taking a very different approach—test absolutely everyone. So far, the government has actually tested about 10% of the total population, and the number of active cases in Iceland is genuinely falling. Testing everyone works! They also have run up a grand total of eight deaths. Expect to see more about Iceland in an article on countries that have begun to win the fight.