Paper: Sweden and the ‘Herd Immunity’ Response to COVID-19

An academic paper attempting to make sense of Sweden’s COVID-19 “herd immunity” policy describes a cavalcade of preventable horrors.

The article (which was published in Humanities and Social Sciences Communications) was – in its own words – published as an attempt to make sense of Sweden’s policies in narrative form. “Sweden was well equipped to prevent the pandemic of COVID-19 from becoming serious,” it begins, pointing out that the seeds to disregard expert opinions were planted several years before:

In 2014, the Public Health Agency merged with the Institute for Infectious Disease Control; the first decision byo its new head (Johan Carlson) was to dismiss and move the authority’s six professors to Karolinska Institute. With this setup, the authority lacked expertise and could disregard scientific facts. The Swedish pandemic strategy seemed targeted towards “natural” herd-immunity and avoiding a societal shutdown. The Public Health Agency labelled advice from national scientists and international authorities as extreme positions, resulting in media and political bodies to accept their own policy instead.

That policy was so hands-off as to be meaningless. The government initially offered advice and guidelines, but enforced very little. Schools, bars, offices, restaurants — all remained open:

There has only been one official crisis management plan released during the period of the pandemic, relating to the planned handling and actions—which we obtained through Freedom of Information laws (although some parts have been censored).(2020g, 2020h, 2020e). This plan was issued by the Ministry of Justice in June 2020, updated in September 2020, and focused on the impact of the pandemic on society (2020g, 2020h). The key points included: not to spread fear and panic, to prevent social unrest, and to limit the impact on the industry/economy/hospitality sector. This plan does not include anything about healthcare, healthcare capacity or infection control measures (2020g, 2020h).

Soon, Sweden became a standout among countries, described as a miracle that proved all the hand-wringing that other countries were doing over curbing transmission to be completely wrong. The “herd immunity” model was working, declared politicians and headlines approvingly, and soon anti-vaccine and anti-masking activists all over the world were pointing to Sweden to show how wrong public health experts could be.

A December 2020 fact-check provided by Reuters shows the sorts of narratives that were quickly spun almost entirely out of whole cloth, using far-right disinformation purveyor Dennis Prager’s claims that lockdowns did not work as a case study and highlighting the extremely high rate of COVID-19 deaths in Sweden compared to its neighboring countries:

According to mortality analyses from the Johns Hopkins Coronavirus Resource Center (here), the case fatality rate in Sweden is 2.6% — higher than that of neighboring Finland (1.6%), Norway (0.9%) and Denmark (1.0%), as well as the United States (2.0%). As a country, Sweden has had 66.76 COVID-19 deaths per 100,000 people, compared to 7.23 in Finland, 6.28 in Norway, 14.59 in Denmark, and 82.72 in the United States.

Despite the early signs that “herd immunity” was not an attainable goal without significant mitigation strategies, Sweden continued its policy of downplaying the dangers of the pandemic to the public as much as possible. This predictably led to deep political polarization and loss of faith and trust in Sweden’s government by 2021:

The first time the authorities advised people to use face masks on public transport at peak time was in December.

Some blame Sweden’s failures and shortcomings on the enormous power entrusted to the Public Health Agency, which is part of Sweden’s “administration model”.

Agencies are in charge of making day-to-day decisions in the areas they are responsible for.

It is very likely that once the threat is over, this model will have to be dismantled and rebuilt.

The handing of the pandemic will inevitably leave Swedish society deeply scarred and divided, while its repercussions might be felt way beyond the next general elections in September 2022.

And then came the disinformation campaigns, which were — as in other countries — mixed liberally with xenophobia and racism, sprinkled with threats of violence, and served up to the public through official government channels:

The Public Health Agency and Ministry of Health and Social Affairs discouraged the use of face masks by the public and claimed face masks are ineffective, dangerous and spread fear (2020a, Vogel, 2020; Bjorklund and Ewing, 2020, 2021j). Although some healthcare institutions did implement mask-use on their own initiative, mask wearing was actively discouraged or “not allowed” (at least at some points during the pandemic) in healthcare settings, elderly homes, schools and other settings, even resulting in professionals being laid off and people being denied access (Lundquist, 2020; Orange, 2021; Nordwall and Bolin, 2021; Ågren, 2021; Vogel, 2020; Bjorklund and Ewing, 2020, 2021j).

Ageism, too, played a part in Sweden’s massive death toll. For example, the journal article described how the elderly were routinely denied what might otherwise have been lifesaving care, such as receiving morphine instead of oxygen.

Children, who were erroneously considered to not to be vulnerable to long-term effects from COVID-19 infections, were also very deliberately denied preventative care:

Schools and municipalities have alerted social services and parents who wanted to protect their children by keeping them at home were fined. Few or no infection control measures were taken in many schools, and face masks were often not allowed (Aschwanden, 2021; Höög and Adman, 2020).

[…]

The Public Health Agency denied or downgraded the fact that children could be infectious, develop severe disease, or drive the spread of the infection in the population; while their internal emails indicate their aim to use children to spread the infection in society (Lindblad et al., 2021, 2020–2021b; Höög and Adman, 2020; Vogel, 2021; Ludvigsson, 2020).

At the end of the day, Sweden saw an astronomical and fully preventable death toll, widespread destruction of community trust and loss of faith in national media and political systems, increasing social inequalities and socioeconomic stratification, and its actions even spawned several more examples of global conspiracy theories and magical thinking that caused ripple effects of preventable deaths and suffering, all over the world:

The Swedish strategy has not shown to be superior in any measurable aspect compared to the Nordic neighbours or internationally (Balmford et al., 2020, 2020k; Braithwaite et al., 2021; Bjorklund and Ewing, 2020). This Swedish laissez-faire strategy has had a large human cost for the Swedish society. However, relying on public responsibility seemed to have worked to some extent as a consequence of the Swedish high trust in authorities.

The Swedish strategy has also been at the base of the controversial Great Barrington Declaration (published October 4, 2020) aiming for natural herd-immunity by letting the infections spread in a “controlled way” in society (Kulldorff et al., 2020), with several of the initiators/defenders having strong ties to Sweden (2021e). This strategy is considered internationally as unscientific, unethical, and unfeasible (Aschwanden, 2020; Aschwanden, 2021; Khalife and VanGennep, 2021; Sridhar and Gurdasani, 2021). Consequently, we argue that the Swedish strategy and several of its supporters have undermined efforts to suppress the infection in other countries (Kulldorff et al., 2020; Mccurry, 2020; Giesecke, 2020; Vogel, 2020, Bjorklund and Ewing, 2020).

The architect of Sweden’s COVID-19 policy, Anders Tegnell, has resigned as of March 2022 — to join the World Health Organization as a “senior expert.”