A few days ago, Dr Michael Ryan of WHO singled out Sweden for praise for its handling of the covid19 crisis. This is significant because Sweden was being pilloried as arrogant at best, irresponsible at worst for its refusal to join most of rest of the world in state enforced lockdown.
Sweden’s extensive testing regime produced a high number of cases. That was pounced on and used to show them to disadvantage against other countries without reference to the actual testing regimes in place elsewhere. There was little interest too in the ‘the bottom line’, that is the number of deaths relative to population.
As I write, Sweden, with a population of 10.3 million, has a death toll from the virus of 2.7 thousand. Ireland with a population of 4.5 million, has reported 1.3 fatalities. So we are more or less equivalent in terms of ‘the bottom line’.
However, the difference is that Sweden still has an economy in better shape to recover its stride once the crisis subsides. And Swedish people, particularly the vulnerable in every category, will not have endured the long weeks of morale crushing, livelihood and, in many cases, life threatening lockdown.
I am not about to argue we took the wrong approach. It may well be we took the right one, for us. The issue worth exploring is how Sweden was able to manage the challenge so far as well as Ireland without taking a wrecking ball to their economy and without otherwise compromising their citizens’ health and welfare. What is it about Sweden that is different? Are there lessons we can learn from them?
This crisis brought the world abruptly into uncharted and dangerous water. We had nothing to guide us but the tentative road maps of computer modeling based on data from previous pandemics. However, the nature and reach of this new, ‘novel’, deadly virus and the widely different socio-economic and demographic conditions to which it would migrate are not so easily collated and analysed. In the panic induced by a pandemic, it is understandable that worst case modelling is seen as a very real, universal threat.
Professor Neil Ferguson of Imperial College predicted dire consequences for Sweden. As we now know, he took a very discretionary approach to lockdown himself. The trajectory of the disease in China was presumed to map the way for everywhere else. Because they were forced to build hospitals in mid crisis, Britain decided to be prepared and opened a number of purpose built hospitals on the basis of Ferguson’s graphs. To say they have been underused so far is a massive understatement. Ireland followed suit by commissioning hotels for potential hospital overflows. Emergency legislation brought our private hospitals temporarily under public governance. The measure has so far not required the redeployment and rationalizing of resources that was envisaged.
Well better be prepared, one may say. Indeed, but one also needs to recognize that conditions vary hugely, country by country, and costly, excessive measures will be an added economic burden once the crisis subsides.. Wuhan, where the virus started, is a city of 11 million. Northern Italy is not as densely populated as China but it is far more densely populated than Ireland. Italians are gregarious and socially tactile and their median age is ten years or so older than ours. The Italian fashion industry, whose hub is in Northern Italy, has extensive trade links with China. On the other hand, unlike us, they are known to have a health service that works well in normal times.
Factoring in the relevant data variants and making decisions tailored for particular places and conditions calls for independent-minded, confident coolheadness. It does sound like national stereotyping, but Sweden appears to stand alone in its ability to live up to its reputed, somewhat charmless, coolheadedness.
Like us, they faced the same challenges of clusters of infection in residential units and migrant centres. Yet, their government decided they could rely on citizens to follow guidelines and common sense to combat the crisis. So shops, schools and even cafes remained open. The requirements of social distancing of course affected their internal economy and Sweden like everywhere else will suffer the knock on effects of the global economic stasis well into the future.
But the cost won’t be nearly as high for Sweden as things stand. When we compare our situation with theirs, we may well ask ourselves did we have to pay such a high price for the same outcome? With hindsight, couldn’t we too have taken a less draconian, less repressive approach?
It is not quite so simple. Our situations may be similar in terms of outcome but to adopt the Swedish strategy would have meant taking far greater risks for us. Their hospital and testing capacity, the specific things that won the praise of the WHO, were judged equal to the projected demands of the pandemic. Sweden may be a laid back sort of place but a lot of their signature sangfroid is due to their general readiness for ‘events’ however they arise. Remember it was Sweden who first picked up the radiation from Chernobyl and alerted the world to the catastrophe.
It is easier to be calm when you are prepared. It has often been noted that Swedes are more willing to pay high taxes for a better prepared, better performing public service than we are. Usually it is our own politicians who make such comments and it comes across as a reflection on our relative immaturity and short-sightedness, rather than a measure of our trust in them.
But it comes down to trust. We do not associate taxation with value for money. If there was an obvious correlation between what we pay and what we receive, rather than what we pay and state profligacy, we would likely be less grudging towards the public purse.
The Swedes take no nonsense from their public representatives. They do not endow government ministers with state cars, chauffeurs and private secretaries. They have access to their tax returns. Long before carbon emissions were an issue, Swedish prime ministers used public transport. The people’s largesse extends to giving each of their public representatives a public transport season ticket. That perhaps more than anything else shows how the Swedish electorate expect their politicians to conduct their public duties. Their local councillors, like ours hold part time positions. Unlike ours, they don’t receive a salary. Expenses are paid to public representatives in the same way they are paid to all public servants.
Lean efficiency characterizes Swedish public life while consultative bodies, endless commissions of enquiry and million euro political spin machines are our political staples. It is doubtful if Swedes would tolerate a government minister offering to quadruple a stipend to an international body like the WHO in order to make a political point without as much as a by your leave from parliament, let alone the electorate.
Trust and transparency is what builds relationships. Swedes are trusted by their government to behave like responsible adults in a crisis because that is what they have shown themselves to be by expecting no less from them. This perhaps is the lesson we can take from Sweden at this time.