While most countries hunker down in lockdowns in an effort to stop the spread of COVID-19, Sweden is taking a drastically different approach.
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Not only is there no lockdown, but Sweden hasn’t closed its borders, cafes, schools or public transport. Instead, it is trusting people to voluntarily adopt softer measures to stop the virus spreading. Last week, Sweden did ban gatherings of over 50 people which was seen as a huge move for the otherwise unrestricted nation.
While this relaxed approach might seem like a welcome freedom to people stuck in lockdown, it has attracted widespread criticism.
So why is Sweden taking such a relaxed approach and why is it getting so much criticism?
The criticism mainly lies in fears that Sweden isn’t taking the problem seriously. In fact, there is so much concern that a group of leading medical and scientific experts launched a petition in a desperate bid to convince the Swedish Government to introduce more stringent measures.
The petition, which was signed by more than 2000 doctors, scientists, and professors, claimed the Government is leading the nation towards a “catastrophe”.
While Sweden’s approach is unusual, the Public Health Agency’s lead epidemiologist Anders Tegnell defended it, telling CNBC they are trying to achieve the same thing as other countries, just in a different way.
“Sweden has gone mostly for voluntary measures because that’s how we’re used to working,” Tegnell told CNBC. “And we have a long tradition that it works rather well.”
He also said “so far, it’s been working reasonably well”.
And while Sweden does have a relatively low number of cases, sitting just below 5000, academics have suggested the number is only low because of a lack of testing.
So why is Sweden taking this approach?
Writing for The Conversation, professor of genetic epidemiology at Lund University, Paul Franks, and professor of internal medicine and epidemiology at Lund University, Peter Nilsson, outlined the reasoning behind Sweden’s herd immunity approach.
The best estimate for COVID-19’s mortality rate is around 1.4 percent. Franks and Nilssn said that in comparison the Spanish flu had a mortality rate as high as 3 percent in some regions of Sweden.
Because COVID-19 can be milder than the flu in some cases, there is a belief that Sweden might be able to achieve herd immunity, according to the professors. Herd immunity is where a large proportion of the population catch and develop an immunity to a virus or infection.
However, herd immunity is far from flawless and has been criticised by The World Health Organization (WHO) as not being far-reaching enough. The WHO says far greater action is required to tackle the coronavirus.
Dr Arindam Basu, an associate professor of epidemiology and environmental health at the University of Canterbury, highlighted the ethical dilemmas of the herd immunity approach in an article for The Conversation.
Dr Basu wrote that while herd immunity seems like a good idea at face value, without a COVID-19 vaccine it is unethical and dangerous.
“If vaccines are not available and the infection spreads, some people will develop a mild version of the disease and recover. But it is dangerous and unethical to rely on this method to combat the disease.
“First, the intermediate and longer-term consequences of coronavirus are not yet known. And second, while some people are not badly affected by the disease, under a herd immunity strategy they could still pass the virus to elderly people who are at high risk of dying from it,” Basu wrote for The Conversation.
On Wednesday 26, March at 11:59pm the New Zealand Government placed the country at alert level 4, meaning people must isolate in their homes and all non-essential businesses must close. People are only allowed to leave their house for essential supplies or to exercise nearby.
The Government also announced that only residents and citizens (and their children and partners) can enter the country during the lockdown. They are also subject to testing upon arrival and if they are showing symptoms or have inadequate self-isolating plans can be put into quarantine.
Dr Basu said if New Zealand had instead relied on herd immunity and even a conservative 10 percent of the population caught COVID-19 that would still be 500,000 people, more than enough to overwhelm the hospital system.
Instead Dr Basu said the safest approach was to stop the spread of the virus and flatten the curve so the health system isn’t overrun.
This is achieved by controlling borders, imposing self-isolation, restricting public gatherings, tracing the contacts of existing cases and isolating people with the virus, according to Dr Basu.
“With these measures in place, we give ourselves the best chance of putting the coronavirus genie back in the bottle sooner rather than later, and minimising the number of deaths,” Basu wrote.
New Zealand, Italy and the United Kingdom have imposed restrictions like this in an effort to stop the virus spreading.