Swedish PM warned over 'Russian roulette-style' Covid-19 strategy

Criticism is mounting in Sweden of the government’s approach to Covid-19, with academics warning that its strategy of building broad immunity while protecting at-risk groups – similar to that initially adopted by the UK – amounted to “Russian roulette” and could end in disaster.

The prime minister, Stefan Löfven, on Sunday night called on all Swedes to accept individual responsibility in stopping the rapid spread of the virus as the number of patients in intensive care in Stockholm continued to rise sharply.

“There will be a few decisive moments in life when you must make sacrifices, not only for your own sake but also for those around you, for your fellow humans and for our country,” Löfven said in a rare public address. “That moment is now.”

But while the prime minister said “more invasive decisions” may yet come, he announced no further restrictions. “Everyone must do their part,” he said. “I understand it’s frustrating … But right now it is necessary.”

Sweden, which on Monday reported 2,016 confirmed coronavirus cases and 25 deaths, has shut universities and senior high schools, banned gatherings of more than 500, asked all citizens to avoid non-essential travel and advised those who feel ill and are aged over 70 to stay at home.

Unlike most EU countries, however – including its Nordic neighbours Denmark, Norway and Finland – it has not introduced stricter suppression and social distancing orders such as closing bars, restaurants non-essential shops and lower schools, nor has it placed citizens in near-total lockdown, as in Italy, Spain and France.

Sweden’s chief epidemiologist, Anders Tegnell, has denied the country’s approach is to rapidly build group immunity to the virus, a tactic seemingly pursued in Britain and the Netherlands until both recently changed tack after warnings that their health systems could be overwhelmed and death tolls would soar.

But Tegnell conceded to the Svenska Dagbladet newspaper last week that such an objective was “not contradictory” with what he described as the government’s core strategy, which was to ensure “a slow spread of infection, and that the health services have a reasonable workload”.

On Sunday night, Tegnell told Swedish TV the outbreak would “calm down” in May but return in the autumn. “It will be important how much of the population is infected,” he said. “It will determine what happens in the autumn.” Coronavirus could be stopped either by “herd immunity, or a combination of immunity and vaccination”, he said. “It’s basically the same thing.”

Swedish health professionals are increasingly expressing concern that the government may be favouring the health of the economy over that of the public. Leading experts last week were fiercely critical of the Swedish public health authority in an email thread seen by state broadcaster SVT, accusing it of incompetence and lack of medical expertise.

“I’m deeply concerned,” Fredrik Elgh, a virology professor at Umeå University, told SVT. “I’d rather Stockholm was quarantined. We are almost the only country in the world not doing everything we can to curb the infection. This is bloody serious.”

Another expert in the thread, Joacim Rocklöv, a professor of epidemiology and public health at Umeå, said: “Does this mean this is a calculated consequence that the government and public health authority think is okay? How many lives are they prepared to sacrifice so as not to … risk greater impact on the economy?”

The Journal of the Swedish Medical Association has published a cautionary paper on the dangers, while the daily Dagens Nyheter has printed multiple strongly worded op-eds, including one on Saturday by by Stefan Hanson, an international health PhD, and Claudia Hanson, an epidemiologist.

“We see the situation in Italy,” the authors wrote, “and we are only a few weeks behind … We can’t surrender! The UK, which had the same strategy as Sweden, has now changed completely. It is Stefan Löfven’s duty to do the same in Sweden.’’

Marcus Carlsson, a mathematician at Lund University, has published YouTube videos arguing that there is no evidence of a “herd immunity” approach controlling a virus outbreak anywhere in the world. He described the government’s approach as “a mad experiment with 10 million people”.

Tegnell and Löfven were “playing Russian roulette with the Swedish population,” Carlsson said. “At least if we’re going to do this as a people … lay the facts on the table so that we understand the reasons. The way I am feeling now is that we are being herded like a flock of sheep towards disaster.”

Löfven on Sunday night urged Swedes to get a takeaway lunch from a local restaurant to support local business. Carl Johan Sonesson, a senior local politician in Skåne county, said on Facebook that while protecting older and other at-risk people, Swedes should “consume, eat out, have fun, but responsibly” and “think of all the smaller businesses”.