On a dark afternoon in March, 2020, Angelica Jularbo, a nurse, was in her workplace at a highschool in Stockholm, when one in every of her college students got here in complaining of a headache. Jularbo, a mom of 4, tasks the combination of sternness and heat that one expects from a nurse. In the earlier month, COVID-19 had begun sweeping throughout Europe, however Swedish faculties remained open. As Jularbo bent to take the scholar’s temperature, the scholar coughed after which stated, “Oh, maybe I should tell you, my partner has been diagnosed with corona.” Jularbo ordered the scholar to go house instantly. “Don’t go back to class to get your bag,” she stated. “We’ll have someone bring it to you.”
Four days later, Jularbo woke with a fever and a splitting headache. “I understand why people who are really sick, or people who are in excruciating pain, say, ‘I just want to die,’ ” she instructed me. She was so drained that she couldn’t go away her room for a number of days. One morning, she made tea and sat on the sofa, decided to see her youngsters off to highschool; she woke as much as the sounds of them coming house, tea cool on the desk. After 9 days, the final two symptom-free, she went again to work. But every week later the headache and fever returned. She locked herself in her workplace to keep away from exposing anybody. “I was so, so scared that I had made someone else in the office sick,” she instructed me.
Jularbo’s sickness got here at a pivotal time for Sweden. While lockdowns, curfews, and journey bans have been being rolled out throughout the remainder of the world, Swedish eating places, shops, bars, museums, day cares, and elementary faculties all remained open. People have been inspired to make money working from home and to scale back journey, however each have been optionally available. Masks weren’t really helpful and remained uncommon. Households may combine; till the tip of March, even events of as much as 5 hundred folks have been allowed. The man behind Sweden’s coronavirus response is Anders Tegnell, the nation’s head epidemiologist. Tegnell labored in Zaire through the 1995 Ebola epidemic, after which served as an skilled on infectious illnesses for the European Union earlier than being employed by the Swedish public-health company, in 2013.
The Swedish structure offers authorities companies extraordinary independence, so Tegnell and the public-health company have led a lot of the coronavirus response, and, constitutionally, the federal government has little energy to impose restrictions. Tegnell, who’s sixty-four and tall, with spherical glasses, has usually stated that lockdowns usually are not supported by science and that the proof for mask-wearing is “weak.” His stance is a startling departure from the scientific consensus, however he maintains that if different nations have been led by consultants moderately than politicians, extra nations would have insurance policies like Sweden’s. The world has been left gawking. American liberals have been shocked that the nation of Greta Thunberg may appear so scientifically backward. Right-wing activists in Minnesota held up indicators throughout anti-lockdown protests studying “Be Like Sweden.” Within the nation, Tegnell has turn out to be an icon of Swedish exceptionalism, believed to be excessively cheap, levelheaded, and rational. Supporters praised him for not giving in to political panic. Wearing a masks in Sweden was typically seen as a signifier of being anti-science.
Jularbo has many pals and colleagues who contracted COVID-19, and her case was extreme. But I met her within the “Anders Tegnell Fan Club” on Facebook, which incorporates a smorgasbord of multimedia tributes: T-shirts bearing his face, a chocolate figurine in his picture, a poster along with his face glowering above the phrases “Wash your hands.” “I prefer to have medical experts making the decisions instead of maybe a prime minister who knows, excuse me, shit, about health and medical issues,” Jularbo instructed me. She’s not the one individual within the group who has caught the coronavirus. Staffan Hugemark, a fifty-three-year-old who works at a software program firm, received sick alongside along with his household after coming back from a ski journey in northern Italy. Still, he just lately had a falling out with an outdated good friend who disagreed with Sweden’s insurance policies. “People look at Sweden and think that it’s a disaster here, and it’s not,” he stated. Viktoria Ellénius, a forty-seven-year-old former aesthetician, received sick early within the pandemic and couldn’t work for weeks, which triggered her to lose her skin-care enterprise; she couldn’t get a check, however she thinks she had COVID-19. Nevertheless, she believes that Tegnell’s insurance policies saved the nation from the prices of a lockdown, together with financial harm and widespread melancholy. “At the beginning, I didn’t like Anders Tegnell,” she stated. “But the more I have heard about him, the more time has gone by, the more I love him.”
Jularbo is now working with long-haul COVID-19 sufferers within the rehabilitation unit of a hospital in Eskilstuna, seventy miles west of Stockholm. She suffers from long-term signs herself, together with lingering fatigue. “I’ve never been tired like this,” she instructed me. “My alarm goes off, and it’s like, shoot me. I don’t care if my kids get to school on time. I don’t care about anything.” Still, she’s pleased with how Sweden’s public-health company has dealt with the pandemic. “They’ve been good. They haven’t been running around listening to what everybody else does,” she stated. This winter, she messaged me, “I’m more worried about you living in the states. The pandemic is hitting hard.”
Most mornings, my husband, who’s Swedish, FaceTimes along with his pals or household in Sweden. Early within the pandemic, the calls appeared like home windows into atypical lives, largely uninterrupted. Children had birthday events and sleepovers. Adults met in eating places and bars. A good friend despatched a video of a fitness center class in Stockholm—twenty folks respiration closely in a windowless room. My father-in-law is in his seventies and has a extreme lung situation, which signifies that if he’s contaminated with COVID-19, it’s extra more likely to be deadly. But whereas my husband and I, in California, stayed house, he and my mother-in-law have been nonetheless going out procuring and seeing pals with out sporting masks. They’re not reckless or uninformed folks. My father-in-law is a retired engineer who reads the paper each morning, and we virtually all the time agree about politics. Yet each time we recommended that maybe they need to be sporting masks once they went to, say, a bar, we have been met with well mannered skepticism. My father-in-law just lately mentioned masks along with his lung physician, a senior doctor at one of many nation’s high hospitals, whose recommendation was that the one motive one would possibly think about sporting one was as a result of different folks would suppose you have been sick and provides you extra space. This was the philosophy my in-laws adopted. A wholesome individual “can’t wear a mask in Sweden,” my mother-in-law instructed me, in October. “People will look at you like you are a very strange person.” The Swedish well being company communicated to the general public that there was inadequate proof that masks stop transmissions, that they’re usually used incorrectly, and that they may very well be used as an excuse to not distance correctly, which might be dangerous.
Tegnell launched the nation’s light-touch method to the pandemic in March, as instances have been mounting. Internal e-mails obtained by the freelance journalist Emanuel Karlsten present that the federal government not less than thought of whether or not the technique would possibly result in extra widespread immunity. In an e-mail trade between Tegnell and the pinnacle of the Finnish public-health company, on March 14th and 15th, Tegnell recommended that retaining the faculties open may assist the younger and wholesome develop immunity sooner. His Finnish colleagues famous that their fashions discovered that closing faculties would lower the an infection charge among the many aged by ten per cent. Tegnell responded, “Ten percent might be worth it?”
However, Sweden appears to have settled on its ultimate technique primarily by means of a mixture of unorthodox scientific conclusions, pragmatism, and folkvett, a very Swedish notion of widespread sense. No epidemiologists thought that self-isolation ought to be a long-term resolution. “Lockdown is a temporary measure that you do to buy you time,” David Nabarro, a long-time United Nations adviser and one of many World Health Organization’s particular envoys on COVID-19, instructed me. But most nations have been unable to get the virus below management and determined to go away lockdowns in place till a vaccine grew to become out there. This appeared unsustainable to Tegnell. He additionally shirked masks. A 12 months in the past, there have been few research that immediately measured the affect of masks on viral-particle emissions and group unfold of the virus, and managed experiments have been troublesome to conduct, for logistical and moral causes. Over the course of the pandemic, proof supporting masks has piled up. An evaluation of masks mandates in German cities discovered that they might have lowered COVID-19 infections by about forty-five per cent. Another examine examined U.S. states with masks mandates, and located that the every day progress of infections was two per cent decrease in states the place a masks mandate had been in place for a couple of weeks. By April, 2020, the W.H.O., the Centers for Disease Control, and different teams determined that there was sufficient proof, and really helpful face coverings. The C.D.C. now firmly concludes that “experimental and epidemiological data support community masking to reduce the spread of SARS-CoV-2.” Yet Tegnell remained unhappy. In April, 2020, he wrote a letter to the European Center for Disease Control urging towards a masks suggestion, saying, “The argument for and evidence for an effect of face covering to limit the spread from asymptomatic persons is not clear. . . . The arguments against are at least as convincing.”
As the Swedish technique garnered consideration, Johan Giesecke, Sweden’s former head epidemiologist, instructed UnHerd, a British YouTube channel, that he anticipated the an infection fatality charge to be “much, much lower” than was being reported within the media on the time. “I think it will be like a severe influenza rate, on the order of 0.1%.” (A examine by the Swedish public health-agency later discovered that the speed was not less than six occasions greater in Stockholm.) He stated that the distinction between Sweden and different nations’ insurance policies was that “the Swedish government decided early, in January, that the measures we should take against the pandemic should be evidence-based. And when you start looking around at the measures that are being taken now by other countries, you find that very few of them have a shred of evidence.” Tegnell stated that he had been in shut contact along with his counterparts within the United Kingdom, who have been planning equally mild restrictions. But instances within the U.Ok. have been growing quickly. On March 16th, scientists at Imperial College London printed a paper, primarily based on an epidemiological mannequin, predicting that, except some type of lockdown was imposed, greater than 5 hundred thousand Brits would die from preventable COVID-19 infections. Every week later, the Prime Minister, Boris Johnson, introduced that his authorities could be closing faculties, bars, and eating places, falling consistent with the remainder of Europe. “It was slightly frustrating,” Tegnell instructed me, once I spoke to him, in August. “We were really hoping we could take us through this crisis together.”
Sweden is a rustic of ten million folks, concerning the dimension of Los Angeles County, and virtually twenty per cent of Swedes reside in Stockholm, the most important metropolis. In April, 2020, a widely-circulated pre-print model of a paper by researchers at Uppsala University, adapting the Imperial College mannequin, predicted that, below the Swedish technique, fifty per cent of vulnerable Swedes could be contaminated inside thirty days, leading to over eighty thousand deaths by July. That spring, the virus started spreading unchecked in Sweden. “It just kept adding up,” Tegnell stated. “I mean, you’re always kind of hopeful and think that, O.K., this is something that’s going to pass over.” Soon, the per-capita dying toll was among the many highest in Europe. Slight modifications have been made to the Swedish recommendation: guests to nursing properties have been banned on March 30th; folks weren’t allowed to collect in teams bigger than fifty. Tegnell instructed me that the dying toll weighed on him. “I think this was a big frustration and feeling of failure for us,” he stated. But he remained steadfast, usually saying, in interviews, “Judge me in a year.”
Tara Twana, a member of the Stockholm County Council, heard concerning the mounting infections in nursing properties firstly of the pandemic and felt grateful that her aged mother and father nonetheless lived at house. Twana is forty-nine, with lengthy hair that she wears in a blowout. She and her household are Iraqi Kurdish, and her father was one of many leaders within the peshmerga motion for Kurdish independence. The household fled Iraq in 1988 and sought asylum in Sala, Sweden. “The people in Sala were very very kind,” Twana instructed me. As a toddler, Twana resented her mother and father’ activism, which frequently required that they journey away from house, however, in school, she joined a left-wing political social gathering and started to become involved in native politics. Since becoming a member of the county council, she has focussed her efforts on public well being and ladies’s points.
In the start of the pandemic, Twana was “very happy” with Tegnell’s response. “I have a lot of trust in the Swedish government,” Twana stated. “Maybe I’m assimilated a lot in the Swedish society.” At the federal government’s recommendation, she and her household restricted their motion considerably however by no means wore masks. Then, on the finish of March, Twana’s sixty-seven-year-old mom, Pari, got here down with a headache and fever. Twana tried to examine her right into a hospital to maintain her away from her father, Abdulla, who was eighty-three, however docs instructed them to remain house. They stated that there was no have to put on masks however that they need to attempt to keep aside in the home. They spoke to 1 one other on the phone from completely different rooms.
Every week later, Abdulla wandered into his bed room, wanting confused, and requested Pari the place he was and whether or not there was a bathroom in the home. She referred to as an ambulance, which took him to the hospital, the place he examined constructive for the coronavirus, with a hundred-and-five-degree fever. Twana’s mom was quickly admitted, too, as her signs worsened, and husband and spouse shared a room. Two days later, Twana’s father’s oxygen ranges started dropping. Twana referred to as him on FaceTime to say goodbye. At Christmas, he’d given her a e book that he had written, completely by hand, on Kurdish historical past in Mesopotamia, and had requested for her suggestions. She hadn’t had time to learn it, however she lied, telling him that she had favored it. She instructed me, “He was so happy. I promised I would publish his book.” He died sixteen hours later.
Twana, and a few others in Sweden, really feel let down by how their authorities has managed the pandemic. Alexandra Rönnholm, a fifty-four-year-old authorities worker, misplaced her husband in January. She wrote to me to say that Tegnell and his colleagues “have acted too late and too little which has led to over 12000 people premature death including my husband. He would have lived without Corona!” Nanaz Fassih, a fifty-two-year-old pediatric nurse, was skeptical of the Swedish response from the start; she tried to put on a masks to work in hospitals and clinics, however was instructed that this was not allowed. (Today, masks are extra generally utilized in Swedish hospitals.) On December 25th, she misplaced her eighty-three-year-old father to COVID-19. She had usually heard the Prime Minister talking in assist of the well being ministry’s insurance policies. “He said the strategy is going well,” she instructed me. “How can he say it is good?” Twana needs that the federal government had instituted stricter protections. “That’s a politician’s work, to take information and protect the people in society,” she stated. Instead, she stated, “Anders Tegnell, he was Prime Minister.” She added, “I still believe in the government. I do. But I’m very, very sad about how they dealt with the issues with the pandemic.”
This summer season, case counts started to drop in Sweden. When I spoke to Tegnell on the finish of August, he felt that the worst was behind him. Just a couple of weeks later, he and different worldwide consultants had a particular viewers with Boris Johnson, to offer recommendation on how Sweden had introduced numbers down with their light-touch method. “I think we are reasonably optimistic,” he stated. “Our prognosis is, No, we don’t really see a huge second wave coming on.” This didn’t final. By December, instances and hospitalizations have been greater than they’d been because the earliest days of the pandemic. Intensive-care models in Stockholm and Malmö, the nation’s third greatest metropolis, have been full. “It was just this development we did not want to see,” Björn Eriksson, Stockholm’s director of well being and medical care, stated throughout a press convention. Confidence within the public-health company had fallen from sixty-eight per cent in October, to fifty-two per cent in December. The authorities appointed an impartial fee to research the Swedish response to the pandemic, and handed a brand new legislation quickly permitting the state to shut companies as wanted.
Tegnell’s prediction of a tapering epidemic curve and quickly-attained immunity by no means got here to move. Sweden’s per-capita case counts and dying charges have been many occasions greater than any of its Nordic neighbors, all of which imposed lockdowns, journey bans, and restricted gatherings early on. Over all in Sweden, 13 thousand folks have died from COVID-19. In Norway, which has a inhabitants that’s half the dimensions of Sweden’s, and the place stricter lockdowns have been enforced, about seven hundred folks have died. It’s probably that some easy coverage modifications—particularly shutting down visitations to nursing properties sooner, and offering extra P.P.E. and testing to nursing-home employees—would have saved lives. And the technique doesn’t appear to have helped the economic system a lot: the Swedish G.D.P. fell by round three per cent, higher than the European common, however much like the drop in different Nordic nations.
Fredrik Elgh, a virologist at Umeå University and one in every of Tegnell’s former bosses, needs that Sweden had applied restrictions like these utilized by different nations within the area. “Why don’t they go the same route as our neighbors that have been so successful?” he stated. “We could have done that, too, if we had followed their path.” The fatalities within the elder properties, which account for about fifty per cent of the COVID-19 deaths in Sweden, appear particularly pointless; if visits to those services had been banned sooner, if their employees had been suggested to put on masks and get examined often, it’s doable that hundreds of lives may have been saved. People from each pro- and anti-Tegnell camps consider that this was an pointless tragedy. (Tegnell agrees, though he doesn’t suppose that the duty lies solely with the well being company.) “The Swedish strategy aimed at protecting the elderly has failed,” Mats Melin, the nation’s former chief justice and the present head of the government-appointed Corona Commission, instructed me. In December, Sweden’s King, Carl XVI Gustaf, criticized the nation’s insurance policies, telling the state broadcaster, “The Swedish people have suffered enormously in difficult conditions,” and including that, when it got here to the technique that the nation employed, “I think we have failed.” Stefan Lofven, the nation’s Prime Minister, instructed reporters, “The fact that so many people have died cannot be seen as anything else than a failure.”
But, though the result in Sweden was a black spot in Scandinavia, “compared to other countries in Europe, it’s not the worst off,” Patrick Heuveline, a professor of sociology at U.C.L.A. who research pandemic mortality charges, instructed me. “It’s not as bad as Italy, Spain, the U.K., and Belgium for example.” Tegnell holds up this statistic when defending his technique, claiming that sparsely-populated Norway and Finland are the outliers, and that Sweden ought to be in comparison with the remainder of Europe. Sweden has a bigger foreign-born inhabitants than different Nordic nations, and its inhabitants is extra concentrated in city areas, Tegnell claims. Other consultants are skeptical of this argument. “I find no correlation between proportion of foreign-born and Covid death rate,” Heuveline wrote, in an e-mail. “Norway has a higher proportion of foreign-born than Denmark, which has about the same proportion as Italy (about 10%), but Covid-19 mortality is much higher in Italy than in Denmark, and higher in Denmark than in Norway.” Over all, Elgh, Heuveline and different consultants argue, Sweden’s inhabitants is extra much like the opposite Nordic nations. Its first infections additionally got here later than in different elements of Europe, giving its authorities extra time to warn its residents of the virus’ severity. For these causes, comparisons to the remainder of Scandinavia, that are much less favorable to Sweden, could also be extra apt.