Sweden’s corona trauma – a story of blind faith

Sweden’s corona trauma – a story of blind faith

Sweden’s corona policy receives a lot of international attention. The “Swedish way” is either seen as a role model or a disaster. Yet, the Swedish “corona trauma” painfully uncovers the consequences if a democracy lacks a critical civil society.

Disclaimer: I rarely comment on issues that fall outside of my academic research. This time I do as a European citizen living and working in Sweden. It is a subjective commentary that I know many of my Swedish friends will not like. I hope it will provoke critical reactions and I know it is not based on social scientific methods.

Swedish politics are rarely in the spotlight of the international press. Around the globe, the image of Sweden is overwhelmingly positive, not polarized. Last year, this radically changed. Throughout the continent, critics of lockdowns and those outright denying the existence of the virus protested waiving Swedish flags insinuating that the Swedish approach supports their case. In response, international observers have continuously pointed to the high number of infections and deaths due to the coronavirus in the Nordic state. For them, Sweden offered proof that restrictions and lockdowns are the only way to avoid a health-related disaster.

What is most striking for me living and working as a foreigner in Sweden, however, is that whatever happened, Swedes trusted their authorities and their government without questioning national policies. This might sound positive to all those that are sick of all the distrust in other European countries, the questioning of government policies and the fear of divided societies. However, it also lays open that Sweden has stripped itself of one of the greatest strengths of a democracy: the ability to self-correct. It is true that Sweden is slowly changing its approach as well, but this comes late and only half-heartedly. Passionate and controversial discussion might be demanding and at times exhausting. But this is the prerequisite of a free society. Swedes speak a lot about individual responsibility when characterizing their corona strategy. In truth, it is blind faith. Sweden’s “corona trauma” could fundamentally reshape Sweden – hopefully for the better, but maybe for the worse.

Health: what is the “Swedish way”?

To be clear: In terms of health, the “Swedish model” has been a disaster. While testing has varied greatly across Europe, the death ratio per one million inhabitants might provide one proxy to understand how a country is doing compared to others. Considering all EU countries, Sweden ranks only slightly below average. Of the nine EU member states that have a worse record, however, hardly any is comparable to Sweden. Two (Italy and Spain) suffered first among European countries of coronavirus infections with only a short time to prepare. Others are much more densely populated than Sweden (e.g. Belgium), have a different culture with people traditionally living less isolated (e.g. France), or suffer from much weaker health systems because of significantly lower prosperity (e.g. Bulgaria). A regional comparison of northern Europe, for the sake of this article defined as all countries bordering the Baltic Sea plus Norway, the United Kingdom, and Ireland, provides for a much more adequate comparison. In Sweden, 990 out of one million people has died with Covid-19. Almost all northern European countries do better, some significantly. Poland (855), Lithuania (842), Germany (543), Ireland (503), Latvia (480), Denmark (285), Estonia (234), Finland (111) and Norway (96) are cases in point. In the region, only the United Kingdom (1285) scores worse than Sweden.

Another, maybe even better proxy is the excess morality per 100,000 inhabitants. According to The Economist, Sweden – again – scores worse than almost all other countries in the region with 81. Germany (21), Denmark (6) and Norway (2) all do much better. Of the northern European countries included in The Economist’s data, only Britain (124) scores worse than Sweden.

While this is the result of the “Swedish way” that has been somehow different, the distinctiveness of Sweden’s corona policy is sometimes overestimated, and it neglects that all countries have necessarily made mistakes in handling the coronavirus. So, what is the “Swedish way”?

In contrast to other European countries, Sweden’s public health authority aimed for a long-term strategy avoiding a cycle of opening and closing. In the spring and the fall when other countries imposed shutdowns and lockdowns, Sweden remained comparatively open. During the summer when life in continental Europe felt almost normal, Sweden had still more restrictions in place. Many people suspected that the rationale behind Sweden’s coronavirus policy was one that aimed at herd immunity, i.e. one of a controlled and steady infection. Indeed, whenever Sweden’s state epidemiologist Anders Tegnell reported a relatively high proportion of people that had already been infected, he seemed enthusiastic – as far as this is an appropriate characterization given his calm personality.

Calls to allow home office, keep distance and hygiene rules sound similar in Sweden as across the continent. Already in the spring, Sweden even asked its citizens to avoid public transport. This stands in contrast to shops, restaurants, bars and cinemas staying open for the entire year. Young school students always went to school, older ones had digital home schooling.

A significant difference was also that the Swedish health authorities doubted the protective effects of face masks. Only shortly before Christmas, a recommendation to wear them in public transport during rush hours was issued.

In sum, Sweden did take a different policy, but life was far from normal as many tend to believe in other parts of Europe. Sweden never denied the virus as right-wing populists suggest. The failures of the “Swedish way” might be debatable. Personally, I believe there were three major ones from an entirely health-related viewpoint: keeping schools open, not properly protecting nursing and elderly homes (just like in many other European countries), and ignoring evidence of the effectiveness of face masks.

The two faces of societal trust

The most striking feature for a foreigner living and working in Sweden, however, has been that the Swedish authorities did not issue regulations but recommendations. To my surprise as a continental European: it worked. Whoever expects that the Swedish population would ignore those recommendations and search for loopholes to enjoy life, is mistaken. Unlike in many other democracies – most notably in the United States – the Swedish population trusts in the authorities and follows the recommendations. This is a precious asset of Sweden that is deep-rooted in Swedish history of conflict avoidance, compromise and consensus.

Consider Sweden’s remarkably short history of labor movements. Instead of fighting for workers’ rights the Swedish Trade Union Confederation, Landsorganisationen (LO), sees itself as carrying a macro-social responsibility to preserve labor peace for the sake of common prosperity of all classes. This self-identification is often associated with a treaty named after the town in which it was negotiated, the Treaty of Saltsjöbaden. It was concluded between the LO and the Swedish Employers Association, Svenska arbetsgivareföreningen (SAF), in 1938. However, even before this legend captured in the expression of the “Saltsjöbaden spirit”, saltsjödadensandan, was constituted, labor disputes had, with some exceptions like the Ådalen shootings of 1931, skotten i Ådalen, been much more confined than in other European countries.

Another example is Sweden’s famous welfare state policy, folkhemmet. Introduced in the early 1930s by the social democratic party of Sweden, folkhemmet like the labor peace approach strived to combine comprehensive welfare with a solidary wage policy encouraging companies to invest in research and innovation. Hence, the promise of a comprehensive welfare state was again coupled with favorable conditions for economic growth. It was – yet again – rather an agreement between labor and capital instead of a contradiction. From the 1990s, Sweden’s welfare state has largely been dismantled and was substituted by a narrative of self-responsibility and individual freedom of choice. To the Swedish identity, however, folkhemmet, or better: the myth of folkhemmet, remains constitutive to this day.

This specific mix of trust and conflict avoidance coupled with the narrative of individual choice and self-responsibility was not entirely responsible for the Swedish coronavirus catastrophe, but it contributed to it. Building on the trust of the Swedish population and following the idea of self-responsibility, the Swedish authorities did not adopt a hands-on approach to tackle the virus but issued recommendations. This policy was demanding and requires at least three aspects to work well:

First, tackling the coronavirus pandemic is simply not a matter of individual choice. An individual decision has direct implications on the health of the rest of society. Hence, it requires societal collective action.

Second, since Sweden has not fully adopted the idea of individual choice, collective societal self-responsibility would have been possible. This, however, requires a collective debate weighing different options and preferences since any such collective effort is a trade-off between different goals and values. In Sweden, however, a broad range of decisions, including over diseases, is depoliticized by means of a meritocratic approach to politics. Not politicians but public agencies take the most far-reaching decisions. Not politicians but experts are driving the country’s course. This is consistent with the culture of consensus and trust. Hence, Sweden’s collective efforts were not based on a controversial political discussion but on faith in recommendations issued by health experts.

Third, in this constellation, it all boils down to the expertise of the experts and in the quality of their recommendations. If the recommendations of the Swedish public health authorities would have worked, Sweden could have made it perfectly well through the coronavirus crisis. The challenge is that – literally – the question of life and death lies in the hands of a small group of so-called experts.

Without any doubt, this Swedish approach works extremely well when with most political issues. Sweden is an economically successful and enormously efficient country. The “Swedish model” is not doomed to fail. In fact, in most cases, it works remarkably well and other European countries could certainly learn a lot from it. It is, however, very risky since it relies on the premise that politicians are taking good decisions (e.g. what if Sweden was governed by its right-wing populists, the Sweden Democrats? Would people still trust in them?) and experts to have the necessary expertise.

When the experts refuse to correct their mistakes…

Tragically, it does not work in the coronavirus pandemic for three simple reasons: First, the recommendations of the public health authorities do not yield the expected results and they do not or only very slowly change their course. Second, in this situation, politicians have been reluctant to take over the responsibility or to replace the experts. Third, there is hardly any outcry from Sweden’s civil society (there are always exceptions, of course!). No self-correction from critical public commentary arises but thousands of people are dying not only from the coronavirus, but from the country’s blind faith. It is true that criticism is on the rise – particularly in Swedish media. But this only developed in late-2020 and early-2021 and focuses mainly on politicians and less on the public agencies.

It might be unfair and simplified to blame only Anders Tegnell, Sweden’s state epidemiologist, for the failure. However, since he makes the public appearances and is widely acknowledged as the embodiment of the “Swedish way” by both supporters and critics, let me focus on his role. In my opinion, Tegnell is entirely unsuitable for his job.

Tegnell apparently has difficulties in acknowledging reality and admitting mistakes. In late-2020, Jan van der Linden, professor of intensive care at Sweden’s most renowned medical research center “Karolinska”, rightly compared Tegnell with Donald Trump when telling Swedish daily “Dagens Nyheter” that both never admit mistakes and fallacies. Such inability is particularly problematic for a scientist since the very idea of the sciences relies on the principle of verifying and falsifying working hypotheses and adapting research and its applications according to new information.

Tegnell’s strategy and predictions are apparently as good as a gamble. In spring 2020, he told Swedes that one should wait until the autumn to judge on the Swedish strategy because a high level of immunity would lead to far lower cases in the fall. In November, Tegnell admitted talking to the Financial Times that it was “a big mystery” who had immunity and who did not. This surprises even more since the coronavirus is mutating relatively slowly. If Tegnell’s strategy did not even work with the coronavirus with which other diseases would it?!

Tegnell’s communications is remarkable, the least to say. Take the example of face masks. At first, he suggested that it was unsure whether they had any protective effect. When more and more studies indicated that they had, he switched his line of argument saying it was difficult to wear them properly. In addition, he was concerned that wearing face masks creates a sense of security among Swedes and make them ignore social distancing rules. (I have never heard an explanation from him why he thought this would be a problem in Sweden even though it was apparently not an issue in other European countries.) During the fall when it became clearer that also Sweden would not be able to entirely avoid recommending face masks, he adopted yet another line of argument indicating he does not want to confuse the Swedish public and remain consistent in recommendations. Inconsistence, in turn, seemed not to be a concern for Tegnell when he questioned the effectiveness of the corona vaccine in an article in the Swedish daily “Dagens industry” on Christmas eve. Only days before, Tegnell had lamented that Swedes should get vaccinated.

A lack of knowledge

Neither Tegnell’s unsettling behavior nor the disastrous results of his course have seriously undermined societal faith in his policy. It is true that his approval ratings are dropping, and that critical media commentary is increasing. However, the focus of the public’s slowly emerging criticism is the political leadership. In mid-December when Sweden was one of the European countries hardest hit by the pandemic, Tegnell still enjoyed approval ratings of 60%. In the spring when Sweden was suffering as well, trust in Tegnell was even higher. This is even more surprising given that the corona pandemic was not the first time Tegnell was responsible for a tragedy. Ten years earlier, Tegnell oversaw vaccination when recommending the Swedish population to get vaccinated against the swine flu. From these vaccinations, hundreds of children and young adults suffer from incurable narcolepsy. While Tegnell was by far not the only international expert to recommend such vaccination it is surprising that even the combination of the swine flu vaccination and the lack of positive results from Tegnell’s corona containment strategy did not irritate the Swedish population.

In early summer when wearing a face mask, friends called me “unpatriotic” as if distrust in Tegnell’s recommendations was a criticism of the entire country. Gina Gustavsson, political theorist based at Uppsala University and one of the few critical voices in the early stages of the pandemic, has written highly informative pieces in the Swedish and international press on the nationalist undertones of the Swedish public’s approach to the coronavirus.

Swedish nationalism is coupled with remarkable ignorance. Before leaving for the summer vacations to other European countries, most Swedes did not even know that most other Europeans were wearing face masks at all times when being in public – at least indoors. As late as early-December, most of my friends had not heard of the different standards of face masks such as FFP2 standard. They also had no idea of the different vaccines’ modes of action. And maybe most importantly, hardly any of my friends, colleagues and acquaintances knows of the incoming studies on potential medium- and long-term grave side effects of a coronavirus. For most, surviving the coronavirus is all that one should strive for. If they knew of the growing knowledge about long-term impacts on organs, most notably heart diseases, more could be critical of the Swedish way that seems to have played with the idea of herd immunity. In German public television, by contrast, epidemiologist and parliamentarian Karl Lauterbach warned numerous times against potential negative long-term impacts on organs already in spring 2020.

Not ready to make the corona policy a matter of choice

Tegnell’s apparent incompetence and the lack of societal knowledge trusting the authorities is coupled with a desire not to stick out. After the summer, a public opinion poll showed that more than 70% of the Swedish population believed that face masks offer effective protection. However, in the same poll, less than 10% indicated willingness to wear them as long as the public authorities did not recommend them. Sweden’s press, government and civil society was too patient (and still is) with the authorities.

In an informative piece, the Swedish China scholar Johan Lagerkvist of Stockholm University compared Swedish societal trust to the Confucian culture of China. Lagerkvist has been one of the earliest critics of the Swedish government’s refusal to take responsibility. He criticized that the government of Stefan Löfven started to pass on responsibility to ordinary people and their self-responsibility. I agree Lagerkvist’s criticism. Löfven should have acted much earlier than in winter 2020 when he sidelined Tegnell and agency for the first time suggesting a tougher approach. However, I also believe that people in any country, but particularly in a democracy when authority is carried out in the name of the people, demands responsibility for oneself and for the entire community.

Societal trust, without doubt a precious good, is a prerequisite for any democracy and almost all European countries currently suffer from a lack of it. The Swedish example demonstrates, however, that there can be too much of all good. Where trust turns into blind faith, a democracy strips itself of one of its greatest advantages: the ability to self-correct. What it needs is a balanced mixture of trust and a critical sense of responsibility and belonging to a community. The “Swedish exceptionalism” is that it suffers from critical responsibility while the rest of Europe lacks societal trust.

Once the pandemic is over and Swedes have the time to reflect there is a chance for the country to self-correct such as any other European society will have a similar window of opportunity. If Swedes clearly acknowledge the failures during the pandemic, disappointed trust could either turn against the existing elites and result in the further rise of the right-wing populists, the Sweden Democrats. (The Sweden Democrats have suffered in opinion polls during the pandemic.) A more optimistic and hopeful scenario is possible as well. In discussing the failures of the crisis that the Swedish King has already admitted in his remarkable Christmas address, Swedes could take first steps to embrace a critical and controversial public discussion.