All Luck and No Virtue: Sweden’s Coronavirus Response

All Luck and No Virtue: Sweden’s Coronavirus Response

Sweden bet on both national character and herd immunity, hoping they would complement each other. Months later, the country has little testing and one of the highest rates of cases.

State epidemiologist Anders Tegnell of the Public Health Agency of Sweden speaks during a news conference about coronavirus (Naina Helen Jama/TT News Agency/AFP via Getty Images)

In the spring, my neighbors here in Sweden were having friends over for Easter and going to restaurants, gyms, and swimming pools while my family and friends in Italy could not take a walk around the block without being questioned by a police officer. The differences were striking even for someone who, as often happens to those living in a foreign country, is used to surprise and estrangement.

In Sweden everything was open and functioning as usual. The government had decided not to implement disruptive measures such as closing schools for children younger than sixteen so that parents could continue to do their jobs. It recommended that people work from home, but never prevented them from going to their offices if they chose to do so. In fact, some were actually encouraged to show up at work so as not to communicate a sense of emergency. Healthcare workers were supposed to wear masks and protections only when dealing with suspected COVID-19 cases to avoid spreading panic.

When my friend brought his mother to the hospital with COVID-19 symptoms in April, healthcare workers took off their PPE as soon as she tested negative, despite the test’s high rate of error. Swedish politicians, public health experts, and the people I knew explained this approach as the natural response of a country that runs on trust. The government trusted people to comply with recommendations as if they were laws; people trusted the government to take care of them in the best possible way; politicians trusted experts to come up with the best measures. Everybody was in agreement and everybody was trusting.

I come from Italy, a place where it is hard to find two people who agree with each other (to borrow Alexis de Tocqueville’s description of nineteenth-century France), a place where the government is blamed for the rain. My feeling of displacement was therefore profound in those early days of March and April. I could not rejoice at my luck for having landed in Sweden and being able to enjoy freedom as if there were no pandemic, and not only because my family and friends were on the other side of the wall. Because what I saw around me, in Sweden, was not freedom.

Months later, what I see is still not freedom as I understand it. Instead, Swedes interiorize norms and rituals and act as if they were free. The country is famous for its so-called consensus culture, but people generally begin in agreement rather than ending there. I argued in the Boston Review that this characterizes an organicist society, where individual choice and public choice perfectly overlap and dissent is expelled; where twenty eminent scientists can publish an editorial against the Swedish approach in one of the country’s two flagship newspapers and have almost no impact on public debate or policy.

But there is something else I have seen in these past months: denial. At the beginning this was to be expected; it was the same in Italy, France, the United Kingdom, and the United States. Coronavirus was always someone else’s virus—the Lombardy virus, the Chinese virus, the Italian virus. As infections spread, people got busy drawing distinctions: Europe is not China, they said, the United States is not Europe, China is not Italy. Some countries notably went the other way and learned from similarity: Greece, for example, modeled its policy on its Mediterranean neighbor Italy. In Scandinavia, Norway, Denmark, and Finland decided to lock down early, apparently judging that pandemics trump national character, rituals, and geography, especially as societies become more interconnected.

But Sweden went its own way. It decided to bet on both national character and herd immunity, hoping they would complement each other. The prevailing attitude was that the virus might run faster among those who did not conform to the customary Swedish independence between generations, or those who favored crowded venues to the solitude of the forest and privacy of their docks—but that would help establish some immunity among the larger population. Interviewed by the Financial Times at the beginning of May, Anders Tegnell, the state epidemiologist and architect of the Swedish no-lockdown approach, was serene: “In the autumn there will be a second wave,” he said. By then, “Sweden will have a high level of immunity and the number of cases will probably be quite low.”

The virus did hit some groups more than others. As in other places, it hit the old, the weak, the ones with few options. In Sweden, many migrants and refugees find work in essential jobs such as healthcare and nursing facilities. Without the necessary PPE or the option of staying home to care for sick family members, they became vectors; they were at greater risk of contracting the virus themselves as they continued to interact with colleagues at work without being provided masks. Testing has never been the default option in Sweden, even for healthcare workers. According to Our World in Data in mid-June—at the height of its testing effort—Sweden was administering only twenty-seven tests per 1,000 people, compared to 180 in Iceland, ninety-eight in Denmark, and forty-seven in Norway.

The result? A disease that was still spreading in Sweden at the end of June, even as it had been contained elsewhere. The country’s seven-day new infection average on June 25 was 1,275 cases per day, compared to forty-two in Denmark and eleven in Norway. This number has since declined, but so has testing, which was drastically curtailed in early July. And the dead stay dead. As of August 25, COVID-19 had already killed fifty-seven of every 100,000 Swedes, compared to fifty-four out of 100,000 in the United States, eleven out of every 100,000 in Germany and two out of every 100,000 in Greece.

Confronted with this grim picture, Tegnell continued to defend the Swedish approach, conceding only that things went worse than he had “hoped.” This was the very same expert who claimed all along to be basing his policies on scientific evidence and mathematical models. It turned out he just banked on luck—and lost. “If we were to encounter the same disease again, knowing exactly what we know about it today,” he told Swedish Radio on June 3, “I think we would settle on doing something in between what Sweden did and what the rest of the world has done.” He insisted that the basic strategy was sound, although there was “potential for improvement,” adding that whereas other countries introduced many measures at once, not knowing which of them was going to work, Sweden was right to run its experiment. Otherwise, Tegnell insisted, “you don’t really know which of the measures you took had the best effect.” It was left to Jimmie Åkesson, leader of the far-right nationalist Sweden Democrats, to voice his “astonishment.” “For months critics have been consistently dismissed,” Åkesson tweeted. “Sweden has done everything right, the rest of the world has done it wrong. And now suddenly this.”

The failure of Tegnell’s approach is not really a matter of bad luck. If anything, Sweden was far luckier than Italy, Spain, or Germany. The virus reached the country relatively late. Swedes had ample opportunity to prepare and take steps to contain its spread. They had the three great assets of time, money, and organization—assets they could have used to stock up on PPE, set up treatment and quarantine facilities, and test, track, and treat as the World Health Organization advised. They had knowledge and expertise in spades, and they had a trusting and compliant populace. Perhaps most important, they had the example of other countries to learn from. If Sweden did not see Italy—then the epicenter of the crisis in Europe—as a useful model, it could have used Denmark, which locked down early even while acknowledging the uncertainty of such measures. As Danish Health Minister Magnus Heunicke said in March, “We have no evidence that everything we are doing works. But we would rather take a step too far today than find in three weeks that we have done too little.” Instead the Swedish government decided to do almost nothing and just hope for the best.

Niccolò Machiavelli, the sixteenth-century Florentine philosopher, described the human condition as dominated by luck (fortuna) and virtue (virtù). The second, he argued, lies in not wasting the first. The vagaries of chance should not simply be accepted; they should be recognized and used. “I hold it to be true that Fortune is the arbiter of one-half of our actions,” Machiavelli wrote in The Prince. “But she still leaves us to direct the other half, or perhaps a little less.”

In this sense Sweden has been lucky—but not virtuous. The country had many chances to change its approach by responding to new evidence and correcting earlier mistakes. On April 18, Parliament voted to allow the government the power and discretion to introduce emergency measures without asking for Parliament’s approval. The exceptional and time-limited law was a dead letter. In a stroke of preparedness, at least since the beginning of April, schools and other organizations all had plans ready to move most of their activities online (Sweden is already among the most networked societies on earth). But they never used them. Failing government (in)action, citizens could have listened to the few who have spoken out against official policy. They could have held both the government and so-called experts like Tegnell accountable for the rising death toll. None of this happened. Swedes chose instead to stand behind their leaders, ignore the data, and put Tegnell’s image on coffee cups and T-shirts.

To fully understand why Swedes went along with the country’s lack of a plan, we need Machiavelli’s thirteenth-century Florentine predecessor, Dante Alighieri. Two of the mortal sins named in the Inferno are ignavia and hybris. The first, which translates roughly as “moral torpor,” is the laziness of those who rest in comfort and never question anything. The ignavi are walking dead, “the miserable lot, who never were alive.” Hybris, which Dante borrowed from Greek tragedy and myth, is nearly the opposite. It is the flaw of Icarus and Oedipus, Ulysses and Prometheus. It is the arrogance and vanity that blind the hero to his true circumstances, and which inevitably lead to his fall.

Sweden’s COVID-19 policy bears the mark of both ignavia and hybris. Countries like Italy and Spain made mistakes and had an unbearable number of deaths, yet they were virtuous in making the best of the hand they were dealt. Others, like Denmark, Norway, and Finland, were also virtuous as they tried to learn everything they could from mistakes and missteps elsewhere. Sweden, by contrast, wasted its luck. Arrogant and vain, it sleepwalked into this crisis and continues to sleepwalk through it. And that is more than a shame. It’s a sin.

Adele Lebano is a political scientist. She divides her time between Sweden, Italy, and the United States.