https://pmc.ncbi.nlm.nih.gov/articles/PMC11592722/
During 2020, however, Sweden had ten times higher COVID-19 death rates compared with neighbouring Norway. In this report, we try to understand why...
Although Sweden is one of the few countries with multiple high-quality health and population registries,
there were important problems with the reporting of COVID-cases, hospital admissions and even deaths. This was not only due to limited testing, but also to case-definitions being relatively strict and being changed several times during the pandemic (Villani et al., 2020, 2020f, 2020b). There were delays of several weeks, and differences between the official sources (Public Health Agency, National Board of Health and Welfare, Statistics Sweden) (Bjorklund and Ewing, 2020). There are also concerns about data-manipulations, in particular of COVID cases and child deaths (Vogel, 2021; Bjorklund and Ewing, 2020).
This pattern of secrecy, cover-ups and data-manipulations was present on national, regional and municipal levels—with even official websites (e.g., Government strategy) being updated without changing the “date of last update” (Sörensen, 2020). For example, although several of the people involved publicly made statements that face masks were not needed, or even “dangerous” or contra-productive (2020r, Bjorklund and Ewing, 2020)—they later claimed they had always been supportive of their use (Tegnell, 2021, 2021j). The Swedish Work Environment Authority and the State Epidemiologist even started erasing related emails requested by journalists.(Sörensen, 2020; Sandberg, 2020).
Although this is illegal, the practice of withholding information and erasing emails became widespread among official agencies during the pandemic...
Protecting the “Swedish image” (Sverigebilden) nationally and internationally has appeared to be more important than protecting the lives of Swedish residents, including healthcare workers, elderly, individuals with risk factors (e.g., comorbidities), minority groups and the socio-economically less advantageous. This is evidenced by the high excess mortality in these groups, lack of proper protective personal equipment, and denial of healthcare. There remains a lack of ethical consciousness and the skill to include ethical reasoning in decision-making processes; and lack of compassion for the victims of the pandemic (Bergmann, 2021b; Bergmann, 2021a).
The Swedish strategy was not pro-active in stopping the spread of the virus and this was acknowledged as never being the aim. Authorities reacted slowly and reactively, not dynamically, and never changed paths abruptly. It could be argued that the Swedish strategy was quite efficient and successful if the aim was to let the infection spread at a moderate pace in society.
Yet the projected “natural herd-immunity” levels are still nowhere in sight 1.5 years after the start of the pandemic. Herd-immunity does not seem within reach without widespread vaccinations, and with newer variants it may be unlikely. While maintaining healthcare demand at acceptable levels was a stated goal, healthcare resources were under major pressure, with numerous reports on staff shortages, individuals being denied healthcare (in elderly care and outside), and overwhelmed hospitals during 2020 leading to postponed (urgent) healthcare for non-COVID related diseases (2021d, Bark, 2020). Even accurate numbers on COVID-19 infections and deaths were no priority, as clear from the restricted access to (often suboptimal) testing and healthcare, lack of contact-tracing to identify suspected cases, delays in reporting and non-sensitive case-definitions (leading to underestimations).
The cost in terms of infections and deaths of this pandemic in Sweden has been larger in some other more densely populated and more centrally located countries, yet is still markedly higher than in the other Nordic countries (Rizzi et al., 2021; Nanda et al., 2021) and long-term health and societal effects cannot be ignored.
Several studies have shown that the human costs would have been significantly lower in Sweden if stricter measures had been implemented, without more detrimental impacts on the economy (Kamerlin and Kasson, 2020; Sjödin et al., 2020; Sheridan et al., 2020; Born et al., 2021b; Amiri, 2021; Born et al., 2021a). The Swedish strategy has not shown to be superior in any measurable aspect compared to the Nordic neighbours or internationally (Balmford et al., 2020, 2020k; Braithwaite et al., 2021; Bjorklund and Ewing, 2020). This Swedish laissez-faire strategy has had a large human cost for the Swedish society.
