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Disclaimer: I offer this in good faith, and I don't disagree with your broader points.

I had to visit Stockholm twice in September to go to an Embassy. I caught the train from Copenhagen, where it was mandatory to wear masks on public transport (though not outside this).

As the train crossed the bridge into Sweden an announcement came over the intercom saying that we could now take our masks off.

As an outsider, I have had the chance to compare the way that a bunch of countries and populations have handled the pandemic. Perhaps the most stark shocks were actually in Copenhagen where I watched people queuing to get into pubs and sitting at densely packed tables at restaurants (September).

I'm always hesitant to judge because there are such complex dynamics at play and there is such and opportunity for biases to creep into what you see. But walking past it, it was hard not to wonder if it would come back to haunt them.

While visiting Sweden it was pretty clear that, aside from the masks, there was absolutely a change in behaviour (social distancing, hand hygiene). Compared to pre-pandemic visits.

The Radisson Blu had packaged up it's buffet breakfast into little containers for safety (that was a truly surreal breakfast -- tiny little glass jars of cheese).

I'm not saying Sweden's approach is right or wrong. The rest of the world hasn't been in any way consistent in their approach(es). But Sweden has definitely taken a different path on several issues.

Hey, that was pretty cool to hear. Thanks for sharing that experience.

The one thing I have continuously relearned about this virus is that pandemics are incredibly complex. It makes sense the pandemic spreads into every context humans place themsleves in.

I feel like Sweden (the world?) wasn't well prepared for a pandemic. Hopefully we can prepare better for the next one.

Everyone has the benefit of hindsight now. Having read a little bit about Anders Tegnell, I believe he is making decisions in good faith, and you can't ask for more than that. Trying to apply his expertise to the problem.

The majority of countries out there have made slip ups. Australia, which has fared better than most, had several "The Ruby Princess" and a hotel quarantine breach. They're still managing to tear each other apart politically even though the total deaths for Australia (pop 25 mil) is 909.

In some ways I think we've gotten off lightly with this pandemic. It could have been Ebola, or with similar survival rates.

We've actually proved as a global society that we can all pull in the right direction -- vaccines, etc. Has it been perfect? Not even close. Has it been worse for minorities and lower socioeconomic groups? Absolutely.

We can only hope, and plan that some of these things are a catalyst for changes that protect us next time, and make the world a better place in general.

Regarding the "lack of information for those caring for the elderly", that sounds fairly implausible, because information about the epidemic has been abundant.

The proportion of old people among the dead is not much different in Sweden from other comparable countries; it seems to me that any strategy with "protect the elderly and let the younger people take the hit" is doomed to fail. The more infections there are in the general population, the more infections there will be among the old and weak. And of course even the young and fit will also have a proportion among them who get seriously ill.

Maybe I should make it clear I don't defend the strategy. I'm not an expert and honestly I don't know what the best national strategy for protecting against a pandemic is.

Regarding the lack of information for the elderly care tough, I know Anders Tegnell (who was the spokesperson for FHM during most press conferences) have said in several interviews that he regards that as a failure on FHMs part. They believed that stressing that the elderly were the most vulnerable would be enough, but says that this was probably a mistake.

The Swedes have been misleading so much on this whole issue it’s hilarious.

First, Tegnell refused to believe in asymptomatic transmission.

Then he lied that herd immunity was never considered but we have emails from him to the broader scandinavian health directors saying that they should consider herd immunity through natural infection.

Then they insist that the only reason Sweden looks so bad is because of care homes (which, btw, is greatly affected by the fact that Tegnell didn’t believe in asymptomatic transmission well after every health department was officially basing policy on it). Well, care homes amounted to about 50% of Swedish deaths. So even if you completely excused Swedish care home deaths, while doing no such thing for its neighbors, it still had a death rate that was 2.5x that of Denmark and even worse compared to its other neighbors. So if we count Danish care home and old people deaths, but don’t count Swedish care home deaths, Sweden is still 2.5x worse in terms of death rates.

Finally, for all of that, Sweden was also close to the worst performing economy among its neighbors. Final economic numbers will take some time to really settle in, but what is clear is that Sweden didn’t get any economic benefit for not declaring an official lockdown.

Finally, let’s not compare for a moment. Sweden failed on its own terms. Here are some of the things Tegnell said we’re gonna be the benefits of the strategy:

1) Close to herd immunity in major parts of Sweden especially Stockholm after the first wave. This was absolutely destroyed when it was discovered that the worst parts of Stockholm had about 10% infected at most. It was nowhere close to the minimum 20-25% they were predicting. 2) Much better second wave than neighbors. Besides a couple of weeks lag (I’m not entirely clear why this lag existed, but Swedes have a summer tradition apparently of retreating to nature etc, which likely played a role in the improvement over summer as well as delaying the spread), Sweden has once again become the worst affected of its neighbors. 3) Better 2nd wave than 1st. It’s not worked out that way. The 2nd wave is worse than the first.

It would be one thing if the Swedes were like “oh well, this is how we want to do it”. But Tegnell has relied on both Swedish exceptionalism “oh, we Swedes are better than everyone else and so don’t even need to declare lockdowns” and contradictorily has also criticized other governments any week things haven’t looke as bad in Sweden.

Tegnell was proven right according to the latest research:

"Previous studies have shown that asymptomatic individuals infected with SARS-CoV-2 virus were infectious3, and might subsequently become symptomatic4. Compared with symptomatic patients, asymptomatic infected persons generally have low quantity of viral loads and a short duration of viral shedding, which decrease the transmission risk of SARS-CoV-25. In the present study, virus culture was carried out on samples from asymptomatic positive cases, and found no viable SARS-CoV-2 virus. All close contacts of the asymptomatic positive cases tested negative, indicating that the asymptomatic positive cases detected in this study were unlikely to be infectious."

https://www.nature.com/articles/s41467-020-19802-w

To me, this sounds like Tegnell (who is an expert and has studied viruses and pandemics) knows what he's talking about. If you've ever seen an interview with him it becomes quite apparent that he's got a real scientidic mindset.

That study is an extremely weak support to the claim that this virus can't spread asymptomatically - it's nearly useless for that purpose. They only studied a small number of people at the very tail end of the infection who showed that they had some evidence of virus in them. They did not look at whether those patients actually had an active infection - they could have simply been detecting remnants of dead virus in their systems. They certainly didn't look at all at people in the incubation stage pre-symptoms.

Nature is one of the two top journals in the world and their conclusions directly contradict what you're saying. This was a study of 10,000,000 people.

Reading the article I understood it like this.

~10 million residents from Wuhan (almost same size as Swedish population) got screened for covid. In ~30k people who recovered from covid, 107 tested positive for covid a second time. Roughly ~1000 people were in contact with asymptomatic carriers, but none (as in 0) tested positive for covid.

I did some simple google searching as well, and while it seems possible to transmit the virus without symptoms it also seems that a small minority of cases are transmitted by asymptomatic carriers. The numbers I find are ~20%. Sure, that isn't negligible, but I can understand why experts would base a strategy on those with symptoms.

My understanding of the political system in Sweden is that the administration is unusually independent and not very political. That leads to way more rational decisions compared to if politicians made the decisions. Also the infections were distributed very unevenly in the population with immigrants (Somali in particular) being disproportionally affected https://apnews.com/article/1d7916cf6e48b7a231b894ef9cda1a19.

Yeah, that is my understanding as well. We have a word for politicians that try to use the ministeries to "get it their way". "Ministerstyre", very roughly translates to "rule through ministry". Ruling by "Ministerstyre" is a surefire way to never get any votes for you and maybe even for your party again.

It’s actually illegal:

Independence of administration Art. 2. No public authority, including the Riksdag, or decision-making body of any local authority, may determine how an administrative authority shall decide in a particular case relating to the exercise of public authority vis-à-vis an individual or a local authority, or relating to the application of law.

https://www.riksdagen.se/globalassets/07.-dokument--lagar/th...

In terms of COVID, what the Swedish system led to was over reliance on one person. Whose strategy, incidentally, was criticized by his predecessor from the beginning. So if this had happened a few years ago, or if the predecessor would have had a slightly longer term, the same “rational system” would have led to a 180 different response.

And the problem for that 1 person was that Tegnell dismissed asymptomatic transmission. Dismissing the possibility of asymptomatic transmission led to making a mockery of his plans.

Everything since then has been an attempt to save face, including coming up with nonsensical excuses about how Sweden cannot do some things because “free dumb” (which it has since proceeded to do anyways).

Ironically, the faceless bureaucratic nature of public health in most countries allowed them to change tacks when they were wrong. In Sweden, since Tegnell became so intimately connected with and responsible for the Swedish response (to the point that politicians would blindly accept what he was saying), it became difficult for him to accept where he was wrong and then change strategy accordingly.

The rest of the world had it easier. Politicians would blame the WHO and China, public health officials would anonymously blame the politicians, and vice versa.

Within all this blaming it was still possible, as various public agencies in the rest of the world have, to actually change and improve responses based on new information since no one individual was tied to the earlier plan.

Of course, in general, the Swedish system is a lot better. But the pandemic has exposed a flaw that it’s over reliant on a single source of expertise. They mah need to consider having a separate private source of expertise (for example, the UK has something called SAGE) that can step in if the original source is unable to make necessary adjustments.

The covid response did not depend on the opinion of a single person. The FHM is responsible, not Tegnell. This was clarified early during the pandemic (somewhere around May maybe?). The director of FHM essentially told everyone during the press conference that it was very shameful of "some people" to paint Tegnell as the sole responsible for "the failures of the swedish strategy". An example here disproving the "crazy scientist Tegnell myth" is that the messaging remained exactly the same even when Tegnell went on vacation during the summer.

Also, it's even more complicated since FHM don't have authority to tell other government institutions how to run their business. You could call them a governmental support function, if that helps.

Regarding that Swedish politicians are "free dumb" and "they can't do anything". We have laws that could impose lockdown in the event of war, but these laws do not apply to a pandemic/epidemic. My understanding is that Norway and Denmark have similar laws, just that they do apply to pandemics/epidemics. I don't think it is right for politicians to have the ability to lock up people when the law does not support it. We should have had a law that could be used during a pandemic but we didn't.

I also think that the asymptomatic carrier thing is more complex than you describe. I don't think a majority of the cases were from asymptomatic carriers and if you follow the recommendations (social distancing + wash your hands etc.) it wouldn't be a problem.

So Sweden banned gatherings of 50 or more people, while countries that banned order of magnitude smaller groups did an order of magnitude better. Allowing groups up to 50 isn't anything like a lockdown as understood in many other countries. Also I think it was never practically feasible to isolate vulnerable people as you describe. As far as I know, no country has successfully kept society open in this way yet also protected vulnerable people and it was reckless and irresponsible to try to do so.

So Sweden banned gatherings of 50 or more people, while countries that banned order of magnitude smaller groups did an order of magnitude better.

And Spain locked people in their homes to the point where there was a black market in borrowing other people's dogs in order to have a legal reason to go outside, and did worse. There is not an obvious relationship between severity of lockdowns and deaths or hospitalizations. You see this in the US too, where the media have been demonizing Florida for months for its relatively lax restrictions, while its death rate is right at the national average.

Also I think it was never practically feasible to isolate vulnerable people as you describe.

And it is practical to expect the entire population to put their lives on hold for a year because of a disease that is not a significant danger to most of them?

Locking people into their homes like Spain and France did might have other ill effects, like a depression epidemic. Or people getting fed up with stupid politically motivated approaches gathering en masse to protest, making matters worse. The problem in Southern Europe is that people like to party. That still doesn't warrant 1 km radius lockups which I hope would be deemed a violation of human rights in court. I understand that we're not allowed to gather in large groups, but restricting going out on a bike ride alone or with your partner or walking the dog is quite a different matter. Also the French curfew is exagerated, eleven o'clock would have worked equally well. I guess we shall see in a few years which approach was correct.

I just hope the vaccines achieve immunity and stop this pandemic. This is great news. Too bad it's not approved in the EU yet. Hopefully early next year.

I don't think that lockdown is an instant recipe for covid handling success. There are many countries that "performed poorly" despite going into lockdown.

Also, I think you are missing the point. The swedish strategy was based on people following the recommendations over a long period of time. Locking down is not a sustainable strategy, especially when you believe that the pandemic might last for several years.