SWEDEN'S CORONA EXCEPTIONALISM

NA 2020-04-02

write.as/nickaylott/swedish-corona-exceptionalism

Sweden has long been seen as exceptional, in both positive and negative ways. But it has probably never deviated from the European norm as starkly as now. While the rest of the continent has locked down to stem the spread of coronavirus, life in Sweden remains much closer to normality than in almost any other European country. (So does life in Belarus, but that's a bit different.)

Yes, restrictions are in place, and they are gradually tightening. Universities and colleges have gone over to providing distance learning. Ten days ago, public gatherings of more than 50 people were prohibited (although private firms and other businesses can break that limit if they want). Stockholmers have been asked to work from home if they can. People have been urged not to travel to and from the bigger cities. The economy is suffering badly, as elsewhere. But shops, hairdressers, gyms, restaurants, bars and, crucially, public-sector schools are open. Kids' outdoor activities are still mostly on.

The Swedish Public Health Agency has explained that its goal is to slow the spread of the virus sufficiently to keep public healthcare – the capacity of which is, as elsewhere, being rapidly extended – from becoming overwhelmed. This, of course, was the British, Dutch, Finnish and Swedish strategy of mitigation. Or at least it was, until Britain, Finland and the Netherlands abandoned it, and switched to suppression.

How to explain this Swedish deviation? Why do the Swedish authorities remain attached to the mitigation strategy when no one else does? Why do they still think it can work in Sweden?

Is Sweden different?

It could be that Sweden is different to those places in Europe in which coronavirus has already proved so devastating. Swedes are generally younger, fitter and leaner than most Europeans. They smoke less. They live in smaller households; indeed, households containing more than two generations are very rare. As one shrewd Swedish historian put it, "social distancing is basically a national characteristic".

On top of that, some Swedes think that their values are seeing them through.

Swedish public health officials can often sound very vague in their recommendations. They are aware of this, but they emphasise the importance of individual responsibility. Curiously, this approach has stimulated a burst of nationalist sentiment. An example could be heard yesterday in "Tankar för dagen" (Thoughts for the day) on Swedish radio's morning news programme (akin to the similarly named slot on the BBC's Today programme, only longer and even more pointless). The crisis had made the contributor feel "extremely proud to be Swedish", she said, partly due to the "respect for science" displayed in its public policy. A columnist wrote triumphantly of Swedes' "different traditions [to those in other countries], uniquely high trust in each other and a consensus that the team comes first". When you have such assets, he argued, it becomes "more efficient to explain to people why they should do things, rather than sending the military onto the streets" – which is presumably what the rulers of less virtuous societies are forced to do.

Well, perhaps. This supposed libertarian tradition, in which people don't need to be compelled by the state to do the socially responsible thing, chafes somewhat against the vast battery of Swedish laws that regulate such central parts of life as drinking, work, parenting and even sex. In those areas, people obviously can't be trusted to do the socially responsible thing.

But let's leave aside what Swedish values actually entail. The question is, could belief in them nevertheless help to explain the Swedish corona strategy? Partially, yes. The authorities very probably reckon that a combination of Sweden-specific factors – good health, demographics and public-spirited (or maybe deferential) values – will be enough to keep coronavirus manageable.

Yet even that doesn't quite clear up the mystery. OK, it could be that bigger European countries have different corona challenges, so there could be good reasons why Sweden's policy differs from theirs. But what about comparison with the other Nordic countries? The Swedish authorities cannot possibly believe that their measures are more effective against the virus than the much harsher ones imposed in Denmark, Norway and Finland, with comparable geographies, societies and exposure.

The only possible inference is that the Swedish authorities reckon that their measures are as effective as they need to be, and no more. In other words, they must think that coronavirus is less dangerous than their neighbours do, and that those neighbours are wildly overreacting. As two academic epidemiologists have noted, "the Swedish government anticipates far fewer hospitalisations per 100,000 of the population than predicted in other countries, including Norway, Denmark and the UK".

But we are still really just describing the different policies. We still don't have an answer to the question of why these differences have occurred. Might it have something to do with the way that countries take decisions?

Non-political policy

A frequently rehearsed argument in Sweden is that its decision-making on this difficult issue is protected from politics. "It is important for politicians to flex their muscles [a loose translation of the word dådkraft], and it has become almost a competition [in the rest of Europe] to implement the most drastic measures," claimed Sweden's former chief epidemiologist. The media, he continued, "also play a part" in promoting the spread of unscientific policy: "why aren't we doing in our country what they've done in country X?" I have heard more than one acquaintance make the same criticism of other countries' way of making anti-virus policy.

It is probably true that Swedish policy-making is less political than it is elsewhere. The country has a nearly unique relationship between politicians and bureaucrats. By tradition, the government sets the broad direction of public policy, but a raft of independent authorities, or agencies, have operational responsibility for implementing it. In Britain, we talk of "ministerial responsibility" for everything that a certain government department does. Sweden, by contrast, is allergic to "ministerial steering".

In my view, this bureaucratic autonomy is currently accentuated by a weak minority government and an unusually passive prime minister. The results are quite visible.

The daily press conferences on the effects and spread of the virus are not fronted by ministers, as you might expect, but rather by civil servants. In this crisis, the Public Health Agency, and particularly the current chief epidemiologist, have assumed the sort of leadership roles that politicians elsewhere would take. Every few days, it is true, the prime minister has led government press conferences. But ministers have said explicitly that they are waiting for requests from public officials before they act. One columnist has observed that the customary relationship between politicians and bureaucrats has somehow been turned upside down in Sweden.

So, at last, we might have a plausible hypothesis about Swedish exceptionalism. The authorities, taking into account specific local circumstances, have calibrated what they see as a balanced policy of mitigating coronavirus. That all the neighbours are doing things differently doesn't bother those Swedish authorities, because they are protected from politicians' panic and unscientific impulses.

Bring back the politicians?

Fine. But who is right? Have Sweden's neighbours overreacted? Or has Sweden under-reacted? No one can tell – yet. In my view, though, there is no guarantee that insulation from politics will bring better policy outcomes.

It has been a bit odd to see many on the Swedish left (though not all) defending rule by experts rather than rule by democratically elected politicians. The same columnist who wrote about the wonders of Swedish traditions has, in another article, accused critics of the Public Health Agency's preferred direction of being "populists", because they are not qualified epidemiologists. (His main target was the editor of the most influential newspaper, Dagens Nyheter.) However, the agency also has plenty of critics who are epidemiologists.

Any organisation can become over-protected. It can suffer from "groupthink", in which challenges to established truths become practically impossible, despite changing circumstances. Could that perhaps have happened at the Public Health Agency?

Its track record during the coronavirus crisis is not unblemished. Earlier on, the chief epidemiologist could sound rather dismissive of the danger, only to backtrack later. On their return from half-term breaks in the Alps, Swedes were told not to self-isolate unless they were unwell, which sounded unconvincing even then. His injunction to Stockholmers to work from home came three days after he had criticised firms for allowing their employees to do exactly that, on the grounds that it wasn't fair on workers who couldn't do it.

Then there was the part that he played in the decision, 11 years ago, to recommend mass-vaccination of the entire Swedish population against swine flu. No other state did that. The vaccine hadn't been tested thoroughly enough, and hundreds of youngsters were left with awful, permanent handicaps. You can't help thinking that, in most other countries, such a disaster would have put more of a constraint on the subsequent careers of those responsible for it.

Indeed, come to think of it, this current pandemic is the third international crisis in 11 years in which Sweden has found itself out of step with other European countries. There was swine flu; there is coronavirus; and, in between, there was the mass migration of 2015. Do they have something in common? Are public officials really the right people to weigh up conflicting public interests and make the really big calls? Could it possibly be that Swedish crisis-management suffers not from too much political influence, but rather too little?

In this case, I hope not. Time will tell!