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The answers to your most-asked questions about the coronavirus outbreak in Sweden

The Local Sweden
The Local Sweden - [email protected]
The answers to your most-asked questions about the coronavirus outbreak in Sweden
Sweden hopes to increase testing capacity to be able to carry out over 20,000 coronavirus tests each week. Photo: Mikael Fritzon / TT

UPDATED: The situation around the coronavirus outbreak is developing quickly, which in many cases may lead to confusion or worry. We asked our readers what questions you had about the outbreak and reactive measures in Sweden, and we're working to answer them in this article.

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We have chosen to make this article completely free for everyone. Please support our coverage by considering joining as a member. Scroll to the bottom for more information.

If you've got a question, please fill in this quick form, and we'll update this article with the answers as we're able to respond to them, after checking with relevant authorities when needed.

Please note that we're not medical or scientific professionals, so if you have medical questions (such as whether your symptoms are consistent with coronavirus, or what treatment is suitable), please refer to Sweden's 1177 healthcare website or the Public Health Agency

Here are the questions we've answered so far:

What is the current situation in Sweden regarding the coronavirus outbreak?

The situation is changing fast, and we're reporting the daily updates in this article, while you can keep up-to-date with all our coronavirus coverage here. We update this Q&A article regularly, and you can see when it was last updated in the top left hand corner.

You can also find updates on KrisInformation, updated when authorities issue new guidance, and the Swedish Public Health Agency's website, updated once daily.

What do I do if I have symptoms?

If you have symptoms that are consistent with the coronavirus, including a dry continuous cough or a fever, you should stay at home and avoid social contact until you've been symptom-free for at least two days, according to the Public Health Agency. That applies even if the symptoms are mild, such as a slight cough.

Don't go to a hospital or doctor's surgery, but call 1177 if you're feeling very unwell (or the emergency number 112 if it's an emergency situation) and get advice from a medical professional.

If you have symptoms but are otherwise fit and healthy, consider avoiding the 1177 helpline and simply isolating yourself until two days after you become symptom-free. The helpline has had a much higher number of calls than usual recently, making it harder for people who need healthcare advice to get through, so you're advised only to call if you are feeling very ill.

If it's an option for you, check 1177's website instead, or take an online diagnostic test (currently in Swedish only). If you have symptoms but are otherwise in good health, it's likely that you won't be tested for the virus, as Sweden is focusing on putting its resources towards protecting the most vulnerable people in society.

But make sure that you limit contact with other people as much as possible if you get sick, to help limit the spread of the virus.

How similar is the coronavirus to the flu?

Some of the symptoms may be the same, but the coronavirus is not the same as the seasonal flu.

You can read an in depth explanation of why experts say the distinction is important here. One reason is the higher risk of serious symptoms and death from the coronavirus compared to seasonal flu; the coronavirus is also significantly more contagious according to current estimates, and there is not currently a vaccine.

As of March 26th, the 2019-2020 winter in Sweden had seen 7,740 diagnosed cases of flu (caused by three different influensa viruses) and at least 65 deaths. That's a milder season than earlier years.

By March 30th, over 4,000 cases of the coronavirus had been confirmed, and 180 deaths of coronavirus patients in Sweden.

How many people have been tested for the coronavirus in Sweden?

On March 30th, Prime Minister Stefan Löfven said that 36,000 people had been tested for the virus as of a few days earlier. The Public Health Agency has increased testing capacity and is now able to test up to 12,000 people per week.

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How many people is Sweden able to test per week?

As of March 30th, Sweden is currently testing between 10,000-12,000 people for the virus every week, and the same day the government announced that it had asked the Public Health Agency to increase testing. The goal is to carry out around 20,000-30,000 tests every week, with a focus on those in the healthcare sector, Health Minister Lena Hallengren said.

Why has Sweden changed how it is testing people?

Sweden has been adjusting its strategy as the outbreak developed. Initially, people who showed symptoms after travel to high-risk regions abroad or close contact with confirmed cases were tested, since these were the most likely cases in which the symptoms (which in many patients are similar to those of the common cold or flu) might be a sign of coronavirus.

Authorities also traced the movements of infected people in order to contact people who may have been exposed to the virus, and test them if it was deemed necessary. They said that when this was done, it was typically only the closest contacts such as family members or close colleagues who also tested positive, rather than for example others who had been on the same flight or train.


Representatives from Sweden's Public Health Agency, National Board of Health and Welfare, Karolinska Institute and Civil Contingencies Agency at a press conference on Monday. Photo: Pontus Lundahl/TT

But now the authorities have shifted their focus away from testing all possible cases, and instead on protecting the most vulnerable groups. People with severe respiratory symptoms or who belong to a risk group will still be tested. 

That means anyone who is generally healthy but has symptoms of the coronavirus (including a fever and cough) is advised to stay at home and limit social contact until they have been symptom-free for at least two days, but they may not be tested.

Sweden made this change following the first signs of community infection (cases that could not be linked to overseas travel or previously confirmed cases). This meant that contact tracing would no longer be as effective, since not all cases were accounted for, so in order to best prioritize resources, the Public Health Agency has shifted resources to focus on the most seriously ill or at risk patients.

The high worldwide demand for tests has prompted the EU's disease control authority to call for member states to save on resources.

Studies so far show that around 80 percent of people only experience mild symptoms, so if these people stay at home that both reduces the burden on the healthcare sector and prevents these people infecting others.

However, as of March 30th, Sweden was working to increase testing capacity. One of the major aims is to test more workers in the healthcare sector, which could mean more people in essential jobs could go back to work if it's established they do not have the virus.

How accurate are the statistics about confirmed case numbers in Sweden?

Because Sweden like several other countries is no longer testing every possible or suspected case of coronavirus, this means that going forward the number of confirmed cases will almost certainly be lower than the total number of cases in Swedish society.

That's because the government is no longer focusing on trying to completely contain the virus, but on halting or delaying its spread to reduce the burden on the healthcare sector and reduce the impact on society.

How prepared are Sweden's hospitals?

As of March 30th, all regions had spare capacity for hospital beds and intensive care beds.

The virus began spreading in Sweden later that in some other European countries, which bought time to prepare for the expected high number of cases.

Field hospitals have been set up in cities across the country; in Stockholm, a field hospital that would usually take three months to set up was ready within just ten days. This added 140 beds to the 450 already made available for those being treated for Covid-19. Only patients being treated for the new virus will receive care at the field hospital, and none had been treated there as of March 30th. If needed, it will be possible to expand the field hospital to hold 600 beds, and this is expected to be complete before Easter.

Will my access to running water, electricity or gas be affected by the coronavirus?

It's very unlikely to have any impact, authorities say.

The Local asked Maria Bergstrand, an operative manager from the Swedish Civil Contingencies Agency (MSB), if people needed to be prepared for power outages or loss of running water. Here's what she said:

"No, we don't think so. We are working with that, and have recommended to [the organizations and individuals who are responsible for provision of water and electricity] that they should be working with this right now, planning so that their organisation and work will be able to continue even if some staff are home sick, for example. We've been giving recommendations and support to these organisations," she said, adding that none of the relevant organisations had raised any concerns about their ability to continue so far.

Has anyone in Sweden recovered from the coronavirus?

Yes. Sweden's first coronavirus patient, a woman in Jönköping, was recovered and discharged from hospital in early March, healthcare officials told The Local.

The region's deputy infectious disease doctor told us that the Swedish Public Health Agency's official criteria for recovery are very strict, so even then she was not formally registered as recovered in Sweden's coronavirus statistics.

"Because this is a new kind of infection we are very keen to collect as much data as possible, so the follow-up of these people is quite long," he noted at the time.

Worldwide, more than two thirds of all confirmed cases have led to confirmed recovery so far. The vast majority of Sweden's patients have only experienced mild symptoms and can be expected to make a full recovery.

But the Public Health Agency does not currently publish statistics on the people who recover and are discharged from hospital or intensive care units.

Is Sweden implementing social distancing?

'Social distancing' refers to limiting social contact in order to reduce the spread of an infectious disease. It includes avoiding crowded spaces, cancelling events likely to draw crowds, working from home instead of at an office, and deliberately staying a certain distance away from other people in order to limit the spread of illness.

It's different from self-quarantine, which is when an individual limits all social contact after showing signs of the illness or otherwise being exposed to the virus. 

As of April 1st, Public Health Agency guidelines were expanded to include the requirement that everyone in Sweden "keep distance" from others in public spaces, and that organisations and companies introduce measures to make this possible -- such as limiting the number of people allowed in a shop at one time, and marking boundaries on the ground to ensure people keep their distance, for example.

Other earlier recommendations, including to follow good hygiene practices, work from home if possible, and avoid all non-essential travel, remain in place.

Elderly people and those in other risk groups have been asked to avoid leaving their homes as much as possible, for example by doing grocery orders online or asking friends, neighbours or relatives to run errands. And anyone who shows even the slightest cold- or flu-like symptoms is asked to self-isolate and avoid all social contacts.

These recommendations are part of Sweden's law on preventing the spread of infectious diseases, so individuals are obligated to comply, but there are currently no sanctions for individuals who violate them.

Sweden has also introduced a ban of events over 50 people, a national ban on visits to elderly care homes, and restrictions that mean cafes and bars can only offer table service and should space out their tables and seats. These bans are different from recommendations, and people and companies who go against them can face legal sanctions.

It's possible Sweden will introduce further measures in the coming weeks, particularly if the healthcare system starts to struggle with a rising number of cases.

But for now, there's a focus on asking individuals to take their own responsibility.

What's the difference between a ban and a recommendation?

The Public Health Agency is the authority responsible for issuing general guidelines, which are usually referred to as "recommendations". They expect members of the public to follow these recommendations, which include things like keeping a distance from others in public, practising good hygiene, working from home if you can, and avoiding non-essential travel.

The reason they're not called rules or bans is that there's no legal framework to enforce them or impose sanctions.

They are still part of Sweden's law on the prevention of the spread of infectious diseases, which obligates everyone to help halt the spread of infection. That means they are not optional.

The government can also introduce legislation in response to the coronavirus, and has done so. Most legislative changes have been to mitigate the economic impact of the virus on businesses and individuals. But the government has also introduced a few bans: these include rules around how cafes and restaurants must operate, a ban on public events over 50 people, and a nationwide ban on visiting elderly care homes.

In contrast to the recommendations, people found to be violating these government bans (such as organisers of events over 50 people, or a cafe that fails to follow the new rules) could face consequences such as fines, imprisonment or having their business shut down.

Can I visit elderly relatives?

No, you should avoid it if at all possible. The Public Health Agency has advised against non-essential visits to people in the over-70 age group, even if you yourself aren't showing any symptoms.

This is because this group appears to be most severely affected by the virus. People aged over 70 have been advised to stay at home as much as possible. If you do need to visit an elderly relative, for example to bring them groceries, the advice is to be extra careful about hand hygiene and keep a two-metre distance.

You should certainly check in on elderly relatives and neighbours, and if you are symptom-free and healthy, you might consider checking if you can carry out errands such as grocery shopping or collecting items from a pharmacy (you will need to register as a proxy to collect prescription medicines) for them. And of course, you can have phone and video calls.

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Why hasn't Sweden closed schools?

This was a very common question from our readers, with many pointing to school closures in multiple other countries.

On March 17th, the Swedish government and Public Health Agency said they would recommend schools for upper secondary education (gymnasie level, which includes children aged 16 and older) to close, as well as universities and municipal education for adults (komvux). This took effect on March 18th.

Schools are urged to introduce distance teaching, to ensure that children are still able to receive their education. University students will still be able to receive student loans, even if their distance courses are cancelled, Minister for Higher Education Matilda Ernkrans told a press conference on March 17th.

The decision is technically a "recommendation", but it is assumed that schools will follow it.

Schools for younger children may be told to close at a later stage, according to authorities, but it is not seen as an effective measure in terms of containing the virus at this stage. This is both because of the nature of the virus (children appear to be affected to a lesser extent than older adults) and because of the societal impact.

"It is not possible to just close schools without knowing where the children are going – for both social, psychological but also infection prevention reasons," the agency's general director Johan Carlson said at a press conference on March 13th.

"Many parents with important jobs for society, for example those working in healthcare and welfare would have to stay at home with their children. It is not possible at the moment to replace the parents with the grandparents, which is perhaps otherwise common," he said.

Sweden has fast-tracked legislation that enables municipalities to offer child care for parents in essential jobs, such as healthcare and welfare, if all schools do end up having to close. This was not previously possible, because Swedish law states that everyone must be treated equal.

Swedish ministers and the Public Health Agency have warned that further decisions to close all schools could come at a later stage as the infection spreads. It is already possible for individual schools to close if there's an outbreak at that particular school, or if so many teachers fall ill that it is not possible for classes to continue.

Some schools have already made the decision to close. Municipalities (which are responsible for state schools) and the boards of privately-run schools have been given extra decision-making powers allowing them to introduce their own measures to deal with the outbreak. That could include changes to the length and timing of the school year for example, or the introduction of distance learning.

Can my child's school send them home for having a cough?

Yes, schools have the right to ask a parent or guardian to collect their child if the child is sick. 

Normally this measure probably wouldn't be taken with a mild symptom such as a cough or sore throat, but the Public Health Agency advice is that anyone with even mild symptoms should stay home for as long as they display these symptoms and for at least two days after becoming symptom-free.

This is because even if children aren't thought to be seriously affected by the coronavirus, they may still pass the infection on. 

Can I get a refund if an event I bought tickets to is cancelled due to the virus?

Sweden has banned all events for over 50 people, and many organisers even of smaller events are choosing to cancel to reduce the spread of the virus.

If you booked a ticket before the ban came into effect and you bought it directly from the event organiser, you are typically entitled to a refund if the organiser cancels the event. If they postpone the event and offer to rebook you to a new date, you are not obliged to accept this.

If the company goes bankrupt however, it can be harder to get this money. 

If you need help, you can contact the independent consumer organisation Hallå Konsument or a municipal consumer adviser (details here). If the company won't admit fault, you can file a report with Sweden's National Board for Consumer Disputes (ARN), which will assess the case for free if a business has rejected or failed to respond to a complaint.

Can I travel overseas, and if I do will I be able to come back to Sweden?

The Swedish Foreign Ministry is currently advising against all non-essential travel overseas. This advice is in place until at least April 14th.

This follows previous advice not to travel to China's Hubei province, and to avoid all non-essential travel to other parts of mainland China, as well as to all of Iran, all of Italy, to the town Daegu and Gyeongbuk Province in South Korea, and to the federal state Tyrol in Austria. You can find the latest travel advice here.

It's worth noting that those earlier region-specific restrictions were due to the risk posed by the widespread outbreaks in those regions, while the general advice against overseas travel is more to do with the general uncertainty over the situation.

Sweden does not require a quarantine for symptom-free returning travellers.

On March 19th, Sweden implemented an entry ban for non-EU citizens, falling in line with an EU-wide ban on entry to Schengen countries.

Swedish citizens and residents are still able to return to Sweden. The entry ban does not apply to EU/EEA citizens, nor does it apply to people who can demonstrate a particularly important reason to travel to Sweden, for example "diplomats, people in need of international protection and people who are to perform necessary functions in Sweden, such as healthcare staff and people transporting goods to Sweden".

Many travel operators, including TUI, Ving and Apollo, had previously cancelled their trips between now and April 14th, but will bring home those who are currently on a trip overseas.

It's also worth bearing in mind that large numbers of flights are cancelled worldwide due to the uncertainty over the coronavirus, the fast pace of change, and entry restrictions in many other countries.

If you decide to travel abroad, be aware that your travel insurance will likely not apply if you go on a non-essential trip despite the Foreign Ministry restrictions, and you should keep up-to-date on the situation.

Can I travel within Sweden by train? What about over the Öresund bridge?

As of March 19th, the Public Health Agency has recommended against non-essential travel within Sweden. That includes planned vacations and visits to family or summer houses.

Some train companies have made changes to their services, and rail operator SJ has changed its rules around rebooking.

This means that if you have a booked trip with SJ, you can cancel it and get a voucher of the equivalent amount, to use for a future trip. That applies even if you had a non-refundable ticket, and it applies to all journeys booked from 2pm on March 19th to April 19th.

SJ had already announced it would be running routes at reduced capacity, cancelling one in four trains across the country, and advised any travellers with cold or flu symptoms to stay at home. Future changes to timetables are likely. You can keep up with the latest SJ traffic information here.

MTRX, which runs train services between Stockholm and Gothenburg, is offering all passengers who book from now until the end of April a free empty seat next to them, and is also offering free cancellation on many tickets.

Denmark has closed its borders, which means that only people with a special reason (details here) can cross the Öresund bridge to reach Denmark from Sweden. People who live and work in Denmark will still be allowed in, including cross-border workers based in Sweden, but people based in Sweden will no longer be able to use Copenhagen Airport (other than for inbound flights in order to return to Sweden).

SJ is offering free re-booking or a full refund on any tickets for train journeys from Sweden to Denmark which are affected by the border closure. You just need to make sure to apply for the refund or re-book before your scheduled departure time.

Is there any change to public transport within Sweden?

As of March 30th, there were no major changes to the scheduling of Sweden's local public transport, but some regions were adjusting their rules. Under Public Health Agency guidelines, people who are showing any cold- or flu-like symptoms (including a cough or sore throat, for example) should stay at home and avoid public transport altogether.

Stockholm's public transport operator SL has asked passengers to get on buses at the back door (usually reserved for passengers getting off, and people with pushchairs) to avoid close contact with the driver, and to spread out through the vehicle. The company has also asked passengers who need to travel to make their trips outside rush hour where possible, and not to board buses that look full -- there are more buses in circulation than those visible on the SL app, it said.

Some changes have been made in Stockholm to buses, ferries, trams and trains, but so far the subway and commuter trains have not been affected.

In Västra Götaland, some routes are affected due to a staff shortage, but otherwise there are no changes. 

And in southern Sweden, Skånetrafiken has heavily reduced traffic across the Öresund Bridge after Denmark closed the border, and is offering passengers refunds on period tickets to Denmark, but there were no other major changes. 

How can I help others in Sweden during the outbreak?

People most at risk, namely the elderly and those with certain pre-existing conditions, are being urged to stay home as much as possible and to get help with errands such as grocery shopping. People who experience symptoms of the virus are also asked to stay at home, to avoid infecting others.

It's possible to order items online, but for many shops delivery times are currently longer than normal due to high demand, and it's also possible to pick up prescription medicines for someone else if you first register as a proxy.

Several groups have been set up by people keen to help others, particularly in terms of delivering food and groceries. If you are able to help, or if you need help, you can join the group and state where you are and what help you need or can offer. You might be able to find a group for your neighbourhood by searching 'corona', 'coronavirus' or 'hjälp' ('help') plus the name of your city or neighbourhood on Facebook.

If you need help and go through one of these groups, please use caution. While the majority of offers of help are likely to be genuine, it's possible that scammers will exploit the opportunity. Try to check that the person's profile is genuine and get some information about them before sending them a payment, for example.

Small businesses are typically most vulnerable to economic crashes. If you're in a position to do so, supporting these businesses is a way to help your local community and the economy.

If you can continue to shop, order online, buy gift cards for restaurants or cultural organisations, this will help the businesses survive the uncertainty. And many businesses are offering extra services to support their communities during the coronavirus outbreak.

You can read more about ways of helping others in Sweden in this article.

***

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We hope our paying members understand why we have chosen to make these articles about the coronavirus free for everyone, but if you have any questions, please let me know.
 
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Editor, The Local Sweden

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