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Opinion: Sweden, don’t gamble with patients’ coronavirus symptoms

Swedish healthcare professionals must be careful not to dismiss the experience of coronavirus patients since we still know so little about the virus, writes Lisa Bjurwald in her column for The Local.

Opinion: Sweden, don't gamble with patients' coronavirus symptoms
File photo of a rehabilitation clinic for coronavirus patients in Sweden. Photo: Pontus Lundahl/TT

62 days. 78 days. 90 days. Weeks, then months of being bed-ridden with a high fever and chest pains, out of breath from trying to grab a glass of water. A large, unknown number of Swedish residents are suffering from drawn-out cases of confirmed or suspected Covid-19.

Now, as journalist colleague Agnes Arpi and I can report in today's ETC daily newspaper, there's another factor to add to their mutual list of ailments: doctors brushing off their symptoms as anxiety or stress.

Swedish healthcare has a high overall standard. Indeed, many foreign residents (not least those coming from countries where specialist care is expensive or inaccessible) still extol the virtues of Sweden's mostly free healthcare, even though it has simultaneously fallen to the bottom of many international surveys.

A case in point: Before the pandemic, Sweden had the lowest number of available hospital beds relative to population in the entire European Union, something the Swedish Medical Association has slammed as “a disaster”.

There's also been a large increase in the time you have to wait for planned surgery. According to the so-called Vårdgarantin ('care guarantee'), the maximum waiting time is supposed to be 90 days. In 2019, almost a third of patients (29 percent) had waited longer than that – up from 12 percent in 2012.

But when the Swedish healthcare system works, it often works brilliantly. That's why this phenomenon is so shocking.


A temporary coronavirus testing tent set up outside Södertälje Hospital. Photo: Pontus Lundahl/TT

In Facebook groups for Covid sufferers and our extensive interviews, affected men and women of all ages and backgrounds share nightmarish stories of having their Covid symptoms ignored and put down to anxiety, stress or depression by the medical profession. One recent poster was even sent to the emergency psychiatric ward.

This in the middle of a pandemic now declared the worst global health emergency the WHO has ever faced. Many of the displayed symptoms should be well-known by doctors and nurses by now, and many are hard if not impossible to fake, such as low oxygen levels, fever and a lack of taste and smell.

“You just don't want to go to work, do you?” pre-school teacher Åsa was humiliatingly told by her local GP. “But I love my work,” she exclaims in our interview. “I even miss ‘my' kindergarten kids when I'm on holiday!”.

Another woman, a young Stockholm-based mother of two, was formally diagnosed with anxiety. After insisting for months, sometimes despairing and even agreeing to try online therapy at one point, she was finally allowed a lung x-ray examination. It turns out she was likely to have had several blood clots in one of her lungs (a well-reported sign of Covid-19). As one interviewed doctor admits, undiagnosed and untreated blood clots in the lungs could result in death.


Coronavirus antibody tests. Photo: Johan Nilsson/TT

Whether all of the numerous long-term sufferers can be proven infected or not is beside the point. For starters, the current antibody tests and the conclusions drawn from them have come under heavy criticism lately, as they seem to fail to pick up a sign of infection in those who fell ill at the beginning of the outbreak.

American scientists have even reported that the tests we have to make do with for now can fail to detect an ongoing infection. Many of those who've been sick for months have beaten the virus itself, but are suffering from the severe after-effects science is only just beginning to chart and understand, ranging from lingering tiredness to frightening neurological damage.

All of this means that the experience of patients should carry more weight than in normal, non-pandemic times. The Swedish medical profession needs to be humble in the face of this. They should admit that they're still learning about the virus, keep an open mind, and show empathy for the afflicted.

And here's the part where the individual resident in Sweden can make a difference.

Almost all of our interviewees tell us that they've hesitated seeking help because they didn't want to burden the Swedish healthcare system. Having seen the media's dramatic footage of people gasping for air hooked up on ventilators, they all reasoned that “well, I'm not actually dying, so I'll wait a little longer…”.

It's a sympathetic attitude, of course, but counter-productive. Better safe than sorry, especially now that our emergency wards aren't as strained as during the first stretch of the pandemic.

From a societal standpoint, it's a bad idea not to keep track of thousands of individuals who could be contagious. Every single person sent back to work like Åsa risks infecting several others, even starting a local cluster of Covid infections.

Thus, you could argue that it's your moral responsibility to get any symptoms of Covid-19 checked up. And if the doctor claims your headache, cough and high fever are probably just stress-related? Call the press – why not The Local.

Lisa Bjurwald is a Swedish journalist and author covering current affairs, culture and politics since the mid-1990s. Her latest work BB-krisen, on the Swedish maternity care crisis, was dubbed Best reportage book of 2019 by Aftonbladet daily newspaper. She is also an external columnist for The Local – read her columns here. Do you agree or disagree? Share your thoughts in the comments below.

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OPINION & ANALYSIS

‘Chemical crayfish’: Why does the Swedish media love killjoy festive news?

It's time for this year's "kräftskivor", Swedish crayfish-eating parties! A cause for celebration? Not if the Swedish media has its way.

'Chemical crayfish': Why does the Swedish media love killjoy festive news?

Sweden’s main newswire this week ran a story warning that an analysis of the eight brands of Swedish crayfish available in the country’s supermarkets contained elevated levels of PFAS, a persistent pollutant which can damage your liver and kidneys, disrupt your hormones, and even cause cancer. 

But don’t worry. If you weigh 70kg or more, you can still safely eat as many as six of the outsized prawn-like crustaceans a week without being in the risk zone. 

While I’m sure the news story, which was covered by pretty much every paper, is accurate, it is also part of a grand Swedish media tradition: running miserable, killjoy news stories whenever there’s a sign that people might be planning to have a bit of festive fun. 

The two public service broadcasters, Swedish Radio (SR) and Swedish Television (SVT) are by far the worst offenders, their reporters unusually skilled at finding a downbeat, depressing angle for every public celebration. 

To give readers a sense of the genre, we’ve spent half an hour or so searching through the archives. 

‘This is how dangerous your Christmas tree is’ (and other yuletide cheer)

Source: Screenshot/SR

Christmas is a time for good food, drinking a little too much, and cheery decorations to ward away the winter darkness. But have you considered the risks?

SR has.

In “This is how dangerous your Christmas tree is”, a local reporter in Kronoberg looked into the possibility that your tree might have been sprayed with pesticide, or if not, might be covered in pests you will then bring into your house. 

By far the most common recurring Christmas story reflects Sweden’s guilt-loaded relationship with alcohol. 

You might enjoy a few drinks at Christmas, but what about the trauma you are inflicting on your children?

In this typically festive report from SVT in Uppsala, a doctor asks, ‘why wait for the New Year to give up alcohol? Why not start before Christmas?’, while the reporter notes that according to the children’s rights charity BRIS, one in five children in Sweden has a parent with an alcohol problem, with many finding drunk adults both “alarming and unpleasant”. 

God Jul! 

The Swedish media finds ways to make you feel guilty about the food you eat at Christmas too. You might enjoy a slap-up Christmas dinner, but what about those who suffer from an eating disorder? SVT asked in this important, but less than cheery, story published in the run-up to the big day. “This is the worst time of the year,” Johanna Ahlsten, who suffered from an eating disorder for ten years, told the reporter. 

Don’t you just love a cosy Christmas fire? Well, perhaps you shouldn’t. A seasonal favourite in Sweden’s media is to run warnings from the local fire services on the risk of Christmas house fires. Here’s some advice from SVT in Blekinge on how to avoid burning your house down. 
 
Those Christmas lights. So mysigt. But have you ever added up how much those decorations might be adding to your electricity bill? SVT has. Read about it all here
 
Finally, isn’t it wonderful that people in Sweden get the chance to go and visit their relatives and loved ones over Christmas.
 
Well, it’s wonderful if you’re a burglar! Here’s SVT Jämtland on the risk of house break-ins over the Christmas period. 
 
Eat cheese to protect your teeth! and other Easter advice 
 
 
“Eat cheese after soda”. Good advice from Swedish Radio. Photo: Screenshot/Richard Orange
 
For the Swedish media, Easter is a fantastic opportunity to roll out all the same stories about the risks of open fires and alcohol abuse, and that they do. But the Easter celebration has an additional thing to be worried about: excess consumption of chocolate and sweets. 
 
Here’s Swedish Radio, with a helpful piece of advice to protect your teeth from all that sugary ‘påskmust’, Sweden’s Easter soft drink. “Eat cheese!”. 
 
Yes, you and your children might enjoy eating all those pick-and-mix sweets packed into a decorated cardboard egg, but have you thought who else has had their grubby hands on them? SVT has. In this less than joyous Easter article  a reporter gives viewers the lowdown on “how hygienic are pick-and-mix sweets?” (According to the doctor they interview, sugar acts as an antibacterial agent, so they are in fact less dangerous than the newsroom probably hoped). 
 
Perhaps though, it’s better to avoid those unhealthy sweets altogether, and instead cram your mouth with healthy raw food alternatives, as SVT advises in this Easter report
 
Aren’t daffodils lovely? Well they’re not if you’re a dog. They’re deadly, according to this Easter report from Swedish Radio on all the “dangers lurking for pets over Easter“.
 
Glad Påsk!
 
Midsommar drowning  
 
Midsommar, again, has all the same possibilities for worried articles about excess drinking etc, but in the summer there’s the added risk of drowning. 
 
From Midsummer until the start of August, the temp reporters who take over Sweden’s newsrooms as everyone else goes on their summer holidays churn out a steady stream of drowning stories, all of them with a slightly censorious tone. After all, most of these accidents are really about excess drinking.
 
Here’s SVT Västmanland tallying up the Midsummer weekend’s death toll in a typical story of Midsommar misery. 
 
So, what is the reason for the Swedish media’s taste for removing as much mirth from festivities as possible?
 
It’s partly because Sweden’s media, unlike that of many other countries, sees its public information role as at least as important as entertaining or interesting readers, so an editor is likely to choose a potentially useful story over a heart-warming one. 
 
This is the aspect of the Swedish media beautifully captured by the singer Lou Reed when talking about how he’s more scared in Sweden than in New York in the film Blue in the Face
 
“You turn on the TV, there’s an ear operation. These things scare me. New York, no.” 
 
But it is also reflects the puritanical streak that runs straight through Swedish society, leading to a powerful temperance movement, which meant that by 1908, a staggering 85 percent of Socialist parliamentarians in Sweden were teetotallers.
Sweden is now a liberal country where you can get good food and drink, and enjoy a decent nightlife, but sometimes that old puritanism bubbles up.
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