Explained: What's going on with Sweden's changing advice for close contacts of coronavirus cases?

The Public Health Agency's recommendations now state that people who have had close contact with someone who has tested positive for the coronavirus should take the following steps:

• Avoid close contacts with other people for 14 days
• Try to keep at least an arm's length distance from the sick person, if you share a household with them
• Work from home if possible
• Keep a close lookout for coronavirus symptoms (and stay at home if you experience any)

The first two points were a change from what had previously been advised, and the Public Health Agency confirmed to The Local that the latest guidance came into effect on July 23rd, following new guidelines for contact tracing, aimed at regional healthcare authorities.

But the agency's advice page for people whose family members are sick was only updated on September 1st.

Up until that date, it had stated that symptom-free family members should "do as normal and go to preschool, school or work, but at the same time be especially attentive to other symptoms". There was no mention of avoiding close contacts during the incubation period, and no specific advice for people who had been exposed to Covid-19 outside their household. 

The section advising people to "do as normal" was removed from the Public Health Agency's website on September 1st, before being replaced three days later with the guidelines that had come into effect over a month earlier. 

When The Local asked why the website was updated, a press spokesperson for the agency told us: "The page was updated with the current recommendations, since the old ones were still there."

"The content on the Public Health Agency's website is constantly being worked with, and during a review of the Covid-19 pages it was discovered that this text was not updated," they said.

Asked how the outdated information came to remain on the website more than a month after the guidelines changed, he said: "We missed updating this page."

Asked if the public could trust that all the guidelines on the website were now up-to-date, the spokesperson said: "Yes. We are constantly working on keeping our information up-to-date and accurate, but the state of knowledge about Covid-19 is constantly improving. For that reason some of our material on the site is constantly changing."

Advice on the 1177 Vårdguiden (healthcare guide) website and emergency services website Krisinformation until early September also advised family members of Covid-19 patients to act as normal if symptom-free, with no guidance to avoid close contacts.

Both websites were updated on September 4th, and a press spokesperson from 1177 told The Local that the guidance had been updated that week.

A drive-through coronavirus self-test at a distance in Lund. Photo: Johan Nilsson/TT

What about work that can't be done from home?

The advice to avoid close contacts during the incubation period but to work from home only "if possible" might seem contradictory, particularly for those whose work requires close contacts with others.

Everyone in Sweden is currently advised to work from home if possible until at least the end of 2020. That applies regardless of your job, risk level, or contacts, but it is subject to what is agreed between employees and their workplaces. 

People whose jobs cannot be done from home will in general still be going into work (although those in risk groups are eligible for compensation if they cannot do so), while other workplaces require employees to come into the office at a limited timetable or for certain meetings or tasks.

• Can my boss force me to return to the office?
   
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• What should you do if your workplace doesn't feel coronavirus-safe?

The Local asked the Public Health Agency if the guidelines should be interpreted as a stronger recommendation to work from home for people who have been in contact with someone who has Covid-19. We gave the example of an employee who has been told by their employer they should be physically at the workplace two days a week or for certain meetings, but whose job could be done from home if necessary.

"It's not possible to say something specific since it's very different from case to case. What both employers and employees should follow is as normal our general guidelines. We also write this on the page Om du eller någon i familjen har blivit sjuk (If you or someone in the family gets sick): We recommend that as many people as possible work from home during the autumn. Home-working should be chosen in agreement with the employer so that the business is not hit by negative effects. For the employer, it is important that home-working is carried out with consideration to work environment. If you have met someone who has Covid-19 you should work from home if it is possible," a press spokesperson for the agency responded.

The virus can be spread through droplets, for example when an infected person coughs, talks or eats. Photo: Gorm Kallestad/Scanpix/TT

Should we expect more changes to the advice?

Yes. In early September, the Public Health Agency said it was investigating stricter instructions for household members of people who test positive for the coronavirus. 

What's more, the instructions which people receive after testing positive may vary depending on which region you live in.

Although the national guidelines come from the Public Health Agency, it is Sweden's 21 administrative regions that make decisions on healthcare, and a recent survey by Swedish public radio showed that the instructions vary. This means that in some parts of Sweden, people who receive a positive test are urged to avoid leisure activities or shops, where they may come into contact with other people, but in other areas healthcare providers do not pass on this instruction.

• How coronavirus advice for close contacts varies depending on where in Sweden you live