What you need to know about Sweden's new local coronavirus recommendations

The Local Sweden
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What you need to know about Sweden's new local coronavirus recommendations
People might, for instance, be advised to avoid Stockholm nightclubs, such as Berns (pictured above in pre-coronavirus times). Photo: Stureplansgruppen

Starting on Monday, Sweden's regional health authorities have increased powers to ask for stricter coronavirus recommendations in response to local outbreaks.


What's happening?

From Monday, October 19th, regional health authorities in Sweden will be able to work with the Public Health Agency to issue allmänna råd, or 'general recommendations' to combat local coronavirus outbreaks. 

Previously, these recommendations have only been issued at a national level.
What are allmänna råd
Bitte Bråstad, Chief Legal Officer for the Public Health Agency describes the measures as "something in between regulations and recommendations". "You could say it's a 'strong recommendation'," she told The Local. 
The guidelines are not legally binding, so there are no fines for violating them. But they are not considered optional and apply to residents and visitors in Sweden alike, all of the time. 


How will they be applied in Sweden from this week? 
Local and regional authorities are not empowered to issue allmänna råd, but the Public Health Agency will work closely with them, giving them "a wide mandate to issue recommendations in their region".

Sweden's state epidemiologist Anders Tegnell will hold meetings with the worst affected regions in Sweden on Monday and Tuesday this week and work with them to to identify which measures would be most appropriate to their region. 
"You could say that the allmänna råd issued by the Public Health Agency will give the local authorities an extra support in combating the virus on the a regional level," Bråstad said.
Why is the change necessary? 
According to Bråstad, as the cluster-like spread of the virus has become more apparent, it has shown a need for more targeted local measures. 
"The need is based on our knowledge, what we now know about the nature of the virus and the it’s epidemiology, as well as... the virus’ ability to spread in clusters," she said.
"Having local differences in regulations could help combat local spreading more appropriately and effectively than imposing the same measures nationwide. Additionally, the intention is that the local allmänna råd should be in force for a short period only."
What recommendations can be made under the new policy? 
According to the new updated recommendations announced on October 13th, the authorities can instruct citizens to: 
1. Avoid travelling on public transport 
2. Avoid unnecessary travel outside the region or part of a region affected
3. Avoid visiting people in risk groups or who live in care facilities 
4. Avoid indoor environments where people gather, such as shops, shopping centres, museums, libraries, swimming pools, and gyms. Only supermarkets and pharmacies are excluded. 
5. Avoid meetings, concerts, lectures, sports training and competitions.
6. Avoid bars, restaurants and cafés
7. Avoid physical contact with everyone apart from those you live with. 
"They are rather far-reaching this time," Johan Nöjd, the infectious diseases doctor for the region of Uppsala, which has seen a sharp rise in infections, told The Local. "It's more of a lockdown situation, but a local lockdown." 
Johan Nöjd, infectious diseases doctor for the region of Uppsala. Photo: Nils Petter Nilsson/TT


What changes are we likely to see first and where?
It's likely that any new local recommendations will happen in the regions currently seeing the biggest rise in cases. In the week ending October 11th, four regions reported more than 50 cases per 100,000 residents: Jämtland, Örebro, Uppsala and Stockholm.

In Uppsala, Nöjd said contact tracing was not revealing a clear link to any specific environments, meaning he is likely to issue the less targeted recommendations, such as "avoiding public transport" and "avoiding visiting people in care facilities". 
"A problem here is that we don't see any specific milieu where the transmission of virus happens. It seems to be here and there: It's social activities, people going to afterworks, but also people gathering in flats in groups of four or five." 
"It's a little bit difficult for me to see which of these local recommendations would be applicable to Uppsala for the moment, because we don't see anything special for gyms or concerts," he said.
"But these transmission reports are coming in all the time, you can have 100 new ones in a day, so perhaps tomorrow we will have several talking about concerts or about restaurants, and then perhaps we could say that in Uppsala now for two or three weeks it is the Public Health Agency's advice not to be in restaurants late at night." 
He said that in Dalarna, where there were last month a series of outbreaks linked to ice-hockey matches and training, it might be appropriate to issue a regional recommendation to avoid ice hockey or group sports for two to three weeks.  
In Stockholm, where busy nightlife venue have also caused worries recently, the authorities might issue a general recommendation to avoid nightclubs. 
If there is a recommendation against visiting nightclubs, bars, or cafés in a region, will they close? 
They don't have to, but they might decide to do so of their own accord. This would likely depend on whether they can adapt to the new recommendations in a way that makes sense for the business, such as offering takeaway meals or spacing out tables, or whether it is more cost-effective to close while the recommendations are in place.


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