Opinion: One year and one million cases later, Sweden still has a Covid communications problem

Clear, sustainable measures that would be easy for the public to understand and stick to long-term; that was supposed to be the hallmark of Sweden’s coronavirus strategy.

But over the past year, recommendations have often been vague or even appeared contradictory. At the time of writing, around two thirds of regions have local recommendations on top of the national ones, two of them urging people to enter a "personal lockdown", some saying that all non-essential travel and visits to shops should be avoided, but others varying.

Unlike many countries, no consistent system regulating which measures are introduced at which point has been made public (when The Local asked in February if authorities could give examples of which specific data or metrics would be looked at to decide whether to introduce further measures, Health Minister Lena Hallengren said “No, we can't”).

This is exacerbated by the fact that its recommendations have at many times differed significantly from those elsewhere.

Authorities did not mention social distancing until around a month after it was being enforced in much of Europe; businesses have remained open with limits on opening hours and customer hours only recently introduced; face masks were not recommended until December (and then only on weekdays in rush hour, though many regions have urged their use in all indoor environments). 

More than a year ago, several experts spoke to The Local and warned of the risk of unclear communications around the coronavirus and how to curb its spread. Later in summer, columnist Lisa Bjurwald summed it up in a piece arguing "rules can't be lagom".

Sweden: Why would we close stores due to a pandemic? This is a secular society. Only science matters. Science says they can stay open.

Also Sweden: You are forbidden from purchasing alcohol today in recognition of the Crucifixion.

— Ian Higham (@highamian) April 2, 2021

As this Tweet points out, in other areas Sweden's rules are very clear-cut.

But despite law changes increasingly being used as part of Sweden's raft of Covid-19 measures, the recommendations for private individuals remain extremely vague, left open to interpretation – for example, that people should limit social contacts by socialising only "in a smaller circle", with "the people you normally meet".

Leaving some room for flexibility helps people to adapt to their circumstances, for example so that people living alone aren't isolated, but this is too open to interpretation. To some people, it could easily be read as "carry on as normal". Although the government has, since December, pointed to eight as a suggested maximum for gatherings, the Public Health Agency has mostly steered clear from giving numbers, even as a guide. 

Of course in any country you will always get people who choose not to follow guidance.

But as a starting point, the "what" and the "why" need to be clearly explained. In a situation where every individual's actions could affect a chain of other people, it's not enough to expect people to take responsibility without telling them what that means.

It's not only the public that has been left confused. Prime Minister Stefan Löfven was criticised for shopping trips when this was against Stockholm's restrictions; the director of the Civil Contingencies Agency resigned (but kept his salary) after travelling to see his daughter in Spain against advice to avoid "non-necessary travel". Despite resigning, he insisted his trip had been in line with guidance because he judged it to be "necessary", highlighting the difficulties in delegating risk assessment to private individuals.

As well as some of the guidance being vague, at several points during the pandemic, the overall message has been dampened by restrictions being relaxed just as the incidence rate rises.

This is partly down to the slow-moving nature of Swedish bureaucracy, with no option for a peace-time state of emergency. Having checks in place is a good thing for democracy, but here it has led to mixed messaging.

Additional recommendations for over-70s and risk groups were scrapped in late October, with no corresponding tighter measures for the general population, just as cases were rising in the early second wave. 

Just weeks later, the maximum number of people allowed at some seated events was raised to 300, at the same time as regions began introducing local tighter restrictions in an effort to curb the sharp rise in cases. As a result, the change to events never really took effect. 

Those regional restrictions themselves have had peculiar differences between regions. In some regions, and not always those with the highest infection rates or new variants, people are told to avoid all non-essential travel, or to avoid non-essential visits to indoor public places altogether, but that doesn't apply to other regions.

Recently, regions complained of poor timing after authorities said people who were fully vaccinated could "expand their circle of close contacts slightly". The government and Public Health Agency later clarified that people should still limit those circles to "small groups" in line with the general recommendations, rendering the updated guidance irrelevant. Several regions have warned vaccinated people not to expand their circles.

Sweden has allowed eight fans into games at football grounds recently, but there are no such limitations on indoor shopping centres. Which is where AIK fans went to protest (via @Xolazi) pic.twitter.com/VAOksjckFU

— Guardian sport (@guardian_sport) May 4, 2021

Sweden is certainly not the only country that has struggled to get its message across in an understandable way.

Elsewhere, limits on how many people can meet and in which circumstances, when and for what purpose you can leave your home, have changed at short notice, confusing members of the public trying to keep up.

But there has to be a middle ground: clear communications, explaining simply how Covid-19 spreads, and how different measures have an impact. 

Some of the clearest explanations I've seen are the BBC's explanation of what's called the Swiss cheese model (showing how no measure gives full protection, but they can work together) and interactive explanations from El Pais (in English) on how the virus spreads in indoor environments and how to reduce the risk. 

State epidemiologist Anders Tegnell and others behind the strategy have been questioned repeatedly about whether it's time for stricter measures.

The answer is generally the same: "We don't need stricter measures, we need people to follow the measures and recommendations we have in place."

But for that to happen, communication from authorities about what people need to do and why needs to be much, much clearer.

• What’s missing from Sweden’s coronavirus strategy? Clear communication