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KEY POINTS: The new verdict on Sweden's coronavirus response

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KEY POINTS: The new verdict on Sweden's coronavirus response
STOCKHOLOM 20211029 Coronakommissionens ledamöter fr v Camilla Lif, Mats Thorslund, Shirin Ahlbäck Öberg, Mats Melin (ordförande), Göran Stiernstedt, Vesna Jovic och Ann Enander då Coronakommisionens delbetänkande presenteras i riksdagen på fredagen. Foto: Christine Olsson / TT / kod 10430

The Coronavirus Commission, appointed to examine Sweden’s coronavirus strategy, has presented its second interim report on Sweden's response to the pandemic.


What's the Coronavirus Commission?

In June last year, Sweden appointed a panel to investigate the response to the coronavirus and evaluate the actions by the government and other authorities. It is headed by Mats Melin, an attorney who formerly served on Sweden's top court for administrative cases.

Their first report, which looked specifically at the handling of the pandemic in the elderly care sector, was presented in December last year.


What did the first interim report tell us?

In short, it found that Sweden had failed to protect its elderly.

The 300-page report was summed up like this in the English version: “Apart from the general spread of the virus in society, the factor that has had the greatest impact on the number of cases of illness and deaths from Covid-19 in Swedish residential care is structural shortcomings that have been well-known for a long time. These shortcomings have led to residential care being unprepared and ill-equipped to handle a pandemic. Staff employed in the elderly care sector were largely left by themselves to tackle the crisis.”

At the time, more than 7,000 people had died of Covid-19 (listed as an underlying or contributing cause of death) in Sweden. Of these, almost 90 percent were aged 70 years or older, and half of them were living in a long-term residential care facility. Just under 30 percent were receiving home help services.

Protecting the elderly population – an age group which is particularly vulnerable to serious illness from Covid-19 – was a key tenet of Sweden's pandemic response, but the report also noted that Sweden did not have an especially high share of deaths in care homes as a proportion of total Covid-19 fatalities compared to other countries.

The government and Public Health Agency both admitted the attempts to protect the eldery failed, while Sweden's healthcare watchdog condemned “serious flaws” in elderly care during pandemic. The commission's report looked into exactly what led to these failures, and who was responsible. You can read more about the first report in The Local's article from December 2020.


Second report: What went wrong, and who is to blame?

The second report, published on October 29th, 2021, presents the Coronavirus Commission’s criticisms of the Swedish response to the pandemic on a number of different points.

The report concludes that the response to the pandemic was slow, describing initial measures to control the virus as “insufficient to stop or even substantially limit spread of virus in the country”.

It describes a number of aspects of Sweden’s preventative measures as “inadequate”, such as existing legislation and pandemic preparedness, going on to say that the current system of disease prevention and control is “decentralised and fragmented” to an extent that it is unclear who holds responsibility.

The commission directs strong criticism at the Swedish regions for being slow to introduce large-scale testing, despite instructions from the Public Health Agency and the government, going on to describe it as “a complete failure” that large-scale testing was delayed until discussions about responsibility and funding were resolved.

Criticism is also directed at the Work Environment Authority, after a disagreement between them and the Public Health Agency around the use of PPE led to confusion among workers. The Commission describes the Work Environment Authority’s actions as “a betrayal” of employees forced to work without appropriate PPE.


On a positive note, the commission praises healthcare workers, noting that the healthcare system was able to adapt and scale up care for people affected by Covid-19 “largely thanks” to healthcare staff. However, it notes, this was not without sacrifice, with staff being used “almost to breaking point”. 

You can read more on the Corona Commission's website here, and if you're a member you can sign up for The Local's Inside Sweden newsletter here, to read our editor's thoughts about the report in her Saturday email to members.

What needs to be done to protect against future pandemics?

The commission has a number of suggestions for how these issues could be avoided in future pandemics. 

It calls on the responsible authorities to ensure that there is sufficient capacity to “rapidly scale up” testing and contract tracing in the future. 

On PPE, it states that “national preparedness must be significantly improved, in terms of both maintaining stockpiles and purchasing the necessary products at a national level”. 

Although the report praises healthcare workers and states that the healthcare system “by and large” was successful in making necessary adaptations, the commission suggests that staffing issues within healthcare “must be included in health care contingency planning”, with better working conditions for healthcare workers a good first step towards rectifying these issues.

Will anyone be held accountable for failings?

It's hard to say.

Many of the key figures are stepping down anyway for unrelated reasons. Prime Minister Stefan Löfven is retiring this month, as is Public Health Agency director-general Johan Carlson. State epidemiologist Anders Tegnell is 65 years old and will likely be retiring relatively soon, too. It is not clear what Health Minister Lena Hallengren's role will be in Finance Minister Magdalena Andersson's new government.

Andersson's job in looking after the finances during the pandemic may not be closely enough linked to the health crisis to leave her vulnerable to severe criticism. Sweden's next general election is coming up in September 2022, but it is still too early to tell whether or not the pandemic will be a talking point (most of the opposition supported the government's pandemic measures, at least initially).

When will the final report be released?

A final report is expected by February 2022.

The commission mentions a number of topics which will be addressed in the final report, including the problematic division of responsibilities in the way Sweden has chosen to organise communicable disease and prevention, and an evaluation of Sweden’s choice to use voluntary rather than intrusive measures in tackling the pandemic – which it does not evaluate in the second report.


Join the conversation in our comments section below. Share your own views and experience and if you have a question or suggestion for our journalists then email us at [email protected].
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Anonymous 2021/10/30 19:28
Couple of further thoughts. Regarding the delay and volume of testing, I remember Anders Tegnell saying repeatedly at the then-daily press conferences around March-April-May 2020 that the biggest problem was the lack of laboratory capacity to analyse the huge new volume of tests. There just weren't enough qualified laboratory assistants in Sweden to cover the massive additional workload. I've no idea how they eventually sorted that one out because lab assistants don't grow on trees, but perhaps they reorganised their priorities, or provided intensive training just for covid analysis without becoming a fully-fledged lab assistant. And once again, the testing of thousands of people was/is a _regional_ responsibility, albeit under the overall monitoring of the Public Health Agency. One aspect that the Commission doesn't seem to have covered is the relative absence of political authority at the beginning of the pandemic. The now-departing PM Löfven has never been a good speaker and seems to avoid the limelight to the extent that we've rarely seen him during the pandemic apart from a few pre-recorded wooden statements or introducing other people to do the talking. The Minister for Health and Social Affairs, Lena Hallengren, was also remarkably absent to begin with but picked up later as the situation became more serious. This left Anders Tegnell and his colleagues to initially face the press and the public virtually alone for several weeks, if not even months, without any significant political support. Hallengren ultimately caught up and on the whole has done a reasonably good job in the circumstances. Löfven is no doubt a nice guy privately, but he's not a good prime minister.
Anonymous 2021/10/30 13:00
Well said, Bruno. Anders Tegnell has done a fantastic job, and we should all be grateful for his dedication along with his team. Sometimes in difficult situations due to stipulations of Ordningslagen (Swedish Code of Conduct) and Smittskyddslagen (Swedish Communicable Diseases Act) – a point brought up by the Commission in their report and also by Johan Carlson when interviewed yesterday. Many people across the board seem to agree that Swedish pandemic-related legislation needs to be reviewed and coordinated. As for PPE, I seem to recall press reports back in March 2020 that stocks of PPE were globally non-existent and impossible to get hold of. But before the pandemic arrived, you can be sure that any agency, organisation or company would have been crucified by auditors and inspectors for stockpiling PPE just in case a pandemic might turn up. Everything these days is just-in-time in order to avoid cashflow being tied up in inventories, and goods becoming soiled or outdated. It's a damned if you do or damned if you don't situation. Same goes for covid-testing equipment. Another interesting point is Sweden's decentralised regional structure. Here again, it's difficult to be on the right side of the fence at the right time. Numerous organisations and large companies worldwide have gone through the decentralisation process only to return to a centralised organisation a decade or two later. Even before corona/covid arrived, discussions had already started (again) as to whether the Swedish healthcare services should stay as 21 regions (previously landsting) or become centralised. As with most things, there are advantages and disadvantages with both. As it is, Sweden is a very decentralised country all the way down to municipal level. But sadly, it looks like blame games and point-scoring have started. No doubt a large number of academics and 'experts' will be sharpening their knives ready to pounce on Anders Tegnell again. Some of them seem to be determined to see his downfall. Sad.
Anonymous 2021/10/30 10:45
Shame on Andres ??? here is a good one for the books. This man has safeguarded the entire country’s sanity by allowing it to function as close as possible to normal. I’ve had a taste of Covid measures in 3 countries…….Norway….who kicked every foreigner like paupers …….I managed to catch the last train to Stockholm…..still hasn’t resumed……and stayed put in Sweden for 3 months while watching the Australian style lockdown in France. Then, another one in October where I managed to bugger off to Austria……also in lockdown…..just encouraging you to get out ne get some fresh air. I did numerous trips to Stockholm last winter and trust me… was a hell of lot better than being in France where, in the end, the casualty tally ended up much worse despite locking everyone up. Just check the CFR ( case fatality rate ) which by the way proves how more performant the Swedish health system is compared to. Lot of countries, starting with France. Andres Tegnell showed coolness under pressure, Sweden was because of its political system, sheltered from the headless chicken political runs displayed in Norway and Denmark……….Norway having even armed soldiers patrolling the border……. Yes, the virus ripped through senior homes…….same as anywhere else due to poorly qualified staff, more than perfectible regional organisation and as mentioned ……poor testing in other regions. But, France with its highly centralised government did worse. Stay home….take an aspirin and call if things get worse……they did and a lot of people died. What would we have given to have an Andres Tegnell at the helm.
  • Anonymous 2021/11/25 23:06
    i Can o ly underline and support what you said and please add the chicks from Germany and France, Italy etc. Sweden was and is the small gallic village surrounded by the romans and guess who was more intelligent...
Anonymous 2021/10/29 21:03
If Tegnell was in charge of the pandemic response in the US, the US would have been doing even more poorly than it did. Shame on Anders.

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