The Financial Times ran a piece on September 10th about the doctor in Sweden who charted that country’s course through the COVID-19 pandemic without shutting the country down. Many people have probably heard at least something about this, but probably not much detail. Here we present selected excerpts of the FT piece (and of course a link to the whole piece), supplemented by additional material and comment.
At the start of this year, Anders Tegnell was just a low-profile bureaucrat in a country of 10m people, heading a department that collects and analyses data on public health. Today, he has become one of the best known — and most controversial — figures of the global coronavirus crisis.
For many Swedes, their state epidemiologist has embodied a rational approach as other countries have appeared to sacrifice science to emotion. “I wish I were coming with you to see him,” one of Sweden’s leading chief executives confided to me just before I went to see Tegnell. “The way he has stood for what he believes in while the rest of the world does something else is admirable.”
Public support for Tegnell has remained high over a period in which life, while very different to before, has been more normal than in many other countries. Such is his stock in Sweden that there are stories of people having his bespectacled face tattooed on their bodies, while some on the American and British right have seized on Tegnell as a champion of freedoms they feel they have lost during lockdown.
Consider by comparison our Dr Anthony Fauci in the United States, who has also enjoyed (or been beset with) alternating fame and criticism (some of that coming from our publication), as the American “demigod” of Coronavirus response. Yet Dr. Tegnell took a far different tack, and to Richard Milnes, his non-Swedish interviewer and rather thoroughly indoctrinated in the “mask up and shut down” COVID theology, what Tegnell did amounts to some kind of crazy, deadly heresy. We continue:
But for a minority domestically, and many internationally, he is a far more problematic figure. The populist Sweden Democrats have called for him to resign after thousands of elderly in care homes died. That has given Sweden the fifth-highest death rate per capita in Europe, five times higher than neighbouring Denmark and about 10 times more than Norway and Finland.
For some local experts, Tegnell’s standing alone as the world locked down inspires none of the CEO’s veneration. “Tegnell is known for his stubbornness. You wonder what this would have looked like with a different person in charge,” says a Swedish epidemiologist who has been a critic of Tegnell’s. International media have been harsher still: The New York Times has called Sweden a “pariah state” and “the world’s cautionary tale”.
[DR. TEGNELL] “At the outset, we talked very much about sustainability, and I think that’s something we managed to keep to. And also be a bit resistant to quick fixes, to realise that this is not going to be easy, it is not going to be a short-term kind of thing, it’s not going to be fixed by one kind of measure. We see a disease that we’re going to have to handle for a long time into the future and we need to build up systems for doing that,” he says, with his arms crossed tightly to his chest as they are for nearly the entire hour-long interview.
This is indeed a very rational assessment. As COVID began its meteoric spread from China, I also early on realized that this was not a “flare-up” that would eventually die out, as many American politicians posed. That kind of thing had happened before with SARS, MERS and H1N1 “bird flu” in the past, but COVID-19 was a new creature and its appearance in all areas of the world without regard or response to climate (“It will die by summer, like the flu”), and its particular and peculiar predilection for the United States, Brazil, Western European and Russian people suggests that there is possibly something particular about these nations and their people that is more conducive to the virus and its spread – something which I have not yet seen an explanation offered for. SARS-Cov-2 was the new endemic illness as well as a pandemic. This one may eventually become a somewhat rare backgrounder, but it will always be with us. That is my assessment, based on little more that observation of the pattern of the spread and the observation of the nations in which the disease has been most active. We continue:
Our meeting comes as things appear to be going his way. As coronavirus cases rise in pretty much all other European countries, leading to fears of a second wave including in the UK, they have been sinking all summer in Sweden. On a per capita basis, they are now 90 per cent below their peak in late June and under Norway’s and Denmark’s for the first time in five months. Tegnell had told me the first time we spoke in the spring that it would be in the autumn when it became more apparent how successful each country had been.
Today, the architect of Sweden’s lighter-touch approach says the country will have “a low level of spread” with occasional local outbreaks. “What it will be in other countries, I think that is going to be more critical. They are likely to be more vulnerable to these kind of spikes. Those kind of things will most likely be bigger when you don’t have a level of immunity that can sort of put the brake on it,” he adds.
Herd immunity is one of the most controversial concepts of the Covid-19 crisis. Tegnell is adamant that it was not Sweden’s goal to allow the virus to run its course until enough of the population had been exposed and the infection rate slowed. But he argues immunity is at least in part responsible for the sharp recent drop in Swedish cases and questions how its neighbours will fare without it. “What is protecting Copenhagen today? We will see,” he adds.
Presently the penetration rate of the virus looks to be about 25 percent of the population of the US, but again, there also appear to be other factors that make this higher in the US and lower in some other countries. It is very difficult to track because the availability of technology and personnel to track the virus varies from nation to nation and government to government. But early on, I proposed the following hypotheses:
- The most reliable number-of-cases reporting will come from the United States, because our press freely reports crises, and all the more so if they can be used to damage President Trump’s re-election chances.
- The second most reliable reporting will likely be from Russia. Like the United States, Russia has a large population, and while the West is often unfamiliar with this fact, Russia has a superb technology advantage to many countries. Also, Russia’s population mostly lives in very large cities scattered across the nation, and for the most part, there is not much travel between these cities relative to the US. People tend to stay where they are. Those cities may have other problems but extremely good and inexpensive communications technology, often far superior to what I see in the US, is a fact of modern Russian life. This makes everything and everybody easy to track.
- The least reliable reporting is likely to be from China. This is simply because the government there is already secretive, owing to the nature of Communism itself not to allow failure among its bureaucrats.
- The most reliable treatment approaches are likely to be reported from Russia first, and the US second. The reasoning for this follows my first hypothesis – the very large political dog in the US game, and the frothy, impulsive nature of American news media make a real understanding of important news very difficult in times of crisis. Russia’s news media is government owned, and, owing to Soviet-era “traditions”, reporting tends to be very brief, factual and without commentary.
Dr Tegnell continues to show what I might call a “Russian” sense of practicality while operating in an “impulsive” Western social and political context. We continue as Richard Milne comments to Dr. Tegnell:
The only other country not to lock down in Europe was authoritarian Belarus, I say. He erupts in a burst of nervous laughter: “That’s no comparison.” He looks awkward as I mention strong support for Sweden’s strategy from some US libertarians and UK supporters of a hard Brexit. “Odd bedfellows,” is his sole comment.
His dislike of national lockdowns is obvious. “It’s really using a hammer to kill a fly,” he insists. Instead, his approach has been about having a strategy that can work for years if needs be, rather than the constant chopping and changing seen in the rest of Europe. “We don’t see it as viable to have this kind of drastic closing down, opening and closing. You can’t open and close schools. That is going to be a disaster. And you probably can’t open and close restaurants and stuff like that either too many times. Once or twice, yes, but then people will get very tired and businesses will probably suffer more than if you close them down completely,” he says.
Sweden’s approach was predicated on trying to keep its healthcare system working but also looking at public health in the broadest sense, rather than narrowly trying to minimise Covid-19 deaths. So children’s sports carried on, as did primary school lessons, yoga sessions, drinking and eating out with friends, and shopping.
Dr Tegnell looks at the whole picture, and in particular his thoughts on school attendance has been echoed by Laura Ingraham and Tucker Carlson in the US, among other conservatives. It is also being followed in the American “Red States”, most of whom also experienced substantially lower positive diagnoses and morbidity rates than the progressive “Blue States”, now also experiencing rioting.
If the reader wonders that I might be drawing a connection between the virus morbidity rates, the rioting and the locality’s political governance style, you would be correct. Dr Ternell responded to the school situation as shown below:
So he looks at schools not just as a place where the virus might spread but also the most important part of health for a young person. “If you succeed there, your life will be good. If you fail, your life is going to be much worse. You’re going to live shorter. You’re going to be poorer. That, of course, is in the back of your head when you start talking about closing schools,” he adds.
In June, Tegnell described the rush to lock down in the rest of Europe and the US as “it was as if the world had gone mad”. He appears more emollient today, but he still displays signs of disbelief at the approaches of others. Adopting face masks is “more of a statement than actually a measure”. He adds: “Face masks are an easy solution, and I’m deeply distrustful of easy solutions to complex problems.” I ask him about another previous comment: hadn’t he said that Sweden, in the local vernacular, had “ice in its stomach” whereas other nations had acted emotionally?
“That comes back to sustainability. Sustainability, to a certain extent, is to have ice in your stomach because you need to believe in the long-term effects of what you’re doing and not starting to doubt them too early,” he says. Tegnell seems to have few doubts. He caused a stir in June by suggesting that Sweden would have been tougher if it knew at the start of the pandemic what it knew then. But when I ask him today if he would have done anything differently, he answers that while it would have been good to know how Covid-19 would develop “I’m not sure it would have changed very much.”
President Trump has fallen under ‘fresh’ criticism that he considered it necessary to “downplay” the severity of COVID, this in a discussion with author Bob Woodward (central reporter of the Watergate / Nixon conspiracy), but the President repeatedly and personally asserted that his job in a crisis is to lead the nation calmly through the crisis rather than incite panic. It would appeaer that Dr. Tegnell would tacitly agree with the American President. COVID is best taken in stride, just like any other problem. There is no rational reason that the whole world should have gotten in the uproar that it did over this virus, and this remains true, no matter what hysteria tempts one to think or feel.
It would seem that playing the long game is working. Sweden is not suffering a “second wave” because it already endured a strong wave of morbidity. In the case of an endemic virus, it is possible that isolating the population only suppresses its progress, and this, if true, may be a very bad idea. Psychologically, we already know that it is a bad idea to “imprison” whole nations indefinitely to fear of something that cannot be seen or controlled, and if so, it looks like Sweden’s move was the wisest possible. Time will tell, not only for Sweden, but for places that took the same approach, like the Republic of Georgia, Russia at present (not planning to shutdown anymore), the US State of South Dakota and other states that did not shut down, and so on. We just have to watch and see.