29 June 2020

Sweden’s odd response to COVID-19

EU’s competences in the field of public health are quite scant and mainly limited to supporting the modernization of national health systems’ and improving their efficiency. The lack of coordination between the Member States gave rise to a wide arrange of approaches, often contradictory.

EU’s competences in the field of public health are quite scant and mainly limited to supporting the modernization of national health systems’ and improving their efficiency. While one of the EU’s health policy objectives is to “protect and improve the health of EU citizens”, the role of the EU in doing so is that of coordinating and facilitating the exchange of best practices between the Member States. During the recent COVID-19 health crisis, the insufficiency of this approach has became manifest. The lack of coordination between the Member States gave rise to a wide arrange of approaches, often contradictory. This resulted in frictions among the Member States especially for what concerns the freedom of movement. With the following policy focus, Adele Lebano delves into the case of Sweden, which opted for one of the most debated policy responses across the entire EU to the COVID crisis. Her insights – building on Sweden’s national character and public philosophies – help us better understand the peculiarities of this approach within the European scenario.

 


As an Italian living in Sweden, I have become accustomed to surprise by the many ways that Sweden is different—not just from Italy, but from its own reputation as an exceptionally virtuous country and a model society. This double estrangement is especially dismaying during this public health crisis.

By letting its citizens live their lives mostly as usual, the Swedish government’s soft, non-interventional approach to the pandemic has challenged the paths undertaken by other countries and the recommendations of the World Health Organization (WHO). Sweden has decided to go lagom— a Swedish word that means “just right,” neither too much nor too little; few restrictions have been imposed; people are mostly asked to keep clean and physically distant. Sweden has also decided not to test and track the disease’s spread. This may be a realistic choice in anticipation of a lockdown that would be unsustainable for people and for the economy, but it still feels odd. The “right” response to the pandemic has been elusive, but different local approaches do say something about our conceptions of politics and society—about our ideas of life and attachments and the links between private values and public choices.
Despite the disagreement among analysts and foreign media on its appropriateness, the Swedish soft way of managing coronavirus is explained as a reflection of Nordic individualism, trust in institutions and in fellow citizens. People will do the right thing out of sense of responsibility, it is thought. They do not need to be coerced into a lockdown because they can be trusted to act properly. Yet crowded streets and bustling play parks may tell a different story.

In Sweden these days, high schools are closed, and university classes have moved online, but university canteens are open. People are encouraged to work from home, and a ban on meetings of 500 people, later reduced to 50, was introduced in March and extended until December. Yet elementary schools, where social distance is hard to observe and certainly more than 50 gather, remain open and compulsory as usual. There are no restrictions on supermarkets, shopping malls, indoor amusement parks, or public transport and trains.
The Minister of the Interior, while speaking in defense of the Swedish way to fight the pandemic, has threatened harder measures should the population not respect recommendations for social distancing. Meanwhile, in Lund, the municipality has dumped manure in public parks to discourage gatherings. Soon we will know if warnings and nudging have been effective.

Sweden public health authorities have admitted that things went wrong in nursing homes, but have not fundamentally changed their approach.

According to Our World in Data (www.ourworldindata.org) Sweden recorded over 56,000 total confirmed COVID-19 cases by June 18. In nearby Denmark, a much more densely populated country, the number is 12,000; in Norway, 8,600; and in Finland, 7,100. The total confirmed COVID-19 deaths in Sweden have reached 5,053, a relatively small number when compared to Italy (34,514), the United Kingdom (42,288), or the United States (118,434), but much worse than Sweden’s neighbors: Denmark (600), Norway (244), and Finland (326). Sweden’s 500.33 COVID-19 deaths per million people—compared to countries that chose a lockdown—does not reassure: 357.8 (United States); 103.59 (Denmark); 45.01 (Norway); 58.84 (Finland). Half of the deaths occurred in nursing homes.
Sweden public health authorities have admitted that things went wrong in nursing homes, but have not fundamentally changed their approach. On its website Sweden’s Public Health Agency states that: “as long as siblings or other members of the family do not show symptoms of disease they can go to school, preschool, or their workplace.” Children of parents with coronavirus, for example, attend school, as long as they do not appear ill. With the curve rising and hospitals struggling, parents like me, who would rather keep their kids home, are constantly reminded that school is compulsory in Sweden. In many cases—and at odds with Sweden’s soft approach to the public health emergency—parents are warned that they will be reported to the social services for keeping their children out of school. Meanwhile, schools admit that they can do little to protect kids from the virus, beyond showing them how to wash their hands properly and use hand sanitizer.
The government’s mild and contradictory measures largely rest on the view of state epidemiologist Dr. Anders Tegnell, who believes that the soft approach will help the country cope in the long run because the virus is here to stay, and sooner or later most people will probably get it. Swedish media and a former Prime Minister Carl Bildt have expressed confidence in the Swedish character and traditions—a combination of trust in institutions, loose family ties minimizing occasions for contagion, and a ‘natural’ inclination to social distancing—to see the country through the pandemic.

Is the proclaimed belief in the Swedish character and individual responsibility at the heart of the country’s response to coronavirus?

In an editorial in the Dagens Nyheter, a major Swedish newspaper, a group of scientists from the Karolinska Institute, Uppsala University, and Chalmers University of Technology called the architects of the strategy “officials without the talents to predict or control the epidemic,” and urged the government to intervene with “radical measures.” But such dissonant voices and sporadic organized resistance, for example, among teachers, are rare. For the most part the Swedes back up the government and its choices. Polls show growing support for the governing Social Democrats and Prime Minister Stefan Löfven in the last few weeks.

Is the proclaimed belief in the Swedish character and individual responsibility at the heart of the country’s response to coronavirus? As an observer, that’s not what I see. Rather it seems the mark of an organicist society, one in which individual freedom always gives way to public good, where individuals’ goals and expectations are shaped by the will of the government. Indeed the secret of Sweden’s exceptionalism rests in a social compact that limits—not expands—people’s reliance on each other because it fosters dependence on the state. The Swedish formula, I think, combines anomie— lack of social and moral norms, not individualism in the liberal sense —with organicism.
In Sweden, government action against coronavirus is relaxed and contradictory, and so are people’s responses. At the root of the synergy is a unique pact between state and citizens. The state provides for people’s material needs so that they will not have to depend on each other for their welfare or be exposed to chance. In exchange, citizens trust the state to make decision in their interest. Trust, or the confidence that a party will act fairly and in the interest of the other party, is an essential element of society. When there is trust, people do not need to act defensively or attack out of fear of being attacked. In the absence of complete information, trust supports stability and reduces uncertainty.

For over a century the Swedish state has committed to taking care of the children, the sick, and the old.

Yet trust maintains an element of conditionality. Trust is gained, but it is also tested and revoked if not honored. For trust in government to be a good thing, citizens need to keep doubting, examining, questioning, and judging governments and their choices. In an organicist society however, tests on trust cease. And, with blind trust in the government, people are relieved from the responsibility for what happens around them—even to them—to their fellow citizens and to their family. For over a century the Swedish state has committed to taking care of the children, the sick, and the old. Yet the bargain is dangerous for its citizens because taking responsibility, listening to one’s own needs, and taking care of others is what makes us human and protects us from arbitrary power.
In contrast to the Millian idea that democracy flourishes where individuals can choose their life commitments and exercise independent critical judgment over institutions and policies, Sweden offers a model of democratic success that favors stability over freedom, dependence on the state over interdependence among citizens. Swedish society, to quote a key Swedish idea, is folkhemmet, the “people’s home”—a place where, just like in a family, all members have their place and their needs taken care of.
What has struck me as an outsider in Sweden is people’s privateness, which is not the same as individuality. In the Swedish homes that I visited, life is organized around social rituals and habits that leave little to individual initiatives. Such rituals, I have noticed, defeat socio-economic differences or political and geographical divides, and in some sense do make Swedes equal.

Swedes trust the government and its choices to be ‘just right.’ And here the notion of lagom appears less humble than one may expect.

The key ideas of Nordic social democracy are linked with the Lutheran tradition and its strict, non-mediated relationship between the individual and God. Full commitment to that relationship leads to salvation. Similarly, an unchallenged, exclusive relationship between the individual and the state is regarded as the path to well-being. Denmark and Norway share the same Lutheran roots, however, they have made a very different choice in the face of the pandemic, enforcing a preventive lockdown to control the spread of the virus. So the source of Sweden’s distinctive way is hard to place. Perhaps the quasi-religious allegiance to the state was facilitated by the Social Democrats’ long hold on the country. The Swedish version of social democracy was inaugurated by the social-democrats—the SAP [Socialdemokratiska Arbetareparti]—in the 1930s and has largely dominated its political life ever since.
Swedes trust the government and its choices to be ‘just right.’ And here the notion of lagom appears less humble than one may expect. If the social compact promises that decision-making processes will produce ‘just right’ outcomes, governments don’t need good arguments to justify their actions. And if the Swedish approach to coronavirus is at odds with scientific evidence, it needs little justification, only citizen’s trust.By accepting the compact, citizens agree to embrace the majority view and stand behind government decisions. And the state, committing to take care of its citizens, releases them from the burden of moral choices. Yet, even Rousseau, considered by some as the founder of an organicist view of politics, believed that only the never-ending effort to balance individual interests and the public good could produce a “general will.” Sweden, by contrast, appears to have solved this tension, together with other daunting questions about values, as if basic, competing political ideas such as equality, freedom, justice have been permanently settled. Welfare protection, material comfort, and social cohesion are obtained by putting aside conflicts of values and moral dilemmas to focus on managerial tasks. Sweden seems to have succeeded in the shift that so concerned Weber: turning politics into the management of means.

The Swedish organicist model of democracy encourages citizens to suspend their capacity to choose. And if practice makes perfect, individual agency and moral literacy—as well as untold numbers of lives—are at risk.

 

(The original version of this article appeared in Boston Review).

 

 

Photo credits Flickr CC: Pedro Szekely

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