A False Promise: Sweden’s Disastrous Bet on Herd Immunity
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All eyes were on Sweden in April 2020. Students attended school mask-free, families gathered at large parks, and businesses remained open. For the most part, people kept to their daily lives, despite the crisis brewing around them. Life was good.
Meanwhile, nearly 4,000 miles away, most New Yorkers were too scared to go outside. Many stayed shut indoors and distanced themselves from strangers, friends, and even family. Schools and businesses were closed, screeching ambulances became the norm, and police officers leaned out of blaring cars with big megaphones, urging everyone to pull their masks up, keep to themselves, and stay away from others. We watched bitterly from behind closed doors as Sweden turned a blind eye to the pandemic. We couldn’t help but wonder what a momentous mistake they were making, and what this naive blunder would cost them in the long run.
While the rest of the world was enforcing mandatory lockdowns, business closures, and mask-wearing, Swedish authorities ensured that life within the nation’s borders continued as if it were any other year. Their strategy was aimed at building a vast base of immunity in Sweden’s general population while protecting the more vulnerable groups. In other words, by allowing a sufficient percentage of the population to become infected with (and ideally, be immune to) the virus, those who lacked immunity would have a lesser chance of getting sick, and all of this would be achieved without “radical” measures like social distancing. This approach, known as “herd immunity,” is quite controversial. Some health experts have even commented that Sweden’s actions are comparable to “playing Russian roulette with public health.”
Herd immunity is usually achieved once some percent of the population, around 70 percent for COVID-19, becomes immune, either through vaccination or prior infection. However, without an approved vaccine, Swedish epidemiologists justified their strategy by suggesting that exposure to and recovery from COVID-19 would lead to long-term immunity (“natural herd immunity”). Of course, the fact that people can become reinfected with COVID-19 renders this theory false. Moreover, researchers warn that without an effective vaccine in widespread use, attaining herd immunity against the coronavirus is practically impossible, mainly because levels of immunity simply won’t be high enough to guarantee protection for everyone.
Still, Dr. Anders Tegnell, chief epidemiologist at Sweden’s Public Health Agency and face of Sweden’s “strategy,” tirelessly defended herd immunity during the preliminary months of the pandemic. “In a few weeks’ time we might reach herd immunity, and we believe that is why we’re seeing a slow decline in cases, in spite of sampling more and more,” Tegnell commented back in April. Other epidemiologists supported Tegnell, noting that herd immunity has proved successful against other diseases throughout history, such as measles, and that Sweden’s statistics would continue to worsen before they improved.
But based on the data, this theory failed. In the spring, the number of cases in Sweden (15,332) was nearly double that in Finland (4,000) and Denmark (8,108), both of which had imposed strict lockdowns. Moreover, Sweden’s death toll (1,938) was far higher than that of its neighbors.
Another main facet of Tegnell’s argument was that building up immunity in the spring would result in a much milder second wave. When confronted by skeptics, Tegnell assured them to wait until fall before judging how Sweden had addressed the pandemic. That time has arrived.
The second wave of COVID-19 is hitting the nation hard, with nearly 19,000 new cases recorded on December 8. One in five people in Stockholm even tested positive for the virus. Hospitalizations and per capita death count are rising more rapidly than those in Sweden’s neighbors, including Denmark, Finland, and Norway. Authorities are pressed to decide whether or not to abandon Sweden’s first-wave strategy and play it safe.
While several virologists are warning against “pushing through” the second wave with supposed herd immunity, Tegnell asserts that citizens’ adherence to the rules will save Sweden from more tragedy and disaster. He reasons that Sweden’s vigorous social safety net and widespread trust in the country’s public agencies would effectively encourage citizens to stay home if they needed to.
However, other experts, like Frederik Sund, head of the infectious disease clinic at the university hospital in Uppsala, Sweden, believe that Tegnell is once again unnecessarily putting the population in grave peril. Sund suggests a widespread lockdown across Sweden, like those enforced in several other countries.
Furthermore, keeping local enterprises open and running did not save Sweden from the financial recessions experienced by the rest of the world. Despite the absence of restrictions within Sweden, its economy has suffered considerably during the pandemic due to its dependence on global value chains. With Sweden’s financial state in shambles and its death toll rising, those opposed to herd immunity warn that continuing to seek this unreasonable goal will be fruitless and not worth the risks. These critics argue that Sweden’s “trial run” for herd immunity should immediately come to a close and that the government should mandate harsher restrictions.
Heeding this advice, bans on large gatherings, curfews, and other protocols were finally put in place in early November. Prime Minister Stefan Lofven even exhorted citizens, “Don’t go to the gym, don’t go to the library, don’t have dinner out, don’t have parties—cancel!”
It is no doubt that this shift in attitude was an apt decision. Tegnell’s approach to the pandemic was unique, but it cost thousands of civilians their lives. Rather than abiding by the guidelines laid out by the World Health Organization, Swedish authorities chose to take a gamble on public health and jeopardize the lives of citizens. Despite the warnings of experts and the release of studies that demonstrated the possibility of reinfection, daily life in Sweden continued with nothing more than a wish for immunity that had yet to be fulfilled. With a COVID-19 vaccine on the horizon, Swedish authorities made the right decision to abandon the “Swedish model” and protect civilians until a vaccine arrives. The end of this tragic, disaster-worn year has nearly arrived, and researchers have still seen no evidence that Tegnell’s laissez-faire strategy is worth pursuing, only making Sweden’s next steps in approaching this crisis more crucial to the nation’s future.