Beachgoers in Lomma, Sweden, this August. Was the country’s lax lockdown inspired or foolhardy? Photo: IBL/Shutterstock

The twisty tale of Dr Tegnell

The rockstar epidemiologist is leading Sweden through a great Covid experiment. Six months in, is it paying off?
October 5, 2020

If you look back at what Sweden’s state epidemiologist Anders Tegnell said in March, it’s interesting to see how much he got right. Lockdowns, he said, could only be kept in place “for a very limited amount of time before people get tired,” so should be reserved for when you really need them. Closing schools, he warned, would damage not just children but the functioning of society, by keeping parents at home. The pandemic was “a marathon not a sprint,” as it would be at least a year before vaccines became available. It was better to impose national restrictions light enough to keep in place for long periods—measures that were “sustainable.”

When I last wrote a letter from Sweden at the end of April, it was an open question whether the country had been right to eschew hard lockdown. By June, however, it looked like Tegnell had lost the argument. Lockdowns had dramatically reduced infection in Europe, while cases in Sweden had yet to reach their peak. The death rate was creeping towards that of Italy, and opposition politicians were finally turning on Tegnell’s agency, with the leader of the populist Sweden Democrats calling for his resignation.

Today, though, the story looks far from clear cut. In July, Sweden’s infection rate began to drop, sinking at the start of this month below that of its Nordic neighbours.

While Denmark had opened amusement parks and even let crowds back for football games, Sweden, sticking to Tegnell’s light-but-steady strategy, had kept its 50-person limit in place. Now that the UK and other European countries are wrestling to bring a resurgence under control without reimposing strict lockdowns, Tegnell is regaining his status as a sort of rock star, finding himself, to his evident discomfort, praised by the libertarian right. He is doing non-stop international TV interviews. He has even been in to brief Boris Johnson. Sweden’s newspapers, meanwhile, have begun to gloat, particularly over rising cases in Denmark, which raised hackles in June by refusing to open borders to its harder-hit neighbour (prompting the New York Times to dub Sweden “a pariah state”).

When the Sun in September described Tegnell as a “hero,” the Swedish Expressen tabloid gushed that the strategy was being lauded worldwide. But it’s worth pointing out what Tegnell got wrong. He initially maintained that China would contain the virus. He told Swedes in February it was safe to travel during the country’s spring “sport holiday”; Stockholmers brought back so much infection the city had one of Europe’s worst outbreaks. He claimed Sweden’s age segregation would make it easier to protect the elderly; the virus cut a swathe through care homes. He said Stockholm could reach herd immunity in May; antibody tests and a recent rise in infections suggest the city still isn’t there. Europe’s lockdowns have also arguably been both more effective and better tolerated (at least the first time around) than he warned. Last month, Tegnell drew criticism even in Sweden after linking the country’s death toll to a string of mild flu seasons, before admitting he’d got the idea from a discredited YouTube video by an Irish diet faddist turned lockdown sceptic, knocking his credibility.

Nonetheless, with few countries willing to go back into lockdown, many now see the Sweden strategy as the way forward. As early as April, Mike Ryan of the WHO was promoting Sweden as “a future model,” with citizens learning to avoid infection situations voluntarily. That does now seem to be happening, with Carl Heneghan, of Oxford’s Centre for Evidence-Based Medicine, claiming the UK’s new measures represented “a move towards Sweden.” He cited Sweden’s decision to keep bars and restaurants open, but with table service only to reduce contagion. 

A move towards Sweden today, however, is not an acknowledgement it was right to impose only light restrictions in March. By pushing infections into the future, lockdowns gave countries time to source equipment and get test capacity and contact tracing up and running (or attempt to). Sweden in April was testing much less than most European countries today. Hospitals across Europe have also got better at treating serious cases. Some who died in Sweden would not have done so had they become ill today. Finally, Sweden is itself shifting strategy. Cases in Stockholm nearly doubled in one week in late September, leading the city’s health chief to warn that “far too many have stopped following the Swedish Public Health Agency’s recommendations.” The government delayed a planned increase in the maximum crowd at seated events.

Tegnell, meanwhile, has for the first time said he is willing to close schools, make face masks mandatory, and impose other heavy measures. The authorities plan to target these new restrictions as tightly as possible on areas with outbreaks, and then lift them within two to three weeks. Ever the outlier, as the rest of Europe “moves towards Sweden,” Sweden is moving towards something else.