Author : Ramanath Jha

Occasional PapersPublished on Jul 20, 2020
ballistic missiles,Defense,Doctrine,North Korea,Nuclear,PLA,SLBM,Submarines

Sweden’s ‘Soft’ COVID19 Strategy: An Appraisal

  • Ramanath Jha

    Many countries imposed stringent lockdowns in response to the COVID-19 pandemic. Sweden, however, adopted a ‘soft’ approach of self-imposed social precautions without state regulation. This evoked extensive criticism within and outside the country, especially in view of its high death rates in comparison to its Nordic neighbours. The Swedish government, however, has been steadfast with its strategy. As countries emerge from lockdowns and begin to reopen their societies, there are many lessons to learn from Sweden’s soft COVID-19 strategy.


Ramanath Jha, “Sweden’s ‘Soft’ COVID-19 Strategy: An Appraisal,” ORF Occasional Paper No. 258, July 2020, Observer Research Foundation.


The rapid spread of the COVID-19 virus has had an enormous impact across the globe. Countries have scurried to seek cover under lockdown measures to slow the rapid spread of the virus and flatten the infection curve. This is true of non-democratic countries, for whom draconian regulations are a normal practice, and democracies as well, many of whom have resorted to equally heavy-handed control despite such hard measures being contrary to their political grain. The severity of the threat from the virus was so palpable that countries rendered their entire citizenry immobile through governmental fiat. Most other countries have followed the example of Wuhan, China, which went into lockdown on 23 January 2020.[1] By the first week of April, about 3.9 billion people—or more than half of the world’s population—were under some form of lockdown.[2] Thirty-two countries in Asia, 43 in Europe, 38 in the Americas, and 44 in Africa imposed lockdowns.[3]

Why did so many countries decide that lockdowns were essential to tackle the spread of the virus? Were they simply following China’s example in Wuhan? China was initially able to convince the world that its containment strategy, no matter how extreme, had been successful. The internal pressure that countries faced from the pandemic and the expectation that they should do something to save the lives of their people may have convinced many governments to embrace lockdowns without sufficient thought and analysis of the consequences. The lockdowns allowed many governments to appear like they were decisive and in control of the situation.[4]

Several countries may have also wanted to avoid a situation as dire as in Italy, which was decimated by the rapid spread of COVID-19 among its population. Italy’s first case was detected on 30 January. By the end of February, over 1000 cases were reported, rising to over 100,000 by the end of March and 200,000 by the end of April. The first death was reported on 21 February, rising to 29 deaths at the end of February, 12,428 deaths by the end of March and 27,967 deaths by April-end.[5] Within weeks, the virus had overloaded Italy’s healthcare system, and the enormous influx of patients “forced the doctors to decide not to intubate some very old patients”,[6] with doctors and nurses compelled to decide who will live or die.[7] The endless flood of victims forced the city of Bergamo, the epicentre of the pandemic in the country, to send surplus bodies to less burdened crematoriums in neighbouring towns.[8] Italy’s vulnerabilities echoed around the world and gave governments a glimpse of what awaited if they did not do enough to slow the spread of the virus. The panic catalysed the installation of lockdowns across continents, as countries cowered in mortal fear.

Several countries may have also been taken in by the frenetic worldwide research activity. The academic response to the virus, the level of international consultation and competition, and the speed of work have been unprecedented. While there is still no certainty on the outcome of this global effort, the expectation that a vaccine will soon be found may have impressed some nations to play the waiting game through lockdowns.

The approaches to lockdowns have been wide-ranging, with variations in their total period, the severity of restrictions, implementation and penal action. For instance, Wuhan was put under complete lockdown for 76 days, while Italy imposed a two-month nationwide lockdown.[9] In Colombia, people were allowed to leave the house depending on their national ID card number;[10] in Serbia, a specific dog-walking hour was introduced.[11] Meanwhile, Belarus’s president went against medical advice and endorsed vodka and saunas as a way to stay safe.[12] In general, however, governments forbade all non-essential internal movement,[13] thus targeting improved health and hygiene and a halt on all forms of social congregation.

Through the lockdowns, countries were trying to achieve three key objectives. First, to break the chain of the spread of the virus to prevent it from multiplying. Second, to buy time to allow the country’s health system to prepare itself for the oncoming onslaught of infected people and not be overwhelmed by the disease. Third, to re-engineer human behaviour and prepare people to wash their hands regularly, wear masks, and maintain social distance at all times.[14]

The Swedish Strategy

Although most countries opted to impose shutdowns to counter the spread of the COVID-19 virus, Sweden consciously chose an alternative path of self-imposed social precaution without state regulation. While several countries curtailed the freedoms of their citizens during the forced closures, the Swedes enjoyed normal life almost completely unimpeded. Sweden did not stop flights nor close national borders, no national emergency was declared, no stay-home orders were issued and workplaces continued to function even as working from home was encouraged.[15] Primary schools, hairdressers and shopping centres remained open. Public transportation, cinemas, libraries, restaurants and coffee shops continued to function.[16] The Swedish government recommended social distancing and citizens above 70 were advised to stay indoors. It also recommended people work from home if possible, avoid unnecessary international travel and limit long-distance road travel within the country. The police were given no powers to stop and question or impose fines even if some citizens violated advisories and restrictions.[17]

This system placed the onus on the Swedes to be responsible and help the country navigate the quagmire through self-discipline. The aim was to limit the spread of the disease by making recommendations instead of imposing a quarantine. The government hoped that by keeping large parts of the society open and functional and by following scientific advice, the country could avoid some of the worst social, economic, and medical consequences of the COVID-19 pandemic.[18]

However, the Swedish strategy was not completely free of restrictions. Congregations of 50 or more people were prohibited. Drinks could only be served at seated tables and not bars. Restaurants were mandated to ensure a two-metre distance between tables, and patrons were advised to only sit at their tables and not wander around the restaurant. Universities and high schools were shut and classes were conducted online. All visits to care homes were banned. “Everyday life in Sweden is not the same as before. There are fewer people in shopping centres and public transport. Working from home is the new normal for those who can. But people continue to socialize outdoors freely.”[19] Clearly, Sweden was not left unimpacted by the pandemic.

Philosophy guiding the strategy

Why did Sweden choose to act differently from the rest of the world? Swedish author and historian Johan Norberg lists four reasons for the country’s decision.[20] First, Sweden is constitutionally different from many other democracies. For several centuries, the country has had a system of administrative independence, which allows for a unique division of power where governmental agencies are free to take decisions in accordance with scientific advice without political intrusion. The system provides little space for ‘political grandstanding’. According to Erik Angner and Gustaf Arrhenius from Stockholm University’s Department of Practical Philosophy, “Critics who deplore Sweden’s so-called lax approach to COVID-19 do not seem to understand that this approach is to a great extent determined by fundamental constitutional constraints…By law and tradition, Swedish politicians can’t tell the various government agencies what to do, and agencies count relatively few political appointees among their staff”.[21] Similar advice was also given in two other Nordic countries by their scientific community, but this was reportedly overruled by political decision-makers there.[22]

Second, Sweden is a highly trade-dependent country and has suffered hugely on account of other countries closing their borders. Shutting down domestic industry and businesses would have further run down the country’s economy and exacerbated the loss of livelihood. Swedish trade unions, which typically have a voice in government decision-making, were not in favour of shutting down the national economy. Swedish Prime Minister Stefan Löfven, a former trade union leader, understood the public mood well. Prominent Swedish industrialists, such as Jacob Wallenberg, backed this line of action and exhorted the government not to lose sight of the impact of containment measures on businesses. “Unemployment could be hit by 20-30% while economies could contract by 20-30% as well,” Wallenberg warned.[23]

Third, the Swedish government believed it could achieve the gains of a lockdown without imposing a lockdown. “We have a high trust culture,” Norberg argued. Swedes usually trust the authorities, follow rules set by the authorities even when not implemented by force, and shame those who do not follow advice.[24] Hjalmar Didrikson, co-founder of venture capital firm Alfven Didrikson, highlighted the reasons why Sweden’s strategy would work. “We respect common sense, and we see pragmatism as a virtue. Most people enjoy the same basic education and healthcare, creating more of a level playing field when it comes to society. We have a tradition of trusting science – it was after all a Swede who initiated the Nobel Prize. We tend to be quite a collective people, we care a lot about what people think of us, yet we are also very individualistic.”[25]

Fourth, the Swedish government believes that the only way to beat the virus in the long term is through immunity. It believes that if the virus moves through the population slowly, Swedes will obtain some sort of immunity as a community in a few months,[26] thereby passing through the stages of lockdown, opening up, virus resurgence and further uncertainty that other countries will experience without having to shut down.

Additionally, the Swedes are also aware of the difficulties that arise in a lockdown. In a country as health conscious as Sweden, complete physical inactivity would have been highly unpopular and detrimental to public health. Johnny Warström, CEO and co-founder of interactive meeting platform Mentimeter, noticed that “some people have found it hard mentally and physically to be at home all the time, and have felt quite locked in. The pandemic is a crisis, not only for people getting sick from the virus, but also from the measures.”[27] This is now in evidence worldwide as lockdown fatigue is setting in. Several anti-lockdown protests have hit countries like the US, Germany, Australia, the UK, Brazil and Spain.[28] It appears that the length and severity of the lockdown, on the one hand, and the level of compliance, on the other, have an inverse relationship.

According to Professor Johan Giesecke, an advisor to the Swedish government, the country’s scientific community is convinced that “Everyone will be exposed to severe acute respiratory syndrome coronavirus 2, and most people will become infected”.[29] He also said, “There is very little that we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in one year from now, the figures will be similar, regardless of the measures taken”.[30] It is in this background that Sweden decided to follow a strategy to allow a slow community spread, while concentrating on post-infection healthcare.


Sweden’s COVID-19 strategy has had mixed results, but the negative outcomes have not been dire enough to shake the Swedes’ confidence in their course of action. Sweden is highly urbanised; 85 percent of its 10.1 million population lives in cities. About one million reside in the capital Stockholm, and over two million people live in the larger Stockholm metropolitan region and county.[31]

Sweden reported its first case on 15 February.[32] A month later, it had 1,040 cases and three deaths. The figures reveal that virus cases took eight days, seven days and nine days to double. However, the next doubling took 15 days and then a month, clearly indicating that Sweden had successfully slowed down the spread of the virus. With deaths, after reaching 1,203 deaths on 8 April, the figures doubled in 15 days and then in more than a month. The death toll as of 24 June reveals that the doubling rate of death has slowed further.

Table 1: Progress of COVID-19 in Sweden

Date No of cases Deaths
15 Feb 01
15 Mar 1,040 3
23 Mar 2,046 27
30 Mar 4,028 146
08 Apr 8,419 1,203
23 Apr 16,755 2,021
26 May 34,440 4,125
31 May 37,113 4,395
24 June 60,837 5209

Source: Worldometer[33]

As of 24 June, the most number of deaths in Sweden were in the 80-90 age group, at 2157, followed by 1331 deaths in the 90 and above age group, and 1141 deaths in the 70-79 age group (see Table 2), clearly illustrating that the elderly have had to bear the brunt of the disease. The figures also speak volumes of the excellent general health of the populace and the country’s stellar healthcare system.

Table 2: COVID-19 (As of 24 June 2020)

Age Total deaths Percent deaths
9 years and younger 1 0.02
20-29 8 0.15
30-39 13 0.25
40-49 44 0.85
50-59 150 2.88
60-69 364 6.99
70-79 1141 21.90
80-90 2157 41.41
90 and above 1331 25.55
TOTAL 5209 100

Source: Statista 2020[34]

Only 6.9 percent Swedes have diabetes.[35] It has three times less obesity (9.7 percent) than in the US (30.6 percent). The Swedish healthcare system is ranked eighth in the world.[36] “The proportion of the Swedish population reporting to be in good health (80 percent in 2015) is much higher than the EU average (67 percent).[37] The country’s annual death rate is falling, and stood at 9.4 deaths per thousand population in 2018, down from 10.62 per thousand in 2000. The median death age on account of the coronavirus (81 years) is not much different from Sweden’s normal average life expectancy (83 years).

Furthermore, quite remarkably, despite the high number of cases, Sweden’s health architecture has not been overwhelmed by the disease, as Italy’s was. Sweden’s state epidemiologist Anders Tegnell reported that despite the high number of cases, 20 percent of all intensive care beds remained vacant.[38] Sweden’s heavy investment in its healthcare system over several years has made it one of the best in the world, paying dividends during the ongoing COVID-19 crisis.

Citizens have maintained the government’s trust by adhering to social distancing norms. Few people venture outdoors, and the elderly stay in. This was most evident during Easter, when social visits are typically common, with travel decreasing by 90 percent.[39]

Criticisms of the strategy

The Swedish approach garnered criticism from domestic and international governments, the media and experts, with some even suggesting the “Sweden’s relaxed approach to the coronavirus could already be backfiring”.[40]  “Severe critics have described it as Sweden sacrificing its (elderly) citizens to quickly reach herd immunity”.[41] US President Donald Trump, when asked about the Swedish method during the coronavirus task force briefing on 10 April, remarked, “I think we could have followed that approach. And if we did follow that approach, I think we might have 2 million people dead.” On a different occasion, he added,” Sweden is suffering greatly”.[42]

The Journal of the Swedish Medical Association published a cautionary paper on the damages and mathematician Marcus Carlsson described the government’s approach as “a mad experiment with 10 million people.”[43] Twenty-two Swedish researchers from top universities and research institutes have publicly censured the ‘relaxed strategy’ and have exhorted politicians to amend it. The group alleged that the public health agency had claimed on four occasions that the spread of infection has levelled out despite evidence to the contrary. They advised that mass testing of healthcare personnel be made mandatory and encouraged the use of proper infection control equipment by health professionals working with the elderly.[44] Lena Einhorn, a virologist and one of the 22 signatories, said, “There are thousands of trials going on right now around the world for treatment. Already there are a couple of drugs that have shown very, very promising results in small trials. Within the next few weeks and months, most likely, we will be able to lower the mortality. That to me is the most important reason to push this epidemic in front of you as far you can”.[45]

Further, the Swedish strategy was premised on the calculations that a slow spread of the virus among the people would result in community immunity.[46] This, it was anticipated, would develop over a few months, and the speed for such immunity was predicted based on a mathematical model used by public health officials. This part of the Swedish strategy does not seem to be fructifying as predicted. For instance, in Stockholm, just 7.3 percent of “inhabitants had developed Covid-19 antibodies by the end of April, raising concerns that the country’s light-touch approach to the coronavirus may not be helping it build up broad immunity.”[47]

Another significant criticism is that  the government seems to have slipped on its promise of shielding at-risk groups. Around mid-May, the Swedish public health agency admitted that “48.9 percent deaths were care home residents”. It appears there was reluctance to send patients from care homes to hospitals. Several medical professionals believe that “a lot of lives could have been saved if more patients had been able to access hospital treatment, or if care home workers were given increased responsibilities to administer oxygen themselves, instead of waiting for specialist Covid-19 response teams or paramedics”.[48] The prime minister even admitted that the country “did not manage to protect the most vulnerable people, the most elderly, despite our best intentions”.[49]

Sweden’s immigrant communities, who are among the country’s most deprived groups economically, were also severely affected. A Swedish public health agency survey, published on 14 April, revealed that “a disproportionate number of immigrants, in particular from Somalia, Iraq, and Syria, were among the COVID-19 cases registered at Swedish hospitals.”[50] Somalis, who constitute just over half a percent of Swedish population, made up five percent of the hospitals’ confirmed cases, and the Somali-dominated Rinkeby-Kista district was the worst affected in the country.[51]

Sweden has also been criticised for its very high per capita death rate in comparison to its Nordic neighbours, although it has had fewer deaths per capita than the UK, Spain, Italy, Belgium and France.[52] As of 24 June 2020, Sweden recorded 511 deaths per million as against the much lower 104 deaths per million in Denmark, 59 in Finland and 46 in Norway.[53]

Battle of strategies: Britain vs Sweden

An interesting skirmish emerged between leading infectious disease specialists in Sweden and Britain over their countries’ strategies. The debate is significant as both countries claim to have been guided by science in their decision-making on the course of action. Initially, Britain, in the image of Sweden, signaled it would pursue a go-slow approach to allow the pathogen to circulate more widely and begin to create what virologists called herd immunity.[a] “Our aim is not to stop everyone getting it. You can’t do that. And it’s not desirable because you want to get some immunity in the population. We need to have immunity to protect ourselves in the future,” Britain’s chief scientific adviser Patrick Vallance said on 12 March.[54]

However, this changed with the appearance of a paper by epidemiologist Neil Ferguson and his COVID-19 Response Team at Imperial College London, published on March 16. The paper asserted that if robust action was not taken to stop the virus from infecting a previously unexposed population, then 510,00 people in Britain and 2.2 million in the US would die in a wave of infections that would overwhelm their healthcare infrastructure. Johan Giesecke, Sweden’s former chief epidemiologist and an advisor to the World Health Organization (WHO), argued that Ferguson’s mathematical simulation shocked the British government and persuaded it to do “a 180-degree U-turn” in panic. The Ferguson model was quickly embraced at the highest levels on both sides of the Atlantic, first by the UK and then by US.[55]

Giesecke has attacked the Ferguson model, labelling it “not very good” and “overly pessimistic.” He noted it was neither peer-reviewed nor published in a scientific journal and said in a webinar briefing conducted by Chatham House, the London-based think tank, that he thought someone should write a book about “how a not very scientific paper changed the policy of an entire country.”[56] Giesecke also said the Imperial College forecasts were almost hysterical and the Ferguson paper so fundamentally flawed by debatable assumptions—for instance, the percentage of people who were asymptomatic but still infectious—that “it loses all value” as a predictive tool.[57] While he agrees that imposing a strict lockdown will slow the spread of infections for a while, he asked, “But then, what next? No democratic society can remain in lockdown for many months or years. Their economies cannot withstand it, and the public won’t allow it.”[58]

Ferguson defended his stand claiming that “the majority of epidemiologists in the world support my position.” Ferguson said that “Sweden is still seeing increases in deaths and cases” and that Sweden’s mortality rates were “approaching New York City,” which has seen the greatest overall fatalities in the US so far. He said Britain, by contrast, “acted in time to keep the nation from being overwhelmed.”[59] Meanwhile, both Britain and Sweden are reporting high number of deaths. By 24 June 2020, Britain has counted 42,927 deaths at 632 per million and Sweden 5209 deaths at 511 per million.

Sweden’s Remedial Action

Swedish decision-makers have acknowledged some of the shortcomings in the country’s COVID-19 strategy, including the high number of deaths among the elderly in nursing homes. Half of those over 70 years old who have died from COVID-19 in Sweden lived in nursing homes, according to national statistics at the end of April. Tegnell admitted that he was surprised by the high incidence of deaths in care homes. “We thought our elderly homes would be much better at keeping this disease outside of them than they have actually been,” he said.[60]

Sweden has promptly reacted to this gap in its strategy. The government plans to spend about 2.2 billion kronor (US$220 million) on ratcheting up staff levels to help protect the country’s oldest citizens. Another 2 billion kronor will go toward compensating local authorities for the extra costs they have incurred in dealing with the pandemic.[61] However, nursing homes in Sweden are for the very frail, and even in normal times, 28 percent of men and 19 percent of women die within six months of entering the facility.

COVID-19 has not impacted only Sweden’s nursing homes. “The coronavirus has swept through Europe’s care homes killing thousands of residents. According to one recent study, on average the number of deaths account for half of the total victims”.[62] Most affected care homes were understaffed and lacked safety measures. Many care workers throughout Europe have alleged widespread wrongdoings in the nursing and care home sector. And several announced that they will not accept new guests due to increasing number of cases and deaths.[63]

Other European countries have also faced a similar situation as Sweden with their immigrant communities. Norway’s immigrant population, which makes up 15 percent of the country’s demography, had 25 percent of the cases. In Finland’s Helsinki, Somalis formed 17 percent of the positive cases, which is ten times more than their share of the city’s population.[64]

In regard to the slow progress made towards community immunity, Tegnell admitted in May that the antibodies figure was “a bit lower than we’d thought”, but added that it reflected the situation some weeks ago and that by now “a little more than 20%” of Stockholm’s population had probably contracted the virus.[65] However, this was much lower than the 25 percent expected by the Swedish public health agency based on the mathematical forecasting model by Tom Britton.[66] On Sweden’s high rate of deaths compared to other Nordic countries, Tegnell pointed out that critics were using figures that have a ‘”number of fundamental errors” and that countries record statistics in different ways, such as recording deaths reported only from hospitals.[67]

In early June, Tegnell conceded that there were weaknesses in the Swedish strategy. “If we were to encounter the same illness with the same knowledge that we have today, I think our response would land somewhere in between what Sweden did and what the rest of the world has done,” he said.[68] Sweden has also dropped its top health authority’s daily briefings on COVID-19, restricting them to twice a week.[69] Many have regarded this as a roll-back on transparency.

While the Swedish authorities have accepted that some broad elements of the overall policy have shown weaknesses and that some needed to be tweaked and others tightened, they continue to be committed to the overall direction determined for the country. Regarding the course of action adopted by the rest of the world, Giesecke opined, “I think there has been a huge overreaction in most countries around the world. They are doing the wrong thing. That’s what I think. They should be doing more like Sweden does.”[70] Despite some setbacks, especially deaths, Tegnell believes that “that does not disqualify our strategy a whole.” Asked if Sweden was basing its decision on a set of data different from the world and pressed into sharing the data on which its decisions were based, Tegnell said, “I think the question is what data the rest of the world is basing its decisions on. That is just as relevant. In most countries you find nothing.”[71]

Popular opinion in Sweden

Despite worldwide consternation and quite some criticism, most Swedes have backed the government’s COVID-19 strategy. A poll in Dagens Nyheter showed 70 percent of the population had a high degree of trust in Sweden’s approach. Moreover, trust in the country’s public health agency has increased since the coronavirus pandemic began.[72]

Many prominent Swedes are also backing the government. Didrikson disagrees with the criticism that the policy endangers people in the interests of the economy, saying that the policy is based on expert scientific advice and trust. “We’re putting decisions in the hands of those who know better. In Sweden we are trying to look at the facts as much as possible and we are taking a long-term view……. We don’t know if the Swedish authorities are right or not, but we trust them.”[73]

The WHO remarked that the Swedish strategy, a combination of trust and strategic controls, could be a key model for other countries in the long term.[74] “If we are to reach a ‘new normal,’ in many ways, Sweden represents a future model,” Mike Ryan, the WHO’s top emergencies expert, remarked in April. “What it has differently done is that it really, really has trusted its own communities to implement physical distancing.”[75]

Lockdowns, Vaccines and Drugs

Many countries that went into lockdown pinned their hopes on a vaccine being discovered sooner rather than later. But a vaccine that is safe, effective and provides long-term protection is yet to be found. The encouraging part is that the virus and its sequence are already known, being fully characterised genetically  within two weeks of first being reported.[76] There are several techniques in which vaccines are made, but it is important to use a technique that allows the vaccine to be developed in a timeframe that is meaningful for this pandemic.[77] Normally, a vaccine takes several years to develop. Additionally, to contain the COVID-19 virus, the vaccine has to be made available in massively large quantities that can be administered very quickly in all communities across nations.[78]

The problem with the development of a vaccine is that it must go through several phases to test its tolerance and safety. Even if the development process is ramped up, it could take 12-18 months before a vaccine is ready. Although numerous global efforts to find a COVID-19 vaccine are currently underway, experience reveals that the drop-out rate of vaccines is high. Only one in ten vaccines goes from the laboratory to clinical testing and finally to the market.[79] Even if this extremely optimistic timeframe is achieved, getting enough doses for all 7.8 billion people around the world would be a monumental task. The distribution process will undoubtedly be through priority (the elderly, medical and nursing staff) before it is available to the larger public. It is safe to assume that at the quickest pace possible, a vaccine cannot be made ‘delivery-ready’ before 2022.

Politicians around the world, from Canada[80] to Australia[81] and even the US[82] are assuring that a vaccine will soon be found. Even if a vaccine is miraculously ready in a year’s time, that is simply too long to put any country into a lockdown. As Arthur Caplan, professor of Bioethics at New York University said, “We cannot plan public policy on a miracle”.[83] A quicker outcome of the on-going research efforts may yield effective drugs that could save lives. However, given the speed of the epidemic and the minimum time that would be needed to develop, test and market drugs, it may not yet be quick enough for many lives.

Conclusion: Analysing Lockdown Strategies in Sweden and Beyond

Any analysis of the Swedish strategy ought to begin by acknowledging that the country has shown great audacity in carrying out an experiment based on an analysis of the available body of knowledge with inconclusive evidence. In essence, Sweden has chosen to walk the ‘herd immunity’ path, although the Swedes do not officially subscribe to this term,[84] and distanced themselves from what Norberg calls the ‘herd mentality’ path.[85] The latter approach has been adopted by a number of countries based on what others have done. Sweden appears to have made a more holistic assessment of the situation, factoring in the opinion of its best scientific minds, the quality of its citizenry, its highly democratic traditions urging it not to restrict people’s fundamental rights, the significance of the economy and employment, and the impact of a lockdown on health and mental wellbeing.

The fight against the pandemic is not a quick game. It is a long-drawn process in which countries are likely to experience many ups and downs. They may make many mistakes and may be compelled to amend their strategies to ultimately reach their goal of stemming the spread of the virus. Judgements passed in the interim will merely be commentary without any insight on the result.[86]

It is also appropriate to recognise that the same approach is not always applicable when battling a crisis in different landscapes. There are several local circumstances and traditions that have allowed Sweden to adopt such a strategy. The same strategy is unlikely to work in countries like India, where the population is huge, urban densities are high, and general levels of education and awareness low.

At the same time, scientific decision-making, which is the hallmark of Sweden, and the concern for democratic freedoms, which all democracies should heed to, cannot be ignored in other countries. For democratic countries, a key takeaway from Sweden must be the immense faith reposed by the government in their citizens. According to David Heyman, Distinguished Fellow at Chatham House, “The most noteworthy accomplishment in Sweden……. is that people understand how to protect themselves and how to protect others. That is the most important base that any country can have, whether they have locked down or haven’t locked down……Sweden has put people at the base of this and I think that is most important for a lasting and sustainable intervention.”[87]

In the final analysis, all COVID-19 strategies will be judged by one measure alone—the cost at which the virus was vanquished. It will be computed by comparing the long-term socio-economic cost with the human lives lost. The loss of human lives has been inordinately high in Sweden thus far. Many of these lives could have been saved if greater attention had been paid to preventing the virus from reaching nursing homes. However, barring this failure, Sweden seems to have calibrated its response to the virus very carefully. It has allowed most normal activities and only restricted those that have the greatest capacity to spread the contagion. The country’s tradition of enormous respect for scientific advice, its obeisance to human freedom and dignity, its disallowance of police intrusion in citizen’s lives and the trust in its citizenry are remarkable and a lesson in the democratic conduct of a nation.

This cannot be said of the countries that rushed into restrictive lockdowns. As the Swedes contend, no real scientific evidence has established the efficacy of lockdowns. An action as drastic as the complete shutdown of a country ought to be based on sound evidence that it would be an effective antidote to the virus. The burden of proof lies on those who propagate that approach; countries that imposed lockdowns must prove its positive impacts. But this has not been the case.

A fallout of imposing lockdowns has been that the governments were focused on controlling the virus without considering the impact on human life, including the loss of livelihood, the loss of educational opportunities for students, rising domestic abuse, leaving the old and disabled without help, and the impact on mental health.

The pandemic still has a long way to go. If at the end of it the Swedish strategy goes terribly wrong, many lives that could have been saved will have been lost. But perhaps the country would have done well on other counts. There would not have been an exacerbation of the economic downturn and massive loss of livelihood, and the government would not have been held guilty of causing pain and suffering through the restrictions. However, if Sweden also succeeds in matching other countries on deaths per million, the strategy will end up being admired. On the other side, countries that declared long and total lockdowns will have little to show in terms of their economy and preservation of people’s fundamental rights. They will already have caused massive loss of livelihoods and suffering for many of their citizens, compromised the health of many by forbidding movement, and under-servicing non-COVID-19 ailments. Besides, if these countries also failed to curb the spread of the virus and keep the death toll low, they will see terrible tragedies.


[a] The term refers to the ability of the antibody or immune system of people who had already been infected to prevent re-infection. If a large number of people develop solid immunity against a virus and antibodies develop in the population already infected, then there is a population immunity and the virus cannot infect the community. In other words, the disease is looking for people to infect, but at one point, it only finds immune people around and then the disease dies out.

[1] Ewan Somerville, “Coronavirus China: When did Wuhan lockdown begin and for how long?”, Evening Standard, April 8, 2020,

[2] Ryan Fahey, “Half the world in lockdown: 3.9 billion people are currently called on to stay in their homes due to coronavirus”, Daily Mail, April 2, 2020.

[3] “Coronavirus: The world in lockdown in maps and charts”, BBC News, April 7, 2020.

[4] Ibid

[5] “Total Coronavirus Deaths in Italy”, Worldometer.

[6] Jason Horowitz, “Italy’s Health Care System Groans Under Coronavirus -a Warning to the World”, The New York Times, March 12, 2020.

[7] Ibid

[8] “Italy’s dead overwhelm morgues as virus toll tops 8,000”, Medical Express, March 26, 2020.

[9] “Italy begins to emerge from world’s longest lockdown”, The Economic Times, May 4, 2020,

[10] “Coronavirus: The world in lockdown in maps and charts”, BBC News, April 7, 2020.

[11] Ibid

[12] Ibid

[13] Ibid

[14] Ramanath Jha, “Lockdown: uncertain gains, rising losses”, Observer Research Foundation, May 22, 2020.

[15] Johan Norberg, “How Sweden is Responding to the Coronavirus”, The Cato Institute, April 16, 2020,

[16] Ibid

[17] Ibid

[18] Heather Farmbrough, “Why Sweden’s Approach To Coronavirus May Not Be What You Think”, Forbes, May 14, 2020.

[19] Tae Hoon Kim, “Why Sweden is unlikely to make a U-turn on its controversial Covid-19 strategy”, The Guardian, May 22, 2020.

[20] “How Sweden is Responding to the Coronavirus”

[21] “Why Sweden’s Approach To Coronavirus May Not Be What You Think”

[22] “Webinar: Weekly COVID-19 Pandemic Briefing – The Swedish Approach”, Chatham House, April 29, 2020.

[23] Ibid

[24] “How Sweden is Responding to the Coronavirus”

[25] “Why Sweden’s Approach To Coronavirus May Not Be What You Think”

[26] “How Sweden is Responding to the Coronavirus”

[27] “Why Sweden’s Approach To Coronavirus May Not Be What You Think”

[28] John Sibley, “Anti-lockdown protests around the world”, Reuters, May 16, 2020.

[29] Johan Giesecke, “The invisible pandemic”, Lancet, May 5, 2020.

[30] Ibid

[31] “Quick Facts About Sweden”,

[32] “Total Coronavirus Deaths in Sweden”, Worldometer, May 25, 2020.

[33] Ibid

[34] “Number of coronavirus (COVID-19) deaths in Sweden 2020, by age group”, Statista 2020, June 24, 2020.

[35] “Sweden”, World Health Organization – Diabetes country profiles 2016.

[36] “Health Stats: compare key data on Sweden & United States”, NationMaster.

[37] “State of Health in the EU, Sweden, Country Health Profile 2017”, OECD.

[38] “Dr Anders Tegnell – Sweden’s Decision Not to Impose Quarantine”, The Daily Social Distancing Show, May 5, 2020.

[39] “The biggest myth about Sweden is that life is going on as normal”, The Local, May 27, 2020.

[40] Melissa Godin, “Sweden’s relaxed approach to the coronavirus could already be backfiring”, Time, April 9, 2020.

[41] Jon Henley, “Swedish PM warned over ‘Russian roulette-style’ Covid-19 strategy”, The Guardian, March 23, 2020.

[42] Phillip Bump, “Asked about Sweden, Trump undercuts the idea of quickly reopening the United States”, The Washington Post, April 11, 2020.

[43] “Swedish PM warned over ‘Russian roulette-style’ Covid-19 strategy”

[44] David Nikel, “Sweden: 22 Scientists say Coronavirus Strategy Has Failed As Deaths Top 1,000”, Forbes, April 15, 2020.

[45] “Why Sweden rejected a coronavirus lockdown”, BBC Newsnight, April 23, 2020.

[46] “How Sweden is Responding to the Coronavirus”

[47] Jon Henley, “Just 7.3% of Stockholm had Covid-19 antibodies by end of April, study shows”, The Guardian, May 21, 2020,

[48] Ibid

[49] Ibid

[50] Nathalie Rothschild, “The Hidden Flaw in Sweden’s Anti-Lockdown Strategy”, Foreign Policy, April 21, 2020,

[51] Ibid

[52] Johan Ahlander, “Sweden tops Europe COVID-19 deaths per capita over last seven days”, Reuters, May 19, 2020.

[53] “COVID-19 Coronavirus Pandemic”, Worldometer, 24 June 2020.

[54] William Booth, “A tale of two epidemics: Scientists in Sweden and Britain fight over who took the right public health path”, The Washington Post, May 8, 2020.

[55] Ibid

[56] “Webinar: Weekly COVID-19 Pandemic Briefing – The Swedish Approach”

[57] “A tale of two epidemics”

[58] Ibid

[59] Ibid

[60] “Why Sweden’s Approach To Coronavirus May Not Be What You Think”

[61] “Sweden revises Covid-19 strategy after deaths of elderly spiral”, Indian Express, May 25, 2020.

[62] Valerie Gauriat, “The deadly impact of COVID-19 on Europe’s care homes”, Euronews, May 14, 2020.

[63] Erbil Basay, Serife Cetin, Yususf Ozcan, Senhan Bolelli, Aski Kiyagan, Baris Seckin, “Nursing homes in Europe struggle with COVID-19 pandemic”, Anadolu Agency, April 2, 2020.

[64] Lena Masri, “COVID-19 Takes unequal toll on immigrants in Nordic region”, Reuters, 14 April 2020,

[65] “Just 7.3% of Stockholm had Covid-19 antibodies by end of April, study shows”

[66] Maddy Savage, “Coronavirus: What’s going wrong in Sweden’s care homes”, BBC News, May 19, 2020,

[67] “Sweden: 22 Scientists say Coronavirus Strategy Has Failed As Deaths Top 1,000”

[68] Rafaela Lindeberg, “Man Behind Sweden’s Controversial Virus Strategy Admits Mistakes”, Bloomberg, June 3, 2020,

[69] Charles Daily and Bloomberg, “Sweden to drop daily coronavirus briefings as scandal grows over its loose handling of the pandemic”, Fortune, June 10, 2020,

[70] Ibid

[71] Ibid

[72] “Why Sweden’s Approach To Coronavirus May Not Be What You Think”

[73] Ibid

[74] Ibid

[75] “A tale of two epidemics”

[76] Robert Salata, “COVID-19: When Will There be a vaccine?”, University Hospitals Roe Green Center for Travel Medicine & Global Health, March 27, 2020.

[77] “Webinar: Weekly COVID-19 Pandemic Briefing – Vaccines”, Chatham House, May 13, 2020,

[78] Ibid

[79] “Covid-19: How close are we to a vaccine and who will get it first?”, France 24 English, April 13, 2020,

[80] “Scientist says a coronavirus vaccine in just 12 months is ‘fake news’”, 60 Minutes Australia, May 17, 2020,

[81] Ibid

[82] Ibid

[83] Ibid

[84] “Sweden’s Coronavirus Strategy Targeting Herd Immunity Could be Adopted Globally, Say Analysts”, HospiMedica, May 14, 2020.

[85] “How Sweden is Responding to the Coronavirus”

[86] Andrea M Voyer and Jason J Czarnezki, Opinion, “An American perspective on the Swedish coronavirus strategy”, The Local, April 22, 2020,

[87] “Webinar: Weekly COVID-19 Pandemic Briefing – The Swedish Approach”

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Ramanath Jha

Ramanath Jha

Dr. Ramanath Jha is Distinguished Fellow at Observer Research Foundation, Mumbai. He works on urbanisation — urban sustainability, urban governance and urban planning. Dr. Jha belongs ...

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Ramanath Jha

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