Kontroverzni švedski epidemiolog Anders Tegnell, arhitekt “švedskega eksperimenta” glede ravnanja ob epidemiji korona virusa, se danes vse bolj dozdeva kot prerok, “švedski eksperiment” pa kot edini dolgoročno vzdržen pristop k ravnanju glede epidemije. Tegnell je pustil celotno javno življenje odprto, odprte šole, vrtce, trgovine, restavracije. Tudi nošenje mask ni obvezno. So le pripročila glede tega, kako ravnati in koliko ljudi je smiselno imeti hkrati v nekem prostoru. Ja, švedske številke glede novih okužb so bile še do konca julija zelo visoke, nad 100 novih okužb na 1 mio prebivalcev. Veliko starejših ljudi je umrlo. Toda danes, ko Evropo pretresa drugi val epidemije, je število okužb na Švedskem nizko in še upada ter je za 90% nižje kot julija. Vsi se sprašujejo ali zato, ker je Švedska dosegla potrebno stopnjo prekuženosti (čredno imunost).
Richard Milne je v Financial Timesu objavil zelo dober pogovor s Tegnellom. Ob njegovi trezni racionalnosti je zanimivo predvsem to, da ga v pol leta, ko je vodil kontroverzni “švedski eksperiment”, ki so ga mnogi označili kot kriminala ali zločin nad ljudmi, nihče ni poskusil zaustaviti. Vlada mu ni vzela pooblastil. Zato, ker na Švedskem odločitev glede ukrepanja v epidemiji ne sprejemajo politiki, pač pa agencija za javno zdravje (kot naša NIJZ). Švedi neodvisnost institucij jemljejo resno.
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.
The 64-year-old Swedish doctor was meant to spend 2020 helping Somalia set up a public health agency as well as sending questionnaires out to Swedes to gauge different aspects of their wellbeing. Instead, his approach to Covid-19 — to keep schools, restaurants, fitness centres and borders open while refusing to follow China in imposing a formal lockdown — has seen him become an unlikely polarising figure for a polarised age.
For many Swedes, their state epidemiologist has embodied a rational approach as other countries have appeared to sacrifice science to emotion.
“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.
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.
Sweden’s approach to the pandemic is unusual in large part because its governance is unusual. Unlike in pretty much every other country, it is not politicians who take the big decisions but Sweden’s public health agency, due to its constitution giving big powers to independent authorities. In practice, this means Tegnell. “This whole approach is Tegnell’s. The government has accepted it without questions,” says the critical epidemiologist.
That makes his ability to stand alone as the rest of the world locked down seem all the more remarkable. I ask him about it, suggesting it must be easier just to go with the flow. “Yes, of course it is. But I am not alone,” he says, dutifully listing the backing of the 500 staff in the public health agency as well as Sweden’s government and population.
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.
I suggest to Tegnell that an alien landing in Sweden would have difficulty knowing there is a pandemic whereas in England or France, with face masks prevalent, they would realise immediately. He argues that while that might be true on the surface, especially with masks — which Sweden is one of the few countries not to recommend wearing in public — the differences elsewhere are exaggerated. Swedes have stopped travelling just as much as neighbours; hotels and restaurants may not have closed but have been severely affected.
He points to the markings in supermarkets showing people where to stand and detailed restrictions on restaurants in terms of how many people they can have and how they serve them.
“These types of restrictions don’t exist almost anywhere else than in Sweden. We have really tried to focus on places that we have known are going to be really dangerous, while going into a record shop and buying a record will not cause hundreds of people to get infected,” he says, adding: “It is there, but I think, as an alien, you need to be here a bit longer to see it.”
Vir: Richard Milne, Financial Times