COVID-19 pandemic in Sweden

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COVID-19 pandemic in Sweden
COVID-19 Outbreak Cases in Sweden per capita with Legend.svg
Confirmed cases per 10,000 residents by region
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationSweden
First outbreakWuhan, Hubei, China
Index caseJönköping
Arrival date24 January 2020
(4 months and 1 day)
Date25 May 11:30 CEST
Confirmed cases33,843[1]
Severe cases1,957 ICU hospitalisations[1]
Deaths
4,029[1][note 1]
Official website
Swedish Public Health Agency Covid-19
(in Swedish)

The ongoing COVID-19 pandemic was confirmed to have reached Sweden on 31 January 2020, when a woman returning from Wuhan tested positive. On 26 February, following outbreaks in Italy and in Iran, multiple travel-related clusters appeared in Sweden. Community transmission was confirmed on 9 March in the Stockholm region. Since then, individuals in every län (county) have tested positive for COVID-19. The first death was reported on 11 March in Stockholm, a case of community transmission.

Sweden has not imposed a lockdown, unlike many other countries, and kept large parts of its society open. But the public is expected to follow a series of recommendations[note 2] from the government agency responsible for this area, in this case the Public Health Agency of Sweden. The Swedish constitution prohibits ministerial rule and mandates that the relevant government body, in this case an expert agency – the Public Health Agency – must initiate all actions to prevent the virus in accordance with Swedish law, rendering state epidemiologist Anders Tegnell a central figure in the crisis. The government usually follows agency advice – politicians overruling the advice from its agencies is extremely unusual in Sweden – as it has with legislation limiting freedom of assembly, temporarily banning gatherings of over 50 individuals, banning people from visiting nursing homes, and physically closing secondary schools and universities. Primary schools have remained open, in part to avoid healthcare workers staying home with their children.

The Public Health Agency issued recommendations to: if possible, work from home; avoid unnecessary travel within the country; to engage in social distancing; and for people above 70 to stay at home, as much as possible. Those with even minimal symptoms that could be caused by COVID-19 are recommended to stay home. The 'karensdag', or initial day without paid sick-leave, has been removed by the government and the length of time one can stay home with pay without a doctor's note has been raised from 7 to 21 days.

Sweden began testing for the virus in January, and as of 10 May 2010, approximately 177,000 samples had been analyzed. As of 25 May 2020, there have been 33,843 confirmed cases, of which 1,957 have received intensive care, and 4,029 deaths[note 1] related to COVID-19 in Sweden, including cases in which the cause of death is not attributed to COVID-19, with Stockholm County being the most affected.[1] As this only includes cases confirmed in a laboratory, the actual number is believed to be higher due to the number of laboratory-confirmed cases only amounting to 70% of an excess mortality observed in Sweden since late March. In early May, 14% of the COVID-19 deaths in Sweden had not been confirmed in a laboratory.

Background[edit]

Outbreak of a novel coronavirus disease[edit]

On 12 January, the World Health Organization (WHO) confirmed that a novel coronavirus (nCoV) was the cause of a respiratory illness in a cluster of people in Wuhan, in Hubei province, China, who had initially come to the WHO's attention on 31 December 2019. This cluster was initially linked to the Huanan Seafood Wholesale Market in Wuhan City.[6][7] A few days later, on 16 January, the Swedish Public Health Agency issued a press release highlighting the discovery of the novel coronavirus, and the agency monitoring the situation. The risk of spread to Sweden was described as "very low" as there was yet no evidence that the virus could spread between humans, but they recommended that individuals developing cough or fever after visiting Wuhan should seek medical care, and asked for healthcare professionals to be observant.[8]

After the World Health Organization classified the novel Coronavirus as a Public Health Emergency of International Concern on 30 January and demanded that all member states should cooperate to prevent further spread of the virus, the Agency requested for the Swedish government to classify the novel disease as a notifiable infectious disease in the Swedish Communicable Diseases Act as both dangerous to public health (allmänfarlig) and dangerous to society (samhällsfarlig), where contact tracing is required,[9][10][11] giving the disease the same legislative status as Ebola, SARS and Smallpox.[12] The agency also announced that they have analysing methods that can diagnose a case of the novel disease ‘within hours’ after testing, and that such tests had already been carried out, but that all had turned out negative.[9]

The COVID-19 outbreak was declared a pandemic by the WHO on 11 March,[13]

Pandemic plan[edit]

Following the 2005 outbreak of the H5N1 avian flu, Sweden drafted their first national pandemic plan, which since then had undergone several revisions. Since a 2008 revision to prepare for the 2009 swine flu pandemic, the plan includes the formation of a National Pandemic Group (NPG) in the event of a possible pandemic. The group involves several agencies, and define each agency’s role.

Photograph depicting a building
The Public Health Agency

The plan states that the Public Health Agency of Sweden, headed by director general Johan Carlson, will be the expert agency responsible for monitoring diseases with a pandemic potential, and with the mandate to assemble the National Pandemic Group to coordinate pandemic preparations and strategies on a national level, between the relevant agencies. The plan includes four additional governmental agencies: the Swedish Civil Contingencies Agency, the Swedish Medical Products Agency, the Swedish National Board of Health and Welfare and the Swedish Work Environment Authority, as well as the county administrative boards of Sweden and the employer's organisation Swedish Association of Local Authorities and Regions.[14][15]

Preparedness[edit]

In the 2019 Global Health Security Index of the ‘most prepared’ countries in the world for an epidemic or a pandemic published by the Johns Hopkins Center for Health Security, Sweden was ranked 7th overall. Sweden received high rankings regarding prevention of the emergence of a new pathogen, early detection and reporting of an epidemic of international concern and having a low risk environment. However, the Swedish health system received a lower score, questioning if it was sufficient and robust enough to treat the sick and protect health workers.[16] [note 3]

Before the outbreak of the new coronavirus, Sweden had a relatively low number of hospital beds per capita, with 2.2 beds per 1000 people (2017),[18] and intensive care unit (ICU) beds per capita of 5.8 per 100.000 people (2012).[19] Both numbers were lower than most countries' in the EU. The total number of ICU beds in Swedish hospitals was 526.[20]

History[edit]

COVID-19 cases in Sweden  ()
     Deaths        Recoveries        Active cases

Feb Feb Mar Mar Apr Apr May May Last 15 days Last 15 days

Date
 # of cases[a]
# of deaths[a]
2020-02-04
1(n.a.)
1(=)
2020-02-26
2(+100.0%)
2020-02-27
3(+50.0%)
2020-02-28
11(+266.7%)
2020-02-29
14(+27.3%)
2020-03-01
14(+0.0%)
2020-03-02
19(+35.7%)
2020-03-03
32(+68.4%)
2020-03-04
62(+93.8%)
2020-03-05
87(+40.3%)
2020-03-06
146(+67.8%)
2020-03-07
179(+22.6%)
2020-03-08
225(+25.7%)
2020-03-09
326(+44.9%)
2020-03-10
424(+30.1%)
2020-03-11
620(+46.2%) 1(n.a.)
2020-03-12
771(+24.4%) 1(+0.0%)
2020-03-13
923(+19.7%) 2(+100.0%)
2020-03-14
994(+7.7%) 3(+50.0%)
2020-03-15
1,063(+6.9%) 5(+66.7%)
2020-03-16
1,146(+7.8%) 7(+40.0%)
2020-03-17
1,265(+10.4%) 8(+14.3%)
2020-03-18
1,410(+11.5%) 14(+75.0%)
2020-03-19
1,553(+10.1%) 21(+50.0%)
2020-03-20
1,733(+11.6%) 30(+42.9%)
2020-03-21
1,867(+7.7%) 38(+26.7%)
2020-03-22
1,984(+6.3%) 50(+31.6%)
2020-03-23
2,166(+9.2%) 61(+22.0%)
2020-03-24
2,396(+10.6%) 82(+34.4%)
2020-03-25
2,710(+13.1%) 104(+26.8%)
2020-03-26
2,996(+10.6%) 135(+29.8%)
2020-03-27
3,362(+12.2%) 167(+23.7%)
2020-03-28
3,662(+8.9%) 202(+21.0%)
2020-03-29
3,943(+7.7%) 240(+18.8%)
2020-03-30
4,359(+10.6%) 284(+18.3%)
2020-03-31
4,834(+10.9%) 333(+17.3%)
2020-04-01
5,320(+10.1%) 386(+15.9%)
2020-04-02
5,874(+10.4%) 457(+18.4%)
2020-04-03
6,475(+10.2%) 535(+17.1%)
2020-04-04
6,832(+5.5%) 607(+13.5%)
2020-04-05
7,172(+5.0%) 694(+14.3%)
2020-04-06
7,561(+5.4%) 784(+13.0%)
2020-04-07
8,299(+9.8%) 868(+10.7%)
2020-04-08
8,953(+7.9%) 982(+13.1%)
2020-04-09
9,598(+7.2%) 1,068(+8.8%)
2020-04-10
10,052(+4.7%) 1,158(+8.4%)
2020-04-11
10,448(+3.9%) 1,260(+8.8%)
2020-04-12
10,912(+4.4%) 1,357(+7.7%)
2020-04-13
11,349(+4.0%) 1,442(+6.3%)
2020-04-14
11,829(+4.2%) 1,533(+6.3%)
2020-04-15
12,433(+5.1%) 1,646(+7.4%)
2020-04-16
13,056(+5.0%) 1,754(+6.6%)
2020-04-17
13,744(+5.3%) 1,833(+4.5%)
2020-04-18
14,276(+3.9%) 1,921(+4.8%)
2020-04-19
14,665(+2.7%) 2,009(+4.6%)
2020-04-20
15,127(+3.2%) 2,093(+4.2%)
2020-04-21
15,835(+4.7%) 2,155(+3.0%)
2020-04-22
16,557(+4.6%) 2,228(+3.4%)
2020-04-23
17,310(+4.5%) 2,308(+3.6%)
2020-04-24
18,087(+4.5%) 2,390(+3.6%)
2020-04-25
18,561(+2.6%) 2,449(+2.5%)
2020-04-26
18,861(+1.6%) 2,512(+2.6%)
2020-04-27
19,408(+2.9%) 2,574(+2.5%)
2020-04-28
20,134(+3.7%) 2,619(+1.7%)
2020-04-29
20,912(+3.9%) 2,664(+1.7%)
2020-04-30
21,508(+2.9%) 2,697(+1.2%)
2020-05-01
22,040(+2.5%) 2,719(+0.8%)
2020-05-02
22,338(+1.4%) 2,738(+0.7%)
2020-05-03
22,596(+1.2%) 2,758(+0.7%)
2020-05-04
23,055(+2.0%) 2,769(+0.3%)
2020-05-05
23,692(+2.8%) 2,854(+3.1%)
2020-05-06
24,421(+3.1%) 2,941(+3.0%)
2020-05-07
25,172(+3.1%) 3,040(+3.4%)
2020-05-08
25,857(+2.7%) 3,175(+4.4%)
2020-05-09
26,366(+2.0%) 3,220(+1.3%)
2020-05-10
26,644(+1.1%) 3,225(+0.2%)
2020-05-11
27,055(+1.5%) 3,256(+0.9%)
2020-05-12
27,761(+2.6%) 3,313(+1.7%)
2020-05-13
28,420(+2.4%) 3,460(+4.4%)
2020-05-14
29,046(+2.2%) 3,529(+2.0%)
2020-05-15
29,697(+2.2%) 3,646(+3.3%)
2020-05-16
30,055(+1.2%) 3,674(+0.8%)
2020-05-17
30,313(+0.9%) 3,679(+0.1%)
2020-05-18
30,707(+1.3%) 3,698(+0.5%)
2020-05-19
31,285(+1.9%) 3,743(+1.2%)
2020-05-20
31,523(+0.8%) 3,831(+2.4%)
Notes:
  1. ^ a b Data on cases and deaths is compiled by Folkhälsomyndigheten at 11:30 (UTC+02:00) each day. Swedish authorities does not publish data on recoveries. Reports of new cases and deaths to Folkhälsomyndigheten might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days. Data includes deaths with a confirmed Covid-19 diagnosis where the cause of death isn't attributed to Covid-19. As of data from the National Board of Health and Welfare from 21 April, this number amounted to 4.5% of cases confirmed in a laboratory. Data includes confirmed cases (U07.1) but excludes non-confirmed cases (U07.2). As this only include cases confirmed in a laboratory, the actual number is believed to be higher due to the number of laboratory-confirmed cases only amounting to 70% (as of 3 May) of an excess mortality observed in Sweden since late March, according to an statistical analysis by the Public Health Agency based on data from from the Swedish Tax Agency and the European mortality monitoring activity (EuroMOMO). By late April, there had been approximately 2800 excess deaths in Sweden.[2][21][22]

On 31 January, the first Swedish case was confirmed in a woman in Jönköping who had travelled to Sweden from Wuhan on 24 January directly from Wuhan. The case was fully isolated and there are no reports of further spread.[23][24] The second case was diagnosed at Sahlgrenska University Hospital, Gothenburg on 26 February, after a man who had recently returned from northern Italy following the COVID-19 outbreak in Italy had developed symptoms.[25][23] With five additional cases confirmed on 27 February,[26] the Swedish Public Health Agency ('Folkhälsomyndigheten') put out a statement that these cases were all related to travel to high-risk zones and that there was no evidence of community transmission.[27] Disease control measures, including extensive contact tracing, turned up over 200 travel-related cases in the following weeks, all with connection to confirmed cases or travel to high risk regions.[28]

On 27 February, Uppsala County confirmed its first case in a woman with a travel history to Germany, where she had met with an Italian colleague, and had been admitted to Uppsala University Hospital[29] after seeking medical attention with flu-like symptoms. This came as the first cases of community transmission was confirmed among two patients who had sought care at S:t Göran Hospital, Stockholm, on 6 March.[30] They were assumed to have been infected through community transmission approximately 7 days before seeking care.[citation needed] The following day, Jämtland and Västernorrland also confirmed initial cases.[31][32]

Responding to indications of local transmission in the Stockholm area and Västra Götaland, the Public Health Agency on 10 March raised the risk assessment of community spread from moderate to very high, which is the highest level.[33][33][34][35] The first death was reported on 11 March, when a person in their 70s from the Stockholm region died in the intensive care unit of Karolinska University Hospital. The person was reported to have acquired the virus through community transmission, believed to have occurred about one week before death. The person also belonged to a risk group.[36] After the first case in Västmanland County was confirmed on 13 March, the disease had reached all of the 21 regions in Sweden.[1]

The Public Health Agency of Sweden declared on 13 March that stopping the spread of COVID-19 has entered a "new phase" which requires "other efforts". The continued focus is now to delay spread among the population and to protect the elderly and most vulnerable against the disease.[37] The health agency believed that 5–10% of the population in Stockholm County were carrying the virus on 9 April.[38] In mid-April, it was reported that out of the approximately 1,300 people who had died after having caught the virus, one third had been living at nursing homes. The figure differed between the regions. In Stockholm, the city most affected by the pandemic, half of the deaths had been residents in one of its many nursing homes.[39] The Health Agency saw the spread at the homes as their biggest concern as of then, but "not as a failure of our overall strategy, but as a failure of our way to protect the elderly".[40][41] The situation led to the Health and Social Care Inspectorate to begin carrying out controls at the homes.[39]

Response from the authorities[edit]

The Swedish government has tried to focus efforts on encouraging the right behaviour and creating social norms rather than mandatory restrictions. Government officials including Swedish prime minister Stefan Löfven has encouraged each individual to take responsibility for their own health and the health of others, and to follow the recommendations from the Public Health Agency of Sweden,[42] as the agency responsible for monitoring a pandemic and coordinating the response. The Swedish constitution mandates that government agencies should work independently from the government and that the relevant expert agencies must issue advice prior to any government actions within the agency's area, in this case aiming to prevent the spread of the virus, with a strong mandate that the expert agencies should initiate actions, avoiding rule by ministers.[43] However, the agencies do not have the power to pass laws. Instead, they give out recommendations on how someone can or should act in order to meet a binding regulation within the agency's area of activity (in this case The Swedish Communicable Diseases Act). Although there is no legal framework for a governmental agency to impose sanctions on someone for going against its recommendations, it isn't optional as the recommendations work as guidelines on how to act in order to follow a regulation (in this case an obligation to help halting the spread of am infectious disease).[44][45] The independence of Swedish agencies and the choice of 'recommendations' instead of legislation has received much coverage in international media.[46] Swedish foreign minister, Ann Linde described Sweden as having ‘rather small ministries, but rather big authorities’ (with the Public Health Agency being one such authority), and this going back 300–400 years, and Sweden being characterized by a very high level of trust in its authorities from both the people and the politicians, and that Swedes had a very strong urge to following recommendations from authorities, thus making legislation largely unnecessary. When asked if Sweden would consider tougher restrictions, Löfven and Linde both made clear that the Swedish government wouldn't hesitate to do so if deemed necessary and on advice from the expert agencies, but that such measures needed to be taken at the right time, and they believe it's hard to make people adhere to lockdowns for an extended period.[47][48]

Strategy[edit]

According to the Swedish Public Health Agency, the Swedish strategy aimed to protect its senior and/or vulnerable citizens, and to slow down the spread of the virus, in order to keep the healthcare system from getting overwhelmed.[49][50][51][52] They are also mandated by law to make their response based on scientific evidence.[53] In April 2020, an adviser to the Public Health Agency, Johan Giesecke, a former state epidemiologist, said:

We, or the Swedish government, decided early, in January, that the measures we should take against the pandemic should be evidence-based. And when you start looking around at the measures being taken now by different countries, you'll find that very few of them have a shred of evidence...
But we know of one that has been known for 150 years or more, that washing your hands is good for you and good for others when you're in an epidemic. But the rest, border closures, school closings, social distancing... there's almost no science behind most of this.[52]

Representatives of the Swedish government, as well as its agencies, have repeatedly denied that pursuing herd immunity is part of the Swedish strategy, as claimed by foreign press and scientists in and outside Sweden.[54][55][52] According to state epidemiologist Anders Tegnell, herd immunity had not been calculated in the strategy, and if it had been the goal, "we would have done nothing and let coronavirus run rampant". But he believed, in April 2020, that Sweden would benefit from herd immunity in the long run,[55] and reasoned that all countries would eventually have to achieve it to beat the virus.[56] In May 2020 he said that he believed it was unlikely that Sweden, or any other country, would ever reach full herd immunity, and also that it would be a mistake to base a strategy on a hypothetical vaccine, as it would likely be years until there is a vaccine that can be distributed to an entire population. Instead, he believed COVID-19 was something "we’re going to have to live with for a very long time".[57]

A photograph of Anders Tegnell.
State epidemiologist Anders Tegnell, the architect of the Swedish strategy

While many countries imposed nationwide lockdowns and curfews, such measures were prohibited by the Swedish constitution.[58] Although the government were later granted more authority for imposing restrictions on transport following a temporary amendment in April,[59] the Swedish authorities considered lockdowns to be unnecessary, as they believed that voluntary measures could be just as effective as bans.[58] Although many considered this to be a 'relaxed' approach, it was defended by the authorities as well as government officials, among them Prime Minister Stefan Löfvén, to be more sustainable, as unlike lockdowns, it could be in place for "months, even years".[60][57] Representatives from the Health Agency has also argued lockdowns lacked scientific basis, with Tegnell remarking that the Health Agency had "looked at a number of European Union countries to see whether they have published any analysis of the effects of these measures before they were started" but that they "saw almost none".[61][57] Similarly, they have also criticized other countries for imposing lockdowns without an exit strategy.[57][62]

Unlike many European countries, including neighboring Denmark and Norway, Sweden did not close its preschools or elementary schools as a preventive measure. This was met with criticism within Sweden.[63][64][65] According to the Health Agency, the main reasons for not closing schools was that as a preventive measure it lacked support by research or scientific literature, and because of its negative effects on society. They argued that many parents, including healthcare professionals, would have no choice but to stay home from work to care for their children if schools were closed. There was also concern for a situation where elderly people babysit their grandchildren, as they are of bigger risk of severe symptoms in case of infection. According to agency's estimations, closures of elementary schools and preschool could result in an absence of up to 43,000 healthcare professionals, including doctors, nurses and nurse's assistants, equalling 10 percent of the total workforce in the sector. In May, Tegnell said that the decision was right, as the healthcare system would not have managed the situation the past months if Swedish authorities had chosen to close elementary schools.[66][67][68]

After the Danish government went against the advice of the Danish Health Authority and closed their national borders in March, Tegnell remarked that there were currently no scientific studies supporting border closures to be an effective measure against a pandemic, and that "history has proven it to be completely meaningless measure". He argued that it could, at best, delay the outbreak for one week, and also pointed out that the WHO had recommended against border closures.[69][70][61]

Measures[edit]

On 10 March 2020, responding to indications of community transmission, the Public Health Agency advised everyone with respiratory infections, even mild cases, to refrain from social contacts where there is a risk of spreading the virus, in private as well as working life. They also ask health care staff working with risk groups, including nursing homes, not work if they have any symptoms of respiratory infection. Relatives of elderly should also avoid unnecessary visits at hospitals and in facilities for elderly, and never visit if there are any respiratory symptoms.[71][72]

Social distancing[edit]

On 16 March 2020, the agency recommended that people over 70 should limit close contact with other people, and avoid crowded areas such as stores, public transport and public spaces.[73] At the end of March, 93% of those older than 70 said that they were following the recommendations from the health service to some extent, with the majority having decreased their contacts with friends and family.[74] The same day, they also recommended that employers should recommend their employees work from home.[73] One month later, statistics showed that roughly half the Swedish workforce was working from home.[75] The following day, the agency recommended that secondary schools and universities use distance learning,[76] with schools following suit all over the country.[77] The decision to recommend distance education for secondary and tertiary education, but not for elementary schools, was that studies at secondary schools and universities to a higher extent require commuting and travelling, and that students would not depend on parental care while not in schools, and school closings therefore did not risk interrupting society.[78][79]

In April, many of the organisations running the public transport systems for the Swedish counties had reported a 50% drop in public transport usage, including Kalmar Länstrafik in Kalmar County, Skånetrafiken in Skåne County, Stockholm Public Transport in Stockholm County, and Västtrafik in Västra Götaland County.[80][81][75][82] In Stockholm, the streets grew increasingly emptier, with a 30% drop in the number of cars,[83] and 70% fewer pedestrians.[75]

In mid-May, and on the request of the Public Health Agency, the Swedish Transport Agency temporarily suspended the regulations that allowed for passenger transport on lorries or trailers pulled by tractors, trucks or engineering vehicles at graduations and carnivals. The new rules were to be in place between 15 May and 31 December.[84][85]

Ban on gatherings[edit]

The same day as the first Swedish death to COVID-19, 11 March, the Swedish government passed a new law at the request of the Public Health Agency, limiting freedom of assembly by banning all gatherings larger than 500 people, with threat of fine and prison.[86] The ban would apply until further notice.[87] According to the Health Agency, the reasoning behind drawing the line at 500 was to limit long-distance travel within the nation's borders, as bigger events are more likely to attract visitors from all over the country.[88] Although freedom of assembly is protected by the Swedish constitution in the Fundamental Law on Freedom of Expression, the constitution allows for a government to restrict the freedom, if needed to limit the spread of an epidemic.[89][90] On 27 March the government announced that the ban on public gatherings would be lowered to include all gatherings of more than 50 people, to further decrease the spread of the infection, again at the request of the Public Health Agency.[91][92] The ban would apply to arts and entertainment events including theatre, cinema and concerts, religious meetings, demonstrations, lectures, competitive sports, amusement parks, fairs and markets. The ban did not include gatherings in schools, workplaces, public transport, grocery stores or shopping malls, health clubs or private events.[93][94] The agency also recommended that plans for events and gatherings of fewer than 50 people should be preceeded by a risk assessment and, if necessary, followed by mitigation measures. Additionally, they recommend that digital meetings should be considered.[95] The ban on large gatherings had no end-date, and as of late April, the Health Agency was reported as having no plans for when the ban should be lifted.[96]

Travel[edit]

On 18 March, the Health Agency recommended that everyone should avoid travelling within the country. This came after signs of ongoing community transmission in parts of the country, due to concern that a rapid spread over the country would make redistribution of healthcare resources more difficult. They also called for the public to reconsider any planned holidays during the upcoming Easter weekend.[97][98] The calls to avoid traveling and social interactions during the Easter weekend were repeated several times by agency and government officials, among them Prime Minister Stefan Löfvén and King, Carl XVI Gustaf.[99][100][101] Telia, a Swedish multinational mobile network operator, did an analysis of mobile network data during the week of Easter, and found that most Swedes had followed the agency's recommendations to avoid unnecessary travels during the Easter holidays. Overall, travel from the Stockholm region had decreased by 80–90%, and the number of citizens of Stockholm travelling to popular holiday destinations like Gotland and the ski resorts in Åre had fallen with more than 90%. Travel between other regions in Sweden had fallen as well.[102][103] Ferry-line operator Destination Gotland, who previously had called on their customers to rethink their planned trips for Easter, reported that 85% of all bookings had been rescheduled.[104]

Communication and information[edit]

Anders Tegnell being interviewed by a reporter from a TV news station.
State epidemiologist Anders Tegnell during a press conference outside the Karolinska Institute in Stockholm, Sweden, in 2020

Beginning in March, press conferences were held daily to at 14:00 local time, with representatives from the three government agencies responsible for coordinating Sweden's response to the pandemic; the Public Health Agency, usually represented by state epidemiologist Tegnell or deputy state epidemiologist Anders Wallensten, the National Board of Health and Welfare and the Swedish Civil Contingencies Agency.[105] According to the latter, close to one million people followed each press conference on the TV or the radio. The ratings excluded other types of media.[106][107]

In response to COVID-19, the Public Health Agency of Sweden issued a series of infographics in different languages describing how to protect oneself and others from infection.

For official information on the disease and the situation in Sweden, the authorities referred the public to the website krisinformation.se, which compiles official emergency information from Swedish authorities. The website is operated by the Civil Contingencies Agency, as the agency responsible for emergency information to the public during emergencies.[108] The agency reported a big increase in the number of people visiting the website during the beginning of the pandemic, with 4.5 million views between January and April 2020, compared to 200,000 during the same period in 2019.[106][107]

In March, the Civil Contingencies Agency received 75 million SEK from the government for public service announcements to inform the public about the virus, and how to reduce the spread of the disease to slow down the spread of the virus.[109]

Legislation[edit]

On 16 April, the Riksdag passed a bill on a temporary amendment on the Swedish law on infectious diseases (2004:168). The new law granted the Swedish government more authority, by allowing it to make decisions without a preceeding vote in the Swedish parliament, the Riksdag. The purpose of the law was to enable the government to make speedy decisions on measures against an ongoing pandemic.[110] The bill had initially been criticised by the parties in opposition and the Council on Legislation for being too vague,[111][112] but was accepted by the riksdag following a revision defining the measures, and an amendment stating that all measures needed to be reviewed by the parliament, which came after negotiations between the government and the opposition. Thus, the Riksdag would be able to revoke any imposed measures after they had come into effect.[113] The law would only apply for measures linked to the ongoing pandemic, and it would apply for a limited time only. The law came into effect on 18 April, and would last until 20 June.[114] The bill would allow the government to quickly and independently impose measures such as restrictions on transport and closures of bus station and train stations, ferries and ports, businesses such as restaurants, health clubs or malls, libraries and museums, or schools. The law would also allow the government to make decisions on redistribution of medicine and other healthcare equipment, such as personal protective equipment between different healthcare providers, including privately owned companies.[115][116] The new law would not allow for the government to impose measures to that of would restrict people's ability to go outside, similar to the curfews in other countries, as it would limit people's constitutional right to free movement.[110][114]

The karensdag, the unpaid first day of sick leave, was temporarily discontinued on 11 March in an effort to encourage people to stay home if they were experiencing symptoms consistent with COVID-19.[117] On 13 March, the government decided to temporarily abolish the demand of a doctor's certificate for 14 days for people staying home from work due to illness (i.e. sick pay period). Previously a doctor's certificate was needed after seven days.[118]

On 24 March 2020, the government introduced new restrictions to bars and restaurants requiring all service to be table service only. Restaurants were also recommended increase the space between the tables. Venues that do not adhere to the new restrictions could be shut down.[119][120] Several bars and restaurants were later ordered to close by municipal health inspectors.[121] Beginning on 1 April, all private visits to nursing homes was outlawed by the government. Many municipalities had already forbidden such visits. The national ban was however general, and those in charge of the facilities would be able to make exceptions under special circumstances, provided that the risk of spread of the virus was low.[122]

Following reports of people hoarding medication and concerns of drug shortages, the Medical Products Agency requested for the Swedish government to impose restrictions on purchases. This resulted in a new regulation limiting the amount of drugs purchased at the same occasion to three months worth of consumption, down from a previous limit of one year. The new regulations came to effect on 1 April and would be in place until further notice, and included to both prescription and over-the-counter drugs.[123][124]

Finance and the economy[edit]

In mid-March, the government proposed a 300 billion SEK (€27bn) emergency package to reduce the economic impact of the crisis. The proposal included a system with a reduction in work hours where the government will pay half to salary, aiming to help businesses stay afloat without having to do layoffs. Further, the government would pay the employer's expenses for any sick leaves, which is normally shared between the employer and the state.[125] The normal costs of employer contributions have also been temporarily discontinued for small business owners. This will save small businesses approximately 5000 SEK per employee each month but will result in a loss of tax revenue of 33 billion SEK.[126] The budget emergency package proposed by the government in mid-March to lessen the economic impact of the crisis was supported across the political spectrum, including all parties in opposition in the Riksdag. It was also welcomed by trade unions as well as the private and business sectors. However, some union representatives stressed that 'it won't be enough', a view shared by the biggest employer's organisation, the Confederation of Swedish Enterprise.[127]

On 2 April, the Financial Supervisory Authority ('Finansinspektionen') decided that Swedish banks temporarily can allow exemptions for housing mortgage lenders regarding amortizing of loans.[128]

Advice against travel abroad[edit]

The government has issued progressively stricter advisories against travel. Beginning on 17 February, the Swedish Ministry of Foreign Affairs advised against all trips to Hubei Province, China, as well as non-essential travel to the rest of China apart from Hong Kong and Macao.[129][130] On 2 March the Ministry for Foreign Affairs advised against trips to Iran, due to the uncontrolled spread of the COVID-19 in the country.[131] The Swedish Transport Agency also revoked Iran Air's permit for Iranian flights to land in Sweden from the same date.[132][133] According to the foreign ministry, there were several thousands Swedish citizens in Iran at the time of the ban, many of them with difficulties getting back to Sweden.[134] On 6 March, the Ministry for Foreign Affairs advised against all non-necessary trips to northern Italy, specifically the regions of Piemonte, Liguria, Lombardia, Emilia-Romagna, Trentino-Alto Adige, Valle d'Aosta, Veneto, Friuli Venezia Giulia, Marche and Toscana.[135] Turin, Milan, Venice, Verona, Trieste and Florence are large cities in these regions. The Public Health Agency of Sweden, who initiated the recommendation for the Ministry for Foreign Affairs, states that the decision is based solely on the strain of the Italian health care system.[136] On similar grounds, the foreign affairs ministry also advised against all non-necessary travel to the city of Daegu and the province of Gyeongbuk in South Korea.[137] The advice regarding travel to Italy was extended 10 March to include all of its regions.[138] Finally, all international travel was discouraged on 14 March. The advice was to be in place for one month, after which it would be up for review.[139][140] Travel from non-EU/EEA member states was stopped on 17 March[141] and unnecessary travel within Sweden was advised against on 19 March.[142][143]

The foreign ministry estimated that between 40,000 and 60,000 Swedes were stranded abroad in late March. According to Swedish policy, Swedes travelling abroad have their own responsibility to arrange for any return travels, without assistance from Swedish diplomatic missions, and travellers trying to travel home are referred to airlines, travel agencies or insurance companies. Some of those were critical of the foreign ministry, and were asking for help from the Swedish authorities.[139][144] The foreign ministry were initially reluctant to depart from the policy.[145] However, as a growing number of countries closed their airports and many Swedes found themselves stranded in a foreign country unable to arrange travels themselves, the foreign ministry began work on evacuating Swedish citizens. [144][146] In early May, the Ministry of Foreign Affairs reported that the only location from which stranded Swedish citizens hadn't been evacuated was Gambia.[147]

On 7 April, the foreign ministry extended the advice against all non-essential travel abroad until 15 June, when it would again be reconsidered.[148] On 9 May, Swedish foreign minister Ann Linde said that although a decision about an extension was yet to be made, she made clear that travel wouldn't return to normal after 15 June.[147] On 13 May, the Foreign Ministry again extended the advice for non-necessary foreign travel to 15 July.[149]

Monitoring and modeling[edit]

In early March, the Health Agency expanded the sentinel surveillance system in use for monitoring the influenza season, so that samples from patients with flu-like symptoms would also be tested for SARS-CoV-2 along with the influenza viruses.[150] In early May, approximately 1500 samples had been analyzed within the sentinel system.[151]

Between 27 March and 3 April, the health agency tested approximately 800 randomly selected individuals in Stockholm County, to seek knowledge of the then current infection rate.[152] As it was estimated that Stockholm County by then had the highest infection rate in Sweden, the agency choose to focus on that region.[153] According to the results, 2.5% of the local population were carrying the virus in the upper respiratory tract during the surveyed period.[152] Based on the study and a doubling time of 6–7 days, the agency concluded that 5–10% of the population in the region were carrying the virus on 9 April.[38] This was followed by a similar study on national level. In the study, approximately 4000 people would be tested for an active infection.[154] It was followed by a second national study on 4000 individuals in late April,[155] and a similar national study where "thousands" would be tested for antibodies.[156]

In an April study by researchers at the KTH Royal Institute of Technology and the Science for Life Laboratory, home sample kits where mailed to 1,000 randomly selected individuals in Stockholm to be tested for the presence of antibodies against the SARS-CoV-2 virus which causes the COVID-19 disease. After analysing 440 out of the 550 blood samples returned, the scientists concluded that 10% of the donors were infected during or prior to late March. A follow-up study were carried out later that month with an additional 1,000 tests to determine how much the spread has increased during the weeks between the to studies.[157][158] The same month, a study were carried out by researchers at the KTH Royal Institute of Technology and Danderyd Hospital where staff at the hospitals were tested for antibodies. After analyzing 527 samples, the researchers reported that approximately 20% of the staff had developed antibodies against the virus. The researchers intended to continue testing the entire staff, and to carry out several follow-up tests during the following 12 months to learn how long the antibodies will stay in the body.[159][160] In late April, approximately 11,000 out of the staff at Karolinska University Hospital were tested for the virus in either PCR based or serological tests. The tested individuals included both those with clinical medical and non-clinical medical jobs, as well as staff with non-medical jobs. When 5,500 PCR tests and 3,200 serological tests had been analysed, a total of 15% samples came back positive (7% of PCR tests, 10% of serology tests, with 2% being positive in both tests). Only people without symptoms were tested.[161][156]

Response from the public healthcare system[edit]

Testing and surveillance[edit]

Number of analyzed samples per week
Week Date Tests[162] Positive[163] Positive %[163]
4–8 25 January – 23 February 180 1 1%
9 24 February – 1 March 752 13 2%
10 2–8 March 4,302 211 5%
11 9–15 March 8,990 835 9%
12 16–22 March 10,404 911 16%
13 23–29 March 12,349 1,943 16%
14 30 March – 5 April 17,776 3,211 18%
15 6–12 April 19,880 3,711 19%
16 13–19 April 20,233 3,741 18%
17 20–26 April 24,560 4,171 17%
18 27 April – 3 May 28,802 3,705 13%
19 4–10 May 28,988 4,029 15%
Total 177,216 26,482 15%
Note: Data updated weekly. Latest data from 15 May 2020.

The first tests were carried out in January, and according to the Swedish Public Health Agency, ‘around twenty tests’ had already been carried out before the first positive case was confirmed on 30 January.[9] The agency considered that all individuals who developed any symptoms of disease in the respiratory tract after visiting Wuhan should be tested, even those with less severe symptoms.[164] The Public Health Agency expanded testing for COVID-19 on 4 March beyond only those who have been in risk areas abroad, to also test cases of pneumonia without known cause.[165] Initially, all tests were carried out at the agency's high-containment laboratory in Solna. But in mid-February, in order to increase testing capacity and allow for faster test results, testing also began at the clinical medical laboratories in Göteborg, Halmstad, Lund, Skövde, Stockholm, Umeå and Uppsala.[166]

At the end of March, the number of tests carried out each week numbered 10,000.[167] In mid-April, the number of weekly tests had doubled to approximately 20,000, and 29,000 by early May. On 10 May, a total of 177,000 samples had been tested.[168][163]

Capacity[edit]

The Stockholm International Fairs, Stockholmsmässan, are being converted into a field hospital with the help of the Swedish Defence Force. The field hospital will be able to house 600 seriously and critically sick patients.[169] The Swedish Defence Forces will provide equipment for 30 of the 600 beds and the Stockholm Regional Council will provide the remaining 570.[169] The facilities were initially used for treating less severe cases, as opposed to those needing intensive care.[170] In late April, it was reported that the Defence Force had provided 50 intensive care beds as part of the two field hospitals.[171]

An army-constructed field hospital outside Östra Sjukhuset in Gothenburg on 23 March 2020. The tents contain temporary intensive care units for COVID-19 patients.
Medical tent set up outside Visby Hospital, 14 March 2020.
Medical tent set up outside Enköping Hospital
Streetsigns outside Sahlgrenska hospital from late February telling those with potential symptoms of COVID-19 to wait outside the hospital.

The increasing number of cases in large areas such as Stockholm and Uppsala has resulted in the cancellation or postponement of up to 90% of planned surgeries, including cancer-related surgeries.[172]

Before the pandemic, the Swedish healthcare system had the capacity to treat approximately 500 persons in intensive care units (ICU). The relatively low number of beds had stayed a source of concern as the crisis evolved, and even though the number had increased to 800 at the beginning of April, healthcare professionals continued to express worry that their hospitals would eventually run out of beds. According to the calculations of the Swedish health agency, up to 1300 ICU beds would be needed when Sweden reached the top of the pandemic.[173][174] On 13 April, the National Board of Health and Welfare reported that the total number of ICU beds had risen to 1039, with an occupancy of 80%.[175][176]

Equipment[edit]

On 13 March, media reported that there is a shortage in personal protective equipment (PPE) for health care staff, and hospitals in Stockholm have been forced to reuse disposable PPEs after sanitation. The regional Health Care Director warned about this scenario in early March and government agencies have temporarily waived the public procurement law in order to hastily procure more supplies.[177] The National Board of Health and Welfare ('Socialstyrelsen') confirmed that there is no preparedness storage and nothing to distribute to the health care sector.[178][179] In early April, several counties expressed concern that they might run out of some vital drugs used in intensive care.[180][181] Later that month, Stockholm County reported of an acute shortage of the anaesthetic propofol.[182]

As one of the of the main tasks of the Swedish Defence Force is to support the civil community in case of disasters, their resources were utilized to lessen equipment shortages in the health-care system. The material supplied by the military included crucial medical equipment; X-ray generators, electrocardiographic machines, 154 ventilators and 154 intensive care monitors. The military also supplied personal protective equipment, including 60,000 gas masks and 40,000 protective suits.[171]

Staffing[edit]

On 25 March 2020, Björn Eriksson, the Director of Healthcare in Stockholm, appealed to anyone in the Stockholm region who had experience in healthcare to volunteer. As of the 26 March 2020, 5100 people with healthcare experience had registered as volunteers.[183]

The increasing number of cases in large areas such as Stockholm and Uppsala has resulted in the cancellation or postponement of up to 90% of planned surgeries, including cancer related surgeries.[172]

When it became clear that the civil society would face difficulties managing the emergent crisis, the Swedish Defence Force were called in to assist the civilian society with manpower, equipment, and logistics. The preparations began in February and the first servicemen were deployed in March. By early April the total military deployed in civilian society numbered 400 servicemen, among them a number of officers to support the National Board of Health and Welfare with crisis management and laboratory technicians to support the Public Health Agency of Sweden. Tasks for the military personnel also including collecting and transporting samples. A number of military ambulances were also taken in use within the civilian health system.[171][184]

Impact on society[edit]

Transport[edit]

Air transport in Sweden is primarily run by public and private companies – principally Scandinavian Airlines (SAS) and Norwegian Air Shuttle – and has been severely impacted by the pandemic and greatly reduced. Like airlines around the world, Sweden's carriers have reduced the frequency of their flights, reduced their work force and asked the local government for financial assistance. On 15 March, SAS announced that they would temporarily reduce their workforce by 10,000 people, which constitutes about 90% of their workforce.[185] Soon almost all domestic flights were cancelled. Swedish authorities advised against all non-essential travel inside and out of Sweden. SAS Group decided to fly only four domestic departures and four domestic arrivals from Arlanda from 6 April 2020, plus some international flights,[186] while Norwegian cancelled all domestic flights in Sweden.[187] Several airports closed temporarily.[citation needed]

Rail transport in Sweden, which is principally run by the public operator SJ AB, has continued to operate throughout the pandemic, albeit with a slightly reduced schedule so that additional carriages can be added to trains, which in conjunction with fewer tickets being made available for sale, aims to ensure social distancing of those passengers that continue to travel.[188] The decrease in travel had a big impact on the public transport sector due to a loss of revenue in ticket sales, which led to trade association Swedish Public Transport Association (Svensk kollektivtrafik) asking the government for financial aid.[189]

Politics[edit]

In mid-March, the parliamentary leaders from the parties in the Riksdag agreed on using pairing for the upcoming weeks, to make it possible to decrease the number of members of parliament present during voting sessions, from the usual 349 to 55. This decision was taken both as a measure to lower the risk of spread of the infection (social distancing), and to make sure the daily work in the parliament could proceed even if a big number of MPs would become sick.[190][191] Similar decisions were taken in many of Swedish municipal councils.[192][193] Several regional assemblies also decreased the number of politicians present each session, including Västerbotten County who did it as a measure to decrease long-distance traveling, and Skåne County.[194][195][196]

On 25 March, The Swedish Social Democratic Party together with the Swedish Trade Union Confederation decided to cancel their traditional May Day demonstrations. They will instead hold an event on a digital platform, which will include speeches by the Swedish prime minister and leader of the Social Democrats, Stefan Löfven, as well as union confederation leader Karl-Petter Thorwaldsson.[197] The Left Party also cancelled their nationwide demonstrations, and announced that there would instead be a digital celebration, including a speech by party leader Jonas Sjöstedt.[198] The Almedalen Week, considered to be the biggest and most important forum in Sweden for seminars, debates and political speeches on current social issues, held in Visby every summer,[199] was cancelled as a result of the ban on large gatherings. The decision was taken on 1 April by the organiser after consultation with the major political parties.[200] Prime Minister Stefan Löfvén had already announced that he had cancelled his planned participation in the upcoming event.[201] A similar event in Stockholm, 'Järvaveckan', was also cancelled, and won't be held until 2021.[202] The annual LGBT festival West Pride in Gothenburg was also cancelled as a result of the pandemic. Instead, the organisers proclaimed 25 May to 7 June a 'flag period', encouraging organisations and individuals to hoist the rainbow flag.[203]

Royal family[edit]

Following the recommendation from the Swedish authorities that those over the age of 70 should self-isolate, the Swedish King and Queen, Carl XVI Gustaf and Queen Silvia, aged 74 and 76, both chose to leave the palace to work from distance in the estate Stenhammar in Sörmland.[204][205]

On 5 April, at the first day of the Holy Week, King Carl XVI Gustaf addressed the nation in a televised speech. In his speech, he stressed that all Swedes had an obligation to the country to "act responsibly and selflessly". He also stressed that many who otherwise would travel, spend time with friends and family or go to church would need to make sacrifices during the upcoming Easter holiday. In his speech, he specifically addressed those working or volunteering in the health-care sector, saying "This is a huge task. It requires courage. And it will require endurance. To all of you involved in this vital work, I offer my heartfelt thanks", as well as other people doing vital work in society, to ensure Swedes "can buy food, that public transport continues to operate, and everything else we so easily take for granted – my warmest thanks to you all". He finished saying that all would embrace the message "The journey is long and arduous. But in the end, light triumphs over darkness, and we will be able to feel hope again", ending his speech wishing everyone a happy Easter.[101][206]

Education[edit]

On 13 March 2020, the spring Swedish Scholastic Aptitude Test (′Högskoleprovet′) was cancelled affecting approximately 70,000 prospective students who had registered themselves. This was the first time the Swedish Scholastic Aptitude Test has been cancelled since it was established in 1977.[207] On 23 March 2020 the Swedish National Agency for Education ('Skolverket'), cancelled the national tests to give teachers in Sweden more time to prepare for the possibility of distance education.[208]

Defence[edit]

The Swedish Armed Forces cancelled the international military exercise Aurora 20 which was scheduled to be held between May and June. Austria and Canada had previously announced their cancellation of their planned participation.[209]

Arts and entertainment[edit]

The ban of public gatherings with more than 500 people, later revised down to 50, led to concerts and other events being cancelled or postponed. Concerts cancelled due to the ban on large crowds included four sold-out concerts with Håkan Hellström at the Nya Ullevi Arena, Gothenburg, scheduled for June and August. As the total number of tickets sold to the concerts numbered 300,000,[210][211] it was believed to be a significant blow to Gothenburg's tourism industry, with a potential loss of 900 million SEK (8.4 million) if all concerts scheduled at the arena were to be cancelled.[212] The organiser of the music festival Summerburst had previously announced cancelling their scheduled event at Nya Ullevi.[213] The rock festival Sweden Rock, held every year since 1992 in Blekinge and scheduled for June, was cancelled due to the ongoing pandemic.[214] Theatre and opera were affected, with major venues such as Gothenburg Opera House, Malmö Opera, Royal Dramatic Theatre and Royal Swedish Opera all closing their venues and cancel upcoming events.[215][216][217] In April, the Swedish amusement parks Gröna Lund in Stockholm and Liseberg in Gothenburg announced that they were to cancel or reschedule all concerts scheduled before midsummer.[218] The former had already postponed the season opening indefinitely, while the latter were still hoping to open the park as planned in mid-May. As the amusement parks mostly rely on seasonal workers, closures would result in thousands of cancelled employment contracts.[219]

Starting 30 March 2020 the public library in Gävle will start with a book delivery service for people aged 70 or older. The library will also start a take-away service where you can pre-loan books and pick them in a take-away bag.[220]

Television[edit]

On 6 March, Swedish National Broadcaster SVT held a crisis meeting to consider broadcasting the live finals of Melodifestivalen 2020 on 7 March without an audience, as a response to the growing outbreak. The Danish equivalent had recently decided to broadcast their version of the finals without an audience. Ultimately, SVT decided to allow the audience to enter the arena, although they advised people who felt sick to stay at home.[221]

The popular TV show Antikrundan, broadcast by public broadcaster SVT, where a number of antiques appraisers visits different locations in Sweden to appraise antiques brought there by local people, cancelled their planned tour for the recording of the 2020 winter season. According to the producers, they were instead working on an 'alternative' show.[222] The sing-along show Lotta på Liseberg, which is televised live by TV4 from the amusement park Liseberg in Gothenburg, announced that the 2020 season wouldn't be cancelled, but would be recorded without an audience due to the ban of gatherings.[223] SVT had previously announced similar plans for their live sing-along show Allsång på Skansen, which is broadcast live from the amusement park Skansen in Stockholm.[224]

Sports[edit]

In athletics, all 2020 Diamond League events scheduled to be held in May were postponed, which included the meet in Stockholm.[225] The world's largest half marathon in Gothenburg, Göteborgsvarvet, was postponed until later in 2020 and then cancelled completely on 27 March.[226] The annual recreational bicycle race Vätternrundan, scheduled to be held in June, was also cancelled as a result of the pandemic. The organisers made the decision public on 2 April.[227][228] The professional bicycle race Postnord UCI WWT Vårgårda West Sweden, part of the UCI Women's World Tour and scheduled for August, was also cancelled.[229]

On 19 March, the governing body for association football in Sweden formally announced that the premiere of the 2020 season for the first and second division leagues, men's Allsvenskan and Superettan as well as women's Damallsvenskan and Elitettan, will be postponed to late May or early June. The decision will not affect the leagues below the second level.[230] Two days later it was announced that the 2020 edition of the association football award ceremony Fotbollsgalan was cancelled.[231] Many of the professional teams in the highest division warned that the loss of income following the postponement of the season would have a severe impact on their economy.[232] After consultations with the Public Health Agency, the organization behind youth football tournament Gothia Cup, in Gothenburg, decided to cancel the 2020 event. According to the organizers, the tournament will return in 2021.[233] The youth handball tournament Partille Cup was also cancelled.[234] Professional handball was affected as well, with the last rounds and the finals in the highest men's and women's leagues, Handbollsligan and Svensk handbollselit, being cancelled.[235] Similarly, the Swedish Basketball Federation choose to stop all games until May, effectively stopping the highest divisions SBL and SBL Dam mid-season.[236]

In Speedway, the start of Elitserien, the highest league in the Swedish league system, was rescheduled to 2 June. In order to manage a tighter schedule, the sport's governing body Swedish Motorcycle and Snowmobile Federation also decided to cancel the quarterfinals.[237]

Debate and criticism[edit]

The Swedish response to the pandemic has been heavily debated within Sweden. However, the debate has mostly involved academics, as the opposition in the Riksdag has mostly avoided criticising the response from the government or the agencies.[238] The parties without representation in the government, including the liberal conservative party, the Moderates, the Christian Democrats, the centre-right parties the Liberals and the Centre Party, and the socialist Left Party instead voiced their support for the government consisting of the Swedish Social Democratic Party and the Green Party, in what often is referred to as a 'borgfred' (truce) where the opposition support the government in a time of crisis.[239][240] The exception being the right-wing populist Sweden Democrats,[238] whose party leader Jimmie Åkesson called for school closings.[241] The leader of the Moderate Party, the biggest party in opposition, Ulf Kristersson, said that eventually it will be needed to evaluated by how the government and agencies handled the pandemic, "but not now".[240]

Anders Tegnell being interviewed during his daily coronavirus briefing in April 2020

On 14 April, a debate article was sent to Swedish newspapers signed by 22 academics, saying that the strategy of the Swedish public health agency would lead to "chaos in the healthcare system". Moreover, they said that there was no transparency regarding the data used in the models made by the agency. Anders Tegnell from the public health agency responded to the criticism by saying that there was no lack in transparency in the agency's work and that all data is available to be downloaded by the public as an excel-file on their website.[242] Additionally Tegnell stated that the numbers of deaths presented in the published article are wrong, especially regarding the specific number of deaths per day. Another claim in the article saying that Sweden's statistics were closing in to the ones of Italy was countered by Anders Tegnell saying that unlike Sweden, Italy and many other countries only report on deaths in hospitals, making it hard to compare the numbers of the different countries.[243] He also said in an interview with the BBC that Sweden's strategy is largely working in slowing the spread of the disease; although the death toll in nursing homes was high, the country's healthcare system did not become overwhelmed, and that Sweden's approach had made it better-placed than other countries in dealing with a second wave of infections.[244][245]

Sweden questioned the scientific basis for imposing mandatory lockdown seen in other European countries, relying instead on the civic responsibility of its citizens to keep large parts of its society open. Although senior high schools were closed and gatherings of more than 50 people were banned, shops, restaurants and junior schools remained open. Swedes were expected to follow the recommendations on social distancing, avoiding non-essential travel, working from home and staying indoors if they are elderly or feeling ill.[245][246]

Foreign leaders have used Sweden as a warning example when defending their own strategy, including Alberto Fernández, president of Argentina, and US president Donald Trump, compared Sweden's higher death toll when compared to its neighbouring countries who had applied stricter measures, and said that "Sweden is paying heavily for its decision not to lockdown".[247][248] Some of the harshest criticism from outside Sweden was found in the Chinese paper Global Times, closely linked to the ruling Communist Party of China, accused Sweden of having capitulated to the virus, calling the country 'a black hole' and called for the international community to condemn Sweden's actions.[249] Some, including Swedish Minister for Justice Morgan Johansson, speculated that the strong criticism may be partly linked to the poor relations between the two countries after China's imprisonment of the Swedish book publisher Gui Minhai.[250][249]

Public opinion[edit]

According to surveys carried out in late March and early April, three out of four Swedes (71–76%) trusted the Public Health Agency, and nearly half of the people surveyed (47%) said they had 'very high trust' in the agency. A majority said they trusted the government, and 85% said they trusted the Swedish health-care system.[251][252][253] A March 2020 survey reported that more than half (53%) of the Swedish population had trust in the state epidemiologist, Anders Tegnell, a higher share than for any of the current leaders of the Swedish political parties. The share of respondents who said that they didn't trust Tegnell was 18%. [254] In an April survey, the share who said they trusted Tegnell had increased to 69%, while the number who said they didn't trust their state epidemiologist had decreased to 11%.[255][256]

Media coverage[edit]

Many outside Sweden considered the measures taken by the authorities against the pandemic to be significantly different when compared to other countries. As a result, there was a big increase in international news coverage of Sweden. There was also an increase in interactions on the coverage, including a higher number of shares on social media. The Swedish strategy was sometimes described as "lax", "radical" or even “extreme”. Much of the coverage was neutral, but it was sometimes described as curious, questioning or critical,[54][257][258] and was in some cases accused of being "fake news".[259] A common news story in international media was things being 'business as usual' in Sweden, with its citizens ignoring the recommendations to practice social distancing and avoiding unnecessary travel, often accompanied by footage of crowded streets and restaurants.[54][258] One notable example was an article in the British newspaper The Guardian, claiming that everything in Sweden went on as normal, with Swedes "going about their daily routines". The article attracted particularly high spread, and was quoted by many European newspapers. The Guardian was also accused of misleading their readers in another article, by selectively choosing quotes and putting them in a different context, and by disproportionately giving room to critical voices from Sweden in their reporting.[259][260] Some reported that Sweden chose not to lock down in order to protect the economy.[258] Foreign news outlets often described Sweden as pursuing a herd immunity strategy.[54] This was echoed by US president Donald Trump, who in a press briefing told the assembled media that Sweden was 'suffering very greatly' due to what he referred to as 'the herd', and that the US, if it had not taken much stricter social distancing measures, 'would have lost hundreds of thousands more people'.[261][262] Responding partly to Trump's remarks, which she described by using the word ‘misinformation’, Swedish foreign minister Ann Linde said that the ‘so-called Swedish strategy’ was one of many myths about Sweden, and described it as ‘absolutely false’. Linde said that the Swedish goal was no different from most other countries: to save lives, hinder the spread of the virus and make the situation manageable for the health system,[47] while Sweden's state epidemiologist, Anders Tegnell, when asked about Trump's remarks, said that in his opinion Sweden was doing relatively well, and was no worse off than New York.[263] Remarks similar to Linde's have also been made by Lena Hallengren, Minister for Health and Social Affairs, who disagreed with the belief that Sweden had a radically different approach to the virus compared to other countries, saying she believed that there were only differences in two major regards: not shutting down schools, and not having regulations forcing people to remain in their homes.[264] Linde has also spoken out against reports of Swedes not practicing social distancing, calling it another "myth" in the reporting about Sweden, and she said Sweden's combination of recommendations and legally binding measures had so far proven effective.[47] Swedish experts critical of the Swedish strategy were often quoted in international media, among them immunologist Cecilia Söderberg-Nauclér, one of the most vocal critics,[265][266] who was quoted accusing the government of "leading us to catastrophe" and having "decided to let people die".[260] Over time, the reporting shifted to being more neutral or nuanced, or sometimes positive, with some speculating that the Swedish policy may be more durable in the long run.[258][267]

Statistics[edit]

Cases[edit]

As of 26 April, 18,670 people had tested positive for COVID-19 in Sweden.[1] As of mid-April, Sörmland County was the region most affected by the pandemic (in cases per capita), followed by Stockholm County and Östergötland County.[268]

Total cases[edit]

source: FOHM[1]
Total confirmed cases

Cases per day[edit]

source: FOHM[1]
Cases per day

Note: Data on new cases is compiled by the Public Health Agency of Sweden at 11:30 CEST (UTC+02:00) each day. Reports of new cases to the Public Health Agency might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days.[2]

Intensive care[edit]

Swedish hospitals saw a sharp rise in the number of COVID-19 patients receiving intensive care during March. The number of new patients somewhat stabilised during the first two weeks of April, with between 30–45 patients per day, averaging 39. The number of new patients admitted to ICU decreased slightly during the third week of April, averaging 35. The mean age of the patients who underwent intensive care was 59 years old, three out of four (74%) were men, and the average time between diagnosis and admission to an intensive care unit was 10 days. The majority (68%) of those who received intensive care had one or more underlying condition considered as one of the risk groups, with the most prevalent being hypertension (37%), diabetes (25%), chronic pulmonary heart disease (24%), chronic respiratory disease (14%) and chronic cardiovascular disease (11%). The share of patients not belonging to a risk group was significantly higher among younger patients. Among those younger than 60 years, 39% didn't have any of those underlying conditions.[269] As of 26 April, 1,315 with a confirmed COVID-19 infection had received intensive care in Sweden.[1]

Total hospitalisations[edit]

source: FOHM[1]
Total intensive care hospitalisations

Hospitalisations per day[edit]

source: FOHM[1]
Intensive care hospitalisations per day

Note: Data on new intensive care hospitalisations is compiled by the Public Health Agency of Sweden at 11:30 CEST (UTC+02:00) each day. Reports of new intensive care hospitalisations to the Public Health Agency might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days.[2]

Deaths[edit]

A large majority (93%) of the deaths belonged to at least one risk group, with chronic cardiovascular disease being the most prevalent (53%), followed by diabetes (26%), chronic respiratory disease (18%) and chronic renal failure (16%).[270] More than half of the deaths have been in Stockholm County.[271] As of early May, the mean age among those who had died with confirmed COVID-19 disease were 82,[3] and the majority (54%) of those who had died with the disease were men.[272]

Total deaths[edit]

source: FOHM[1]
Total deaths with confirmed COVID-19

Deaths per day[edit]

source: FOHM[1]
Deaths with confirmed COVID-19 per day

Note: Data on new deaths is compiled by the Public Health Agency of Sweden at 11:30 CEST (UTC+02:00) each day from the communicable disease surveillance system SmiNet. Data on new deaths from National Board of Health and Welfare is based on death certificates. Reports of new deaths to the Public Health Agency might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days. In mid-April, approximately 30% of the cases were reported within 24 hours, 50% within 48 hours, and 90% within one week. Reports to the National Board of Health and Welfare might be delayed for up to three weeks. Data from the Health Agency includes all deaths where a COVID-19 diagnosis (U07.1) had been confirmed during the past 30 days, including cases where the cause of death wasn't attributed to COVID-19 (as of data from the National Board of Health and Welfare from 21 April, this number amounted to 4.5% of cases confirmed in a laboratory), but excludes non-confirmed cases (U07.2). As this only includes cases confirmed in a laboratory, the actual number is believed to be higher due to the number of laboratory-confirmed cases only amounting to 70% (as of 3 May) of an excess mortality observed in Sweden since late March, according to a statistical analysis by the Public Health Agency based on data from from the Swedish Tax Agency and the European mortality monitoring activity (EuroMOMO). As of 10 May, there had been approximately 3500 excess deaths in Sweden. Data from the National Board of Health and Welfare includes all deaths attributed to COVID-19 (U07.1 and U07.2), and is the official Swedish death statistics. On 7 May, 86% of the deaths attributed to COVID-19 were confirmed in a laboratory.[2][162][273][274]

Age and gender[edit]

source: National Board of Health and Welfare[275]
COVID-19 deaths by gender and age

Note: Data is compiled by the National Board of Health and Welfare and is based on death certificates. Data includes both confirmed cases (U07.1) and non-confirmed cases (U07.2)

Excess mortality[edit]

During the pandemic, an excess mortality was observed in Sweden from late March and onwards according to a statistical analysis by the Public Health Agency based on data from from the Swedish Tax Agency and the European mortality monitoring activity (EuroMOMO). By mid-May, there had been approximately 3500 excess deaths in Sweden. As the number of deaths with a confirmed laboratory-confirmed Covid-19 diagnos only amounted to 72% of this number (as of 10 May), the actual number of deaths related to Covid-19 was believed to be higher.[162]

source: Statistics Sweden[1] smoothed by applying exponential moving average with factor 0.8
All-cause daily deaths 2015-2020

Additional charts and tables[edit]

Total all-cause deaths from Jan 1 to May 7 excluding Feb 29, calculated from SCB[2]:

All-cause weekly deaths in Sweden in 2016–2020, from FOHM:
All-cause weekly deaths - Sweden.png

At a point, it was reported that a disproportionate number of those that had died by then were Somali (6)[276] out of 89[277] deaths being members of the Somali community in the Stockholm Region.[276]

New COVID-19 cases in Sweden by county ()

Source: FOHM[278][a] County Cases[b] Deaths[b] ICU-care Analysed samples[279]
Date New Total Diff 7d avg New Total Diff 7d avg New Total Diff 7d avg New Total Week
Blekinge County Dalarna County Gotland County Gävleborg County Halland County Jämtland County Jönköping County Kalmar County Kronoberg County Norrbotten County Skåne County Stockholm County Södermanland County Uppsala County Värmland County Västerbotten County Västernorrland County Västmanland County Västra Götaland County Örebro County Östergötland County
11 11 4
26 37 5
2020-02-04 1 1 1 1 78 115 6
1 1 38 153 7
1 1 27 180 8
2020-02-26 1 1 2 +100% 752 932 9
2020-02-27 1 1 3 +50%
2020-02-28 1 2 2 3 8 11 +267% 1
2020-02-29 1 2 3 14 +27% 2
2020-03-01 14 2
2020-03-02 1 1 3 5 19 +36% 2 4,302 5,234 10
2020-03-03 1 10 2 13 32 +68% 4
2020-03-04 7 21 1 1 30 62 +94% 8
2020-03-05 22 2 1 25 87 +40% 11
2020-03-06[c] 2 8 36 1 11 1 59 146 +68% 17 1 1 1
2020-03-07 5 21 1 5 1 33 179 +23% 21 1 2 +100% 1
2020-03-08 1 2 29 1 11 2 46 225 +26% 26 1 3 +50% 1
2020-03-09 4 6 1 3 64 1 7 15 101 326 +45% 38 0 3 1 8,990 14,224 11
2020-03-10 1 1 1 1 34 26 4 3 8 6 13 98 424 +30% 49 2 5 +67% 1
2020-03-11[d] 6 1 2 1 16 3 16 2 7 4 37 32 6 4 2 57 196 620 +46% 70 1 1 1 1 6 +20% 1
2020-03-12[e] 2 3 2 9 5 7 2 2 32 42 3 11 4 1 3 19 3 1 151 771 +24% 86 0 1 1 6 1
2020-03-13 1 1 9 3 4 3 1 42 31 6 10 3 2 5 19 2 10 152 923 +20% 97 1 2 +100% 1 2 8 +33% 1
2020-03-14 1 3 2 1 25 18 1 4 1 3 5 7 71 994 +7.7% 102 1 3 +50% 1 6 14 +75% 2
2020-03-15 1 2 7 4 1 4 17 4 1 1 18 9 69 1063 +6.9% 105 2 5 +67% 1 5 19 +36% 2
2020-03-16 2 1 1 2 3 34 12 2 2 2 1 7 6 8 83 1146 +7.8% 103 2 7 +40% 1 5 24 +26% 3 10,404 24,628 12
2020-03-17 1 3 1 4 3 1 1 1 6 35 5 5 1 3 1 6 13 16 13 119 1265 +10% 105 1 8 +14% 1 4 28 +17% 3
2020-03-18 1 2 1 2 2 4 2 1 1 8 58 17 1 3 1 10 3 28 145 1410 +11% 99 6 14 +75% 2 15 43 +54% 5
2020-03-19 2 1 2 1 2 1 1 1 2 66 5 5 2 1 14 9 28 143 1553 +10% 98 7 21 +50% 3 8 51 +19% 6
2020-03-20 5 5 5 3 3 1 5 5 84 4 1 2 5 2 23 5 22 180 1733 +12% 101 9 30 +43% 4 17 68 +33% 8
2020-03-21 4 3 14 4 1 3 5 71 6 2 1 8 12 134 1867 +7.7% 109 8 38 +27% 4 13 81 +19% 8
2020-03-22 5 1 9 1 1 3 3 59 11 5 1 1 4 13 117 1984 +6.3% 115 11 49 +29% 6 28 109 +35% 11
2020-03-23 9 3 4 2 3 5 7 99 2 8 2 2 3 9 6 18 182 2166 +9.2% 128 11 60 +22% 7 37 146 +34% 15 12,349 36,977 13
2020-03-24 9 5 4 5 1 2 6 5 105 14 11 3 3 2 4 10 11 30 230 2396 +11% 141 21 81 +35% 9 32 178 +22% 19
2020-03-25 3 13 1 7 7 2 7 2 1 5 13 154 37 15 4 2 3 19 8 11 314 2710 +13% 163 22 103 +27% 11 31 209 +17% 21
2020-03-26 8 4 5 9 7 9 6 2 3 7 132 16 12 3 3 5 20 6 29 286 2996 +11% 180 31 134 +30% 14 40 249 +19% 25
2020-03-27 2 15 1 9 3 3 15 5 4 4 10 176 26 20 1 2 2 11 18 6 33 366 3362 +12% 204 32 166 +24% 17 28 277 +11% 26
2020-03-28 6 12 6 8 10 1 2 4 2 147 8 7 3 5 2 3 25 8 41 300 3662 +8.9% 224 35 201 +21% 20 28 305 +10% 28
2020-03-29 4 10 11 2 2 8 1 4 2 3 150 4 11 1 1 9 15 3 40 281 3943 +7.7% 245 38 239 +19% 24 40 345 +13% 30
2020-03-30 9 10 5 2 15 3 1 5 5 172 60 21 1 7 6 23 27 17 27 416 4359 +11% 274 44 283 +18% 28 31 376 +9.0% 29 17,776 54,753 14
2020-03-31 1 23 1 14 7 1 17 2 5 6 7 209 49 15 8 13 10 29 11 47 475 4834 +11% 305 49 332 +17% 31 33 409 +8.8% 29
2020-04-01 5 19 30 4 13 5 1 5 8 205 49 25 2 5 2 11 29 5 63 486 5320 +10% 326 53 385 +16% 35 48 457 +12% 31
2020-04-02 3 6 1 17 9 4 32 5 7 8 8 216 34 28 12 1 18 47 28 70 554 5874 +10% 360 70 455 +18% 40 46 503 +10% 32
2020-04-03 1 20 1 16 12 2 29 2 2 6 24 245 59 38 1 17 3 27 48 20 28 601 6475 +10% 389 78 533 +17% 46 40 543 +8.0% 33
2020-04-04 4 18 12 2 2 15 1 2 3 12 129 17 11 1 17 6 14 30 3 58 357 6832 +5.5% 396 71 604 +13% 50 36 579 +6.6% 34
2020-04-05 1 7 7 3 12 3 2 2 6 172 27 9 1 8 2 7 30 41 340 7172 +5.0% 404 86 690 +14% 56 45 624 +7.8% 35
2020-04-06 16 12 10 4 10 6 3 10 6 131 18 31 2 4 4 18 53 12 39 389 7561 +5.4% 400 90 780 +13% 62 43 667 +6.9% 36 19,880 74,633 15
2020-04-07 1 28 16 13 6 23 4 14 17 24 243 42 37 7 13 10 46 64 73 57 738 8299 +9.8% 433 84 864 +11% 67 44 711 +6.6% 38
2020-04-08 2 28 1 17 9 8 18 2 7 12 15 271 33 29 1 12 5 23 68 37 57 655 8954 +7.9% 454 115 979 +13% 74 48 759 +6.8% 38
2020-04-09 1 29 1 18 12 8 21 1 5 5 11 240 38 29 4 12 5 25 116 10 54 645 9599 +7.2% 466 86 1065 +8.8% 76 35 794 +4.6% 36
2020-04-10 1 17 18 4 8 19 1 4 6 23 148 41 4 3 15 8 27 69 7 31 454 10053 +4.7% 447 90 1155 +8.5% 78 38 832 +4.8% 36
2020-04-11 9 10 2 2 5 3 10 2 6 200 22 15 2 2 33 32 13 27 395 10448 +3.9% 452 103 1258 +8.9% 82 46 878 +5.5% 37
2020-04-12 1 31 17 3 6 9 2 4 2 14 182 14 13 4 5 18 42 75 22 464 10912 +4.4% 468 97 1355 +7.7% 83 35 913 +4.0% 36
2020-04-13 12 11 3 6 5 6 3 17 9 200 20 13 3 5 6 18 48 21 31 437 11349 +4.0% 474 86 1441 +6.3% 83 42 955 +4.6% 36 20,233 94,866 16
2020-04-14 1 12 11 6 14 12 5 6 4 12 179 16 39 2 5 5 12 63 53 23 480 11829 +4.2% 441 91 1532 +6.3% 84 40 995 +4.2% 36
2020-04-15 28 2 17 6 15 28 2 12 3 19 215 42 32 3 14 5 30 70 30 31 604 12433 +5.1% 435 116 1648 +7.6% 84 33 1028 +3.3% 34
2020-04-16 25 1 21 15 12 23 4 10 13 17 221 47 37 7 3 3 31 84 30 19 623 13056 +5.0% 432 110 1758 +6.7% 87 31 1059 +3.0% 33
2020-04-17 26 24 9 19 36 5 12 15 21 221 64 44 3 19 5 27 77 32 29 688 13744 +5.3% 461 82 1840 +4.7% 86 40 1099 +3.8% 33
2020-04-18 27 29 7 9 35 2 21 1 17 180 8 18 3 3 2 18 48 52 52 532 14276 +3.9% 479 87 1927 +4.7% 84 29 1128 +2.6% 31
2020-04-19 8 8 6 6 15 4 11 2 5 192 13 18 4 7 8 29 31 6 16 389 14665 +2.7% 469 88 2015 +4.6% 83 35 1163 +3.1% 31
2020-04-20 1 10 1 4 10 1 8 6 9 8 9 211 14 32 7 4 2 28 50 23 24 462 15127 +3.2% 472 84 2099 +4.2% 82 27 1190 +2.3% 29 24,560 119,426 17
2020-04-21 4 35 22 17 13 49 11 14 3 7 163 55 32 7 5 12 37 123 64 35 708 15835 +4.7% 501 62 2161 +3.0% 79 35 1225 +2.9% 29
2020-04-22 6 33 3 22 19 31 11 13 5 20 288 50 32 5 9 4 19 79 27 29 722 16557 +4.6% 516 77 2238 +3.6% 74 50 1275 +4.1% 31
2020-04-23 2 41 2 13 18 8 46 11 25 15 22 286 26 41 3 12 17 26 72 38 29 753 17310 +4.5% 532 86 2324 +3.8% 71 25 1300 +2.0% 30
2020-04-24 7 29 1 19 17 10 24 1 2 8 38 224 53 55 4 12 16 36 147 41 33 777 18087 +4.5% 543 88 2412 +3.8% 72 46 1346 +3.5% 31
2020-04-25 45 3 23 2 13 19 1 21 12 138 8 12 5 6 5 94 37 30 474 18561 +2.6% 536 73 2484 +3.0% 70 28 1374 +2.1% 31
2020-04-26 1 5 3 6 5 1 5 2 4 2 23 110 8 8 2 11 11 24 46 17 6 300 18861 +1.6% 525 75 2559 +3.0% 68 26 1400 +1.9% 30
2020-04-27 8 4 11 18 6 23 7 7 10 34 197 10 35 8 4 11 24 99 18 13 547 19408 +2.9% 535 74 2633 +2.9% 67 27 1427 +1.9% 30 28,802 148,228 18
2020-04-28 3 35 4 16 10 11 18 5 21 1 33 223 58 52 17 3 4 21 83 74 34 726 20134 +3.7% 537 79 2711 +3.0% 69 33 1460 +2.3% 29
2020-04-29 6 52 7 21 10 18 43 11 14 7 37 227 34 22 14 18 11 24 149 34 19 778 20912 +3.9% 544 82 2793 +3.0% 69 24 1484 +1.6% 26
2020-04-30 14 3 21 8 20 28 7 12 9 29 176 23 43 9 5 19 14 95 44 17 596 21508 +2.9% 525 76 2868 +2.7% 68 33 1517 +2.2% 27
2020-05-01 2 1 21 2 7 23 7 15 7 12 141 55 13 13 2 9 20 123 34 25 532 22040 +2.5% 494 77 2943 +2.6% 66 15 1532 +0.99% 23
2020-05-02 1 1 2 14 8 13 18 2 12 1 28 80 7 12 6 3 7 13 33 20 17 298 22338 +1.4% 472 72 3014 +2.4% 66 30 1562 +2.0% 24
2020-05-03 3 1 8 2 6 7 1 10 1 6 124 1 11 3 6 4 42 14 8 258 22596 +1.2% 467 75 3088 +2.5% 66 25 1587 +1.6% 23
2020-05-04 64 6 23 11 2 16 14 4 4 38 129 3 21 6 1 4 8 75 17 13 459 23055 +2.0% 456 81 3169 +2.6% 67 25 1612 +1.6% 23 28,988 177,216 19
2020-05-05 3 28 14 21 22 22 5 34 7 21 148 39 52 17 3 4 17 110 49 21 637 23692 +2.8% 445 68 3235 +2.1% 66 19 1631 +1.2% 21
2020-05-06 1 22 23 23 9 24 3 22 8 41 190 34 37 14 8 17 19 177 35 22 729 24421 +3.1% 439 73 3307 +2.2% 64 28 1659 +1.7% 22
2020-05-07 2 19 2 36 15 18 28 8 34 5 13 234 20 42 9 8 25 17 163 37 16 751 25172 +3.1% 458 78 3382 +2.3% 64 28 1687 +1.7% 21
2020-05-08 4 16 1 23 15 10 27 5 26 4 52 206 23 43 8 5 10 21 130 35 21 685 25857 +2.7% 477 56 3433 +1.5% 61 24 1711 +1.4% 22
2020-05-09 1 11 1 51 5 19 33 4 21 18 114 7 41 7 9 7 109 29 22 509 26366 +2.0% 504 60 3485 +1.5% 59 14 1725 +0.82% 20
2020-05-10 4 6 4 6 4 6 2 18 78 6 12 3 1 10 1 86 16 15 278 26644 +1.1% 506 69 3547 +1.8% 57 17 1742 +0.99% 19
2020-05-11 3 12 10 14 11 6 6 11 21 166 1 19 3 1 4 32 54 27 10 411 27055 +1.5% 500 54 3594 +1.3% 53 15 1757 +0.86% 18 20
2020-05-12 4 18 2 27 13 12 29 6 28 4 34 186 33 30 15 10 19 10 150 46 30 706 27761 +2.6% 509 47 3629 +0.97% 49 16 1773 +0.91% 18
2020-05-13 3 22 30 7 15 34 1 31 12 30 197 14 27 6 7 15 26 133 30 19 659 28420 +2.4% 500 32 3650 +0.58% 43 17 1790 +0.96% 16
2020-05-14 2 15 40 13 30 14 5 18 6 39 117 11 37 14 14 14 31 151 24 31 626 29046 +2.2% 484 24 3671 +0.58% 36 16 1806 +0.89% 15
2020-05-15 6 10 30 22 15 35 7 23 2 42 147 19 37 8 14 25 14 154 26 15 651 29697 +2.2% 480 27 3687 +0.44% 32 18 1824 +1.00% 14
2020-05-16 2 1 1 24 8 7 21 3 16 3 21 64 5 24 7 3 18 97 20 13 358 30055 +1.2% 461 19 3697 +0.27% 27 16 1840 +0.88% 14
2020-05-17 1 17 7 4 8 24 2 7 1 11 58 6 3 3 2 89 3 12 258 30313 +0.86% 459 25 3713 +0.43% 21 21 1861 +1.1% 15
2020-05-18 9 15 19 14 5 7 8 3 23 111 6 31 8 6 7 39 37 11 31 390 30703 +1.3% 456 28 3719 +0.16% 16 11 1872 +0.59% 14 21
2020-05-19[a] 6 2 34 14 9 41 2 27 2 65 129 18 35 15 15 38 22 105 22 17 618 30799 +0.31% 380 9 3743 +0.027% 11 1 1873 +0.053% 13
2020-05-20 23 31 1 25 42 19 30 3 11 7 45 105 22 53 16 5 27 22 136 53 27 703 6

(+20)[f]

2020-05-21 3 3 12 6 1 7 37 9 8 36 1 34 147
County Blekinge County Dalarna County Gotland County Gävleborg County Halland County Jämtland County Jönköping County Kalmar County Kronoberg County Norrbotten County Skåne County Stockholm County Södermanland County Uppsala County Värmland County Västerbotten County Västernorrland County Västmanland County Västra Götaland County Örebro County Östergötland County Total cases[b] Total deaths[b] Total ICU-care cases Total analysed samples
Total cases[b] 103 1063 67 1001 574 559 1182 263 641 342 1304 10668 1507 1528 335 422 456 1042 4442 1515 1785 30,799

(304 per 100k pop)

3,720

(36.8 per 100k pop)

1,873

(18.5 per 100k pop)

177,216

(1751 per 100k pop)

Cases per 100k 65 369 112 348 172 427 325 107 318 137 95 449 506 398 119 155 186 378 257 497 383
Total deaths[b] 4 128 3 90 48 18 117 25 40 40 130 1864 204 142 24 19 64 123 392 109 159
Deaths per 100k 2.5 44 5.0 31 14 14 32 10 20 16 9.4 78 69 37 8.5 7.0 26 45 23 36 34 Currently in ICU-care for Covid-19:

372[282]

Total ICU-care 3 55 4 42 26 12 63 23 11 36 77 728 118 109 19 24 32 42 292 67 90
Notes
  1. ^ a b Data is compiled by Folkhälsomyndigheten at 11:30 (UTC+02:00) each day. Reports of new cases and deaths to Folkhälsomyndigheten might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days.[2]
  2. ^ a b c d e f Reported, confirmed cases. Actual case numbers may be higher.
  3. ^ From 6 March 2020 onwards, Stockholm County reported its cases after 24 hours.[citation needed]
  4. ^ Stockholm County decided to only test hospitalized patients from risk groups and healthcare personnel with symptoms from 11 March 2020 onwards.[280]
  5. ^ The Public Health Agency of Sweden decided to only test hospitalized patients from risk groups and healthcare personnel with symptoms from 12 March 2020 onwards.[281]
  6. ^ Cases in brackets have unknown or not yet reported date of death.
Distribution
Amount Percent Amount Percent Rate Amount Percent Rate Category
12854 42% 2072 55% 16% 1385 0% 11% Male Sex
17942 58% 1671 45% 9.3% 488 26% 2.7% Female
3 0.0097% 0 0% 0% 0 0% 0% Unspecified
146 0.47% 1 0.027% 0.68% 2 0.11% 1.4% 0-9 Age
353 1.1% 0 0% 0% 6 0.32% 1.7% 10-19
2686 8.7% 8 0.21% 0.30% 68 3.6% 2.5% 20-29
3531 11% 12 0.32% 0.34% 87 4.6% 2.5% 30-39
4365 14% 38 1.0% 0.87% 223 12% 5.1% 40-49
5474 18% 117 3.1% 2.1% 498 27% 9.1% 50-59
3782 12% 272 7.3% 7.2% 561 30% 15% 60-69
3581 12% 838 22% 23% 357 19% 10.0% 70-79
4445 14% 1529 41% 34% 70 3.7% 1.6% 80-89
2428 7.9% 928 25% 38% 1 0.053% 0.041% 90+
8 0.026% 0 0% 0% 0 0% 0% Unspecified


Cumulative number of confirmed cases per 100 000 inhabitants in the counties of Sweden over time. (Number of deaths per 100 000 in parenthesis.) The list of counties is sorted in descending order by the most recent value of the curves. Sörmland and Stockholm County showed the highest number of cases in relation to their population on April 25, while Bleking showed the lowest level, and was about 5 weeks after the Stockholm Country in development. Logarithmic vertical axis. Data sources: Public Health Agency of Sweden,[1] SCB.[283]

Timeline of responses[edit]

Economic policy[edit]

Local governments, such as the municipal government in Gävle, have applied measures to businesses delaying the payment of invoices until 1 September 2020 at the earliest and deferring rent payments.[284]

See also[edit]

Explanatory notes[edit]

  1. ^ a b Data on new deaths is compiled by the Public Health Agency of Sweden at 11:30 CEST (UTC+02:00) each day from the communicable disease surveillance system SmiNet. Reports of new deaths to the Public Health Agency might be delayed by up to several days, especially around weekends, possibly introducing delays in reported number of cases for the last few days. In mid-April, approximately 30% of the cases were reported within 24 hours, 50% within 48 hours, and 90% within one week. Data from the Health Agency includes all deaths where a COVID-19 diagnosis had been confirmed (U07.1) during the past 30 days, including cases where the cause of death wasn't attributed to COVID-19 (as of data from the National Board of Health and Welfare from 21 April, this number amounted to 4.5% of cases confirmed in a laboratory), but excludes non-confirmed cases (U07.2). On 12 May, 87% of the deaths attributed to COVID-19 weren't confirmed in a laboratory. As this only includes cases confirmed in a laboratory, the actual number is believed to be higher due to the number of laboratory-confirmed cases only amounting to 70% (as of 3 May) of an excess mortality observed in Sweden since late March, according to a statistical analysis by the Public Health Agency based on data from from the Swedish Tax Agency and the European mortality monitoring activity (EuroMOMO). By late April, there had been approximately 2800 excess deaths in Sweden.[2][3][4][5]
  2. ^ A Swedish government agency is an independent body without the power to pass laws. Instead, they give out recommendations on how someone can or should act in order to meet a binding regulation within the agency's area of activity (in this case The Swedish Communicable Diseases Act). Although there isn't a legal framework for a governmental agency to impose sanctions on someone for going against its recommendations, they aren't optional as they work as guidelines on how to act in order to follow a regulation (in this case an obligation to help halting the spread of am infectious disease).
  3. ^ The index is based on 140 questions, grouped into 85 subindicators, 34 indicators and 6 categories, with countries being ranked overall and for each category; Prevention: Prevention of the emergence or release of pathogens (Sweden ranked 2nd), Detection and Reporting: Early detection and reporting for epidemics of potential international concern (7th), Rapid Response: Rapid response to and mitigation of the spread of an epidemic (14th), Health System: Sufficient and robust health system to treat the sick and protect health workers (20th), Compliance with International Norms: Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms (11th), and Risk Environment: Overall risk environment and country vulnerability to biological threats (6th)[17]

Citations[edit]

  1. ^ a b c d e f g h i j k l m n "Antal fall av covid-19 i Sverige – data uppdateras dagligen kl 11.30". Public Health Agency of Sweden – Official statistics at arcgis (in Swedish). Public Health Agency of Sweden (Folkhälsomyndigheten). 30 March 2020. Retrieved 9 April 2020. Lay summaryAntal fall av covid-19 – Statistik – antal fall covid-19. Data updated daily at 11:30 [CET]
  2. ^ a b c d e f "Bekräftade fall i Sverige — Folkhälsomyndigheten". www.folkhalsomyndigheten.se (in Swedish). Retrieved 1 April 2020.
  3. ^ a b "Veckorapport om covid-19, vecka 18" (PDF). Public Health Agency of Sweden. 8 May 2020.
  4. ^ "Faktablad: Beskrivning av datakällor för avlidna i covid-19" (PDF). Socialstyrelsen. Retrieved 9 May 2020.
  5. ^ "Statistik över antal avlidna i covid-19". Socialstyrelsen (in Swedish). Retrieved 12 May 2020.
  6. ^ Elsevier. "Novel Coronavirus Information Center". Elsevier Connect. Archived from the original on 30 January 2020. Retrieved 15 March 2020.
  7. ^ Reynolds, Matt (4 March 2020). "What is coronavirus and how close is it to becoming a pandemic?". Wired UK. ISSN 1357-0978. Archived from the original on 5 March 2020. Retrieved 5 March 2020.
  8. ^ "Nytt coronavirus upptäckt i Kina – Folkhälsomyndigheten". folkhalsomyndigheten.se (in Swedish). Retrieved 27 March 2020.
  9. ^ a b c "Utbrottet av nytt coronavirus kräver samordnade insatser internationellt – Folkhälsomyndigheten". folkhalsomyndigheten.se (in Swedish). 30 January 2020. Retrieved 5 April 2020.
  10. ^ "Folkhälsomyndigheten föreslår att nytt coronavirus tas upp i smittskyddslagen – Folkhälsomyndigheten". folkhalsomyndigheten.se (in Swedish). Retrieved 1 April 2020.
  11. ^ Blohm, Lisa. "Coronavirus på väg klassas som samhällsfarligt". Dagens Medicin (in Swedish). Retrieved 1 April 2020.
  12. ^ "Anmälningspliktiga sjukdomar – Folkhälsomyndigheten". www.folkhalsomyndigheten.se (in Swedish). 3 March 2020. Retrieved 12 April 2020.
  13. ^ Deb, Sopan; Cacciola, Scott; Stein, Marc (11 March 2020). "Sports Leagues Bar Fans and Cancel Games Amid Coronavirus Outbreak". The New York Times. ISSN 0362-4331. Retrieved 12 March 2020.
  14. ^ "Så är Sveriges skydd mot en pandemi". Dagens Nyheter (in Swedish). 28 September 2014. Retrieved 1 May 2020.
  15. ^ "Pandemiberedskap. Hur vi förbereder oss – ett kunskapsunderlag – Folkhälsomyndigheten". Folkhalsomyndigheten (in Swedish). 2019. Retrieved 1 May 2020.
  16. ^ "GHS Index: Findings and Recommendations". Retrieved 29 February 2020.
  17. ^ "About the GHS Index". GHS Index.
  18. ^ "Health Care Resources". stats.oecd.org. Retrieved 17 October 2017.
  19. ^ Rhodes, A.; Ferdinande, P.; Flaatten, H.; Guidet, B.; Metnitz, P. G.; Moreno, R. P. (1 October 2012). "The variability of critical care bed numbers in Europe". Intensive Care Medicine. 38 (10): 1647–1653. doi:10.1007/s00134-012-2627-8. ISSN 1432-1238. PMID 22777516.
  20. ^ Frejdeman, Hannah (13 April 2020). "Efterrapportering att vänta efter helgen". Svenska Dagbladet (in Swedish).
  21. ^ "Veckorapport om covid-19, vecka 18" (PDF). Public Health Agency of Sweden. 8 May 2020.
  22. ^ "Faktablad: Beskrivning av datakällor för avlidna i covid-19" (PDF). Socialstyrelsen. Retrieved 9 May 2020.
  23. ^ a b "Nytt bekräftat fall av covid-19" [New confirmed case of covid-19]. Folkhälsomyndigheten (in Swedish). 26 February 2020. Retrieved 3 March 2020.
  24. ^ Abrahamsson, Anders (3 March 2020). "Första svenska coronafallet kliniskt frisk". gp.se (in Swedish). Retrieved 7 March 2020.
  25. ^ Bolin, Mattias (26 February 2020). "Bekräftat coronafall i Göteborg – person vårdas på Sahlgrenska". SVT Nyheter (in Swedish). Retrieved 26 February 2020.
  26. ^ "Inbjudan till pressträff: Ytterligare fall av covid-19 i flera regioner – Folkhälsomyndigheten".
  27. ^ "Inbjudan till pressträff: Ytterligare fall av covid-19 i flera regioner – Folkhälsomyndigheten". folkhalsomyndigheten.se (in Swedish). Retrieved 27 March 2020.
  28. ^ "Möjliga fall av inhemsk smitta" [Possible cases of domestic infection]. svt.se (in Swedish). 9 March 2020. Retrieved 27 March 2020.
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