Sweden ‘paying the price’ for lockdown reluctance

State epidemiologist’s predecessor blames ‘wishful thinking’ for causing grim second wave

THE predecessor of Sweden’s state epidemiologist has accused him and his team of failing to adequately prepare Sweden for the second wave of coronavirus infections, because “wishful thinking” led them wrongly to believe that immunity would leave the country protected. Annika Linde, who served as state epidemiologist from 2005 until Anders Tegnell took over in 2013, told The Daily Telegraph that the Public Health Agency had shown a reluctance to plan for the worst.

“Wishful thinking – when you don’t believe in the worst scenario – has been guiding Swedish decisions too much,” she said. “The Swedish authorities have been slow all the time. Instead of being proactive, they’ve run after the virus, and the virus has been able to spread too much before they take action.”

Sweden refrained from implementing a lockdown during the spring, unlike the rest of Europe. When Mr Tegnell returned from his summer break at the end of July, he argued that the sharp drop in cases in Sweden over the preceding three weeks could, at least in part, be explained by greater immunity within the population.

He said in July: “The big reduction we see now suggests strongly that the infection is being held back and that we will probably be hit less hard if we see a second wave in the autumn.”

But the country is now seeing the number of new cases rise by as much as 50 per cent a week, with a record 5,990 new cases and 42 deaths reported on Friday – dramatically higher rates than its neighbours.

Last week, Sweden recorded more than twice as many cases as Denmark per million people, and more than four times the number in Norway. That is despite the fact that Denmark carries out four times as many tests per capita.

“I hoped he was right. It would have been great. But he wasn’t,” Ms Linde said of Mr Tegnell’s immunity hopes. “Now we have a high death rate, and we have not escaped a second wave: immunity makes a little difference maybe, but not much difference.”

Mr Tegnell argued on Thursday that Sweden had not been alone in being wrong-footed by the severity of the second wave. He said: “The pandemic has taken off in a way that few countries had expected.”

He conceded that Sweden did not have the level of protective immunity he had predicted it would gain and that the number of undetected infections had been overestimated.

“The number of people we don’t find with diagnostics is with high probability smaller than we thought,” he said. What was now “absolutely obvious”, he continued, was that the brake effect from immunity was too weak to counteract the acceleration effects coming from the colder weather, people’s return to work, and looser adherence to recommendations. But Ms Linde, who unlike Mr Tegnell is an expert on flu, said that, based on past epidemics, the PHA should have been prepared.

“My guess was always that we would see a second wave, and that it would be heavier than the first one,” she said. “This is really typical of pandemics, seeding in spring and summer and then explosion in the autumn.”

Mr Tegnell has always acknowledged that a winter resurgence was possible. But his agency nonetheless waited until Oct 20 before issuing the first set of non-coercive, locally-targeted restrictions to the region around Uppsala. It has now issued them to 18 out of 21 regions, and on Wednesday the government moved to impose a nationwide ban on alcohol sales after 10pm.

Even Tom Britton, the Stockholm University mathematician whose modelling Mr Tegnell’s team relied heavily on in March, now argues the PHA has been too slow.

“Our neighbours slammed down the brakes significantly earlier and harder than we did, as soon as they saw the infection going up,” he said. “Sweden put the brakes on too late.”

Ms Linde said that the PHA should have anticipated the autumn explosion and worked harder on testing, tracking and isolating cases during late summer.

“You have to diminish the seeding, then you will have much fewer people who can act as spreaders when the climate becomes suitable,” she said.

‘Wishful thinking – when you don’t believe in the worst scenario – has been guiding Swedish decisions too much’