Assessing the response to Covid 19: Sweden vindicated

By
Pieter Cleppe
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Anders Tegnell, Sweden's state epidemiologist during the Covid crisis (Copyright: By Frankie Fouganthin - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=89298420 )

Now that all of the statistics regarding Covid are available, it has become possible to finally take stock of the policies implemented to deal with this terrible virus, which is estimated to have killed nearly 7 million people globally. During the first few months of 2020, when not as much was known about Covid, policymakers made the weirdest turns. To make a few wrong calls at that point can still be understood. That many of those erroneous policies continued in the second half of 2020 and afterwards, when an effective vaccine existed, should meet with much less understanding.

Of course, the biggest bone of contention was always about whether there was a need for a so-called “lockdown”, implying all sorts of restrictions on travel, mandatory closures of businesses and schools, combined with massive government spending to mitigate some of the damage of the lockdown decided by the same government. In the West, Sweden was about the only country that did not institute such a lockdown, except for some very limited school closures.

As Swedish MEP Charlie Weimers has put it, the reason is not that Swedish politicians are less prone to the tendency to go too far with certain measures, in the hope that they cannot then be accused of having been overly careless. The reason is that in Sweden, it is particularly difficult for politicians to go against the health policy officials that are appointed to manage a health crisis. Swedish chief epidemiologist Anders Tegnell (picture) was the face of this strategy. He chose not to introduce lockdowns, but focus on the contrary on properly informing the population about the risks of Covid.

Tegnell stated at the end of April 2020:

“Coronavirus is not something that is just going to go away. Any country that believes it can keep it out (by closing borders, shuttering businesses, etc.) will most likely be proven wrong at some stage. We need to learn to live with this disease.”

Time for conclusions

What can we conclude, just over three years later?

In a new study for US think tank Cato Institute, Swedish commentator Johan Norberg makes it clear that the lockdowns were useless. He writes:

«Sweden’s excess death rate during the pandemic was 4.4 percent higher than previously. Compared to the data that other countries report to Eurostat, this is less than half of the average European level of 11.1 percent, and remarkably, it is the lowest excess mortality rate during the pandemic of all European countries, including Norway, Denmark, and Finland».

Norberg does not use the official statistics on the number of COVID-19 deaths in his comparison “because countries have different definitions”. Now that the excess mortality figures are known, it is finally possible to draw conclusions. These are not exactly positive for Western governments, except thus for the Swedish one.

One of the benefits Norberg mentions is that “Swedish elementary schoolers suffered no learning loss during the pandemic”, in contrast to pupils in Belgium, for example, where the learning loss due to the pandemic is estimated to be about half of the acquired knowledge of a normal school year, according to the Flemish Catholic Education Network. A Dutch study from 2023 concludes that the effect of school closures on hospital admissions was virtually nil, which is confirmed by international academic studies. All this is downright devastating for the political class.

The role of the WHO

A lockdown was not envisaged as a tool in the epidemic plans of Western countries. They took their inspiration from China. Italy was the first Western country to act in this way, after some hospitals there could no longer cope with Covid care.

However, an alternative approach to Covid was already visible at the time, namely that of Taiwan, which did not institute a lockdown, even though it is located right next to China, but pursued a policy of strict border controls and quarantine.

However, the international debate on health policy takes place at the level of the WHO, the World Health Organisation, and there, the Taiwanese approach is taboo. In late December 2019, the country warned that a new disease had emerged in the Chinese city of Wuhan. Despite this, the WHO continued to claim there was not much to worry about, in line with the Chinese government, which according to Le Monde was the result of Chinese lobbying not to declare a global pandemic. Taiwan’s vice-president Chen Chien-jen, himself an epidemiologist, complained in 2020 that the WHO website “does not post any of the information shared by [our] country”. That is particularly problematic.

In sum, China not only managed to exclude Taiwan from the WHO, but also managed to engage the international organisation in attempts to suppress information about the Covid-19 outbreak. This despite the fact that China contributes only 0.21% to WHO funding.

In May 2020, microbiologist Herman Goossens, coordinator of the EU Platform on Epidemics, also lamented the approach to follow WHO recommendations. He stated:

“We should have looked at other countries. To Taiwan or South Korea. Countries that have kept the virus under control, thanks to a policy of immediate and targeted testing, combined with thorough contact investigation and isolation of infected persons. Taiwan already systematically quarantined infected persons in early January. But it is not a member of the WHO and was not on our radar. When we look back on this in a few months, we will sigh: guys anyway, we could have prevented that lockdown.”

It is understandable that politicians institute lockdowns in a panic when hospitals can no longer cope with the influx of patients, but when looking back today, in 2023, it becomes evident that such lockdowns have not been able to flatten the curve, or that the overall health damage is ultimately lower in Sweden anyway. The international figures on excess mortality prove this. 

Excess mortality is an imperfect way to measure, but while Covid statistics are notoriously unreliable, excess mortality rates do allow countries to be compared. Whether Sweden had the least excess mortality over those three years courtesy of the “natural immunity” or “group immunity” that the Swedes were already building up more quickly is a plausible hypothesis in this regard, although further research is needed on this. That’s also the case with regards to the extent to which China’s restrictive “zero Covid” policy is the reason why China seemingly had to contend with Covid for longer. In general, there are great uncertainties in such a health debate, which is simply how science works, in sharp contrast therefore to the so-called great truths that were posited with great firmness during the Covid crisis.

Vaccination passports and masks

In two other areas in particular, policymakers have ignored the science. In each case, the WHO went along with this.

First, there was the assumption that vaccination was not just a personal choice, but that those that were vaccinated also protected others. It formed the basis for so-called “vaccination passports“, where people were no longer allowed to enter restaurants if they were not or insufficiently vaccinated. The European Union also enthusiastically went along with this. However, it was already known in early 2021 that vaccination only affected the health of the vaccinated themselves, as vaccinated people could still pass on Covid. One could perhaps make a case that a high number of vaccinated people put less of a burden on hospitals, but in no way is such a thing proportionate to the severe restrictions imposed. Open to discussion was perhaps to make people from risk groups who refused to vaccinate pay a higher insurance premium, but then, of course, one had to do such a thing for all other types of risk as well.

Second was the mask story, where there was a noticeable shift worldwide. First, masks were supposedly ineffective as protection against Covid – in countries like Belgium, this was eagerly communicated, perhaps to disguise the fact that the strategic mask reserve had been destroyed by the government. By the second half of 2020, however, they were allegedly of paramount importance. The WHO also changed its position here, along with politicians that were desperate for tangible measures that could at least feed the idea that one could slow or contain the epidemic.

There is still scientific uncertainty about this, but what is clear is that the cloth masks many were wearing were virtually useless. FFP2 masks may have helped, though questions remain there too. The Brussels regional government deserves a special mentions here, as it even made it compulsory to wear a mask outdoors, – not that this was heavily enforced in the Brussels context. Where this ridiculous measure did no harm per se, however, the same wasn’t true of the mask requirement for schoolchildren, who also suffered learning delays as a result.

While many slowly accepted the painful truth that the Covid virus pounds its way mercilessly through society and that it may be better to focus on protecting the weakest, this approach was considered too limited a response by policymakers. Again, the WHO was among the most hysteric.

The WHO also fails in other areas

In the past, the WHO also made serious mistakes when it comes to fighting Ebola and swine flu, there were numerous financial scandals, and in 2019 it even recognised forms of traditional medicine popular in China, against the scientific consensus.

It also misses the mark on cancer control, which should be an absolute top priority. For instance, the WTO is a strong opponent of methods to help convince smokers get rid of this unhealthy habit by offering them a less harmful alternative. In doing so, the WHO sided against means of tobacco products that avoid the burning process, as the WHO’s so-called “COP” conference has even called for a ban and severe restrictions here. This is despite the fact that, according to a WHO study of its own, “new tobacco products that are less toxic or less addictive could be a component of a comprehensive approach to reducing tobacco-related deaths and disease, particularly among tobacco users who are unwilling to quit or are unable to break their dependence on tobacco”.

Incidentally, Sweden is also a model in this respect. Only 5 per cent of Swedish adults smoke, while the European average is 20 per cent. This has a particularly large impact on public health, as in Sweden the mortality rate and incidence of cancer are 38 per cent and 41 per cent lower than the EU average, respectively.”

As to why, one need not look far. The only derogation Sweden received when negotiating EU accession in the 1990s was that no ban should be imposed on snus, a smokeless tobacco for oral use. Despite its great success in terms of cancer control, the European Commission to this day steadfastly refuses to review this ban, prompted by WHO officials, and it is even now considering to extend it to non-tobacco snus. In that respect, it is interesting to note, by the way, that the European Commission on its own, independently of the Member States, participates in WHO working groups on sometimes far-reaching suggestions to impose restrictions on how tobacco products are presented in the media and outside. It thereby does not distinguish between classic, highly harmful smoking, and less harmful alternatives.

The European Commission will try to have the WHO Framework Convention on Tobacco (FCTC) adopt measures that it wants to impose on the populations of the European Union. This would make it possible to bypass European and national parliaments by invoking the binding nature of the Convention. For this, the European Commission has prepared a position for its delegation to COP10 which brings together the 181 signatory countries of the Framework Convention on Tobacco Control (FCTC) of the World Health Organization (WHO) from November 20 to 25 in Panama. This consists, according to the revelations of September 19 by the German media Table, in a refusal to recognize the reduction of risks, the ban on advertising and threats, imprecise in the German media, on the online sale of vaping, and the overtaxation of reduced-risk products, including vaping. In order to avoid a say for EU member states, the Commission also only gives member states ten days to react when proposing its stance for international policy conferences. A deliberate strategy.

The tunnel vision of the EU Commission and the WHO here is truly disappointing, because today, there are plenty of innovative alternatives to the cigarette, from vaping over nicotine pouches – tobacco-free snus – to heated-tobacco products, about which there is a scientific consensus that they are far less harmful than the traditional cigarette or not harmful at all.

In the UK, fortunately, policymakers are already on the right track, as doctors there can now prescribe vaping as a smoking cessation tool. One million UK smokers will get a free vape there, in addition to coaching. The UK government also already made it clear that it will not accept compromises that run counter to its innovative policies at the upcoming WHO COP10 conference in November, which will address this issue. It is refreshing to hear some dissident voices at such conferences for a change, as traditionally policymakers there talk mostly to themselves, with input then from NGOs to feed the echo chamber.

Conclusion

Meanwhile, the WHO’s approach does seem to be meeting with more and more resistance in the scientific community. For example, one of the Belgian Healthy Ministry’s leading virologists, Steven Van Gucht, stated that he was “surprised [by] the WHO’s sudden communication” in early September, after the organisation had warned of “worrying trends” regarding the coronavirus. According to him, there is no reason to panic: “They want to raise awareness of the virus again.

Assuming that this might be well-intentioned, it is still extremely unwise. After all, a government that communicates carelessly during a crisis can expect some kind of backlash. Commenting on a report that the risk of outbreaks of infectious diseases like measles is increasing due to a decreased vaccination rate in Amsterdam, Dutch newspaper Het Parool notes:

“The lower vaccination rate has been a global problem since the corona period. Since then, fewer people trust vaccination programmes and vaccinating is taken less for granted. The WHO calls vaccination mistrust one of the 10 biggest threats to health worldwide.”

Perhaps the WHO, which went full steam ahead with the unscientific narrative of Covid passports and the like, should do some introspection first.

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