Sweden, Sweden, Sweden. It is the cry of the Corona-Virus Truthers. The stories of Sweden's business as usual strategies are plenty - and among those who only read headlines, they are often wrong. But, Sweden has taken a different approach to the pandemic which has swept the world and I suspect their success has been due more to cultural norms than science, a culture which is not shared by Americans. Swedes value life, social distancing is the norm, they understand the needs of the many over the needs of the one, they are willing to follow guidelines without sweeping orders and they are, perhaps, the world's most successful welfare state.
Like many others, I have been following the unfolding pandemic since mid-January. I can remember sitting in bed with my husband in early February and saying, "I'm going to start fill the pantry and buy additional N-95' masks." (I keep them for home repair projects and mowing). He looked at me as if I had grown an extra head and said, "I think you are overreacting." As I watched China move into quarantine, it was obvious to me (and many others based on briefings to the President that begin in early January) that the U.S. would not come out unscathed in this crisis.
To say I have been focused on the weavings of news, theories, the press conferences....would be an understatement. There are threads within all of this that I have pulled on more than others. An image of a protester waving a sign that said, "Sweden" is one of the threads that has fascinated me. The idea is had we simply been like Sweden and let business go on as usual, we would have been fine. A press-conference on April 23rd featuring two doctors who are the co-owners of Accelerated Urgent Care in California also used Sweden as part of their reasoning for their theory on developing herd immunity and re-opening California's economy. That press conference has gone viral and I have seen it shared by nearly every friend who believe we should reopen full force or who believe the entire virus a media induced hoax. My husband and I watched the videos and while they were compelling and I do not disagree that a significant portion of the country can and should begin to reopen, their hypothesis have not been well-received by many in the broader medical community. I want to say, that while differing opnions do not make them wrong, they also aren't completely right. To everyone who waves Sweden's flag during the pandemic, I say to you I find it bizarre that only the idea that Sweden has not taken measures (which is untrue) are held on to while there is little discussion of what they actually did do and why their response may (or may not be) working, specifically how their society and culture differ vastly from the U.S.
Let's begin by looking at what is, perhaps, the most imporant conversation around Sweden and the Coronavirus. Healthcare. I assume that anyone using Sweden as a reflection of how the U.S. should have handled this pandemic is also aware that the Sweden's healthcare is funded by taxes and is offered to all. I am not an expert on healthcare beyond my own family's needs and the knowledge of what we pay each year, before taxes, toward our own insurance. Having a child with special needs and yearly hospital stays, I can tell you that healthcare eats a significant part of our paycheck. Having read several articles on Sweden's health-care system, I would say it is imperfect, but so is the U.S. healthcare system, the difference being that all Swedes have access to care and in the U.S., it is estimated that one-third of our citizens have no access to healthcare, meaning they have no insurance and do not seek medical care due to lack of funds to pay. And, in many states, access is becoming even more restricted due to party-line ideologies and the continued economic divides plaguing our nation. Sweden's health-care system is a nod to the overall culture of the nation and putting the whole of the nation before the individual.
It is important to note that due to Sweden's early dismissal of heightened efforts around the most vulnerable, they have had a surge of cases and deaths in nursing homes. They have admitted failure in this area and have been seeking to remedy the issue. They have also taken responsibility for that failure, which I use as another measure of how different Sweden's leaders are from American leaders.
What about other fundamental "rights" that we in the U.S. enjoy? Let's talk about gun laws. Sweden, like the U.S., allows individuals to own guns. That is where the similarities end in regards to gun ownership. I came across a fascinating article, written by a man who is both an academic and a hunter, who shows that Sweden is more focused on gun owner responsibilities than rights. What a concept. They have decided to put the safety of others in regards to gun ownership ahead of their rights to merely possess one. Gun owner's in Sweden must take a year-long class, pass a physical and written test and keep all firearms unloaded and locked in a gun safe. Again, putting others first seems to be a cultural norm.
How does Sweden compare to the U.S. in child-rearing practices? This is a topic I have followed for many years, or at least since becoming pregnant with our first child in 2001. I don't even know where to begin with this comparison. Families are first in Sweden. Period. They are not first in our nation. We should be more focused on supporting childbirth and family life, not in an evangelical understanding, which has less to do with family and more to do with religion, but in a humanitarian way and in a way that acknowledges that by putting our children first, we will indeed foster a great nation. I am not saying that every detail they have legislated in regards to family life is correct, but we could learn a few things from the Swedes. Here are a two ways families are placed first that can support their pandemic response and is contrary to American policies.
Either the mother or father is entitled to be absent from work until their child reaches 18 months old.
You have the right to up to 60 days off per year to care for a sick child.
What do gun rights, healthcare and a true families first approach have to do with the Coronavirus response? Sweden has had some success with their pandemic approach. They are also a nation of people who have put trust in the government, largely with good reason. They have systems and cultural norms that can most likely see them through their current strategies, which is more humanitarian than religious in nature. I say they have had only some success as at the writing of this article, they are struggling with increased cases and a higher death rate and are threatening tougher mandates if the increases continue. Let's look at what they have actually put into place.
Closing of all high schools and universities (this would have been met with cries of inequality in the U.S. and demands that either all schools remain open or all close.)
Restaurants operating with restrictions, but should not have more than 50 people at once and are only allowed to serve at tables. No standing. (At the time of this blog post, Sweden is considering tougher restrictions.)
Recommendations to stay home if you have cold or flu-like symptoms and be symptom free for 48 hours before leaving home. With schools having these mandates in place in the US, we all know they are ignored and children are regularly sent to school ill (see paragraph above on how we do not support families in the U.S.) And, many employers frown upon the use of the limited sick days given in the workplace. Sweden has generous sick pay in place, meaning employees will stay home and heal instead of spreading illness in the workplace.
Avoid large gatherings, including parties, weddings, and other activities. Sporting events, concerts, etc. have been canceled until further notice. Again, Sweden is taking measures as well. Gatherings larger than 50 are banned. It is interesting to note that over half of all Swedish households are households of ONE, making it far easier to social distance and prevent the spread of illness.
Work from home if you can. More than 2/3 of all Swedes already worked from home prior to the pandemic. Employers have been asked to ensure this happens where possible. It is my firm belief that without the strict measures the U.S. has taken, based on our cultural norms and Puritan work ethic (not neccessarily a bad practice), many companies here would have required employees to continue to show up for jobs in buildings that could easily be done from home.
Avoid all non-essential travel, both within and outside Sweden. That includes visits to family, planned holidays, and any other trips that can be avoided.
If you are over 65 or belong to a high-risk group, stay home. Nursing homes have limited visitation during this time. The recomended stay home age was age 70, however, due to increased cases, they have dropped the number to 65.
The fact remains that we are not Sweden. We are not prone to following the rules. We are individualistic and in American society the needs of the one almost always outweight the needs of the many. We are approximately 7 weeks into the recognition of the pandemic in the U.S., which is also 16 weeks after the White House began to receive briefings on the virus and 15 weeks after patient zero in Washington state was diagnosed.
There is no doubt that had the U.S. not enacted strict measures, we would have seen surges in more of our metropolitan cities, like my city of Nashville. We are now an international destination and our airport sees 15 million people through its corridors each year. I shudder to think of the number of bridesmaids and country music fans that could have potentially brought Covid-19 to us from New York or Seattle or that we could have sent home with them as souvenirs of their Music City adventures.
So you see, Sweden's approach would have never worked for us. We would have never followed measures voluntarily as Sweden does. We do not have a culture who lives social distancing daily. Our homes and lives are, thankfully, multi-generational, meaning we can more easily transmit disease to our more vulnerable population. Our society does not trust our government to know what's best for us, it's in our nation's DNA. Does that mean the measures put into place should still be in place? That is another blog post for another day. But, for today, keep on carrying on Sweden, with your fabulous culture and your attempt to combat this pandemic in the way that fits your society. I mean it. And, to my friend's in the U.S., stop waving Sweden's flag as a banner of freedom from government oppression unless you are ready to accept more of their ideology, stay awake, read beyond the headline, understand the good of the many outweighs the good of the one (which may be a good reason to begin to open the economy) and give if you can to the needy.
Peace to you.