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An electronic billboard urging sick people to stay home is shown on an otherwise bustling main street in downtown Stockholm on April 1, 2020.

Photography by JONATHAN NACKSTRAND/AFP via Getty Images

While countries around the world impose strict measures to stop the spread of the new coronavirus, Sweden has followed a different path: no lockdowns, no school closures and no ban on going to the pub.

The Scandinavian country is pursuing what Prime Minister Stefan Lofven calls a “common sense” response to the pandemic by keeping the country largely functioning and aiming health measures at the most vulnerable.

“We who are adults need to be exactly that – adults. Not spread panic or rumours," Mr. Lofven said in a televised address to the country last week. "No one is alone in this crisis, but each person has a heavy responsibility.”

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The approach has put Sweden at odds with many countries across Europe, including its neighbours – Denmark, Norway and Finland – where almost all public venues have been shut and people have been ordered to stay indoors. In Sweden, most bars, restaurants and schools remain open, and people continue to mingle in parks and on city streets.

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The government has introduced social-distancing guidelines and encouraged people to work from home. Gatherings of more than 50 people have also been banned, and some businesses, notably cinemas and ski resorts, have voluntarily closed. But few of the measures are mandatory, and almost no one expects Sweden to adopt the kind of fines and police checks that have become commonplace in Britain, France, Spain and Italy.

A growing number of doctors and medical experts worry that the government is taking a huge gamble, especially as the number of infections in Sweden surpass 5,000 and the death toll approaches 300. But public health officials insist their efforts are working and that doing anything more drastic would be unsustainable.

Anders Tegnell is the chief epidemiologist of Sweden's public health agency.

“In Sweden we are following the tradition that we have in Sweden and working very much with voluntary measures, very much with informing the public about the right things to do. That has worked reasonably well so far,” Anders Tegnell, Sweden’s chief epidemiologist and main architect of the policy, said in an interview from Stockholm.

Dr. Tegnell said most people are travelling less, working from home and adhering to social-distancing measures.

“We have so far not had very much of a spread [of the virus] into elderly homes and almost no spread into the hospitals, which is very important,” he said. He added that, so far, the hospital system has generally been able to cope with admissions, but some in Stockholm have faced difficulty. For now, though, he has no plans to change the overall approach.

“We know that [with] these kinds of voluntary measures that we put in place in Sweden, we can basically go on with them for months and years if necessary.” And even though the economy has slowed, “it has the potential to start moving as usual very, very quickly once these things are over.”

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Travel has quieted down, but not halted, at Stockholm's main railway station on April 2.

A man cleans and disinfects a taxi to prevent the spread of the coronavirus.

People take in the cherry blossoms at Kungstradgarden. Health officials have issued recommendations for social distancing in Sweden, but they are voluntary.

Historian Lars Tragardh said Sweden’s response to the pandemic is rooted in its unique social attitudes. “Sweden is a high-trust country in a way, which is highly unusual,” said Dr. Tragardh, a professor of history and civil society studies at Ersta Skondal University in Stockholm.

Surveys show that Swedes trust the government and each other to a degree rarely seen in other countries. An annual study of public attitudes by researchers at the University of Gothenburg found that almost 60 per cent of Swedes said they had a high degree of trust in people. That percentage has remained constant in every survey since 1996, and is about double the level in Britain and the United States. “There’s also trust the other way,” Dr. Tragardh said. “The government and state institutions, generally speaking, trust citizens to do the right thing.”

Swedish family structures also differ from those of other parts of Europe. Almost half of Swedish households consist of a single person, the highest proportion in Europe and well more than the European Union average of 30 per cent. There’s also no tradition of living with grandparents, and elderly people tend to live on their own or in state-supported homes. “Swedes are proverbially suffering anyway from some kind of tendency toward social distancing,” Dr. Tragardh said with a laugh. “So in that sense, culturally speaking, we are well equipped to handle a crisis of this sort.”

There has also been little public pressure in Sweden to close all schools, unlike in Britain, where parents demanded the government do so. That’s largely because Sweden has a high percentage of families with two working parents, and Dr. Tegnell concluded that closing schools would be far too disruptive. Instead, he left primary schools open, and closed high schools and universities, but classes continue online and some may soon reopen.

Not everyone is comfortable with the government’s go-slow approach. Last week 2,000 doctors and public-health experts signed an open letter calling on the government to go further. “We still have some time to react and suppress the virus,” the letter said. “Our nation should not be the exception in Europe."

Emma Frans, an epidemiologist at Sweden’s Karolinska Institute, has some sympathy for the government’s approach. “Locking people in and closing schools is very difficult to sustain,” Dr. Frans said. But she is concerned about the pressure that’s building in the health-care system. “So I’m not sure at all that this will work, but my question is: What is a better thing to do?”

Pedestrians walk in Stockholm's Drottninggatan on April 1.

JONATHAN NACKSTRAND/AFP via Getty Images


Coronavirus: The global picture

Sources: GOVERNMENT WEBSITES, UNIVERSITY OF TORONTO AND JOHNS HOPKINS UNIVERSITY
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