The Nordic divide on coronavirus: Which country has the right strategy?

Looking at the front pages of some news sites in Norway and Denmark, it almost seems as if they are willing the coronavirus outbreak in Sweden to worsen. Will the coming weeks prove Denmark and Norway were right to impose tougher restrictions on the country?

The Nordic divide on coronavirus: Which country has the right strategy?
The Øresund Bridge. Photo: Niels Christian Vilmann/Ritzau Scanpix
“21 dead in Stockholm”, read Monday's headline in Norway's VG. “The number of corona deaths in Sweden rises to 146,” runs the headline in Norway's NRK newswire. “146 people infected with coronavirus in Sweden are dead,” ran Tuesday's story from Denmark's Ritzau newswire.
When the British medical journal The Lancet on Tuesday described Sweden's “slow response” as looking “increasingly poorly judged”, it was the main story on VG's homepage. 
Two weeks after the Norway and Denmark shut schools and kindergartens and asked all but essential workers to stay home, the media in the two countries is watching Sweden's hospital admissions and coronavirus death tally almost as closely as their own, ready for signs of a spike to justify their own lockdowns. 
So far, there has been little conclusive. 
Norway tops the three countries in terms of the number of confirmed cases per million inhabitants with 810, followed by Denmark with 441, and Sweden with 331. 
But this reflects the fact that Norway has tested 87,191 people, while Denmark has tested just 21,378. Sweden's most recent testing figure, from 25 March, was 24,500.
On deaths per million inhabitants, Sweden is currently fractionally ahead with 14 per million compared to Denmark's 13 per million, with Norway way behind on just 6, according to the Worldometers website. 
But the way deaths are rising in Sweden does look more dramatic, according to data from the European CDC put together by Our World in Data. 
Danish and Norwegian politicians have now begun claiming that the lockdown measures have been successful.  
“Over the past week, the number of admissions has risen slightly more slowly than the week before, and without the explosion in the numbers that we have seen in other countries,” Danish Prime Minister Mette Frederiksen said on Monday, as she announced plans to reopen Denmark. 
“There is still uncertainty. But figures for hospital admissions may indicate that it is going the right way. Time will tell if the measures are working well enough,” Norwegian Prime Minister Erna Solberg told a news conference on Tuesday. 
Kåre Mølbak from the Danish infectious diseases agency SSI, told the press conference that he believed Denmark's actions had reduced the average number of people each infected person infects in the country from 2.6 to 1.4. 
“The infection rate in Denmark has been more or less halved. This is a gladdening development. The epidemic is by no means over, but it has been better brought under control than anywhere else in Europe,” he said.
The SSI compared hospital admissions in Denmark against those seen in northern Italy. 
Bjørn Guldvog, the Director-General of the Norwegian Directorate of Health, said on Wednesday that he believed Norway is “well on the way to succeeding” in bringing coronavirus under control, with the infection rate now “moving down towards one”. 
On Tuesday, both Norway and Denmark reported small reductions in the number of people hospitalised with the virus, although the number rose again on Wednesday. 
Some health officials in Sweden have also expressed confidence in their country's strategy, despite growing international criticism. 
Stockholm region's health director Björn Eriksson told Swedish radio: “Up until now the health care system has been one step ahead of the virus”, but he warned “the storm was growing”.

Bjørn Guldvog, Director General of the Norwegian Directorate of Health, Swedish state epidemiologist Anders Tegnelll, and Søren Brostrøm, Director General of the Danish Health Authority.
Allan Randrup Thomsen, a professor of virology at the University of Copenhagen, in an interview with Denmark's Ekstra Bladet newspaper on “Why Sweden is not locking down”, argued the difference between the countries policies was “purely ideological”. 
“I believe that they've based their strategy on the notion that they're just going to ride through the epidemic,” he said. 
Unlike Frederiksen, he said it was still too early to tell if Denmark's lockdown was working, but he said he believed Sweden would pay a price. 
“Sweden is getting a greater spread of coronavirus. They do not have this dampening, which we have worked hard for at home, and so I fear that they will not be able to handle the peak of the epidemic, which everything points to us succeeding in,” he said.  
“I fear they're going to experience a greater number of hospital admissions and deaths.” 
In an interview with The Local, Sweden's state epidemiologist Anders Tegnell argued that the tough actions taken by the authorities in Denmark and Norway were not based on scientific evidence. 
“I think it's political,” he said. “You saw that the head of the Sundhetsstyrelsen [Danish Health Authority] actually went out and said that these are not the measures they had been recommending. 
“If it's an overreaction, or if it's an adequate reaction, we will not know until afterwards.” 
Just as the Danish Health Authority advised against closing borders and was overruled by the country's politicians, the
Norwegian Institute of Public health last Monday called for kindergartens and schools to be partially reopened, but was overruled. 
Tegnell said that in his weekly online meeting with his counterparts in Denmark, Norway and Finland, his approach was respected. 
“I'm not going to name any names, but I do get a lot of support,” he said.  “We meet with the Nordic countries once a week and discuss where we are, and where we're going and so on.
“Nobody is sure who is right anymore. But I think a lot of my colleagues like that we can have an open and technical debate about it, which seems to be more difficult in some of the other countries where the political level has already taken a decision and taken it very quickly.” 
With pressure already growing in Norway for schools to open, Finland already partially reversing its closures, and Danish Prime Minister Mette Frederiksen on Monday announcing plans to start gradually winding down the lockdown after Easter, Tegnell's argument that Sweden has saved the most restrictive measures for when they are most needed may carry more weight in a few weeks' time. 
“These are measures that you can only keep up for a very limited amount of time, so it's much better to save them until you really need them. If you do it too early, then people get tired of them,” he told The Local. 
Nonetheless, Tegnell conceded that he expected pressure on Sweden's hospitals to start to grow, with the field hospitals built in conference centres outside most Swedish cities almost certain to be necessary. 
“Yes, I think that's quite possible, for some weeks. That's what our projections say will be needed.” 
But he said all countries' projections were uncertain. 
“Nobody knows. We are all guessing,” he said.  “My hope, if you put it that way, is that we keep on like this. Like we are going now. We have some 200 cases a day. We are probably going get more of the disease in different parts of Sweden, but it's all going to be on a level that's manageable for health care. And we keep on doing that… for weeks.” 
“That's probably asking for too much, but that's my hope. The worrying part is if it takes off and really produces a lot of cases, especially a lot of cases among the elderly. Because that really would be the worst-case scenario. If we get a big spread in a number of elderly homes and hospitals, and both elderly and health staff start getting sick.” 
He said that the big unknown was the extent to which populations are building immunity to the virus, and what would happen in areas of China, South Korea, or Hong Kong, where lockdowns had successfully contained the virus' spread. 
“We don't even know the level of immunity in China. And of course, that would be very, very good to know, for all of us. If we know that China has sort of reached, quote, 'immunity level', that tells the Swedish something about how we should move forward.” 
“If the level of immunity in China is only a few percent, then we have a completely different scenario in front of us.” 
It is possible, even likely, that over the next few weeks the number of  hospital admissions in Sweden will start to rise much more rapidly than in Denmark and Norway.
If Sweden's health system is overwhelmed, then Denmark and Norway will feel their tougher policies were justified. 
But the real test of Sweden's strategy will come later, when Denmark and Norway start to lift their lockdowns.
Can they return to normal without the infection flaring up again? Will they be hit by a second wave this winter? Will any additional deaths Sweden sees over this Easter be the price it pays for having fewer over the coming years? 
“This is not a disease that you get rid of. And if you don't get rid of it, what are you waiting for?” Tegnell said. “You can either wait for some kind of immunity to develop in your population, or you can wait for a vaccine. And the vaccine is, most likely, at least a year away.” 
Tegnell said he suspects that public policies put in place will anyway turn out to have had less impact on the virus than most think. 
“I wouldn't be too surprised if it ended up about the same way for all of us, irrespective of what we're doing,” he said. “I'm not so sure that what we're doing is affecting the spread very much. But we will see.” 

Member comments

  1. We now have Dr. Fauci’s estimates for the likely death rate in the US: 100-240,000 if social distancing / lock down is maintained across all states vs up to 2.2 M if nothing is done. We have similar estimates for the UK. It would be interesting to understand how the FHM sees this issue. I have looked around but have not been able to find estimates from the FHM for the likely death rate in Sweden. These are surely estimates they have made and the public should know about them. If they are reluctant to release such estimates, the public should understand why.

    Another issue that I haven’t quite got my head around, is to what extent herd immunization plays a role in the Swedish approach? Articles are starting to appear globally focusing on the next phase of the epidemic. That is, once we have gotten through the first peak in hospitalization / fatalities, then what will be the strategy? Clearly governments around the world will not let the global economy come to a complete standstill, and communities will open up again and people will go back to work. The question mark is to what extent the general population will be immune at that point in time? One argument for a less stringent policy now is that it will lead to greater general immunization earlier on in the process and reduce the likelihood of a second extreme peak once things open up again.

    It would be interesting to understand the FHM’s views on this. On the cynical side, I have seen comments from the public suggesting that if immunization is part of the FHM’s strategy (ie., be less stringent on socialization upfront to allow for more immunization), then they are experimenting with people’s lives. On the other hand, perhaps when faced with impossible decisions regarding life or death, immunization is indeed a factor the FHM should consider upfront; perhaps it makes more sense in the long run. Clearly the world will look very different after the first round of this terrible epidemic. But what will it look like on the second round: 60% of the population immunized, or 10%? The latter is a disaster and the global economy will have to go on life support more permanently.

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Today in Denmark: A round-up of the latest news on Monday

Find out what's going on in Denmark today with The Local's short roundup of the news in less than five minutes.

Today in Denmark: A round-up of the latest news on Monday
Sunny weather is expected all week this week. Photo: Niclas Jessen/Visit Denmark

Denmark’s former PM names new party Moderaterne 

Lars Løkke Rasmussen, Denmark’s former prime minister, announced on Saturday that his new centre party would be called Moderaterne, the same name as the leading centre-right party in Sweden. 

In a speech held to mark Denmark’s Constitution Day on Saturday, Rasmussen said the new party would attempt to unite Danes with a variety of different backgrounds and political viewpoints. 

“Some prefer mackerel, and others prefer salmon. Some have long Danish pedigrees, others have only recently chosen to live in Denmark,” he said.

What they all have in common, he said, is their love for Denmark, which is “among the best countries in the world”. 

“How do we drive it forward? We are trying to find an answer to that. How do we pass it on to our children in better condition than we received it?” 

Rasmussen said the party would not launch fully until after November’s local elections, but was ready to contest a parliamentary election if the ruling Social Democrats decided to call an early vote, something he said he did not expect to happen. 

Sweden’s state epidemiologist warns Swedes to be careful in “high-infection” Denmark 

After the per capita number of new coronavirus infections in Denmark in recent days overtaking that of Sweden, Sweden’s state epidemiologist Anders Tegnell has advised Swedes visiting their Nordic neighbour to be careful to maintain social distancing. 

“You need to keep [the infection rate] in mind if you go there, so that you really take with you the advice you have in Sweden to keep your distance, not stay with lots of other people, and not have the close contact that involves a risk,” he told the Expressen newspaper. 

He said Denmark’s higher infection rate was an obvious consequence of the country’s more rapid lifting of restrictions. 

“They chose to open up society relatively quickly even though they knew that there was a certain risk that the spread of infection would increase,” he said. “Because they had vaccinated the elderly and did not see that it would be that dangerous with a certain increased spread of infection.” 

Nils Strandberg Pedersen, former director for Denmark’s SSI infectious diseases agency called Tegnell’s comments “comical”. 

“It’s comical. It’s Swedish spin,” he told the BT tabloid. “Denmark has registered more infections because we test so much more than the Swedes. It’s not the same as having more people infected in the population.” 

More immigrants to Denmark are getting an education 

The education gap between first and second-generation immigrants to Denmark and people of Danish origin has fallen over the last decade, according to a story published in Politiken based on new figures from Denmark’s immigration ministry. 

An impressive 72 percent of 20 to 24-year-old first and second-generation female immigrants now completing further education of university education, compared to 58 percent in 2010.

Denmark records further 853 cases of coronavirus 

A further 853 people were diagnosed with coronavirus in the 24 hours running up to 2pm on Sunday, a rise on Saturday when 592 cases were detected, but still within the range of 600 to 1350 a day within which Denmark has been fluctuating since the start of May. 

Thorkild Sørensen, professor emeritus of epidemiology at the University of Copenhagen, told Ritzau that the sunny summer weather was allowing people to meet outside, and vaccinations were having an impact, allowing Denmark to open up without a surge in infections.

On Sunday morning, 138 people were being treated for coronavirus in Denmark’s hospitals, up four from Saturday, or whom 29 were in intensive care. 

Some 40.4 percent of the population has now received at least one dose of vaccine and 23.2 percent have received both doses. 

Sunny summer weather expected in Denmark this week 

Denmark is expected to have warm sunny weather with temperatures of 18C to 23C, with blue skies and little rain, Danish Meteorological Institute said on Monday. 

“This week looks really nice and summery, and it will be mostly dry weather most of the time,” Anja Bodholdt, a meteorologist at the institute told Ritzau on Monday.  “The only exception is Monday, when people in Jutland and Funen might wake up to scattered showers that move east during the day.” 

Danish property market show signs of cooling 

The number of houses being put on the market fell again in May, according to new figures released from Home, one of Denmark’s largest online estate agents. 

According to Bjørn Tangaa Sillemann, an analyst at Danske Bank, the figures suggest that momentum is seeping out of what has been a “scorching” market over the last year, although he said it was unlikely prices would actually fall. 
“Although demand seems to be declining, it is still high, and when interest declines, it can also make it less attractive to put your home up for sale than it has been recently,” he said.
At Home, 5.1 percent fewer houses were put on the market in May, while the number of apartments put on the market fell 9 percent, and the number of sales fell by 2.1 and 5.7 percent respectively.