Opinion: One year and one million cases later, Sweden still has a Covid communications problem

Opinion: One year and one million cases later, Sweden still has a Covid communications problem
Health Minister Lena Hallengren and Public Health Agency director-general Johan Carlson at one of Sweden's many press conferences about the coronavirus. Photo: Henrik Montgomery/TT
As Sweden reaches a sad pandemic milestone, authorities still struggle to communicate both the severity of the situation and what can be done about it to the public, writes The Local's Catherine Edwards.

Clear, sustainable measures that would be easy for the public to understand and stick to long-term; that was supposed to be the hallmark of Sweden’s coronavirus strategy.

But over the past year, recommendations have often been vague or even appeared contradictory. At the time of writing, around two thirds of regions have local recommendations on top of the national ones, two of them urging people to enter a “personal lockdown”, some saying that all non-essential travel and visits to shops should be avoided, but others varying.

Unlike many countries, no consistent system regulating which measures are introduced at which point has been made public (when The Local asked in February if authorities could give examples of which specific data or metrics would be looked at to decide whether to introduce further measures, Health Minister Lena Hallengren said “No, we can’t”).

This is exacerbated by the fact that its recommendations have at many times differed significantly from those elsewhere.

Authorities did not mention social distancing until around a month after it was being enforced in much of Europe; businesses have remained open with limits on opening hours and customer hours only recently introduced; face masks were not recommended until December (and then only on weekdays in rush hour, though many regions have urged their use in all indoor environments). 

More than a year ago, several experts spoke to The Local and warned of the risk of unclear communications around the coronavirus and how to curb its spread. Later in summer, columnist Lisa Bjurwald summed it up in a piece arguing “rules can’t be lagom.

As this Tweet points out, in other areas Sweden’s rules are very clear-cut.

But despite law changes increasingly being used as part of Sweden’s raft of Covid-19 measures, the recommendations for private individuals remain extremely vague, left open to interpretation – for example, that people should limit social contacts by socialising only “in a smaller circle”, with “the people you normally meet”.

Leaving some room for flexibility helps people to adapt to their circumstances, for example so that people living alone aren’t isolated, but this is too open to interpretation. To some people, it could easily be read as “carry on as normal”. Although the government has, since December, pointed to eight as a suggested maximum for gatherings, the Public Health Agency has mostly steered clear from giving numbers, even as a guide. 

Of course in any country you will always get people who choose not to follow guidance.

But as a starting point, the “what” and the “why” need to be clearly explained. In a situation where every individual’s actions could affect a chain of other people, it’s not enough to expect people to take responsibility without telling them what that means.

It’s not only the public that has been left confused. Prime Minister Stefan Löfven was criticised for shopping trips when this was against Stockholm’s restrictions; the director of the Civil Contingencies Agency resigned (but kept his salary) after travelling to see his daughter in Spain against advice to avoid “non-necessary travel”. Despite resigning, he insisted his trip had been in line with guidance because he judged it to be “necessary”, highlighting the difficulties in delegating risk assessment to private individuals.

As well as some of the guidance being vague, at several points during the pandemic, the overall message has been dampened by restrictions being relaxed just as the incidence rate rises.

This is partly down to the slow-moving nature of Swedish bureaucracy, with no option for a peace-time state of emergency. Having checks in place is a good thing for democracy, but here it has led to mixed messaging.

Additional recommendations for over-70s and risk groups were scrapped in late October, with no corresponding tighter measures for the general population, just as cases were rising in the early second wave. 

Just weeks later, the maximum number of people allowed at some seated events was raised to 300, at the same time as regions began introducing local tighter restrictions in an effort to curb the sharp rise in cases. As a result, the change to events never really took effect. 

Those regional restrictions themselves have had peculiar differences between regions. In some regions, and not always those with the highest infection rates or new variants, people are told to avoid all non-essential travel, or to avoid non-essential visits to indoor public places altogether, but that doesn’t apply to other regions.

Recently, regions complained of poor timing after authorities said people who were fully vaccinated could “expand their circle of close contacts slightly”. The government and Public Health Agency later clarified that people should still limit those circles to “small groups” in line with the general recommendations, rendering the updated guidance irrelevant. Several regions have warned vaccinated people not to expand their circles.

Sweden is certainly not the only country that has struggled to get its message across in an understandable way.

Elsewhere, limits on how many people can meet and in which circumstances, when and for what purpose you can leave your home, have changed at short notice, confusing members of the public trying to keep up.

But there has to be a middle ground: clear communications, explaining simply how Covid-19 spreads, and how different measures have an impact. 

Some of the clearest explanations I’ve seen are the BBC’s explanation of what’s called the Swiss cheese model (showing how no measure gives full protection, but they can work together) and interactive explanations from El Pais (in English) on how the virus spreads in indoor environments and how to reduce the risk

State epidemiologist Anders Tegnell and others behind the strategy have been questioned repeatedly about whether it’s time for stricter measures.

The answer is generally the same: “We don’t need stricter measures, we need people to follow the measures and recommendations we have in place.”

But for that to happen, communication from authorities about what people need to do and why needs to be much, much clearer.


Member comments

  1. I think the plan of Doktor Tegnele still holds: to variolize the population and get them used to the existence of the virus. This might have been sensible at the very beginning, when the leading idea was that a vaccine will not be available soon, maybe never. Things changed though, we had at least 4 vaccines in less than a year, more will come. The idea of infecting people in a controlled way becomes therefore, obsolete and dangerous. Dangerous, because the more people are infected the higher the chance of creating variants. Another unacceptable thing is the total absence of guidance to the population. The non use of masks is criminal: I can’t see elderly people in shops without any precaution. A recommendation? which means a government incapable of taking responsibility to preserve the health of the most vulnerable.

  2. I agree with this wholeheartedly. It’s been unclear from the beginning and people are not getting the seriousness of it. They seem to just go on with their lives as normal. At least this is true with everyone I know.

  3. The thing I notice is that there has been no encouragement to the Swedish people to ‘pull together’, to see this as not just personal but communal, that we are all in this together and that – above all – we need to support our health service to help us. In the UK there have been regular tv news reports interviewing exhausted and desperate health service workers imploring the population to stay home and not make their lives harder.

  4. Just returned from Uppsala from what was an essential and c8mpletely unwanted trip to Sweden. It was like going through a time tunnel to 2019.. I landed in Arlanda to find only half of the people wearing masks; police and most staff all without! Shocked then to find the situation in Uppsala even more bizare with what I estimate as only 1% wearing masks on sometimes near full buses and zero masks on streets or shops (except oddly opticians?). Gyms were often packed and half of hair dressers without masks! And all the clients never with. There was a strange vibe of complete denial throughout mixed with a chippy arrogance. The hotel I stayed at had no covid signs, no plexi shields at reception.. no masks.. and even had breakfast buffet as normal.. completely bonkers. And this is Uppsala the recent red zone inside the red zone. Swedes are simply ignoring the Gov and local authority advice, they listened to the playing down of covid in 2020 and do not want to listen to the update. It is willful blindness and a total breakdown of any notions of solidarity this country used to have; a very odd form of fragile ego and nationalism that prevents any rethink on the terrible state they find themselves in.

  5. I totally agree that there has been and still is a communications problem and a barrage of mixed messages. Guidelines need to be clearer ..but will people follow them? You are being too kind to a public that largely listens when it suits them and totally ignores any advice that gets in the way of their ”normal” lives. It’s just a matter of months now until most of us here are all vaccinated but too many people just don’t have the ”strength” (and I am being polite here) to take the precautions that are necessary at this time, even when we are seeing light at the end of this terrible tunnel at last! If news that we have one of the highest infection rates in Europe, if not the highest, does not change the way people behave…nothing will. Watch the nurse on TV right now …she moves me to be careful …one day she may save our lives ….doesn’t she move you?

  6. A year ago, at the onset, the authorities kept saying that “this is Sweden….because the people follow what the Government suggests because they TRUST the Government”. I remember reading this a few times in the media. Well, it’s obvious this is NOT the case!! People continue as they wish because somehow, the “Democracy” here is different from any other democratic country for some reason or other.
    The Government themselves, especially the PHA have proved utter incompetence and arrogance …. defying any other suggestions from WHO or even considering those other democratic countries where the tight restrictions saved countless lives. I have heard so many Swedes say, why lockdown? They still have high infections in those countries Yes, but how many lives and infections were saved and infections lowered thanks to the lockdown? There can never be any statistics on that, but if one just sits and think for a few minutes……. its not rocket science.

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