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Last Week in Sweden: a Covid Report (November 22 – 29, 2020)

Throughout the Coronavirus crisis, I’ve been summarizing on a weekly basis the most important and talked about happenings from a Swedish perspective. This is week 48.

(This story was originally posted in Swedish)

6,681 people have now died with Covid-19 in Sweden; an increase of 275 reported deaths compared to last week. We’d have to go back to the last week of May to find a week with higher death rates, and it doesn’t show signs of slowing. When The European Centre for Disease Prevention and Control this week published its forecast for Sweden, as well as for other countries, they believed we’ll reach between 50 and 200 deaths per day in December, most likely between 100 and 140 deaths per day (shown by the turquoise line).

The steep increase in deaths is also apparent in Adam Altmejd’s graph, which forecasts how deaths will be reported. We are already up at 60 deaths a day, according to Altmejd’s predictions.

At the same time, Sweden is quite far from experiencing the same high pressure on intensive care units as we were during the spring, but that’s probably due to the fact that the proportion of patients needing intensive care has halved, something I was able to report on earlier in the week. This means that we can – to a greater extent – handle Covid patients on ordinary inpatient wards, but when looking at total occupancy in hospitals, we see that we are close to the peak of spring. If you combine inpatient care and ICU care (orange line) and exclude Stockholm (second graph), we now find ourselves at the top end of numbers we saw in the spring.

This, however, is just the current total of occupied beds. If we instead measure the number of new admissions, 2,100 patients were hospitalized during week 15, the worst week of the year. Now, in week 46, the number is 1,400, but we’ve still yet to reach the peak. This is also the opinion of the Swedish Public Health Agency, according to a newly published scenario. This week, the government said that the Swedish Public Health Agency will update a graph every two months showing their three-month scenario for how the spread of infection can develop. According to the latest scenario, infections in Sweden will reach their peak around December 10 before decreasing again.

Reported cases (all age groups)
Blue: reported cases (simulation); Red: actual reported cases.

There is no solid data on how many people are actually infected right now. Testing capability has reached capacity, meaning there’s a skewed understanding of the situation at both local and national level. The Swedish Public Health Agency still believes, according to its weekly report, that the somewhat less steep upward curve is also due to the fact that the spread of infection is in fact increasing less quickly than before.

Figure 1C: Number of confirmed cases of Covid-19 per week, split between testing among priority groups (shown in gray), and mass testing (purple).

This week, all of Sweden’s regional administrations received harsh criticism for their care for the elderly during the spring. The criticism came from the Swedish Health and Care Inspectorate (IVO), the authority responsible for this type of review. So far this year, more than 3,002 people in nursing homes have died with Covid-19, representing almost half of all cases in Sweden. When IVO examined medical records in the worst affected homes, it appeared that between 16 and 22 percent of those affected had not received individual medical assessments. ”This is a very high figure according to IVO’s assessment. It is important not to just see this as numbers. It’s about people. Such a high figure is not acceptable”, said IVO chief Sofia Wallström, in remarks to Swedish public broadcaster SVT.

Many patients received their medical assessment remotely, and 40 percent of those who did not receive an assessment from a doctor didn’t receive one from a nurse either. In Sörmland, for example, all patients with symptoms received immediate palliative care, irrespective of whether Covid-19 was diagnosed.

Regional authorities, municipalities and care providers will now be subject to compulsory intensified monitoring, and will be required to explain how they plan to remedy the shortcomings. Many harsh reactions to the report were seen during the week.

Heavyweight economic organization OECD has placed Sweden at the bottom of several league tables in its new report, as noted by this blog (in Swedish) earlier in the week. The report garnered a lot of attention this week, not least when it turned out that the OECD had calculated incorrectly. When the OECD updated its findings, it meant that Sweden actually placed worse in another survey, yet it’s important to point out that the OECD doesn’t contribute either analyses or conclusions to the report. There has, however, been plenty of negative news elsewhere this week. Like from Statistics Sweden, which this week lowered the average life expectancy of Swedes, or national daily tabloid Aftonbladet, which calculated that Stockholm is the third hardest hit capital in Europe. The criticism has led Swedish public broadcaster SVT’s political expert to conclude that there is more and more evidence to indicate Sweden’s handling of the pandemic has been a failure. The Prime Minister still thinks it is too early to draw any such conclusions.

Meanwhile, Bloomberg presented a positive image of Sweden, at least when it comes to the economy, where they ranked Sweden 16th out of 53 countries.

Sweden is set to start with rapid Coronavirus testing. Rapid tests show results in 10 to 30 minutes, but require a high virus load to give results. Therefore, it’s said the test should primarily be used in nursing homes and on staff displaying symptoms.

Teachers’ unions have demanded that preschool children be quarantined if they have infected parents. There are guidelines for how an infected parent should be able to drop off their children at daycare safely, but unions believe that it increases the workload of staff in an unreasonable way. There is very little evidence to suggest that the youngest children are contagious to any great extent, but for unions, the main concern is more about workplace issues than contagion, as they ask how educators should find time to implement an ‘airlock’ process for safely welcoming specific children of infected parents.

Substantial crowding was seen in multiple locations over the Black Friday weekend. Despite the government’s multiple extra press conferences and many calls to avoid crowds, shopping centers were bustling with customers this weekend. Nordstan, a mall in Gothenburg, was full, as well as across locations in Malmö and Stockholm, where police took the picture below. Healthcare workers, already pushed to breaking point, despaired upon seeing the picture. Immunologist Agnes Wold, however, thinks the worry about such crowding is exaggerated, since it is indoors at dinners that the spread of infection is at its strongest.

Local police from the city-center Norrmalm district of Stockholm posted this image of a hectic Drottninggatan (a major shopping street) to their Instagram account with the caption, ”We’re on the beat today downtown. More people than we’d hoped for. We’re here for your security.”

Sweden is set to receive vaccines at the same time as Germany. This week, there have been reports that Germany and the United Kingdom have started building vaccination clinics in advance, and Sweden’s vaccine coordinator was clear that all EU countries will receive the vaccine at the same time. He thinks it will be in January at the earliest. Sweden has started preparations for administering the vaccine, but the logistics are difficult, as the vaccine needs to be heavily refrigerated.

Face masks. This week, a test on TV4 of the best face masks was widely circulated. Sweden still hasn’t changed its mind on masks, but State Epidemiologist Anders Tegnell gave an example this week of when it could be appropriate to wear a face mask at work, ”if you’re working more closely than 1 to 2 meters apart and for more than 15 minutes, it may be appropriate,” he told regional daily paper, the Gothenburg Post.

This week’s news in brief:

People on long-term sick leave will continue to receive state sickness benefit even after the standard period of 180 days. The decision has not yet made it through parliament, but this week a new agreement was announced between the government and its unofficial coalition parties.

This week, a 13-year-old died with Covid-19. The mother later explained that her son was also suffering from a severe underlying illness.

Sweden’s universities are demanding students take exams in halls, despite government recommendations to not exceed a maximum of eight people at any public gathering. This was reported this week by both this blog and public broadcaster Swedish Radio.

Prince Carl Philip and his wife Princess Sofia have tested positive for Covid-19. A few days before the infection was confirmed, they participated in an event with the rest of the royal family, but all others in attendance tested negative this week.

In Norrbotten, Sweden’s largest and most northerly region, Covid nurses will receive a lump sum as a thank you for their work. The sum has not yet been announced. In the Värmland region, no such decision has been taken on financial compensation, but it was announced this week that no nurse should have to work with Covid while pregnant, a decision that could well be a guide for the rest of the country.

As long as you follow recommendations, you should be able to celebrate Christmas with the traditional Swedish buffet, says State Epidemiologist Anders Tegnell. This is despite the Prime Minister’s pleas to cancel and stay home. Tegnell also says, however, that people should wait for new advice about the Christmas weekend, which will be issued on Thursday.

Swedes’ travel patterns show signs of a significant decrease, says the Minister of Infrastructure. Travel is not yet down to spring levels, but there’s still been a sizable reduction. His statement is backed up by data from Google’s community mobility report, which shows Sweden’s public transit ridership has fallen sharply.

Finally:

Over the coming week, authorities are set to make an extra effort to reach out to young people through influencers. A headstart was made on the effort last week, where contact was made between Sweden’s most powerful politician and Sweden’s most powerful influencer as Therese Lindgren held a joint Instagram live broadcast with the Prime Minister. For those who want to understand how ‘new power’ in the form of influencers really are trying to take responsibility, this is a must-see:

That’s all for this week, let me know in the comments if you think there’s something missing!

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