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Last Week in Sweden: a Covid Report (November 1 – 8, 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 45.

(This story was originally posted in Swedish)

6,164 people have now died with covid-19 in Sweden; an increase of 84 reported deaths compared to last week. Not since July have so many deaths been reported, and now it seems appropriate to start making use once again of Adam Altmejd’s graph showing the total number of deaths reported per day. The curve is clearly trending upwards, and shows signs of continuing to do so as we move towards a situation resembling that which we saw in the spring. In the last month, Sweden has seen more fatalities than the rest of the Nordic countries combined, and almost all of this autumn’s deaths so far have been Swedes over 70.

The number of cases in intensive care units is also seeing a substantial increase, reaching the same levels seen in July:

”The diagram shows the number of reported ’care sessions’ with Covid-19, grouped by date. Note that the number of patients differs from the number of ’care sessions’ because some patients have been transferred from one intensive care unit to another.”
X-axis: date / Y-axis: number of ’care sessions’

The trend is particularly worrying, most of all because those over 80 are the fastest growing age group. The statistics come from the Public Health Agency, which still only has complete data from week 44, but that data shows over 80s are being admitted to intensive care at a rate almost the same as it was in the spring. Those between 60 and 69 now, as in the spring, constitute the largest number of new ICU cases.

It is also worth noting that those over 80 were relatively underrepresented in ICU statistics throughout the spring. Critics say that this is because the health service chose to remove the elderly from intensive care, among other reasons for fear of overload. Others believe that the elderly generally find it more difficult to cope with intensive care and that it was therefore normal to see lower numbers.

X-axis: week of admission to ICU / Y-axis: ICU cases per 100,000 pop.

Reports also show that the infection rate has more than doubled in the last week. The number of people tested was a record 189,000 and the proportion infected also broke records: 9.7 percent, a total of 18,489 cases. The 20-29 age group still has the highest proportion of infections, but it makes slightly more comforting reading to see that the upward trend for the over 70s seems to be slowing.

Figure 1A: Number of individuals per week, split into negative and confirmed positive cases for weeks 6 to 26; the number of tests split into negative and positive tests up to week 39, and negative and confirmed positive individuals from week 40. The graph shows the total number of completed tests and the number of positive (green) and negative (purple) tests.

Much less heartening is that the proportion infected in nursing homes has almost doubled inside a single week.

Figure 3: Number of cases in elderly care homes per week

All this has led the Swedish Public Health Agency to extend its recommendations to even more regions. The stricter advisories (in short: avoid indoor environments and don’t socialize with others than those you live with) now also apply to Halland, Jönköping, Örebro, Kronoberg and Sörmland. The result? Seven out of ten Swedes now find themselves in something resembling lockdown.

The recommendations do not yet seem to have had any impact. In Uppsala, which was the first region to adopt the new recommendations two weeks ago, there has been no decline in the number of infections. Numbers have doubled over the most recently reported weeks, but local authorities believe that it is only next week that we’ll see the measures will begin filtering through into the statistics.

Confirmed cases: 6,943 (1,809.4 per 100,000 pop.);
+266 new cases at Nov 6; +1,666 (434.2 per 100,000 pop.) last 14 days

What is clearer, however, is that recommendations aren’t being followed especially thoroughly in the region. Numbers using public transport are said to have increased, and Google’s weekly report on movement patterns shows that whilst Uppsala has 17 percent lower activity than last year, there’s been no noticeable decline after the new recommendations came into force. On the contrary, an increase in movement in shopping and entertainment districts during the autumn holidays.

Uppsala, movement pattern for the ‘shopping and entertainment’ category from Google

All these reports are of concern to infection control doctors and the government. Regional authorities have moved to heightened readiness during the week and Germany now categorizes Sweden as a risk zone. The health service is appealing to the public to follow the guidance as issued, and nine further regions want to introduce even more strict advice. In Uppsala this week, a doctor appealed for a ‘hard lockdown’, yet the Minister of Health believes that Sweden has essentially locked down already, and that no new law is necessary.

The government, on the other hand, has said it will invite all other political parties to talks on future strategies.

Anders Tegnell also claims that so far we are only up to 10-15 percent of the infection rates we saw in the spring, and that infections during the autumn have not been as deadly. Neither is the current development much more serious than the scenarios set out by the Swedish Public Health Agency in the summer, but it’s escalating quickly. The Agency continues to reject face masks as a potential solution, saying they’ve seen no evidence of positive effects from countries that introduced general mask-wearing requirements.

So how to interpret all the new recommendations? This week, for example, saw the introduction of a new national limit of 8 people per table in restaurants. This is mostly an abatement of existing restrictions rather than a sudden call for large groups to go to a restaurant, stated the Director General of the Public Health Agency. It remains clear that Swedes should work at home, avoid public indoor environments and exercise outdoors. 

Stockholm’s infection control doctors have suggested to national newspaper Dagens Nyheter that people should cast their minds back to the spring and establish a ‘close-knit social bubble’ with a few close people. According to data collected by the Swedish Public Health Agency, it is clear that most people who become infected do so at work, or during home visits to private dinners and parties.

Did Anders Tegnell deliberately try to steer Sweden towards a strategy that would involve thousands of deaths? Author Johan Anderberg seems to suggest exactly that in his forthcoming book ‘The Herd’. The public health authority said this week that it is neither ”true nor relevant”. However, when national newspaper Svenska Dagbladet published an excerpt from the book this week, Tegnell is alleged to have admitted the above in a conversation with Peet Tull, former head of the Infection Control Unit at the National Board of Health and Welfare.

On Sunday evening, this blog received the emails from Peet Tull, after the author himself confirmed Tegnell’s alleged remarks. It became clear that Tegnell’s two short responses were not reproduced together in the newspaper’s excerpt. When read in context, it’s clearer that Anders Tegnell chooses Tull’s ‘Alternative 3’ because Sweden’s spread is so large that the other alternatives ”probably would not work”.

This makes the email less scandalous, but completely in line with what this blog could already reveal this summer: Anders Tegnell and the Public Health Agency counted on herd immunity as a factor at an early stage of the pandemic.

Mink may have mutated the virus and everything is Denmark’s fault. At least that’s where it has had the most striking consequences after humans first infected mink with Covid-19 for the virus to then mutate and re-infect humans. This means that 15 million mink will now be culled. In Sweden, too, mink have been infected, but have yet to re-infect humans, and so a decision on a mass cull has yet to be made.

Economy

Plenty of news regarding the economy this week:

Budget boost: The government has announced SEK 10 billion extra for regional and municipal authorities to handle increased healthcare costs, as well as SEK 3 billion for testing costs. The latter seems to be needed, as Västra Götaland and Stockholm both flagged this week that they have reached capacity in testing.

State support: Sole proprietorships can now apply for financial support. Previously, only limited companies were able to get help, but a change has now been implemented which will take effect from November 9. Grants from the Swedish Arts Council will also soon be distributed to those working in the culture sector.

Short-term furloughs expire at New Year, but now three parliamentary parties want to extend the scheme, and also include those working in the culture sector.

Bankruptcies are decreasing in Sweden, with fewer having actually occurred than last year. This is assumed to be due to the many government grants and subsidies available.

Other news in brief:

Astra Zeneca believes it can start producing a vaccine in December, said the Swedish-British company’s CEO in an interview with Swedish paper Dagens Nyheter.

6 out of 10 preschool teachers have been in arguments over snotty children, according to TV4. This is because it is unclear when children are allowed to return to preschool.

A man who fell ill with Covid-19 has had such severe problems with his lungs that they had to be transplanted this week; a first for Sweden.

Sweden’s Social Democrats have this week published an opinion piece promising to build ‘the world’s best care for the elderly’, as they have now witnessed the impact of shortcomings in the sector.

Vasaloppet – the world’s biggest cross-country ski race – has been turned into a pro-only race next year, taking place over several days. The move has been praised by state epidemiologist Tegnell.

Prime Minister Stefan Löfven is quarantined, as is Moderate Party leader Ulf Kristersson. Neither are themselves infected, but have been in contact with people who have since tested positive.

Today, I want to tell you about something I learned yesterday afternoon. Someone I’ve been in contact with has been quarantined…

Published by Stefan Löfven, Thursday, November 5, 2020

And finally:

We’ve seen plenty of evidence that state epidemiologist Anders Tegnell has a relaxed attitude to video interviews, but this week’s TV interview may have reached new levels of casual when his wife passed by in the background in her dressing gown.

That’s all for this week, feel free to send in your tips if you feel something’s missing!

Ongoing work for this blog:

  • Examination of the report on which occupations are most at risk of infection
  • Which people influenced Sweden’s early strategy, along with a review of the latest emails about Peet Tull.
  • The Swedish Public Employment Service

This week we will also find out if this blog wins The Swedish Grand Prize for Journalism.

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This article is written under the CC-BY license, and is free to share and republish as long as you link back here.

CORRECTION from earlier SWEDISH VERSION: In an early version of this text when originally published in Swedish, the author Johan Anderberg was described as having hidden the second sentence in Tegnell’s email response. It is true that he reproduced it later in the text as published by Svenska Dagbladet, but then not as a quote. The original Swedish text has been updated to clarify this.

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