Norway and Sweden Conduct an Experiment

Norway and Sweden are neighboring countries and are closely comparable in most ways, although Sweden’s population is around twice as large. That makes their different approaches to the coronavirus, which Paul wrote about here, of interest to the rest of us.

Norway has implemented a lockdown strategy similar to the U.K. Italy, and most American states. Sweden has not. Instead, Sweden has issued voluntary guidelines:

Everyone in Sweden is urged to stay at home if they are at all sick (even a mild cough or sore throat), practice social distancing, avoid non-essential travel within the country, work from home if possible, follow good hygiene practices, and avoid non-essential visits to elderly people or hospitals. People aged over 70 or in risk groups are advised to avoid social contact as much as possible.

Bars and restaurants are open, but with table service only (i.e., no crowding around the bar).

The Norwegian official who has been the public face of that country’s anti-virus efforts has now denounced Sweden’s approach to the epidemic: “Sweden’s coronavirus strategy ‘completely wrong’ says Norway health chief.”

Espen Rostrup Nakstad, the assistant director of Norway’s Directorate of Health, has condemned what he called Sweden’s ‘brake’ strategy for the coronavirus pandemic as “completely wrong”.

The health official, who has been the directorate’s coronavirus figurehead, said that Sweden’s health authorities risked being overwhelmed, forcing the country into a sudden shift to more restrictive measures.

“I think the slightly theoretical idea is that if you have a lot of sick people continuously, with a slight ‘brake’ strategy, such as they are operating in Sweden, that will then be much easier to control. I think that is completely wrong,” he told the country’s NRK broadcaster in an interview.

Nakstad told the VG newspaper that he suspected that Sweden would sooner-or-later, like the UK, be forced to move to a more restrictive approach.

So far, Norway’s harsh approach seems to be working, with only 93 deaths, compared with Sweden’s 687. But there is a catch:

But this has been achieved by suppressing the virus, not stopping it, the Norwegian Institute of Public Health emphasised on Sunday in a report to the country’s government. The institute advised Norway’s government to start preparing the population for a peak in infections which would see a much greater number of people being hospitalised.

The problem is that we can’t self-isolate forever. The virus hasn’t gone away, and when we emerge from hibernation it will resume making its way through the population.

Swedish authorities took offense at the Norwegian’s characterization of their approach to combatting the virus:

When confronted with Nakstad’s quotes at a press conference on Wednesday, Sweden’s state epidemiologist Anders Tegnell said that Sweden’s strategy had been misrepresented.

“I don’t recognise it. We have never wanted to have many sick people at the same time, but quite the opposite. We have never had that idea,” he said according to the Dagens Nyheter newspaper.

He recognised, however, that Norway’s efforts to slow the spread of the virus had been very successful.

“The curve is significantly down there, much better than the curve looks in Denmark, for example,” he said. “But it will be extremely interesting to see what happens when they relax it all. That’s what all countries are worried about. How do we get out of here when we have closed down the whole of society?”.

The Norwegian official who criticized the Swedes’ philosophy concedes that the jury is still out:

“We have to work out the way forward on the go, and neither strategy will reduce the number of infections to zero before we gain immunity through an effective vaccine, or because the virus mutates into a less disease-causing variant,” he said. “Therefore, nobody knows what the best strategy is in the long term.”

He said Norway aimed to control the infection to gain time during which health officials could learn more about the virus and begin planning for a greater number of patients to need treatment “at a later date”.

The hope that draconian shutdown orders will save lives in the long term depends on unknowns: whether hospitals would be overwhelmed with COVID cases absent such measures; whether a cure can be found and deployed in a matter of months; and whether the disease will soon mutate into a more benign form. What we know for sure is that shutdown orders, not the virus, are devastating our economy and hurting many millions of Americans.

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