I wrote this to emphasize Sweden’s reliance on voluntarism and common sense. For some readers, the whole piece was about masks. Sorry about that. It generated 535 comments on the National Post site.
New COVID variants, cooler weather and crowded classrooms have made many people wonder when, not if, restrictive public health measures will return.
Before 2020, we dismissed seasonal flu bugs and reacted in surprise at overcrowded hospitals each January. Today, Canada seems primed to embrace restrictive measures to “protect the system.” Many other countries would agree.
Why don’t we learn from Sweden?
Matt Hancock, Britain’s former health secretary, privately called it the “f—–g Sweden argument.” Hancock saw no need for discussion. At the height of the pandemic, he instructed an aide to “supply three or four bullet (points) of why Sweden is wrong.”
Of course, Hancock never intended these writings become part of The Lockdown Files, an investigation by The Telegraph into 100,000 leaked WhatsApp messages exchanged within the British government during the pandemic. Regardless, his comments captured what every other government did: dismiss or diminish Swedish pandemic performance.
Sweden’s voluntary approach resulted in far fewer deaths during the pandemic, no matter how you measure it.
Canada performed better than most of Europe, but not as well as Sweden. In early 2023, Statistics Canada reported that there were 7.6 per cent more deaths than expected between March 2020 and August 2022. Of the country’s 53,741 excess deaths, 42,215 have been attributed directly to COVID-19. Canada beat Europe’s average excess mortality rate of 11.1 per cent from 2020 to 2022, but not Sweden’s 4.4 per cent.
In a new analysis for the Cato Institute, Johan Norberg describes how Sweden followed a voluntary approach to pandemic policy interventions. Its emphasis on personal responsibility achieved the smallest economic impact, and the least educational loss for students.
Voluntary action does not mean zero restrictions. Sweden limited public gatherings (for example, in theatres and churches) to less than 50 people, but it did not restrict “workplaces, shopping centres or private gatherings.” It banned private visits to nursing homes. Bars and restaurants could offer only table service, and alcohol sales had an earlier cut-off time during 2020 and 2021. Universities and secondary schools were recommended to go online.
However, preschools and elementary schools stayed open. Borders stayed open; no curfews or stay-at-home orders were made; no state of emergency was declared. Public transportation kept running, and there were no mask mandates, especially in schools.
Past experience does not guarantee future performance. In a society that craves certainty, medicine cannot eliminate all cause for anxiety. Therein lies the crux.
The new BA.2.86 COVID variant has some specialists in Ontario and British Columbia concerned. We could even face COVID, RSV and influenza all at the same time: a “tridemic.” Some are calling again for masking. However, Ontario Education Minister Stephen Lecce announced last week that his province’s schools would not make masks mandatory.
Many experts in acute care hospitals seem determined to bring back masks for any virus, despite the evidence. In 2019, the World Health Organization (WHO) published an extensive review of “non-pharmaceutical public health measures” for mitigating influenza. The WHO could not find any evidence that wearing a mask reduced influenza transmission. A Cochrane review published in January also found little evidence to support masking. A study of a London hospital in the United Kingdom during Omicron demonstrated no difference in hospital transmission rates with or without mask mandates.
Dr. Martha Fulford, an infectious disease specialist in Hamilton, Ont., says that new mask mandates are a matter of optics.
“The sad part is that I think masking is now being done because (hospitals) are expecting increasing patient volumes as (respiratory virus) season starts up,” Dr. Fulford told me in a direct message late August. “They have built zero extra capacity, and the masks make it seem like they are doing something. It’s not about data; it’s all about optics…. Now we are just masking for any old virus, it would seem.”
Mandatory masking relies on force to implement. Sweden avoided force, relied on voluntary measures and outperformed its neighbours as a result.
The Lancet published research in June which suggests people transmit viruses primarily when they have viral symptoms. Simply finding virus particles on a nasal swab probably does not matter anywhere near as much as feeling sick. Applying those findings, we can probably go to work safely when we feel well, and we should probably stay home when we feel sick. Healthy people are healthy — who knew?
In a crisis, governments crave conformity, not individual success. Sticking together matters more than standing out. As such, Sweden drove neighbouring governments nuts. The Swedes outperformed everyone else. Maybe we can learn from them.
Great piece Shawn.
Clearly,it triggered many leftist zealots who associate masking with community/collectivism.
Masking has become political virtue signalling.
This is even more evident in the USA.
Well said, Ram. Many commenters fell apart at any discussion about masks.
Too bad
Masks, of course, are only one part of a whole approach.
Still, it was fun to see how much Sweden irritated other governments around the world. It is an act of insurrection to refuse to agree to something if it has no good evidence.
Thanks for posting!
Anecdotally (just the other day), they had their bike helmet on, their bike gloves on, their bike sunglasses on and their mask on…allrightythen
You do you…I’ll do me
Indeed!
Three cheers for eccentricity for sure. 🙂
Too bad it wasn’t just that. Now it’s meant to signal so much more: one’s level of social righteousness, one’s political affiliation, etc
Thanks for posting!
I was in the “ content deactivated” crowd…same with the recent Jordan Peterson article…they allow you and Jordan to publish articles…but the most supportive responses find themselves “ content deactivated” , so slanting the responses.
Had someone repeated the articles verbatim in the responses the censors would have struck.
Are the NP editors virtue signalling, throwing a bone…then “ deactivating” overly enthusiastic responses?
I have no idea how that works. I see the comment numbers go rocketing up, then they get clawed back.
Andris, I cannot imagine how you, of all people, could come up with something provocative enough to get censored. 😀
Sarcasm aside, we live in a world where we must be quiet, and if we are not, someone will quieten us. How does it go: sly as a serpent gentle as a dove?
Thanks for posting!
Good morning Shawn. I very much enjoyed the article well written, very clear and quite informative. I however would have changed the title by leaving out the word “Success” and replace it with something called perhaps”The Common Sense Approach” or even “What did we know for Sure Approach” or finally “The Upside Downside Approach to the Pandemic”. As a Surgeon the final approach I mentioned is the most sensible to me and was absolutely (IMHO) left out of the Management Thought Process. I actually got angry when Doug Ford would say “We will keep you safe no matter how much it cost”.
What did we know and ignore that would have likely changed the death rate and made us look better just like the Swedes. The Medical profession (again IMHO) should have stood up and used Ivermectin a legal, extremely safe human medication with known antiviral effects. Again in my opinion, the Authorities should not have allowed even emergency release of a new technology “vaccines” without better studies. Definitely should not have been mandated which caused significant damage (arguably the Trucker Convoy.
You know me well enough that I could go on but I already apologize for having written an article, an opinion article but again IMHO definite facts “how we could have done better.
Graeme — great to hear from you.
Your note brought this thought to mind: Don’t we usually have a raft of articles assessing how we performed?
I’ve seen articles coming out of other countries. But even there, far fewer than I would expect. Given the funding, regulation, and tax implications riding on the university-government relationship, I wonder how many universities will be enthusiastic about publishing research that (might) criticize their primary benefactor?
Don’t apologize for caring enough to write a longer comment! Appreciate you sharing.
Cheers
A National Post commentor claimed that Canada did better on every account using confirmed cases and covid deaths. The problem is all the countries use different data and measures. The data in that comment also ignores other deaths related to our pandemic response and adverse events. A couple of articles that confirm your view and standardize the data follow.
https://www.spectator.co.uk/article/sweden-covid-and-excess-deaths-a-look-at-the-data/
https://reason.com/volokh/2023/01/10/no-lockdown-sweden-seemingly-tied-for-lowest-all-causes-mortality-in-oecd-since-covid-arrived/
These provide a better measure of success and based on them Sweden outperformed Canada. We need to do real cost benefit analysis when setting policies of all types of issues including our pandemic response.
Robert!
I’m so sorry to have not seen and approved your comment sooner. Comments with links activate the spam protections software. For some reason, I did not get the alert … will check it out.
Thanks for posting this!
Cheers
Evidently the commenters did not read the studies highlighted in the article. The meta studies were full of non RCT’s. They were primarily done pre-covid as well. Just from personal experience in the ER during the 2009 flu pandemic, outside of the ER masking by healthcare staff was minimal, just for one confounding variable that was occasionally mentioned in the studies.
I work in an ER that had the first diagnosed case in our state. We in the ED were exceptionally vigilant in mask wearing both in clinical areas, and any settings where staff were contained in less than ideal spacing. We took care of hundreds of lab positive, symptomatic cases, over 8 months, before staff started to become ill with covid. It leads one to question what a well planned study would show.
And unfortunately Sweden’s example would not work in the US because of the gross far right, neo libertarian culture, where every man is considered an island unto themselves. To consider taking measures in crowded social situations is anathema to these very self involved american citizens.
Thanks for sharing this, Vincent!
My site didn’t alert me that you had posted. Very sorry about that. So I’m only seeing this now. Shoot.
You make an excellent point about context, cultural norms, social expectations, etc. In the end, my piece was a modest ask: Can we learn from Sweden? I believe we can and hope we do before we lockdown Canada again.
Thanks for sharing!
Shawn