As the United States cautiously opens its economy and approaches the 100,000th death from Covid-19, many wonder if the country could have followed a better path. Some cited Sweden as a model for a less intrusive government response that relied on individual adherence to rules and common sense rather than decrees and laws, William Galston told the Wall Street Journal.
Sweden has avoided economic quarantine. It allowed shops, restaurants, bars and nightclubs to remain open, with guidelines for social distancing. It allowed the gathering of up to 50 people. Most of the students in the country continued their classes.
Sweden’s strategy has yielded some positive results. Restrictions on civil liberties have been kept to a minimum. For the most part, citizens were able to maintain a normal social life. As a result, the Swedish authorities may claim to be on a more sustainable path than countries that have relied on more onerous measures. Should America have followed Sweden’s example?
The main differences between the United States and Sweden make it difficult to answer categorically. America is large and diverse, while Sweden is small and relatively homogeneous. Sweden is less populated and has about twice the frequency of single-person households, two factors that tend to limit the transmission of infectious diseases. Economic inequality in Sweden is low and in the United States high, by the standards of advanced economies. Sweden’s population is significantly healthier, with much lower levels of diabetes and obesity, as well as a longer life expectancy. Sweden has a well-funded, widely available public health system. The United States does not.
But the differences are greatest in the area of public attitudes. Sweden is a society with great self-confidence. In the United States, the proportion of the population who believe “most people can be trusted” has declined by a third over the past half century, with confidence in government declining by more than two-thirds. Individualism reigns in the United States. Swedes attach more importance to social solidarity. Sweden has achieved approximately the same level of compliance with anti-virus rules through voluntary decisions as the United States with binding measures.
If the two countries followed the same strategy, Sweden’s demographic and institutional advantages would likely lead to a significantly lower mortality from Covid-19 than from America. In fact, mortality in Sweden is about 30% higher than in the United States, which is not low by the standards of highly developed societies. Swedish officials have acknowledged that their country has failed to protect its senior citizens. If the United States had adopted Sweden’s approach, with its mortality, 30,000 more Americans would have died, many of them parents or grandparents.
Until recently, Sweden’s defenders had a ready answer: States with compulsory quarantine only postpone the inevitable. As most of Sweden’s population is infected, it will achieve “herd immunity” much faster than other countries, whose mortality rate will catch up. In April, the country’s chief epidemiologist, Anders Tegnel, quoted estimates that Stockholm had probably achieved immunity of 15% to 20%, and the Swedish Public Health Agency predicted that a third of Sofia residents would be infected by May 1st.
But when tests were done, it turned out that only 7.3% of Stockholm residents had caught the disease and developed antibodies against it by the end of April. The infection rate in Sweden is between 4% and 7%, no higher than in the United States and far from the level of 60-70% needed to control a pandemic. Sweden’s high mortality rate has not significantly reduced its future vulnerability. During the 7-day period, which ended on May 19, the country reported the highest mortality from Covid-19 in all of Europe.
Nor does Sweden’s approach save its economy. The country’s economy is projected to shrink by 7% to 10% this year, in line with forecasts for European countries and more than the expected decline in the United States.
The best comparison is between Sweden and its western neighbor Norway. The two countries are similar in many ways, including economic inequality, life expectancy, health systems and premature death from risk factors for coronavirus. However, the death rate from Covid-19 in Sweden is 405 per million, nine times higher than in Norway. Yes, the infection rate in Norway is well below that of Sweden, which suggests that mortality there will increase with the easing of restrictions on economic and social activity. But even with that in mind, Norway is doing better.
There is no reason to think that the United States would be better off following Sweden’s strategy – unless you think that maintaining a more normal social life would cost tens of thousands more.