Hello Everybody,
Is this true? Are conditions in Sweden really this bad?
Please, Björn. Tell me this is fake news. Please!
From email sent to me by an Italian wooden puppet with a long nose -
On a gloomy afternoon in March, 2020, Angelica Jularbo, a nurse, was in her office at a high school in Stockholm, when one of her students came in complaining of a headache. Jularbo, a mother of four, projects the mixture of sternness and warmth that one expects from a nurse. In the previous month, COVID-19 had begun sweeping across Europe, but Swedish schools remained open. As Jularbo bent to take the student’s temperature, the student coughed and then said, “Oh, maybe I should tell you, my partner has been diagnosed with corona.” Jularbo ordered the student to go home immediately. “Don’t go back to class to get your bag,” she said. “We’ll have someone bring it to you.”
Four days later, Jularbo woke with a fever and a splitting headache. “I understand why people who are really sick, or people who are in excruciating pain, say, ‘I just want to die,’ ” she told me. She was so tired that she couldn’t leave her room for several days. One morning, she made tea and sat on the couch, determined to see her children off to school; she woke up to the sounds of them coming home, tea cool on the table. After nine days, the last two symptom-free, she went back to work. But a week later the headache and fever returned. She locked herself in her office to avoid exposing anyone. “I was so, so scared that I had made someone else in the office sick,” she told me.
Jularbo’s illness came at a pivotal time for Sweden. While lockdowns, curfews, and travel bans were being rolled out across the rest of the world, Swedish restaurants, stores, bars, museums, day cares, and elementary schools all remained open. People were encouraged to work from home and to reduce travel, but both were optional. Masks were not recommended and remained rare. Households could mix; until the end of March, even parties of up to five hundred people were allowed. The man behind Sweden’s coronavirus response is Anders Tegnell, the country’s head epidemiologist. Tegnell worked in Zaire during the 1995 Ebola epidemic, and then served as an expert on infectious diseases for the European Union before being hired by the Swedish public-health agency, in 2013.
The Swedish constitution gives government agencies extraordinary independence, so Tegnell and the public-health agency have led much of the coronavirus response, and, constitutionally, the government has little power to impose restrictions. Tegnell, who is sixty-four and tall, with round glasses, has often said that lockdowns are not supported by science and that the evidence for mask-wearing is “weak.” His stance is a startling departure from the scientific consensus, but he maintains that if other countries were led by experts rather than politicians, more nations would have policies like Sweden’s. The world has been left gawking. American liberals were shocked that the country of Greta Thunberg could seem so scientifically backward. Right-wing activists in Minnesota held up signs during anti-lockdown protests reading “Be Like Sweden.” Within the country, Tegnell has become an icon of Swedish exceptionalism, believed to be excessively reasonable, levelheaded, and rational. Supporters praised him for not giving in to political panic. Wearing a mask in Sweden was sometimes seen as a signifier of being anti-science.
Jularbo has many friends and colleagues who contracted COVID-19, and her case was severe. But I met her in the “Anders Tegnell Fan Club” on Facebook, which contains a smorgasbord of multimedia tributes: T-shirts bearing his face, a chocolate figurine in his image, a poster with his face glowering above the words “Wash your hands.” “I prefer to have medical experts making the decisions instead of maybe a prime minister who knows, excuse me, shit, about health and medical issues,” Jularbo told me. She’s not the only person in the group who has caught the coronavirus. Staffan Hugemark, a fifty-three-year-old who works at a software company, got sick along with his family after returning from a ski trip in northern Italy. Still, he recently had a falling out with an old friend who disagreed with Sweden’s policies. “People look at Sweden and think that it’s a disaster here, and it’s not,” he said. Viktoria Ellénius, a forty-seven-year-old former aesthetician, got sick early in the pandemic and couldn’t work for weeks, which caused her to lose her skin-care business; she couldn’t get a test, but she thinks she had COVID-19. Nevertheless, she believes that Tegnell’s policies saved the country from the costs of a lockdown, including economic damage and widespread depression. “At the beginning, I didn’t like Anders Tegnell,” she said. “But the more I have heard about him, the more time has gone by, the more I love him.”
Jularbo is now working with long-haul COVID-19 patients in the rehabilitation unit of a hospital in Eskilstuna, seventy miles west of Stockholm. She suffers from long-term symptoms herself, including lingering fatigue. “I’ve never been tired like this,” she told me. “My alarm goes off, and it’s like, shoot me. I don’t care if my kids get to school on time. I don’t care about anything.” Still, she’s proud of how Sweden’s public-health agency has handled the pandemic. “They’ve been good. They haven’t been running around listening to what everybody else does,” she said. This winter, she messaged me, “I’m more worried about you living in the states. The pandemic is hitting hard.”
Most mornings, my husband, who is Swedish, FaceTimes with his friends or family in Sweden. Early in the pandemic, the calls seemed like windows into ordinary lives, largely uninterrupted. Children had birthday parties and sleepovers. Adults met in restaurants and bars. A friend sent a video of a gym class in Stockholm—twenty people breathing heavily in a windowless room. My father-in-law is in his seventies and has a severe lung condition, which means that if he’s infected with COVID-19, it’s more likely to be fatal. But while my husband and I, in California, stayed home, he and my mother-in-law were still going out shopping and seeing friends without wearing masks. They’re not reckless or uninformed people. My father-in-law is a retired engineer who reads the paper every morning, and we almost always agree about politics. Yet every time we suggested that perhaps they should be wearing masks when they went to, say, a bar, we were met with polite skepticism. My father-in-law recently discussed masks with his lung doctor, a senior physician at one of the country’s top hospitals, whose advice was that the only reason one might consider wearing one was because other people would think you were sick and give you more space. This was the philosophy my in-laws adopted. A healthy person “can’t wear a mask in Sweden,” my mother-in-law told me, in October. “People will look at you like you are a very strange person.” The Swedish health agency communicated to the public that there was insufficient evidence that masks prevent transmissions, that they are often used incorrectly, and that they could be used as an excuse not to distance properly, which would be harmful.
Tegnell introduced the country’s light-touch approach to the pandemic in March, as cases were mounting. Internal e-mails obtained by the freelance journalist Emanuel Karlsten show that the government at least considered whether the strategy might lead to more widespread immunity. In an e-mail exchange between Tegnell and the head of the Finnish public-health agency, on March 14th and 15th, Tegnell suggested that keeping the schools open could help the young and healthy develop immunity sooner. His Finnish colleagues noted that their models found that closing schools would decrease the infection rate among the elderly by ten per cent. Tegnell responded, “Ten percent might be worth it?”
However, Sweden seems to have settled on its final strategy primarily through a mix of unorthodox scientific conclusions, pragmatism, and folkvett, a particularly Swedish notion of common sense. No epidemiologists thought that self-isolation should be a long-term solution. “Lockdown is a temporary measure that you do to buy you time,” David Nabarro, a long-time United Nations adviser and one of the World Health Organization’s special envoys on COVID-19, told me. But most countries were unable to get the virus under control and decided to leave lockdowns in place until a vaccine became available. This seemed unsustainable to Tegnell. He also shirked masks. A year ago, there were few studies that directly measured the impact of masks on viral-particle emissions and community spread of the virus, and controlled experiments were difficult to conduct, for logistical and ethical reasons. Over the course of the pandemic, evidence supporting masks has piled up. An analysis of mask mandates in German towns found that they may have reduced COVID-19 infections by about forty-five per cent. Another study examined U.S. states with mask mandates, and found that the daily growth of infections was two per cent lower in states where a mask mandate had been in place for a few weeks. By April, 2020, the W.H.O., the Centers for Disease Control, and other groups decided that there was enough evidence, and recommended face coverings. The C.D.C. now firmly concludes that “experimental and epidemiological data support community masking to reduce the spread of SARS-CoV-2.” Yet Tegnell remained unsatisfied. In April, 2020, he wrote a letter to the European Center for Disease Control urging against a mask recommendation, saying, “The argument for and evidence for an effect of face covering to limit the spread from asymptomatic persons is not clear. . . . The arguments against are at least as convincing.”
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--Lee
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Probably the best beer in the world
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