A Defense of Sweden’s Pandemic Response

During the COVID-19 pandemic, critics accused Sweden’s Social Democrats of abandoning ordinary people. For Jacobin, a political adviser to the Swedish minister of health defends his country’s record, arguing that it prioritized the poor and vulnerable.

A nurse and a doctor put on personal protective equipment in a tent on the grounds of the Sophiahemmet private hospital on April 22, 2020 in Stockholm, Sweden. (Jonathan Nackstrand / AFP via Getty Images)

The COVID-19 pandemic was the most significant global public health crisis of the twenty-first century. Its impact on well-being, health care, education, and the economy cannot be overestimated. Even today, the virus continues to be a global concern. There are vital lessons to be learned. COVID-19 provides the Left with yet another strong argument against neoliberalism, deregulation, and inequality. What it does not provide is a credible case against the Swedish pandemic strategy.

Yet, critics on the Left, marshaling arguments that inadvertently repeat far-right talking points, have since the pandemic taken issue with the Swedish government’s approach to the crisis. The most recent example of is an article by Markus Balázs Göransson and Nicholas Loubere published here on November 19. In it, the authors label the Swedish government’s approach to COVID-19 a failure and claim that it was blind to class. They are wrong on both counts.

From 2020 to early 2023, Sweden’s excess mortality rate ranked amongst the lowest of comparable countries and on par with other Nordic countries. While no single metric definitively assesses the success of a country’s pandemic response, excess mortality is probably the best indicator as it reflects the number of deaths exceeding the norm in non-pandemic conditions.

How did Sweden manage to keep excess mortality down? If the first lie about Sweden’s pandemic management is that we performed poorly, the second is that the government was passive. Extraordinary measures were taken to combat the spread of infections. Public gatherings and events were limited to eight participants, a de facto ban. Cafés, restaurants, and bars were heavily regulated, and so were shops. Upper high schools and universities switched to online teaching, and visits were not allowed in hospitals and elderly care facilities. Testing was ramped up and isolation was mandatory for confirmed cases. As in other countries, public health authorities regularly reviewed measures, modifying and adapting them to the evolving situation.

The government presented a strategy for vaccination against COVID-19 as early as May of 2020. It was carried out swiftly once vaccines were available from December that year. Jabs were of course free of charge and recommended to everyone aged twelve years and up. Vaccine uptake was high, reaching more than 95 percent in the sixty-five or above age group.

In line with the strategy for vaccination, people with the highest risk of severe disease and death from COVID-19 were given their shots first. The elderly population, people with disabilities or underlying conditions, and people living in poor conditions were prioritized. Once vaccinations started in the broader and younger population, it was stipulated that low socioeconomic status would be a deciding factor in prioritizing available doses in the event of a vaccine shortage.

The government, the Public Health Authority, and Sweden’s twenty-one counties that managed the vaccination campaign made extensive efforts to reach out to marginalized groups, earmarking funds to outreach programs, working with civic organizations, leaders in immigrant communities, and religious leaders.

It should be clear to everyone that Sweden’s strategy for handling COVID-19 was far from laissez-faire. It did not ignore workers and marginalized communities. The government’s decision to keep schools operational up to grade nine benefited children from families with low socioeconomic status, children from immigrant families, and children with various disabilities. Academic performance was largely not affected in Sweden during the pandemic whereas children globally lost one-third of a year’s learning. Those prolonged school closures risk making future generations poorer and exacerbate inequalities. It is concerning that Balázs Göransson and Loubere seem to have overlooked these critical aspects.

To reduce the risk of infected people coming to work, the government eliminated the waiting day to qualify for sick pay. The government also raised unemployment benefits and introduced a benefit for persons in risk groups of severe disease who could not work from home. These measures were significant to blue-collar workers, workers in the public sector, and marginalized groups.

Balázs Göransson and Loubere argue that the recommendation by the government and the Public Health Authority to work from home was tailor-made for the middle class. This points to three major intellectual, political, and factual flaws in their criticism against the Swedish handling of COVID-19.

First, Balázs Göransson and Loubere ignore the fact that even in a small country like Sweden, millions of people must go to work every day, pandemic or not. Nurses, sanitation workers, firefighters, care assistants, police officers, drivers, technicians, and many more, could not suddenly work from home. But as people who could did so, face-to-face contacts fell dramatically. In Stockholm, home to 2.4 million people, the use of public transport was down 60 percent during spring 2020, and levels remained low throughout the pandemic.

Second, the authors mix up preexisting inequalities with the pandemic response. It is true that people with white-collar jobs and spacious homes could protect themselves better. But this was the case in countries with lockdown policies too. The way to correct this is to attack inequality, not the Swedish government.

Third, the argument by Balázs Göransson and Loubere attributing the Swedish COVID response to neoliberal dogma, lacks credibility. If the Left believe that people should have more say in how the economy is run, then surely we must trust people to wash their hands in an epidemic? Personal responsibility to a reasonable degree should not be frowned upon. Expressed differently: the people can benefit from guidance; it is power that need restrictions.

This is not the same as letting people “fend for themselves.” Extensive measures should be taken by the government to protect their citizens in a crisis. In the case of an epidemic, this means actions to limit the spread of infections and mitigate any economic impact. The fact that people with low socioeconomic status often have higher risk of infection and poor health, leading to higher risk of death if infected, must be considered.

Equally important, there is great need to improve public health, reduce overcrowding in housing, and boost funding for nursing homes. The supply of personal protective equipment must be secured too. The Social Democratic government was committed to this. (Now the current right-wing government is dismantling the efforts).

Sweden did not do everything right during the pandemic, but it is intellectually dishonest to call it a “cautionary tale.”