Looks Like Sweden Won The Debate After All

Short version:  Sweden clearly won the lockdown debate, opting instead for a far more sustainable strategy that balanced the short-term goal of "flattening the curve" with the longer-term goal of "herd immunity", and the virus is now on the run and all but disappeared from their country as of July.

Longer and more nuanced version:  Sweden is one of those countries that, in our polarized world, you either love them or hate them.  Being the most famous of the non-lockdown countries, the anti-lockdown side loves them while the pro-lockdown side just loves to hate them.  Which makes sense, given how Sweden is one of the few and most well-known countries who chose not to do a lockdown at all.

In truth, however, they are neither a shining city on a hill, nor are they an unmitigated disaster in terms of how they handled the COVID-19 pandemic.  They are in fact...about average by European standards, at least in terms of per capita death rates for now.  Worse than their Nordic neighbors and Germany and Austria, but better than the UK, Belgium, Spain and Italy.  Worse than the USA as a whole, but better than the seven worst US states, especially New York.  Which is nothing to brag about, of course, but hardly a ringing endorsement for lockdowns either.  Especially since they avoided completely annihilating their economy (albeit still suffering) and inflicting other collateral damage that the lockdowns in other countries (especially the UK) did, while still being able to "flatten the curve" and thus keep hospitals from being overwhelmed and collapsing Lombardy-style.

The architect of the Swedish mitigation strategy of moderate social distancing, Anders Tegnell, admits that Sweden could and should have done more.  And yes, they did screw up in several major ways, at least in the beginning.  But he still does not endorse a full lockdown.  So what could they have done differently, short of a lockdown?

Here are the things that come to mind that they should have done but didn't, or should have done earlier but did too late:

• They kept their borders wide open with no hard restrictions on international travel or even any health screenings at ports of entry.  Even Japan and Belarus didn't make that mistake.  In hindsight, that was really quite foolish.
• They did not declare a state of emergency.  Even the Donald did that, albeit belatedly.
• Their gatherings limit of 500 people, first imposed on March 11, should have been cut down to 50 people or some other double-digit threshold much sooner, ideally on that same day or the very next day, rather than waiting until early April to finally do so.
• They should have made virus testing available much sooner.  Instead, until very recently, you literally had to be sick enough to go to the hospital in order to get a test as per their test rationing policy that began in March.
• They made a reasonable stab at contact tracing at first, but gave up when the numbers grew too overwhelming.  (Though even with very little testing, they could still have done it the Japanese way had they started earlier than they did.)
• Like most countries, they should have done a better job protecting nursing homes. In Sweden's case, they should have banned or severely restricted visits to nursing homes much, much sooner, instead of being loosey-goosey about it until finally doing so on March 31.  And they should have made sure early on that the staff had (and used) adequate masks and PPE, which they failed to do.  Even Florida did better than they did, though New York and New Jersey were far worse, as was the UK.
• Their triage protocols for nursing home patients being (not) sent to the hospital turned out to be wholly unnecessary and counterproductive.  Ditto for any other artificial restrictions on health care.  (Other countries did this too, so this was not unique to Sweden.)
• And like most countries also failed at, they should have kept colleges open even if they canceled classes temporarily.  Sending students home to infect their parents and grandparents was probably not the wisest idea in the world.
• And last but not least, they advised against face masks (and apparently still do) on the mistaken belief that they create a false sense of security and lead to less social distancing.  And that stance does not appear to be accurate.  (Though admittedly, the book has still not been 100% written on the question of net effects just yet.)

Aside from those flaws, there is still much to admire about Sweden and their strategy.  But ultimately they are paying a rather heavy price for their earlier errors, even after belatedly correcting such mistakes.  They likely will reach the holy grail of "herd immunity" sooner or later, if they are not already there, but unfortunately due their missteps, the journey turned out to be much more dangerous than the destination.  Thus, we give Sweden a gentleman's C for effort.  Still far better than several lockdown countries did.

As for population density, in case someone uses that argument, it is misleading to compare average densities across nations, given the large variations in density and distribution within each country.  And even so, higher densities do NOT necessarily imply higher per capita death rates, in fact the opposite may very well be true as a result of at least somewhat better healthcare provision in denser areas.

It looks like not only is Sweden's COVID epidemic all but oven now as per Worldometer death rates, and their death curve did turn out to be much more bell-shaped after all, but that Sweden is now quite vindicated indeed compared to even some of their neighbors in terms of cumulative all-cause mortality through the first 24 weeks (roughly the first half) of 2020.  Though worse than Norway, Sweden nevertheless fell very close to and just between Denmark and Finland, and fared far better than Scotland.  So it looks like the lockdown zealot vultures will need to find a new punching bag now--take a guess which country? 

(Hint: it's the one that is still not only debating on whether to reopen schools in the fall, but actually has the GALL to crassly turn the issue into a silly political football because it is an election year.  Really. Meanwhile, most other countries have successfully reopened K-12 schools with essentially no problems, and Sweden never closed them at all.)

Additionally, it looks like the Swedish city of Malmo is in fact doing a particularly good job overall.  After watching and learning what not to do from the early hotspot of Stockholm, they followed essentially the same Swedish strategy minus the nursing home screwups, basically, and as we can see now, it's really paying off.  Their per capita death rate is lower than even Copenhagen, Denmark across the Oresund strait.  That is, they are achieving herd immunity AND protecting the most vulnerable members of society at the same time, while maintaining individual freedom and avoiding an economic depression.  Now THAT is really a shining city on a hill!

(Lest anyone claim that somehow America is too diverse and multicultural for the Swedish model to work here, keep in mind that Malmo is also a very diverse and multicultural city as well.)

In other words, we can certainly learn a lot from Sweden--both what to do as well as what not to do.  But all things considered, Sweden clearly wins the debate hands-down.