As Americans brace for another wave of COVID-19, the possibility of a national lockdown seems very high. Already, many states and cities are issuing stay-at-home orders. With the question of whether to begin implementing more stringent COVID-19 strategies weighing on the minds of politicians and public health officials, we must look back on the different paths nations have taken to control the initial COVID-19 outbreaks.
Sweden’s approach to COVID-19 has received much attention from the media. Painted as an outlier in the Western world, Sweden chose not to impose a lockdown last spring. The country kept schools, restaurants, and other businesses open throughout the pandemic and focused on encouraging voluntary measures of social distancing and mask-wearing rather than mandating these guidelines. According to Antoine Flahault, director of the Institute of Global Health in Geneva, the Swedish people have generally followed the voluntary measures.
After having initially weathered high death rates, Sweden’s reported one of Europe’s lowest rates of daily new cases. Particularly, back in September when many countries were experiencing a resurgence of COVID cases, Sweden’s number of outbreaks was decreasing. Health officials have speculated that this decrease in outbreaks could be attributed to immunity in the Swedish population.
However, Sweden’s initial high mortality rate has taken a toll. As of November 15, Sweden has the 17th highest death per capita in the world with over 6,000 Swedes dead. While Sweden’s death rate per capita is currently lower than the U.S. and various European countries, it still isn’t something to boast about. Compared to its neighbors, Norway and Finland, Sweden’s death toll has been far worse: Sweden’s 600 COVID deaths per million is far larger than Norway’s 55 COVID deaths per million and Finland’s 67 COVID deaths per million.
Due to rising cases, Sweden has recently decided to change course and tighten restrictions. While on the surface this seems like a sensible step forward, in reality, it may not make a significant difference in fighting COVID. In late July, a group of researchers published findings that there was not a significant relationship between COVID mortality rates and a nation’s health policy and actions taken to fight the virus. Specifically, the researchers stated, “rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.” The two factors the researchers did find to be significantly associated with increased mortality per million was “higher obesity prevalence and per capita gross domestic product.”
These findings may seem shocking, but they are supported by what occurred between Sweden and its neighbors. “Our World in Data,” a research team based at the University of Oxford, created a “lockdown stringency measure” that assigns countries scores based on how strict their lockdown measures were. According to the researchers, the index is a composite measure ranging from one to 100 based on nine indicators that takes policies such as school closures, travel bans, and stay at home orders into account.
To get a better idea of what a high stringency score means, let’s look at Belgium. In March and April, Our World in Data gave Belgium a stringency score of 81. During this time Belgium issued a total border closure, stay-at-home orders, ban on public gatherings, cancellation of all public events, and school/workplace closures. Even though Belgium maintained this high stringency score into the summer, it currently has the highest COVID deaths per million. Some experts attribute Belgium’s high death toll to the lack of national cohesion when it came to implementing and following COVID guidelines.
Our World in Data shows Sweden’s government response stringency score has remained in the 50s and 60s throughout the course of the pandemic. What stands out is that Norway and Finland’s stringency scores were always lower than Sweden’s even though they suffered far fewer casualties. When people compare Sweden unfavorably to Finland and Norway they fail to note that the two countries were less restrictive.
Finland and Norway had lower scores than Sweden during the spring and continued to have increasingly lower scores from May until now. During the summer and fall, Norway and Finland had stringency scores averaging around the 30s and 40s while Sweden maintained a score in the mid-to-high 50s. This means that even though Sweden was more “stringent” in its lockdown policy than Norway and Finland, it still suffered more deaths.
Yet this doesn’t mean that there is a positive correlation between how stringent countries are and the number of lives lost to COVID. There are plenty of other factors that influence how COVID impacts a nation besides lockdown “stringency”. For example, Norway and Finland were able to forge a broad political consensus around their pandemic plans. Their plans remained consistent which avoided the confusion associated with switching policies. Also, Sweden’s mortality rates were higher compared to countries that were stricter with their lockdowns as well. While the data appears mixed and contradictory, one thing does seem clear: lockdowns may not be the solution.
As nations across the world move towards reimplementing restrictions, the path forward should not be a repeat of the spring. The lack of a significant relationship between lockdowns and a reduction in COVID deaths means we should not stumble into the same unintended consequences of the last lockdown by repeating the same mistakes. David Nabarro, the World Health Organization special envoy for COVID, stated that the way forward should be a “middle path,” that avoids massive lockdowns and focuses on building a more robust system of local testing and contact tracing. Furthermore, Nabarro stated the goal should be to simultaneously manage cases while keeping the economy functioning, not sacrificing one entirely for the other.
COVID-19 isn’t going away anytime soon. By shutting down our economy and communities we may be causing more harm than good in the long run. Another prolonged lockdown prevents us from recovering from the ruinous effects we’re still experiencing from the spring. The unclear success of mass lockdowns should serve as a cautionary tale for how we approach the long winter ahead of us.
Categories: Foreign Affairs