The country's pandemic policies came at a high price—and created painful rifts in its scientific community.
On 5 April, Anders Tegnell, chief epidemiologist for the Swedish public health authority, sent an email to the European Centre for Disease Prevention and Control (ECDC) expressing concern about proposed new advice that face masks worn in public could slow the spread of the pandemic coronavirus. “We would like to warn against the publication of this advice,” Tegnell wrote. How much people without symptoms contribute to spread was a “question that remains unanswered,” he wrote, and the advice “would also imply that the spread is airborne, which would seriously harm further communication and trust among the population and health care workers.”
On 8 April, ECDC published its recommendations anyway, in line with an emerging scientific consensus. Although questions remained, “use of face masks in the community could be considered,” it said, “especially when visiting busy, closed spaces.” Tegnell still disagrees. “We have looked very carefully. The evidence is weak,” he told Science. “Countries that have masks are not doing the best right now. It is very dangerous to try to believe that masks are a silver bullet.”
Sweden's approach to the coronavirus pandemic is out of step with much of the world. The government never ordered a “shutdown” and kept day care centers and primary schools open. While cities worldwide turned into ghost towns, Swedes could be seen chatting in cafés and working out at the gym. The contrast evoked both admiration and alarm in other countries, with journalists and experts debating whether the strategy was brilliant—or whether Tegnell, its main architect, had lost the plot.
The country did not ignore the threat entirely. Although stores and restaurants remained open, many Swedes stayed home, at rates similar to their European neighbors, surveys and mobile phone data suggest. And the government did take some strict measures in late March, including bans on gatherings of more than 50 people and on nursing home visits.