Trust in science and Sweden's different approach to Covid-19

Being an immigrant in Sweden during the Covid-19 pandemic is a peculiar condition – not only because migrant communities have been particularly exposed to contagion and may be more vulnerable to its economic effects in the long run, but also because one experiences more strongly the sharp contrast between the approach chosen by Sweden (where I live and work) and the rest of Europe and the world (where family and many of my friends are).

The Scandinavian country has a nearly exclusive focus on the elderly and other risk groups, little testing and very few binding measures of social distancing, while many other countries are adopting massive lockdown measures. This contrast becomes an intimate matter, a light form of schizophrenia between different emotional and political ways to handle uncertainty.

As an Italian living and working in Sweden, I am used to the fact that my two countries (the one I come from and the one I live in) are often represented as two extremes of a polarity from many points of view. But the spread of the coronavirus, and the diversity of political reactions in the two cases, has pushed this tendency even further. On the one hand, media broadcast images of the devastating effects of contagion in northern Italy, and tell about Italians being locked down, their freedom of movement minutely disciplined, their resilience expressed through songs from the balcony, or rainbow signs drawn by children in quarantine. On the other hand, calm and rationality seem to be the leitmotiv in Swedish reactions. It would appear as if we were two contrasting ideal-types of how people in a given country, guided or directed by its leaders, respond to a crisis.

International media have started pointing out the “Swedish exception”, and its approach centred on moral suasion and very limited and targeted bans, with a mixture of concern and curiosity. Being in Sweden now feels like finding yourself in the “control group” of a massive political experiment of containment and response to a global pandemic: will we – a unique case in Europe and possibly the world – be proven right, or are we heading for disaster?

A few experts, whose voices are regularly hosted by TV programs and newspapers’ headlines in Sweden, embody this peculiar communicative style that mixes coolness, detachment, and an ostentatious commitment to “science-based” evaluations. In the public TV news program Aktuellt, WHO expert Johan Giesecke surprised the hosts with his laconic statement that the British decision to close down schools was “dumb”. Bacteriologist Agnes Wold, known in the past for her nonconformist opinions, is now appreciated for her “calming” tweets and her tireless support of the recommendations uttered by state agencies.

In one of these agencies, we find the most visible and popular among Swedish experts, state epidemiologist Anders Tegnell. He works for Folkhälsomyndighet (FHM), the national agency for public health, which enjoys considerable independence from national government and is driving the official response to the crisis.

Tegnell is known for his dry and minimal replies to journalists, where he bluntly dismisses unmotivated concerns and unsubstantiated scenarios.

This has earned him some online hate, but also a lot of appreciation and support: as Johannes Klenell has written in an op-ed published in the periodical Arbetet, “in times of crisis, Swedes put their hopes not into screaming populists who go roaring about the country’s breakdown, but into nerds”. In other words, boring bureaucrats and unsympathetic scientists have the power to reassure people – or so opinion polls seem to show.

When Nordic neighbours such as Denmark and Norway have started enforcing stricter measures, for example by closing borders and schools, both the Swedish government and the FHM have commented that those decisions were “political”, that is, not inspired by experts’ recommendations. The head of the Danish equivalent of FHM confirmed the allegation in an interview. Some Swedish media went even further, reporting opinions of Belgian virologists who disagreed with their government’s decision to close down schools and lamented that “politicians had decided not to listen to scientists”.

But science is a contested field: it should neither be imagined as unanimous, nor as completely detached from politics – especially when we discuss medicine, healthcare and the design of non-pharmaceutical mitigation measures. To prove the first point, dissenting positions have indeed emerged in the Swedish academic community, though not uncontroversially: articles reporting criticism against the official approach often receive comments from readers who express their shock or anger for useless debates, and demand more respect and trust for the authorities.

Yet, some epidemiologists and public health experts have started questioning the line chosen by FHM and demand more transparent communication and data sharing from the agency. A group of researchers has produced scenarios for the evolution of the pandemic in the different Swedish municipalities and in the country as a whole, following the example of the Imperial College study that contributed to reverse UK policies initially centred around “herd immunity” – FHM officials also mentioned herd immunity in the beginning, but have stopped referring to it in the last two weeks.

Their simulation shows that only stronger social distancing measures can avoid a serious overload of the healthcare system. But while some restrictions are being gradually implemented, for example banning gatherings of more than 50 people and service at the counter in restaurants, most other choices remain in place. Primary schools are still open, and people are only gently invited to make an assessment by themselves over the real necessity of travelling during Easter: just in case, ski resorts will be functioning. “[In Sweden] we still have a really great level of trust toward each other, but also toward public institutions and politicians” explained foreign minister Anne Lind.

Tegnell said that legal injunctions might be unnecessary, because respecting recommendations from authorities is part of the “Swedish culture”. To corroborate his point on trust and compliance as Swedish traditions, he made the example of the very high national rates of vaccination coverage, despite the absence of legal obligation.

Now, this is an interesting example that brings me back to the Sweden-Italy continuum. The growing skepticism about vaccines has raised real concerns in Italy in the last few years, with the so-called “no-vax” movement, occasionally finding allies among elected politicians, and prompting the government to create more stringent incentives for parents to vaccinate their children. Part of the debate that ensued saw the confrontation of different experts and approaches on how to take into account parents’ anxieties and communicate better about the risks and advantages connected to vaccines, without slipping into the relativism and conspiratorial tones of the no-vax movement.

With all their shortcomings, the recent discussions around vaccines introduced in the Italian public debate an abundant – albeit unequally distributed – dose of scientific information. Not all of this was polite and nuanced: facing the violence of some no-vax campaigners, virologist Roberto Burioni became known for his activism on social media, his aggressive style and his quite dogmatic defence of science that, using his words, “is not democratic” – a formulation that defenders of the official approach in Sweden, who worry about populism and often use sarcasm against self-appointed scientists and “internet experts”, might approve of.

Burioni polarised the public opinion, earning both admirers and critics. Incidentally, in early February, he stated that the coronavirus would not spread in Italy (in the same week, FHM head Johan Carlson said something similar about Sweden). Since then, Burioni has become a staunch advocate for containment measures and an active debunker of covid-related fake news.

The inner workings of science may not be democratic in a literal sense. Indeed, science may look more like an unstable oligarchy governed by imperfect mechanisms of validation, such as experiments, PhD awards, conferences, tenure, peer-reviewed publication and so on. But the way in which techno-scientific knowledge can permeate society and deploy the beneficial effects we expect from it is an inherently political question, and one positioned at the core of democracy as we know it.

Science communication is not just a formal issue: it deals with how scientific hypotheses are shared in a transparent way, made available for learning and critique, tested, improved, and rendered effective. Broadening the focus, this is probably one of the few ways in which governments and scientists can sustain and renew trust among “adults” – a term used by prime minister Stefan Löfven in his recent address to the nation, to call for individual responsibility during the crisis.

The idea of letting qualified experts manage the crisis, and society, in a politically neutral manner would not be entirely new in the Swedish history of social engineering – the development of the Swedish welfare state throughout the 20th century is closely associated with ideas and practices around the scientific management of society.

But a rigid distinction between the scientific and the political level does not hold. After all, epidemiology and public health are not like theoretical physics: by definition, they take into consideration socio-cultural, psychological and economic factors.

In the first days of contagion, when asked why Sweden was not enforcing stricter forms of lockdown, FHM experts often replied quoting the potentially disastrous impact on the economy – something they are actually more reluctant to mention now.

True, a profound economic and financial crisis is ahead of all of us, and the tragic choice between saving the maximum amount of lives now and the maximum amount of livelihoods (and, as a consequence, also of lives) later is haunting and not at all banal. Shouldn’t it be, at least in part, a decision in the hands of a democratically elected and accountable government? A similar point against the “technicisation” of containment measures has been argued for Italy too, where the government is criticised for making disproportionate use of legislative tools such as presidential decrees, in order to speed the decision-making process and avoid long – and in this situation, logistically complex – parliamentary debates.

If we apply the principles of democracy and accountability to a broader perspective, we could also look back and argue that politicians, in Italy and Sweden and all around the world, should be accountable for decades of restructuring, partial privatisation and scaling down of public welfare. Without considering these processes, it is impossible to understand why that line in the graph under which the curve must be flattened, that line representing the level of hospitalisation supported by each healthcare system, is where it is.

Just last week, the Stockholm region – the hardest hit by contagion – finalised the sale (decided months ago) of a public hospital to a powerful industrial group. The influence of for-profit actors in the celebrated Swedish welfare system has been growing for decades, encouraged and supported as a technical choice in the name of efficiency and new public management.

The deal went through in the middle of the virus outbreak, at a time when discussions about defending the public nature of healthcare and proposals about nationalising the pharmaceutical industry are finally emerging. Let us hope that “trust” toward authorities, an otherwise precious asset in many circumstances, will not be the guiding principle in these debates.

Cristiano Lanzano is a social anthropologist and a senior researcher at the Nordic Africa Institute, Sweden. He conducts research on politics and natural resources in West Africa. He has also written on Sweden in Italian media such as Il Manifesto and

The views expressed in this article are the author's own and do not necessarily reflect Corona Times' editorial stance, or the position of any institution.

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