Letter from Sweden: April 15, 2021

From Deborah: Sweden’s Public Health Authority press conference, April 15th.

There is a downward trend of cases in Europe after peaking a few weeks ago. This can vary by country, and in Sweden we are having a surge of cases caused by the more transmissible British variant. The original forecast predicted a tapering off in Sweden early April, so hopefully soon. The cases are spread across all age groups. In good news, covid deaths are very low. We have had no excess mortality in Sweden since January when the vaccination rollout began. Vaccinations of the 80+ age group are now >90%, and 70+ age group > 50%. There continue to be a few infections in care homes even with high levels of vaccinations, and these infections rarely lead to serious illness. Everyone 65+ is eligible to be vaccinated now. Sweden is using Pfizer, Modern and AstraZeneca for this age group, but the AZ vaccine is on hold for anyone under 65.

Hospitals are under pressure with covid admissions increasing rapidly. ICU admissions are also increasing but at a slower rate. 63% of patients in the ICU (390 of 617) have covid. The ICU is now 50-60% busier than usual for this time of year. Patients are being moved between regions to even out caseloads, and 3-4 ICU beds are being created a day to ensure capacity. “Personnel is committed and there have been few resignations.”

The health system is investigating what Swedes call “post-covid” – symptoms that linger, such as breathing issues and tiredness, but usually drop off. They are trying to determine how many people this might include, and how they can be cared for.

There was much talk again about people not being compliant with Sweden’s fairly relaxed “recommendations”. (To recap, we are told to: stay home if we are sick, stay apart, wash our hands, work from home if we can. Only 4 people per table in restaurants, which must stop serving alcohol by 8:30. We are encouraged to shop alone and not in groups. There are restrictions on large gatherings. If you feel sick, a test is delivered to your door by taxi, and the driver waits while you take it, it is free. Everything is open, schools, stores, gyms, salons and always has been.) A survey found that 8/10 Swedes said they were following guidelines, but when they rated each other, the number was much lower. Masks were recently recommended for public transportation. I had thought the uptake was rather low – a new survey puts the number at 30%. I haven’t heard any stories of “mask shaming” in public. The bigger concern seems to be people meeting new people indoors, and the virus “jumping” between households. Supposedly young women, age 18-29 are the worst offenders.

Results of 2 studies were presented:

1. The effect on public health of pandemic measures, using international researchers plus Swedish data

· General health in Sweden is good

· There are indications that psychological health has worsened, people have become more sedentary and reduced their physical exercise

· Certain groups have been impacted more by the pandemic and the measures taken – including worsened health and increased inequality

· Therefore it is important for the public health ministry to adopt focused measures to improve the health of these groups

2. Knowledge about children, youth and covid-19

· There have been increased cases among children and youth, but this can be partially explained by increased testing

· Very few children and youth ages 0-19 are affected by serious illness and death

· Little children are less susceptible to the virus than older children

· Older children and teenagers are less susceptible than adults

· The risk for serious illness among children and youth does not appear to be higher with the more contagious B117 (British) variant than for earlier variants

· The level of infections in a school mirrors the level of infections in the surrounding community

· School is an important factor in children’s health, both in the moment, and for the future

· Ensuring children are able to go to school during the pandemic is an important goal for the entire society

· There will be increased testing of possible infections to include children who have been in contact with children who have tested positive

· The public health authority has reviewed the literature and transmission is not reduced by closing schools. Again, infections tend to follow society and vis-a-versa

· They believe kids tend to catch the virus at home and not from each other

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