Sweden Was Right about COVID


The frontrunner for this year’s Nobel Peace Prize, according to the bets placed with British bookmakers, is the World Health Organization. It’s hard to imagine a worse choice. (Okay, Vladimir Putin.) The bettors’ theory is that the Nobel committee will honor the WHO for its efforts in fighting Covid-19—but it would be absurd to reward an organization that began the pandemic by spreading deadly misinformation, went on to promote disastrous policies, and now seeks new powers to do even more damage next time.

The Nobel jurors in Norway should be honoring the pandemic’s true heroes, starting with an obvious candidate across their border: Anders Tegnell, the state epidemiologist of Sweden. While the WHO and the rest of the world panicked, he kept calm. While leaders elsewhere crippled their societies, he kept Sweden free and open. While public-health officials ignored their own pre-Covid plans for a pandemic—and the reams of reports warning that lockdowns, school closures, and masks would accomplish little or nothing—Tegnell actually stuck to the plan and heeded the scientific evidence.

Journalists pilloried him for not joining in the hysteria, but he has been proven right. In Sweden, the overall rate of excess mortality—a measure of the number of deaths more than normal from all causes—during the pandemic is one of the lowest in Europe. Swedish children kept going to school and did not suffer the learning loss so common elsewhere. Swedish children and adults went on with their lives, following Tegnell’s advice not to wear masks as they continued going to schools, stores, churches, playgrounds, gyms, and restaurants. And fewer of them died than in most of the American states and European countries that delayed medical treatments, bankrupted businesses, impoverished workers, stunted children’s emotional and cognitive growth, and stripped their citizens of fundamental liberties.

If it hadn’t been for Tegnell and a few other heretics in places like Florida, we would not have clear evidence to prevent a similar catastrophe when the next virus arrives. Politicians and officials at the WHO and the Centers for Disease Control are still promoting useless mask mandates and defending their lockdowns with scientific sleight of hand: cherry-picked data and computer models purporting to show that the measures worked. Those claims have been rebutted in hundreds of studies, but journalists and politicians have mostly ignored that research, preferring to parrot the claims of the WHO and CDC officials who wave away the inconvenient findings.

But they can’t easily dismiss the results in Sweden and other places that followed its strategy. The real world trumps a computer model. Tegnell forced the lock-downers and mask zealots to test their unproven theories by making Sweden the control group in a natural experiment, and he did it in the face of extraordinary pressure, as the Swedish journalist Johan Anderberg recounts in superb detail in The Herd: How Sweden Chose Its Own Path Through the Worst Pandemic in 100 Years.

Tegnell was aided by another worthy candidate to share the Nobel, Johan Giesecke, who had formerly held Tegnell’s job and served during the pandemic as an advisor to the Swedish public health agency. Decades earlier, he had recruited Tegnell to the agency because he admired the young doctor’s willingness to speak his mind regardless of political consequences. In early March 2020, as leaders across Europe were closing schools, Giesecke sent his protégé an email with a sentence in Latin. It was a famous piece of fatherly advice sent in 1648 by the Swedish statesman Axel Oxenstierna to reassure a son worried about holding his own in negotiations with foreign leaders. An nescis, mi fili, quantilla prudentia mundus regatur: “Do you not know, my son, with how little wisdom the world is governed?”

Politicians in Sweden were ready to close schools, too, but Tegnell and Giesecke insisted on weighing costs and benefits, as Tegnell had done in a 2009 article reviewing studies of school closures during pandemics. The article had warned that the closures might have little or no effect on viral spread and would cause enormous economic damage, disproportionately harm students and workers in low-income families, and create staff shortages in the health-care system by forcing parents to stay home with young children. Given all those dangers, plus early Covid data showing that schoolchildren were not dangerously spreading the virus, Tegnell and Giesecke successfully fought to keep elementary schools and junior high schools open—without masks, plastic partitions, social distancing, or regular Covid tests for students.

They remained rational when politicians around the world were frightened into full lockdowns by Neil Ferguson’s team of researchers at Imperial College London in mid-March 2020. Ferguson’s computer model projected that Covid would kill more than 2 million Americans and 500,000 Britons by the end of the summer, and that there would soon be 30 Covid patients for every available hospital bed in intensive-care units. The “only viable strategy,” the modelers concluded, was a lockdown strategy like China’s.

Never mind that this strategy had been carefully considered and rejected in the various pre-2020 pandemic plans prepared by the WHO, the CDC, and the health agencies of Canada, the United Kingdom, Sweden, and other countries. The planners’ scenarios had ruled out business closures even during a pandemic as deadly as the 1918 Spanish flu. But once the doomsday numbers from Imperial College made international headlines, the plans were promptly forgotten—except in Sweden, where Tegnell had put Giesecke in charge of evaluating models of viral spread.

Giesecke had the sense to be skeptical. As a pioneer of epidemic modeling in Sweden, he’d seen how wrong computer projections could be, especially the ones from Ferguson’s team at Imperial College. In his opinion, as Anderberg describes it in The Herd, “Ferguson’s career was one long string of disastrous miscalculations with fateful consequences.” Giesecke could recite from memory the exact numbers from Ferguson’s previous scares, like the projection of up to 65,000 British deaths from swine flu (the actual toll was 474). Ferguson’s Covid projections struck him as yet another alarmist miscalculation, based on faulty assumptions about the lethality of the virus, how it spread, and how people would respond. When other researchers used similar modeling techniques to project doom for Sweden, he dismissed their warnings as a “horror scenario of no use to anyone.”

He and Tegnell were similarly skeptical of the claims that China and other countries had “shut down” the virus by locking down society or forcing citizens to wear masks. They had no illusion of reaching “zero Covid.” An isolated country might seal its borders and temporarily escape Covid, but once the airborne virus arrived, there was no stopping its spread (as New Zealand and Australia have belatedly discovered after two years of draconian lockdowns). As country after country locked down, Tegnell emailed his Swedish colleagues, “The world has gone mad.”

Tegnell trusted Swedes to take sensible precautions voluntarily, which they generally did. Many followed the government’s recommendations to practice social distancing and work from home when possible. The elderly and those with respiratory symptoms were advised to stay home, but Tegnell urged people not to wear masks, which he considered ineffective and potentially harmful. He resisted the pressure to order a lockdown when Sweden’s mortality rate rose early in the pandemic. The death toll, while an order of magnitude lower than the doomsday number projected by computer modelers, was nonetheless one of the highest in Europe, and much higher than in neighboring countries.

Tegnell faced intense criticism at home and abroad for Sweden’s “deadly folly,” as the Guardian called it. Foreign journalists, who stood out at the press conferences in Stockholm because they were the only ones wearing masks, portrayed Sweden as a “pariah state” and “the world’s cautionary tale.” Tegnell acknowledged that Sweden had erred by not moving quickly enough to impose restrictions at nursing homes, but he insisted that Sweden’s overall strategy was sound. He and his defenders pointed out that Sweden had been more vulnerable than its Nordic neighbors because the virus arrived earlier and because the country had more international travelers, more immigrants, and more urbanites. It also had more vulnerable older people (what’s been called the “dry tinder” effect) because the previous flu seasons had been much less deadly in Sweden than in neighboring countries. In Denmark, for instance, the rate of mortality had been unusually high in 2019 because of the flu, so there were fewer frail elderly people alive at the start of the pandemic. Denmark’s excess-mortality rate in 2020 was much lower than Sweden’s, but the rate over the entire two-year period was about the same in both countries.

The virus would eventually spread to other countries despite their lockdowns and mask mandates, Tegnell warned in July 2020 as he advised his colleagues and critics to take the long view. “After next summer,” he said, “then I think we can more fairly judge what has been good in some countries and bad in other countries.”

Sure enough, by summer 2021, Sweden was a different sort of “cautionary tale.” Without closing schools or locking down or mandating masks, it had done better than most European countries according to the most meaningful scorecard: the cumulative rate of excess mortality. Critics of Tegnell’s strategy were reduced to arguing that Sweden’s rate was higher than that of several other nearby countries, but this was a weak form of cherry-picking because two of those countries—Norway and Finland—had also avoided mask mandates and followed policies similar to Sweden’s after their lockdowns early in the pandemic.

Today, Tegnell’s strategy looks even better, according to the latest excess-mortality rankings from the The Economist, the World Mortality Dataset, and the WHO. The rankings differ slightly depending on the statistical methods used, but all three groups calculate that Sweden’s cumulative excess mortality rate during the pandemic has been one of the lowest in Europe as well as the rest of the world. The Economist’s method, which adjusts for demographic differences among countries, shows that for every 100,000 people, there have been 61 excess deaths in Sweden. That figure of 61 deaths is higher than in Denmark or Norway (35 and 47 deaths, respectively), but lower than in Finland (72 deaths). It is also lower than in Germany (67 deaths), which won lavish media praise during the pandemic for its strict lockdowns and rules requiring citizens to wear surgical and N95 masks. Most European countries have suffered more than 100 excess deaths per 100,000, including ones near Sweden: the Baltics, Russia, Poland, the Netherlands, Belgium, and Britain.

Sweden has fared especially well by comparison with the United States, which has suffered 206 excess deaths per 100,000. That’s more than triple the rate in Sweden, and there’s another glaring difference: the death toll among the young and middle-aged. Even during 2020, Sweden’s worst year of the pandemic, no excess mortality occurred among Swedes under 70, but the rate soared among younger Americans. The CDC reported that the excess mortality rate rose more sharply among Americans aged 25 to 44 than in any other age group. When researchers analyzed excess deaths among Americans aged 15 to 54, they found that the majority died from causes other than Covid. Many were presumably casualties of the lockdowns’ disruptions: the canceled medical and mental-health treatments, the enforced isolation and inactivity, the surge in unemployment, the steep increases in rates of depression and anxiety disorders, obesity and diabetes, and abuse of alcohol and drugs.

These deaths constitute “a historic, yet largely unacknowledged, health emergency,” according to a study by Casey Mulligan, an economist at the University of Chicago, and Robert Arnott, a statistician and chairman of Research Affiliates. They calculate, conservatively, that America saw 171,000 excess deaths from non-Covid causes from the start of the pandemic through last year. They note that while The Economist has calculated a similarly high rate of non-Covid excess mortality across the European Union, there is a notable exception to the trend: Sweden, where mortality from non-Covid causes has been lower than normal during the pandemic. “Perhaps,” they observe, “Sweden’s result is related to minimizing the disruption of its citizens’ normal lifestyles.”

With the possible exception of the Great Depression, the lockdowns were the costliest public-policy mistake ever made during peacetime in the United States. The worst consequences of lockdowns have been endured by people in the poorest countries, which have seen devastating increases in poverty, hunger, and disease. Yet the WHO has refused to acknowledge these errors and wants to change its pandemic planning to promote more lockdowns in the future. It has even proposed a new global treaty giving it the power to enforce its policies around the world—thereby preventing a country like Sweden from demonstrating that the policies don’t work.

The last thing the WHO deserves is encouragement from the Nobel jurors. The prize should reward those who protected the lives and liberties of millions of citizens during this pandemic, and whose work can help protect the rest of the world during the next pandemic. Besides Tegnell and Giesecke, the obvious candidates are three experts in public health who led the international effort to restore sanity to their profession: Jay Bhattacharya of Stanford, Sunetra Gupta of Oxford, and Martin Kulldorff of Harvard. In fall 2020, they issued a call to end lockdowns and school closures, the Great Barrington Declaration, which won signatures from tens of thousands of fellow scientists and doctors. They marshalled scientific evidence throughout the pandemic to counter Covid hysteria, and they helped persuade leaders in Florida and other places to follow successful strategies like Sweden’s.

That brings us to five worthy candidates for a Nobel, which cannot be shared by more than three people. But given the unprecedented global impact of Covid-19 and the lockdowns, the efforts to prevent that catastrophe deserve more than one prize. When else have so few done so much to help so many? Give the Nobel Peace Prize to Tegnell and Giesecke and the Nobel Prize in Medicine to the Great Barrington scientists. And at the very least, banish the WHO and the rest of the public-health establishment from consideration for any kind of prize. Their chief accomplishment has been to demonstrate a lesson we didn’t need to learn yet again: “Do you not know, my son, with how little wisdom the world is governed?”

John Tierney is a contributing editor of City Journal

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