Dr. Tegnell, thank you so much for joining us
on The Daily Social Distancing Show.
You are chatting to us from a train station right now.
-Is that correct? -Yeah, that's correct.
A train station in Stockholm, Sweden.
Okay. Are you... Do you...
Are you commuting? Are you still out and about?
Yes, I'm commuting from my home,
which is in Linköping, a town some 200 kilometers south.
Okay. Um, Sweden
is an interesting outlier
in the world.
Where most countries in the world have decided
to completely lock everything down,
keep people indoors and shut down the country,
Sweden has gone for a different approach.
Sweden has decided to keep the country fairly open
but require citizens to social distance themselves,
to remain responsible,
to limit gatherings to below 50 people,
and-and I think, you know, like,
older people are meant to stay at home, et cetera.
Tell me about what Sweden is doing,
and then... and then would you mind explaining to me
how Sweden came to that decision to do it differently
to everyone else in the world?
No, but you... I think you have made a fair description.
Instead of closing it down completely,
we have tried to look at different situations
where we know that the spread is most dangerous,
like in restaurants.
And then we have regulators saying restaurants...
You have to see to it that you're not crowded.
You can no longer serve in bars
where people sit very close together for a long time.
You need to have social distance between people,
so one and a half, two meters between people sitting down
and all of those kind of things.
We put a lot of responsibility on the restaurant owners.
Another one is that we have told everybody
to stay home if they feel ill in the morning,
even if only slightly ill.
Say stay at home and...
Because-- And, financially, that's been okay,
since, uh, nowadays, you get paid
even if you stay home when you're sick
from the very first day.
Which the government changed very quickly.
So it's-- there is a great incentive
of staying home if you feel slightly ill.
And we have done a lot of things
to limit the social contacts among the elderly,
uh, giving advice to them to stay home and stuff like that.
So instead of saying, "Close down the whole society,"
we have looked at society and-and closed down the aspects
of society where we think and we know from other diseases
and from what we've seen in other countries
most of th-- to cease...
And I think that has had a great effect, in many ways.
It has enabled our health system to keep on functioning.
-Mm-hmm. -Uh, it has had other interesting effects,
like, over Easter, Swedish people travel a lot.
Only ten percent of the normal travels were done,
which is a lot of change.
Uh, our yearly epidemic of flu suddenly stopped
when we instituted these measures,
in the middle of, uh-- of the normal wave.
-Right, right. -So, in that-- in that way,
it's, uh... it's worked.
And we have used, sort of, what we normally use in Sweden
when it comes to public health,
and that's really telling people to take responsibility
and take, uh-- and sort of do the things they think
would fit them the best in diminishing the threat
to-to spread the disease to other people.
-You-you... -And I think that's, historically, worked very well.
Tell me about what's happening in Sweden.
What have you seen from the numbers in
and around the coronavirus? (stammers)
Do you-- do you think Sweden has it under control?
Do you think, um, Sweden has seen the worst of it?
I think, in Sweden, like in many countries,
it's different in different parts of Sweden,
even if it's a small country.
I mean, Stockholm and the surrounding areas,
which is about half the population of Sweden--
slightly less-- uh, we have had
quite a big number of people
-being ill in the last two months. -Mm-hmm.
While many other parts of Sweden,
including the-the big cities on the west coast
and in the south, have had not very many cases at all so far.
But in Stockholm and the surrounding area,
we have had a fair amount of cases.
We think we are up to about a quarter of the population
who has been infected so far.
Um, death has been down in a fairly slow manner.
So the number of cases have been fairly constant
for at least one month by now,
which means that the health care,
who has transitioned a lot, changed a lot--
they do very different things today
than what they're used to-- but they have been--
kept on working.
And there have always been beds free.
Everybody in Sweden who needs a hospital bed
have gotten a hospital bed for COVID-19 or for other diseases,
-so it's kept on working. -Mm-hmm.
And intensive care has even had at least 20% of the beds free
at any given time.
So, in that respect, the strategy has been successful.
We managed to keep the level of spread
on a level below the threshold of the-- of the health system,
which I think is one very important part
in any kind of strategy.
People look at the numbers of countries around Sweden
and they go, "Their-their death rate is far lower
"in terms of coronavirus.
Sweden's numbers are higher."
But then if you look at other countries like Italy and Spain,
et cetera, they have higher numbers than Sweden.
So-so when you say Sweden is successful,
how do you measure that success?
Are you just looking at the numbers of death?
Or are you looking at it-- at it holistically?
What does that mean, Sweden is successful?
I think we're trying to look at it holistically.
And I'm not saying we were successful
in all different ways. I mean, our death toll
is really something we worry a lot about.
And it's very much related to elderly people's homes,
who have proven to be extremely susceptible to this disease.
And we know that there's a number of things, quality-wise,
that needs to be addressed in those,
and we are addressing them.
We-we have a lot of agencies involved,
and we're seeing some improvement.
But our death toll has very much to do with that.
In other aspects, it's, uh-- many of the things have worked,
I think, reasonably well.
And-and I think the-the good thing is
that we've been able to keep schools open.
Uh, keeping schools open is very important for children
and children's health. We know that for sure.
Uh, we have been able to keep a lot of people working.
And we know that losing your work
is very dangerous to your health.
So we've been trying to take a slightly more holistic approach
to this than-than maybe some other countries have done.
There have been reports coming out saying
that there will be herd immunity achieved,
I think, in Stockholm, at least, over the coming weeks.
What does herd immunity mean for you?
And what are you hoping herd immunity will achieve
for Sweden?
I think, herd-- complete herd immunity,
we're not sure any country will ever achieve,
because that means that the disease goes away,
and I don't really see this disease going away.
But even some immunity in the population,
like the 20%, 25% that we are reaching now,
will have a great effect on the-- on the speed of spread.
So with that and the measures we have in place
and-and with immunity going up,
I think there is a possibility that we can ease down
on some of the restrictions, otherwise, that we have,
so that we, by the immunity level of the population,
can have such a slow spread of the disease
that-that, uh, society can start work
more or less normally again.
-Mm-hmm. -I mean, some portion with--
will always be at risk.
I mean, people, um-- elderly people
will most likely be--
always be at risk for this kind of disease.
And so-- But many things we can then ease up a bit on.
If-if somebody said to you, "Dr. Tegnell,
"you know, your numbers,
"we understand your-your methodology,
"we understand everything you're trying to do,
"but having tripled the death rate of countries like Norway
"and Denmark means that, you know,
you've put some lives above other lives."
Do you think that that's a decision
epidemiologists/governments need to make?
Is it an easy decision to make?
I'm-- You know, I-I-- 'Cause I don't think
anybody has the right answer in this regard.
But I-- but I would like to know, like, how you got--
how you and your team got to that place, where you said,
"You know what, it's worth the risk.
"We-we want kids to be in schools.
"We want people to still be working.
"And we understand that that might lead us
to have a higher death toll initially."
No, I don't think-- We never really calculated
with higher death toll, initially, I-I must say.
That's-that's not right.
-I mean, we calculated more people being sick. -Oh.
-But the death toll really came as a surprise to us. -Ah.
We-we really felt that our elderly homes
would be much better at keeping the disease outside of them,
uh, than actually being in here.
Not that Sweden is the only country with this problem.
I mean, many countries in Europe have problem with elderly homes,
which it's very difficult to keep the disease away from that.
And even if we're doing our best, it's not...
obviously not enough.
Uh, so, um...
We are not putting anybody's life
above anyb-- everybody else's life.
That's-that's not the way we are working.
Uh, we are really trying to-- trying to keep public health
-as good as possible in this troublesome time. -Right.
That's really interesting, 'cause that's--
you know, that's not how it's being reported in many places.
I'm-I'm glad you-- No, I'm glad you said that.
I-- It's-it's interesting to hear it from somebody in Sweden
who's part of this directly.
Because Sweden is doing something differently,
because populations around the world are getting agitated,
because people are growing in-in unrest--
there's protests, people feel-- they want to go back outside,
they want to work, et cetera, et cetera, et cetera-
people are now using Sweden as "the example."
If somebody said to you,
"Dr. Tegnell, people want to take Sweden's model
"and apply it to a country like America,
would you have an opinion on that?"
(exhales) Not really.
I mean, I-I'm sure there are some things from Sweden
that can be transferred to other countries
and some things are not.
I think some things will become increasingly clear.
We are feeling more and more confident
-about closing schools -Mm-hmm.
is not something that's really gonna be very effective
for this kind of disease.
It doesn't seem to be very much of a mo--
Schools doesn't seem to be very much of a motor in this epidemic
like it is in flu epidemics, and so--
So some things, definitely.
Building up trust between the agency
and the population, uh, that we have in Sweden
-is something that takes a long time. -Right.
Uh, the trust level has always been high.
Now it's increasing. We are--
70%, 80% of the population thinks we are doing a great job.
Only, like, five, ten percent doubt at what we're doing.
And we're even finding the people have more--
better and better adherence to our-our guidance.
I mean, more and more people are keeping social distance
and these kind of things,
which is actually the opposite of what you see
in other countries, where people are revolting against it.
Here we see that people are more and more in line
-with what we want-want them to do. -Right.
Well, Doctor, thank you very much for your time.
Um, I hope you catch that train.
And good luck with the rest of your fight against the virus.
Good luck to you.