Reflecting on the not-so-good stats.
Foto: imago images/TT

Stockholm - Alan Shamoun lights a candle on his mother's grave at the Spanga Cemetery in northern Stockholm. The 39-year-old kneels amidst a new field of graves for people who have died in the corona pandemic. Many of the crosses bear Arabic or Romanian names. Immigrants like Shamoun's 78-year-old mother lie buried here. Another is Teresia Jarjis, a Christian who fled Iraq for Sweden in 1996. Her son removes the weeds between the heat-shaped gravestone and a statue of the Virgin Mary.

Sahmoun works as a quality manager for a Swedish company. At the beginning of the year, he received an email from a college who was stuck in quarantine in China. He also read about a virus that is particularly dangerous for the old. He asked his elderly parents, who also live in Stockholm, to stay at home. Shamoun says he feels hurt when the Swedish authorities attribute the high death rates in northern Stockholm to low levels of education among immigrants. “Now they’re saying that a lot of immigrants didn’t understand the information properly. Yet I had already warned my parents about the virus in January.”

On 5 March 2020, his mother, who suffers from diabetes, decided to visit the local health centre just around the corner for a routine check-up. What can go wrong with a visit to the doctor? A few weeks later, she died of Covid-19, and her son is sure that she was selected at the clinic to die.

Only after his mother's death at the Karolinska Huddinge University Hospital did Shamoun find out that his mother went to a doctor on 5 March – after he found a note in her papers. He became suspicious: "I met a woman at the cemetery whose husband also had an appointment at the same health centre at the beginning of March. Now he’s a few rows away from my mother," says Shamoun.

A mother's excruciating pain is ignored

On 8 March, Teresia Jarjis felt unwell. She had a stomach ache and lost her appetite. Days later her condition worsened. Her son tried in vain for two weeks to have the mother treated in hospital. Then she was finally admitted and then transferred to the university clinic in Karolinska Huddinge. Tests confirmed that Jarjis was infected with the coronavirus. Her condition worsened. The 78-year-old was still not transferred to intensive care. On 22 March, a Sunday, she told her family that none of the hospital staff reacted, although she kept pressing the emergency button. She was in terrible pain. Her electronic medical records don’t show a single mention of a doctor's visit. Shamoun's mother died on 23 March.

The Karolinska University Hospital has become synonymous for death in Stockholm. Many of the nearly 2,400 corona deaths in the Swedish capital of approximately 975,000 breathed their last breath here. The hospital is proud that the capacity of the intensive care unit has always been sufficient. Authorities in the Stockholm region would have triaged this case – doctors have excluded patients over 80 or with pre-existing illnesses from intensive care.

The Swedish daily Dagens Nyheter published an article on 24 April which claimed that triage was widespread. The newspaper’s sources were whistle-blowers from within the clinic. According to them, there was simply a lack of personnel. So patients had to be prioritised according to age and health condition.

Alan Shamoun believes that his mother was among those who were left at the mercy of the virus as described by Dagens Nyheter. That's why the staff ignored her emergency calls. The Swedish National Board of Health Investigation (IVO) wants to shed light on the events at the Karolinska clinic. Shamoun doubts that there will be any answers. And he is not the only one convinced that Sweden's failure in the corona crisis goes even deeper.

Lisa Pelling, chief analyst at Arena Idé, a think-tank linked to trade unions, receives visitors in her office in central Stockholm not far from the Drottninggatan shopping precinct, where the hustle and bustle at H&M and other chains seems carefree. Passers-by eat ice cream while window shopping. Instead of masks, the Stockholmers’ preferred accessories are sunglasses and shopping bags.

Pelling believes that a brief lockdown would have provided breathing room for the country to acquire the necessary medical supplies. She is certain that the virus has checkmated a health and care system designed for efficiency. Because of a lack of staff, hospitals that were filling up with seriously ill patients were quickly overwhelmed, she says. Pelling points to figures showing that Sweden had fewer intensive care units and ventilators and had less equipment than any comparable country in Europe. "Nobody considered the possibility of a crisis," she says: "It’s true that there were enough places in intensive care units – for 40-year-olds."

She criticises the fact that sick people from old people's homes were not transferred to clinics where they could have been supplied with oxygen. Instead, they were given sedatives and painkillers to make death by suffocation more bearable. The government now admits mistakes in protecting nursing home residents.

Pelling suspects that the death of the elderly and the death of migrants could both be linked to the privatised care sector. Private companies run old people's homes for the municipalities. More and more carers on temp contracts work in these homes, almost exclusively migrants. They are employed on an hourly basis. While permanent caregivers took sick leave at the first sign of corona symptoms, the hourly workers came to work without being tested for the virus.

Lina Petersson, a nurse, and Johan Rodling, a doctor, are relaxing with a beer at Bistro Banana in the central district of Södermalm. Anyone who enters the bar does not have to use a face mask. Petersson and Rodling experienced the peak of the pandemic in April and May in the Infectious Diseases Department at the Danderyd Clinic in the north of Stockholm. The hospital treated the most Covid-19 patients in Stockholm after Karolinska Hospital. Many patients also died there.

Lisa Petersson and Johan Rodling both stress that the Swedish health care system – unlike, for example, the one in Lombardy – has not been brought to its knees. Rodling is in training to become an infectious disease specialist. The doctor is convinced that the answer to why Sweden had five times as many deaths per 100,000 inhabitants in July could only be provided by later investigations. Certainly, patients who had been rejected by the clinic with mild symptoms or symptoms not recognised as Covid symptoms had died, he admits. "A doctor can only make a recommendation based on the patient's condition during the examination," says the physician.

Herd immunity?

At the end of July, 22 Swedish health professionals published a letter in USA Today. They warned America of following the example of Sweden. Sweden allowed school attendance up to ninth grade, kept shops and restaurants open, allowed events with up to 50 people and neglected to make masks mandatory. The authorities advise those who can to work from home. It was not until 1 April that the government issued a ban on visiting old people's homes.

For the critics, the state stubbornly clings to the concept of herd immunity. The government's chief epidemiologist, Anders Tegnell, rejects this claim. The aim is to create rules that the population can live with in the long term. Tegnell does not attribute the increase in new infections as recently as May to the lax rules, but to increased testing. The number of new infections then slowly decreased in June and July.

The author Elisabeth Åsbrink puzzles over the reasons for Sweden’s special path in the pandemic while enjoying an iced coffee in downtown Copenhagen. She currently feels more at home in Denmark. At the end of March, she published an essay in Dagens Nyheter. "At the time, there was a deathly silence around the corona debate. I had to speak out," she says.

In her piece, Åsbrink drew a connection between Sweden's history and what she sees as the slow response of the government to the pandemic. Spared from all the European disasters of the 20th century, she writes, the Swedes lacked the antennae to detect a real threat. The article was met with a storm of indignation. "I was compared to Hitler by my own left-wing liberal scene because I supposedly approve of war," says the Jewish author. She believes there is a nationalism in her country that social democracy, which has been dominant since the 1930s, disguises as progressive. "Patriots criticise their country because they love it. In Sweden you are a defiler of your own country," she says.

Anyone who, like her, expresses doubts about the corona strategy of the social democrat-green government is considered a silent supporter of the Sweden Democrats. The right-wing populists call the government's corona strategy a "massacre". Sweden is frightened by dissenting opinions, says the author. "We are used to marching in lockstep in the name of progress," says Åsbrink. Her fellow Swedes like to play the role of social justice pioneers. Åsbrink believes that self-image is increasingly failing the test of real life. There is even a tradition of contempt for old, weak and chronically ill people in a country that had forced sterilisation until the 1970s, she says: "I think the reaction in Sweden would be different if 6,000 young people had died.” In no other country in Europe is the gap between rich and poor as wide as in Sweden. "If you're down there like the migrants, you stay there.”

Only those who looked beyond the Swedish borders dared speak out about the corona disaster in old people's homes and immigrant neighbourhoods. "They say I'm married to a Dane, so that's where my ideas come from," says Åsbrink. Now Sweden is experiencing polarisation comparable to Britain’s Brexit dispute. Families and circles of friends are divided over attitudes towards the virus.

Experts expect the number of deaths to double in the autumn. So far, the export-oriented economy has not been helped by not having a lockdown. The unemployment figures are rising. Åsbrink fears that the right-wing Sweden Democrats could profit from a fiasco. The virus is dragging Sweden's ugly side to the surface, she says: "We still refuse to see it," says Åsbrink.