Speech by Minister for Health and Social Affairs Lena Hallengren at WHO briefing 23 april

Published

Dear Director-General, excellencies, my name is Lena Hallengren and I am Minister for Health and Social Affairs in Sweden.

Today, I am here with Johan Carlson, Director-General of the Public Health Agency of Sweden and Olivia Wigzell, Director-General of the National Board of Health and Welfare.  Thank you for the opportunity to brief you on Sweden’s approach to combating COVID-19.

There has been some interest internationally in our approach to combat the virus. Despite this, I would say that there is no unique Swedish way of dealing with Coronavirus. We do what we think is best based on the development of the pandemic in Sweden, and our national circumstances.

We are very practical and open to implementing any measures that we think would be effective. But in order to understand our approach, it helps to be aware of some fundamental characteristics of Swedish society.

Our welfare state is universal, including the health care system. It is publicly funded and accessible to all. In addressing this situation, we try to build on and utilize established national institutions.
There is a tradition of mutual trust between public authorities and citizens. People trust and follow the recommendations of the authorities to a large extent. 

The Swedish Government has from the start of the outbreak applied a ‘whole-of-Government’ approach. We have presented a range of different measures, both voluntary and legally binding, to limit the spread of COVID-19.

Our measures aim to save lives and slow down the outbreak. We’ve carried out a number of reforms to strengthen our health care system so that our doctors and nurses can cope with the extraordinary challenge that COVID-19 poses.

In my presentation I would like to highlight five aspects of our approach to Coronavirus.

First, the Government has overall responsibility, but Sweden’s public health response is largely based on advice from our expert agencies.
Early in this process, the Government decided to let decision-making be guided by available knowledge and evidence on effectiveness. The responsible national agencies, as well as international organisations and authorities such as the WHO, therefore have an important role in our response.

Second, protecting the elderly and people in other risk groups is a top priority.

The Government has banned visits to care homes for the elderly, where the most vulnerable live. We have also issued strict recommendations for people over the age 70 to avoid physical contact with others. The whole population is recommended to refrain from visiting elderly people.

Sweden faces the same challenge as other countries in keeping the elderly safe and protected, especially in vulnerable settings such as care homes. High numbers of infected people in homes for elderly care is one of our major concerns.

Third, social distancing and incentives to stay at home are key tools in our strategy.

The Government has banned public gatherings of more than 50 people. We have also implemented distance and online education for upper secondary schools and higher education.

Our generous welfare systems make it easy for people to stay at home when sick. However, we have carried out some additional changes to strengthen the incentives for people to stay at home from work when they show even the slightest symptoms. Employees and self-employed people will get paid sick leave from day one, and we have waived the need for a doctor’s certificate.

New legislation now authorises the Government to rapidly impose even stricter prohibitions on different kinds of public gatherings, if deemed necessary. It can also force actors to re-distribute medicines according to needs.

Fourth, we aim for strategies that last over time and have public trust. Sweden’s efforts consist of a combination of legislative action, strong recommendations and guidelines, awareness raising and voluntary measures.

Measures need to last over time and be acceptable to the public. Also, we are trying to implement the right measures at the right time.

Distance education and working from home have significantly reduced movement in society. So far, it has not been necessary to implement a total lockdown of the whole of Swedish society or implement confinement measures.

Our assessment at this point is that people mostly follow recommendations issued by the Government and the responsible authorities. This makes us convinced that strong legal measures are not the only way of achieving behavioural change.

That being said: we are monitoring the situation closely and are prepared to implement stricter measures whenever necessary. This brings me to the fifth aspect of our work. 

(Fifth), flexible adaptation to developments on the ground.
 
We are continuously assessing the effectiveness of our interventions and let epidemiological developments guide how we combat COVID-19. 

One example is the new legislation I previously mentioned. Another is the decision to increase testing capacity. We recently adopted a national strategy to ensure that the number of tests increase.

Since the beginning of the outbreak we have also more than doubled our intensive care capacity and re-allocated resources to expand the number of beds available. At present, we have an excess intensive care capacity of around 20 per cent at national level, even if it is under high pressure. 

It is far too early to draw any firm conclusions on the effectiveness of the measures taken in Sweden, but so far, the care needs in Sweden are being met. 

We are monitoring ICU capacity on a daily basis in order to have a good overview and be able to regionally coordinate ICU beds according to needs.

Since the beginning of the outbreak, the geographical spread of COVID-19 has been mostly in the Stockholm area, where most cases of illness have been confirmed so far.
Right now, it is important that everyone keeps adhering to all the recommendations in order to keep numbers down.

I want to emphasise the need for international cooperation and solidarity between countries.

I would like to express Sweden’s strong support and appreciation for the WHO and the important job this organisation is doing.

As one of the largest donors of un-earmarked core funding, I am happy to see that our funding has allowed organisations to act flexibly and quickly when needed.

There is no denying that this pandemic is a tragedy, affecting all countries and all levels of society.

But we can see some other side effects too. Temporarily laid-off employees from different sectors are being rapidly trained in basic healthcare to join the health workforce. Companies have changed their production and started to manufacture personal protective equipment. And since the outbreak started, there has been a major increase in the number of applications to medical courses and programmes in Sweden. I am very glad for this positive development.

I would like to conclude by reiterating the main message for this briefing,

There is no unique Swedish way of dealing with COVID-19. We share the same goals as other countries, we face the same challenges as other countries and we use similar tools as other countries. We do what we think works best for Sweden in our national circumstances. And we are always prepared to implement stricter measures if necessary.

Lastly, I would like to thank the WHO for the opportunity to present Sweden’s response to COVID-19.

Thank you.