The reigning narrative of Sweden during the pandemic is that the Swedish government took a brazenly hands-off approach to COVID-19—and suffered mass, avoidable deaths as a result.
During the spring and summer of 2020, Sweden bucked the international trend by not issuing emergency stay-at-home orders, mask mandates, or school closures. With the exception of restrictions on nursing home visits and large gatherings, the country stayed open during that time.
The concurrent spike in COVID deaths it experienced, particularly in comparison to its Scandinavian peers, was all the proof politicians and much of the press needed to dismiss its liberal approach as inferior to Chinese-inspired lockdowns that swept the rest of the globe.
Yet, this interpretation of Sweden's COVID-19 performance as disastrous and deadly is largely wrong, argues Johan Norberg in a new paper for the Cato Institute.
The data that's accumulated over the past three years suggests that Sweden's "laissez faire approach seems to have paid off," writes Norberg.
"It seems likely that Sweden did much better than other countries in terms of the economy, education, mental health, and domestic abuse, and still came away from the pandemic with fewer excess deaths than in almost any other European country, and less than half that of the United States."
Sweden has largely been dismissed as a failure on COVID-19 because its COVID death rate was middle-of-the-back of the list when compared to other European countries and much higher than other Scandinavian countries that had harsher restrictions.
Neighboring Norway had about half the COVID death rate of Sweden when looking at the period of January 2020 to June 2023, for instance.
Yet Norberg argues just looking at COVID deaths overstates the deadliness of the pandemic in Sweden, given the country's greater surveillance of COVID cases and broader definition of a "COVID-19 death."
Swedish "authorities automatically checked the lists of people who were infected against the population register, so everyone who died and had tested positive for the virus was counted as a COVID-19 death, even if they died from a heart attack or a fall," writes Norberg.
That contrasts with Norway, which depended on individual doctors to proactively report COVID-19 deaths to public health authorities. As a result, the Norwegians probably undercounted their COVID deaths, while Sweden overcounted.
Instead, Norberg focuses on excess deaths—the difference between the number of overall deaths in the country and the expected number of deaths based on past mortality rates. Here, Sweden ended up having the fewest excess deaths of any European country, seeing only a 4.4 percent excess death rate.
That's slightly better than Norway's 5 percent and less than half of Europe's average excess death rate of 11 percent.
Sweden did get hit harder earlier in the pandemic, and it's on this earlier performance that much of the commentary about the country's pandemic failures came from. That snapshot is misleading.
"Sweden's comparatively dismal performance at the start of the pandemic was mostly a result of other countries having managed to delay cases and deaths, rather than having prevented them," writes Norberg. "Sweden suffered most of its deaths in 2020, while the Nordic neighbors and many other countries got them in 2022."
The Cato paper cites one Norwegian public health official as saying, "Other countries managed to delay some deaths, but now, three years after, we end up at around the same place."
Norberg's paper repeats a common practical argument against lockdowns: that they're unnecessary because people will voluntarily restrict their interactions with others in response to rising risk of the virus.
"That people adapt voluntarily when they realize that lives are at stake. Swedes quickly changed their behavior and mostly followed the recommendations," writes Norberg, citing data showing a rise in remote work arrangements and a collapse in public transit ridership early in the pandemic.
He suggests that the reliance on voluntary compliance meant Swedes were more willing to comply with pandemic precautions for longer. Mandatory COVID restrictions in other countries bred backlash to any countermeasures, leading to a greater number of deaths later on.
Perhaps that's true. But if it is, it doesn't seem any of it made much of a difference in the deadliness of the pandemic. Again, Sweden ended up in basically the same place in terms of overall mortality as its Nordic peers (and in a much better place than many other rich countries.) To the degree voluntary pandemic precautions worked, they likely had only the same delaying effect as its neighbors' mandatory lockdowns.
The real benefit of Sweden's more liberal pandemic policies then appears to be that it had far better social and economic outcomes than its neighbors, despite experiencing roughly the same number of excess COVID deaths.
Swedish students suffered no learning loss during the pandemic, whereas half of U.S. students did. The country's economic growth outperformed the eurozone and the United States. It avoided other countries' increased suicide rates and deteriorated mental health.
To be sure, Sweden's COVID-19 policies weren't completely anarchic. Some of the restrictions the country adopted during the winter of 2020 and spring and summer of 2021 were comparable, or even stricter than what many U.S. states had in place.
That includes bans on public gatherings of more than eight people from November 2020 through May 2021. By comparison, many U.S. states had ended capacity restrictions and mass gathering limits well before then.
The country was nevertheless much more respectful of people's individual choices during the pandemic than other European countries and most U.S. states. That additional freedom doesn't appear to have proven more deadly in the aggregate. Instead, it seems to have helped Sweden avoid many of the asocial knock-on effects of banning or restricting public life for months or years at a time.