PANDÈMIA

Sweden has not reached herd immunity

The country hoped to avoid a second wave after opting for lax measures in spring

An image of the Stockholm metro on December 4th. / JONAS GRATZER / GETTY

"In autumn there will be a second wave, but Sweden will have a high level of immunity and the number of cases will probably be quite low". This is what Sweden's state epidemiologist, Anders Tegnell, predicted in May in an interview with the Financial Times, words that are now becoming relevant again in the face of evident miscalculations by the Swedish authorities. For weeks now it has been undeniable that the second wave of Covid-19 is affecting Sweden as much as, or more than, other countries, with a cumulative incidence of more than 700 new cases per 100,000 inhabitants - which is constantly increasing.

The Swedish Public Health Agency (FHM) expects this to continue until around Christmas, when the peak of infections is expected. Yesterday there were more than 7,300 new positive cases and 160 deaths (450 in the last week), and there was a total of 320,000 infections and 7,514 deaths since the start of the pandemic in the Scandinavian country, figures that distance it from its neighbours and are not so different from those of Spain, although in Sweden there are just over 10 million people. The number of deaths in Sweden in relation to its population is five times that of Denmark and ten times that of Norway.

The Swedish authorities have insisted that their response to the pandemic has never been focused on achieving herd immunity, but they have admitted that it is a desirable consequence of the strategy to maintain a low level of restrictive measures for the general population whilst trying to protect risk groups. The FHM predicted that Stockholm would have a Covid-19 immunity level of 40% by the end of May, while mathematician Tom Britton, one of the prominent voices about the epidemic's evolution models back in spring, raised this figure to 50% and predicted that the Swedish capital would achieve herd immunity before the summer. Last week, he reappeared on SVT public television for a dose of self-criticism. "It was a miscalculation", he said, and he attributed it to the fact that they expected Covid-19 to behave like the flu. Tegnell also said that part of the difficulty in predicting immunity levels is that at first "false assumptions" were made that far more people were infected than the official figures showed.

Sweden didn't start doing PCR tests more or less massively until June, so it was impossible to know the actual incidence of the pandemic. In spring, fewer than 30,000 tests were done each week, while the figure is now around 260,000. This is one of the arguments used by the FHM to explain why the number of daily infections recorded is much higher. However, there are many other indicators that the infection is widespread.

The ICU thermometer

There is also concern about the increase in the number of patients hospitalized for covid-19, which has already set off alarm bells in certain regions, fearing a collapse of intensive care units (ICUs). "We need help", Björn Eriksson, the healthcare director for the Stockholm region, warned this week, noting that 99% of ICU beds were occupied (just over half by covid patients) and that they were understaffed. Across the country there are 675 ICU beds (in spring there were over 1,000, partly thanks to an unused field hospital in Stockholm), of which 527 are occupied, half of them with covid patients. All of this has led to a change in tone and strategy by the Swedish government, which has increased restrictions and urges everyone to be in physical contact only with their core group and to meet in groups of eight at the most.

In addition, this week an emergency bill that would give more powers to limit freedom of movement was announced. For example, it would allow the government to close down businesses, such as restaurants and shopping malls, since they cannot do so now. However, if they were to succeed, the law would not come into force until mid-March 2021. What remains unchanged is the issue of the face mask, which is not recommended on the grounds that there is not enough scientific evidence regarding its effectiveness. However, it is increasingly common to see people wearing masks in some enclosed spaces, such as on public transport and in supermarkets.

Collaboration between Oxford and Russia

Anglo-Swedish pharmacist AstraZeneca will begin clinical trials to test the combination of the vaccine it produces, developed by the Jenner Institute at Oxford University, with Russia's Sputnik V from the Gamaleia Institute. Trials will begin later this year. Russia intends to produce the new vaccine if it is proven effective - the Russian sovereign wealth fund RDIF, which has funded the Sputnik V research, reported yesterday. The Oxford and Gamaleia vaccines are based on the cold virus and are therefore, in principle, compatible. The Oxford vaccine has not yet been authorised, while the Gamaleia vaccine is already being injected.

On the other hand, pharmaceutical companies Sanofi/GSK reported yesterday that the vaccine they are working on against the coronavirus will be delayed by at least a year. The reason they gave is that the immune response in people over 50 is not high enough. The interim results of phase 1 and 2 show that immunity is indeed achieved, but only in the 18-49 year old group. The EU has purchased 300 million doses of this prototype.

In Germany, maximum number of infections and deaths

Christmas is close and the situation in Europe is getting worse. Yesterday Germany recorded the highest number of infections and deaths since the health emergency began in March. There were 29,875 new infections and 598 deaths. In Russia, the circumstances are just as dramatic: in the last 24 hours 613 deaths were reported, bringing the total number to 45 893, with Moscow and St Petersburg being the two most affected cities. Portugal, a country that suffered a very mild first wave, counted 95 deaths yesterday, bringing the total number to 5,373. Infections have also soared, with 5,080 new cases reported on Friday compared to the 3,134 ones reported on the day before.

The same worrying trend is seen in England where, ten days after the end of the second round of lockdown, the numbers are once again on the rise, especially in London. Next week the city may enter the maximum level of restrictions, with the closure of pubs and restaurants. Yesterday's infections in the UK were 21,672; and there were 424 deaths.