Evaluation of science advice during the COVID-19 pandemic in Sweden, Brusselaers et al, 2022

SNT Gatchaman

Senior Member (Voting Rights)
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Evaluation of science advice during the COVID-19 pandemic in Sweden
Nele Brusselaers, David Steadson, Kelly Bjorklund, Sofia Breland, Jens Stilhoff Sörensen, Andrew Ewing, Sigurd Bergmann & Gunnar Steineck

Abstract
Sweden was well equipped to prevent the pandemic of COVID-19 from becoming serious. Over 280 years of collaboration between political bodies, authorities, and the scientific community had yielded many successes in preventive medicine. Sweden’s population is literate and has a high level of trust in authorities and those in power.

During 2020, however, Sweden had ten times higher COVID-19 death rates compared with neighbouring Norway. In this report, we try to understand why, using a narrative approach to evaluate the Swedish COVID-19 policy and the role of scientific evidence and integrity. We argue that that scientific methodology was not followed by the major figures in the acting authorities—or the responsible politicians—with alternative narratives being considered as valid, resulting in arbitrary policy decisions.

In 2014, the Public Health Agency merged with the Institute for Infectious Disease Control; the first decision by its new head (Johan Carlson) was to dismiss and move the authority’s six professors to Karolinska Institute. With this setup, the authority lacked expertise and could disregard scientific facts. The Swedish pandemic strategy seemed targeted towards “natural” herd-immunity and avoiding a societal shutdown. The Public Health Agency labelled advice from national scientists and international authorities as extreme positions, resulting in media and political bodies to accept their own policy instead.

The Swedish people were kept in ignorance of basic facts such as the airborne SARS-CoV-2 transmission, that asymptomatic individuals can be contagious and that face masks protect both the carrier and others. Mandatory legislation was seldom used; recommendations relying upon personal responsibility and without any sanctions were the norm. Many elderly people were administered morphine instead of oxygen despite available supplies, effectively ending their lives.

If Sweden wants to do better in future pandemics, the scientific method must be reestablished, not least within the Public Health Agency. It would likely make a large difference if a separate, independent Institute for Infectious Disease Control is recreated. We recommend Sweden begins a self-critical process about its political culture and the lack of accountability of decision-makers to avoid future failures, as occurred with the COVID-19 pandemic.

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Will anyone be held accountable?
Probably not, no :(

The official Corona Commission's final report hasn't gotten much attention at all. (700+ pages plus appendices? I haven't read it myself.) The only comments I've seen from politicians, decision-makers and other people in power have been very defensive and dismissive. They are all still saying that it's too soon to evaluate and analyse, that it "can only be done after all this is over"... o_O:mad:

Sadly and frustratingly, there has been no focus at all on what can be learned from all these mistakes, tragedies, deaths and scandals, no talk about what can be done differently/better next time :(
Also, the Swedish Corona Commission published their final report today. Summary in English here (pdf). Reuters has published a news article on it in English: "Commission finds Sweden should have clamped down harder as COVID hit."

Accountability is a big problem overall in the Swedish healthcare system. Here's a good opinion piece on why.

Not long ago it was announced that the most criticised top-level decision maker, state epidemiologist Anders Tegnell, has been promoted/offered a top-level expert job at the WHO...
 
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Not long ago it was announced that the most criticised top-level decision maker, state epidemiologist Anders Tegnell, has been promoted/offered a top-level expert job at the WHO...

From Bloomberg: "Sweden Jumps the Gun on Covid Strategist’s New WHO Job"

The March 9 report by Sweden’s Public Health Agency FHM said that Tegnell had resigned as state epidemiologist to become a senior expert in a group that will coordinate the work between the WHO, the UN Children’s Fund UNICEF and vaccine organization Gavi. Svenska Dagbladet first reported that the announcement was met with “surprise and confusion” within the WHO.

“We thought that the process was done, but have now realized that it was a mistake on our part,” FHM spokesman Christer Janson said by phone on Wednesday. “The WHO asked Sweden for technical support to this newly founded partnership, and since we appointed Tegnell in coordination with the Swedish government we thought that everything was settled.”

Edit: added article title
 
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Thank you! Everything about this is so bizarre... Why would WHO ever want to hire him in the first place, being fully aware that Tegnell has made many major decisions on behalf of FHM during the pandemic that has literally gone against WHO's explicit recommendations? Knowing that Tegnell has actively tried to influence other countries' policies as well, attempting to convince them to also go against WHO's recommendations?
 
scientific methodology was not followed by the major figures in the acting authorities—or the responsible politicians—with alternative narratives being considered as valid, resulting in arbitrary policy decisions.

The Public Health Agency labelled advice from national scientists and international authorities as extreme positions, resulting in media and political bodies to accept their own policy instead.

Again these alternative facts - so harmful - in question. This is outrageous... I sympathize with you, @mango. Awful. Hoping, despite everything, that critical and persistent voices will rise to demand accountability for all these lost lives, some of which could have been avoided.

In my Province, there were also investigations on "excess mortality", particularly in seniors residences (private and public) during the 1st wave of covid-19. These poor deceased elderly people have been truly the " blind spot " of the government's strategy, the latter giving most of its directives to the preparation of hospitals. Tragic and horrible stories have been brought to light because of lack of protective equipment, flagrant deficiency in the establishment of cold and hot zones, glaring lack of nursing staff and consequently lack of basic care for people, etc. As a result, some of these disabled and vulnerable people were left without water or food and access to the bathroom for several hours or days... it was a human disaster. Recommendations have since been made and adjustments have ensued.
 
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