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Sweden restricts gatherings to eight people as cases reach record highs

BMJ 2020; 371 doi: (Published 19 November 2020) Cite this as: BMJ 2020;371:m4508

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  1. Marta Paterlini
  1. Stockholm, Sweden

Sweden’s population of 10 million will be subject to tougher restrictions from 24 November after the prime minister announced that gatherings will be limited to eight people for four weeks, down from events involving up to 300 people, which have been permitted to date.

“This is the new norm for the entire society, because it’s going to get worse,” Stefan Löfven said, adding that a total lockdown was not an option.

The highly debated Swedish soft approach to controlling the coronavirus pandemic, based on recommendations and voluntary behaviour of citizens, continues to be challenged by a surge in new infections, hospitalisations, and deaths.

The resurgence of the disease hit Sweden weeks later than much of continental Europe, but cases have been on the rise since the start of November. On 13 November, the last day for which national data are available, Sweden reported a daily record of 5990 cases, bringing its overall total to 177 355 cases and 6164 deaths since the start of the pandemic.

Commenting on the current situation in Europe, Anders Tegnell, state epidemiologist at the Swedish Public Health Agency and face of the country’s soft strategy, said that the large increase in cases seen in many countries in early autumn was starting to level off. “Whether Sweden will also follow this pattern and how slow or fast it will go is difficult to predict. It all depends on how good we are at following the recommendations we make,” he said.

The pressure on intensive care facilities is not at the level seen in the spring. On 17 November, about 40% of beds in intensive care units were occupied by patients with covid-19. At present, 600 covid-19 patients are hospitalised, 127 more than the previous week. Of these, 50 patients are in intensive care units.

Björn Eriksson, director of Region Stockholm Healthcare, told The BMJ, “These restrictions were much needed. Numbers are worrying and healthcare staff are overloaded. We want to be one step ahead of the virus and have the time to implement new units if these are needed.”

Marzia Palma, an oncologist at the Karolinska University Hospital, Stockholm—the biggest hospital in the country that hosted most covid-19 cases in the spring—has backed the management of the pandemic so far, but has welcomed the new restrictions. “Now, we feel overloaded because we cannot postpone and put in jeopardy the diagnosis, treatment, and follow-up of other diseases any longer,” she said.

Many commentators have criticised the government for acting too late and the Swedish Public Health Agency for underestimating the second wave. The country’s test and trace system has also been lambasted for failing to work properly. In early November, the region of Stockholm, an area badly affected by the virus, was forced to stop sending out home tests for covid-19 after the Karolinska University Laboratory was unable to process any more tests.

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