Looser regime means Sweden is better placed to face second wave, says chief epidemiologist

Sweden questioned the scientific basis of other EU countries’ strict coronavirus lockdowns as Germany said its number of cases needed to fall from about 2,000 to a few hundred a day before it could ease restrictions further.

As several European countries continued to cautiously lift lockdowns, sending children back to school and reopening some shops and businesses, Sweden’s chief epidemiologist, Anders Tegnell, said their original measures looked difficult to justify.

Sweden has favoured civic responsibility over mandatory rules, closing senior high schools and banning gatherings of more than 50 people, but asking rather than ordering people to avoid non-essential travel, work from home and stay indoors if they are over 70 or feeling ill. Shops, restaurants and junior schools have stayed open.

Polls show many Swedes support the policy, although the interior minister, Mikael Damberg, and the mayor of Stockholm, Anna König Jerlmyr, urged people not to relax as the weather turned warmer, warning that bars and restaurants that did not follow physical distancing recommendations risked being shut down.

The strategy has also been heavily criticised by some senior members of the country’s scientific community and the country has recorded 2,150 deaths – giving it a per-million total much lower than Italy’s and Spain’s, but many times higher than those of its Nordic neighbours.

Tegnell said in an interview with Nature magazine that it was “difficult to talk about the scientific basis of a strategy with these types of disease, because we do not know much about it and we are learning as we are doing, day by day”.

The epidemiologist added: “Lockdowns, closing of border … Nothing has a historical scientific basis, in my view. We have looked at a number of EU countries to see whether they published any analysis of the effects of these measures before they started, and we saw almost none.”

He told the BBC Sweden’s strategy meant it was better placed to face a second wave of the outbreak, because scientists estimated between 15% and 20% of the population were now immune – enough to slow and control the spread of the disease further.

The strategy had worked in the sense that its aim had been to slow the progression of the disease so the country’s healthcare system did not become overwhelmed, he said. Sweden’s relatively high death toll was because “as many as 50% of deaths had come in care homes for the elderly, which have banned visitors” so it was “hard to know how a lockdown would have stopped that”.

In Germany, Lars Schaade, the vice-president of the country’s infectious diseases agency, the Robert Koch Institute, said citizens “should not lower our guard now”, echoing an earlier warning by the chancellor, Angela Merkel, that the country risked rushing out of lockdown and squandering its achievements so far.

Germany, which last week allowed smaller stores, car and bicycle dealers and bookstores to reopen provided they observed strict distancing and hygiene rules, has recorded 150,383 cases and a relatively low death toll of 5,321.

But Schaade said he was opposed to any further relaxation until the number of new daily infections fell. “It is a paradox that due to the success of the measures that have been taken ... these very same measures are now being called into question,” he said. “More contact will mean more infections … which, in the worst case, could bring us to a point where the epidemic is no longer manageable.”

Meanwhile, media in Italy – whose 25,000 coronavirus deaths represent the second biggest tally in the world after the US – said the government was set to gradually begin easing Europe’s longest and toughest lockdown, in place since 9 March, over the course of the next four weeks.

“The next four Mondays will mark the country’s reopening,” the Corriere della Sera newspaper reported. The country’s economy would emerge from lockdown at intervals from 27 April, it said, beginning with some factories, followed by clothing and other shops and concluding on 18 May with bars and restaurants.

The economy’s gradual reopening would be accompanied by strict hygiene and physical distancing measures, the paper said, with only one customer at a time allowed in shops smaller than 40 sq metres and bars and restaurants obliged to keep a distance of one metre between clients. There was no official confirmation.

Spain, which has Europe’s second highest death tally with more than 22,500 fatalities, hailed the fact that for the first time since the beginning of the outbreak, more people were now being diagnosed as cured than those falling sick.

“With all the effort that we have put in, the evolution of the epidemic is obviously beginning to be where it should be,” said Fernando Simón, the health ministry’s emergency centre coordinator. Officials from the country’s 17 regions and central government were to meet later on Friday to discuss easing its six-week lockdown.

In France, where schools and shops are due to begin reopening from 11 May, the finance minister, Bruno Le Maire, said on Friday no decision would be taken on bars and restaurants before the end of next month. “Nothing would be worse than to make a hasty reopening which would then force us to close again,” Le Maire said.

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The Czech Republic unexpectedly opened its borders for outbound foreign travel after recording a decline in the number of infections. The health minister, Adam Vojtěch, said returning travellers would have to prove they were uninfected or spend 14 days in quarantine.

Face masks will remain mandatory until the end of June, but restrictions are being eased on movement within the country, with groups of up to 10 now permitted to gather compared with a previous limit of two. Restaurants and pubs can fully reopen on 25 May, two weeks earlier than initially planned.

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