Swedish Covid Policy Slammed by CEO at Front Line of Crisis

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23 July 2020, 06.53

(Bloomberg) -- The man running one of Sweden’s biggest care-home operators has criticized his country for failing to fully grasp how Covid-19 spreads.

Martin Tiveus, the chief executive of Attendo AB, says Swedish authorities realized far too late that the virus can also be passed on by people who don’t display symptoms. That failure proved particularly devastating for residents in the kinds of elderly care facilities his company runs, he says.

“The single factor that has the strongest correlation with the levels of transmission is what measures you take against infection from people without symptoms,” Tiveus said in an interview on Thursday. “Sweden has been very late in acknowledging that phenomenon.”

Covid Deaths

Sweden stands out for opting against a proper lockdown and instead trying to get citizens to live with the virus by encouraging social distancing guidelines. But the country now has one of the world’s highest death rates per 100,000, with most of those fatalities hitting the elderly.

“We could have protected the elderly much better by implementing more forceful measures,” Tiveus said.

Sweden’s Public Health Agency has acknowledged that people who don’t have symptoms may still be able to spread Covid-19, though it says such transmission is “very limited.” But Tiveus says contagion rates at the care homes he runs prove that asymptomatic transmission is more dangerous than the authorities say.

Attendo participated in a survey conducted by the Karolinska University Hospital, in which all healthy staff at 30 of its elderly care homes in Stockholm were tested. It found that 7% had Covid-19, without displaying any symptoms.

“I can’t judge whether the Swedish strategy generally has been right or wrong, but it is very clear that, for elderly care, the measures have been inadequate,” Tiveus said.

Immunity

Sweden’s strategy has resulted in much higher infection rates than elsewhere in Scandinavia. Scientists are now trying to figure out how many Swedes have developed resistance to the virus.

State epidemiologist Anders Tegnell says “it’s becoming more difficult to make an assessment,” as data so far don’t point to a clear and steady increase in immunity rates, according to Dagens Nyheter.

A study conducted by Werlabs, a private company, showed that 14.5% of 80,000 people who were tested in the Stockholm region had developed antibodies in June and July, DN said.

But Tegnell said antibodies may not be key. “We are getting more and more signals that there are quite a few who are immune without having antibodies. We do not know how many. There has been talk of 20-30% up to 100% more being immune than those seen in the antibody tests we use today.”

Extra Protection

To contain asymptomatic transmission, Attendo requires staff at its homes to use protective equipment that’s outside national guidelines. The extra measures have proved successful and Tiveus says Attendo’s Nordic nursing homes currently have no infections among the roughly 17,000 residents it looks after.

Sweden’s government has appointed a commission to review the country’s Covid-19 strategy. Its first report, which will focus on care homes, is due to be submitted later this year.

Tiveus is urging Swedish authorities to acknowledge the role asymptomatic transmission plays in order to ensure the country isn’t engulfed by a second wave. To that end, he wants stricter requirements for protective gear at care homes. He also wants staff and patients to be tested weekly after any confirmed infections.

“Sweden has to some extent allowed a larger transmission, and has coupled that with a weaker strategy to protect the elderly care,” Tiveus said. “That combination hasn’t worked.”

(Adds comments from state epidemiologist on immunity)

©2020 Bloomberg L.P.