'I haven’t changed my mind': Swedish science chief remains confident country is building immunity

Days after he appeared to admit to flaws in Sweden's outlier coronavirus strategy, the country's state epidemiologist Anders Tegnell has doubled down in an interview with the The Telegraph, saying he is confident Swedes are building immunity and warning his Nordic neighbours that is too early to claim success.

"It's part of the work," Tegnell said of the heavy coverage Sweden's strategy, and as a result its high death toll, has received in the international media. "That's the course we have decided to take in Sweden. And I'm quite happy to tell people about it."

Tegnell faced a cascade of headlines on Wednesday after an interview on Swedish radio in which he said that, in hindsight, the best strategy might have been "something between what Sweden has done and what the rest of the world has done."

He backtracked later that day, saying that he was not suggesting that Sweden should have closed schools, bars, restaurants, or workplaces, or indeed imposed any of the restrictive lockdown measures imposed elsewhere in Europe.

"That interview was unfortunately very wrongly put together and very wrongly advertised," he said. "What I said ... was that after this, we're going to do a lot of evaluation, and of course, there are going to be things we did in Sweden that we think we did right, and there are things in other countries that are also going to be proven right."

The qualities which have transformed Tegnell from an unknown civil servant into one of the stars of the global pandemic - a gift for communication, calm good humour, and impressive sang-froid - have never been put to the test as they have over the past fortnight.

The results of Sweden's first coronavirus antibody tests on May 20 showed that by May 3, only 7.3 percent of those tested in Stockholm were positive, throwing doubt over his argument that Sweden's less restrictive strategy would bring immunity.

Then, in the week to May 29, Sweden had the highest reported per capita death rate in the world due to the virus, leading many to conclude that its strategy had failed.  

At the same time, Norway, Finland, and Denmark have recorded only a fraction of the per capita death rate seen in Sweden, with 44, 58, and 101 deaths per million respectively, compared to 460. They have all now largely lifted their restrictions without seeing a rise in new cases.

But while Tegnell's voice might be a little gruffer than it was three months ago, and he shows occasional signs of fatigue, he is still surprisingly good-humoured.

"Sometimes I feel like a personal punchbag," he joked wryly about the negative media at a press conference on Wednesday. "But that's OK, I can live with that."

This low-key style has endeared him to Swedes. "Is this the most Swedish picture ever taken?" one asked on Twitter as they posted a picture of him going to work on a battered 1973 cycle, wearing a leather jacket and sailing shoes.

But Tegnell also has a steely quality, what he described in a recent interview as "ice in the stomach".  

"I would be hesitant to claim any victories so far," Tegnell cautioned Sweden's neighbours in his interview with the Telegraph. "This is a long-term battle we are fighting and it's not going to be over that easy."

Much of the testing capacity built up in Denmark and Norway to test, track, and isolate outbreaks of cases following the lifting of lockdowns now lies unused after the expected rise in new cases has so far not arrived.

"It could be that these restrictions don't make a difference -  maybe nothing would have happened differently, even if they had done nothing," Tegnell suggests.

"The other thing, which we, of course, need to understand, is it takes quite some time for this to build up."

In Stockholm, he pointed out, the influx of infection had come in the middle of February during the local schools' spring holiday.

"We didn't really have a real epidemic going on until the later part of March. So we're talking four, five, six weeks before anything really takes off. And if you start with even less cases than we did in Stockholm, it probably takes longer."

As for the disappointing antibody tests, he said work was still being done, with a second report expected this week. But based on the slow decline in cases in the Swedish capital, he estimated that perhaps 25 percent of people in the city could now be immune.

"There are a lot of signs that the disease is slowing down, especially in Stockholm area," he said. The number of people being admitted to intensive care, he noted, was now down to about ten a day from a peak of about 50.

"Our regulations have been consistent over the past few weeks. I don't think anything we have done has really made that much of a difference, so this has to be at least partly down to increasing immunity in the population."

"It seems to be clear now, when you talk to specialists in the field," he continued, "that there seems to be a considerable amount of people  who don't develop antibodies, but still seem to be immune.

"I think any rumours that this disease does not create immunity, they are false. Of course it creates immunity."

Tegnell has so far largely blamed Sweden's high death rate on the country's failure to adequately protect people living in care homes for the elderly.

But he told the Telegraph that he also believed Sweden had been a victim of bad luck.

Stockholm's schools had their spring holidays at a time of peak transmission in many other European countries, bringing a large influx of infections back to the city.

"Stockholm, which had it [the spring holiday] when there was a big spread of the disease in many countries in Europe has been by far the hardest hit, while Malmö, who had a spring holiday two weeks before has had almost no spread," he pointed out.  

Indeed, coronavirus infections and deaths in Sweden have been so heavily centred on Stockholm that some question the extent to which the country's strategy alone can be blamed for the death rate.

Sweden's Kvällsposten newspaper reported last week that Skåne, the county that includes Malmö, had seen just 13.3 deaths per 100,000 inhabitants, compared to 17.8 in Copenhagen, despite being much less locked down.  

"We also know that travel from Stockholm is much more extensive than travel from Oslo or Helsinki," Tegnell said.

Even Copenhagen has very different travel patterns. "I don't think the travel to at least the ski destinations is as much, and they don't have the same focus on everyone travelling in the same week that we had in Sweden."

Could the much lower death rates in Oslo, Helsinki and Copenhagen have as much to do with flight patterns in February as closing schools in March? It's possible.

But such questions have not stopped the media turning suddenly critical in Sweden in recent weeks. Hugo Lagercrantz, an eminent emeritus professor at the elite Karolinska Institutet medical university and former Nobel prize committee member, on Thursday called for Tegnell to be sacked.

The level of vitriol, Tegnell conceded, had come as a surprise. "I've been through pandemics before and it's never happened, so that's not expected."

"On the other hand, it's a really small group of persons continuously getting a lot of attention in the media, and that worries me less because I know that when I talk to the people who really know something about coronavirus, that I don't have any problems."