By Lionel Laurent
Removing lockdowns due to coronavirus and the disease it causes (Covid-19) around the world was not expected to be an easy process.
But as cases spread from Spain to Australia, it is worth noting that two of the countries hardest hit during the first phase of the pandemic – Italy and Sweden – remain in control of the spread of the virus.
The confirmed cases on a daily basis in both countries are on average about 200 in each, well below the levels at the peak season, with no new eruption and no pressure on their hospitals.
By contrast, the daily number of cases in Spain exceeded 2,000 last week, while in France it exceeded 1,000. This can in no way be described as a second wave, but it is worth wondering what Italy and Sweden can do differently in terms of virus management.
These countries months ago stood out for the wrong reasons. Italy was the first European country to be hit by a wave of massive coronavirus infections and the first to impose a draconian lockdown. Sweden has taken a more liberal and controversial approach – even unlike the rest of the Nordic and Nordic countries – by keeping schools open and broadly unaffected by simple recommendations on social distance and isolation. of compulsory quarantine.
Although Italy’s lockdown undoubtedly saved lives, it came late. At the same time, he did not come to Sweden at all. On a per capita basis, the number of deaths in Italy, which exceeds 35,154, is around 600 per 1 million people, as is the corresponding number (5,743) in Sweden in relation to its population.
Even so, however, in the current phase, which follows the peak of the pandemic, with Italy gradually reopening its economy and Sweden keeping its policy unchanged, both countries seem to have found their pace to can live with the virus.
Strict and voluntary compliance with the rules in Italy
In Italy, public health management after the lockdown, from the central to the local level, seems to be winning the bet. As in other countries, social distance rules require people to stay one step away from others and wear face masks in public interiors and on public transport, however there is a particularly high level of enforcement and general rigor.
Getting on a train or entering an office building in Italy requires measuring your temperature. Going out to dinner automatically means giving the restaurant your full contact details to ensure that a possible transmission of the infection can be detected.
A special form is required to access tourist destinations such as Sardinia, Sicily and Puglia. In the northern region of Lombardy, the country’s original epicenter of the virus, masks are needed even outdoors. The “breaking” of the quarantine of Covid-19 is treated as a crime, with possible sanctions, including fines or imprisonment.
The effectiveness of these rules is a testament to the willingness and ability of people to apply them, says Rosanna Tarricone, Associate Professor of Health Unit Management at Bocconi University. The rules extend to how people dance in a nightclub or how to sunbathe on the beach.
Without some level of voluntary implementation, they could not go far. Memories of horrific hospital scenes overloaded with Covid-19 patients are also an incentive to implement the measures. There is a sense of collective responsibility mixed with fear.
The coherence of the Swedish strategy
If the lesson from Italy is that adequate state bureaucracy, enforcement and obedience are the key to controlling Covid-19 outbreaks, the case of Sweden must seem contradictory at first glance.
After much hesitation and skepticism about its approach, especially after a horrific record of human losses in nursing homes and a continuing increase in the number of new infections in June, the country has finally remained firm in its original strategy.
There is no obligation to use a mask in Sweden, social distancing is recommended instead of imposed and people are generally advised to stay at home if they feel unwell. The fact that the country’s curve has flattened will undoubtedly provide relief to anti-lockdown protesters in the US, who months ago urged the authorities: “Become more like Sweden”.
In this way, however, one loses the essence. The Swedes did not just benefit from “letting the virus reap” – their immunity levels are still low, according to antibody tests – and no one is urging them to be careful.
There have been behavioral changes there as well: the flow of human traffic is still not normal in many areas, according to Google mobility data, while Swedish officials regularly warn people that not following social distances would lead to stricter measures and rules.
The framework has been tightened at some levels, from banning nursing home visits to closing restaurants that do not follow state regulations in Stockholm. “Social distancing” works.
This is not a model that can be easily reproduced elsewhere. Swedes are a young people, their country is sparsely populated and to a large extent already before the pandemic they lived relatively lonely lives, working from home, in households that often have only one person. The secret here, however, is probably the consistency and coherence of the strategy from the beginning of the pandemic.
This is the key to ensuring that policies around Covid-19 are sustainable in the long run, according to Italian academic Giuliano Di Baldassarre, Professor of Crisis Management at the University of Uppsala in Sweden.
If the goal is to live in a country with the virus until a cure or vaccine is found, a “rises – arrivals” attitude about the rules – like the backlash almost everywhere in the world about whether to use face masks and where – may prove counterproductive and make their imposition impossible.
There is no “magic solution”
Thus, while Italy shows that vigilance and intervention work, Sweden reminds us that this is more of a marathon than a sprint.
There is no immediate and completely successful answer or perfect standard of treatment for Covid-19 and of course everyone makes mistakes. The closure of schools in Italy has brought huge costs and little benefit, while Sweden’s neglect of sound care management of the elderly has likely led to preventable deaths.
However, as we move into a new phase of the coronavirus pandemic, these two countries clearly deserve to be closely monitored to draw conclusions.