6 September 2020. A look at Sweden's unique approach to coronavirus. Video / Sky News / Getty Images
On Swedish National Day in June, Australian man David Steadson raised a flag half mast outside his countryside home two hours north of Stockholm.
He did so to honour the more than 5000 Swedes who had died from coronavirus since the country's leaders decided to go it alone with a strategy that has since polarised experts around the world.
But when locals wandered past Steadson's front yard, they asked him: "Who died?"
The response still resonates with the former public health researcher from the University of Queensland who has called Sweden home for 20 years.
A tent is placed outside of the emergency room entrance to Danderyd hospital in Stockholm in order to screen patients for Covid-19. Photo / Getty Images
The deliberate ignorance sits heavy on his chest, like the virus he has been fighting since March.
Some days it feels like "someone is strangling me", he says. He stays awake until the small hours of the morning when his body is finally "too exhausted to stay awake".
The one-time epidemiologist is "disgusted" at the public health response in Sweden, where more than 85,000 people have contracted the virus and 5800 people have died – but the streets remain jam-packed and masks are few and far between.
He has a message for Australians stuck in lockdown who envy Sweden's freedom: "The Swedish strategy is not a success; it is a failure."
The warning comes as Sweden has registered its lowest rate of positive tests in months, even after a dramatic expansion of the testing regime.
In the past week just 1.3 per cent of tests showed Covid-19 cases, compared to more than 19 per cent at the pandemic's peak. The number is lower than in neighbouring Norway and Denmark.
Public heath chief Johan Carlson told The Times this week that Swedes seemed to be benefiting from the approach.
"Our strategy was consistent and sustainable," Professor Carlson said. "We probably have a lower risk of [the virus] spreading than other countries."
But Steadson said the degree of autonomy afforded to Swedes allowed "confusion and inertia" to rein, as restrictions such as mask wearing and social distancing were voluntary rather than legally enforced.
Leaders relied on the goodwill and co-operation of the people to work from home, stay home if unwell, avoid public transport, funerals, parties and weddings and wash their hands.
"Allowing a deadly virus to just spread in the hope of eventual 'herd immunity' made no sense to me scientifically, given our then limited knowledge, and it absolutely made no sense to my ethically," he told news.com.au.
"People would die unnecessarily, and I was frankly disgusted with what I was hearing from the Swedish Public Health Authority."
In March, with Sweden's borders wide open and testing and screening basically non-existent, the country's Public Health Authority insisted everything was fine.
"A week later, my whole family was ill with symptoms of Covid-19," Steadson says.
"We all recovered within a couple of weeks, then a couple of weeks after that, I fell ill again. I am still ill."
The Swedish strategy, Steadson says, relied on two false assumptions – that the virus could be stopped and that it was not as deadly as feared.
According to New Scientist, Sweden's rate of infection is 8200 per million people (Australia's is around 1000 per million) with a death rate of 57 deaths per 100,000 people, compared with just five in Norway and 11 in Denmark. Australia's current deaths per 100,000 people is 3.1.
Steadson says the pandemic in Sweden is not close to being over.
"In the past two weeks people have been returning to schools and work, and we continue to have 1000 to 2000 new cases a week," Steadson says.
"The numbers have started to trend up again, and it's my expectation they will continue to move up as we move in to autumn and winter. The pandemic is not even close to over in Sweden."
The former University of Queensland academic says that more than five months after becoming infected, he is improving week-to-week but still has days "where I feel as if someone is strangling me and I can't breathe properly".
Anders Tegnell of the Public Health Agency of Sweden speaks during a news conference updating on the coronavirus pandemic situation. Photo / AP
"The last three days I've had an inflamed and painful digestive tract. And sleeping? Forget it.
"In Sweden it's estimated there are over 150,000 people who have been ill with Covid-19 symptoms now for more than 10 weeks. I am one of them. For many weeks I had blood oxygen levels that under normal circumstances would trigger a clinical assessment of supplemental oxygen."
When he first became ill, the advice from doctors was to stay away.
"Having suspected I had Covid-19, I was told not to even go to the doctor for fear of infecting health staff," he says.
Steadson says what is perhaps even more concerning is the portrayal of the virus in Sweden's media.
"Media outlets seem more concerned with protecting Sweden's image than they do in reporting the facts, and challenging the authorities over some of the frankly outrageous statements they make is left almost entirely to foreign journalists," he says.
Swedish model would be a disaster in Australia
Dr Nick Talley is editor-in-chief of the Medical Journal of Australia. He says the Swedish model has been a failure.
Social distancing and lockdown measures are recommended in Sweden, but not mandated. Photo / Getty Images
"In my view, the Swedish model has not been a success, at least to date," he told news.com.au.
"One clear goal at least early on was reach herd immunity – but this was not achieved, not even close, and this was arguably predictable.
"There were restrictions put in place but the philosophy was voluntary rather than compulsory. There is evidence there was a major impact of this voluntary lockdown on behaviour as reflected in, for example, reduced mobility and spending. However the spread of Covid-19 and the death rate was substantially higher in Sweden compared with its neighbours who mandated lockdowns.
"A major contributor to the failure of the voluntary approach was spread of infection into homes for the elderly. Young people also appear to have been the least likely to alter their behaviour which may have contributed to community spread.
"Notably the economy was not saved from contraction by the approach. I am not convinced the Swedish model would be any more successful here in Australia, and arguably if compliance with voluntary recommendations was lower, the results would be worse – look at mask use in Sydney which is voluntary but has been strongly recommended."
