How Did Sweden Flatten Its Curve Without a Lockdown?
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Despite never implementing a full-scale lockdown, Sweden has managed to flatten its curve, prompting its health leadership to claim victory.

In late July, Sweden's 7-day moving average of new cases was about 200, down from a peak of around 1,140 in mid-June. Its daily death totals have been in the single digits for two weeks, well below its mid-April peak of 115 deaths in a single day.

So how has Sweden managed to get its outbreak under control?

1. Behaviour Change

• While Sweden didn't officially lockdown, many in the country have described a locked-down "feeling" that has eased in the summer months.

• "During the months of March to early June, all shops were practically empty, people stopped dining with friends, and families stopped seeing even their closest relatives," said Maria Furberg, MD, PhD, an infectious disease expert.

• "A lock-down could not have been more effective. Handwashing, excessive use of hand sanitizers, and staying home at the first sign of a cold became the new normal very quickly."

2. Immunity

• Furberg said it is likely "some sort of unspecific immunity that protects parts of the population from contracting COVID-19" but it's not necessarily secondary to SARS-CoV-2 exposure.

• For instance, a recent study has found that about 30% of people with mild or asymptomatic COVID showed T-cell-mediated immunity to the virus, even though they tested negative for antibodies.

• It could be that T cell immunity is the result of a previous infection with common cold coronaviruses, but this hasn't yet been established; nor is it certain that T cell immunity is driving Sweden's decline in COVID cases.

3. Path Forward

• Summertime is another factor that may account for the decline, which began around late June -- not directly because of the weather, but social factors related to it.

• Swedes are "outdoors more, and students are not at school," said Anne Spurkland, MD, a professor of immunology at the University of Oslo in Norway.

• Also, "perhaps Sweden has finally gotten better control over the disastrous spread of the virus in nursing homes," Spurkland told.

Spurkland said it's still "too early yet to conclude whether the Swedish approach was the wisest overall. The Swedish government has also unknowingly put the general population at risk for much long-term ill-health caused by the virus."

Furberg doesn't see it that way: "I am very proud of the way Swedes have adapted to the restrictions and regulations and I believe the Public Health Agency of Sweden has picked a good-enough strategy for our country."

Source: https://www.medpagetoday.com/infectiousdisease/covid19/87812

Image source: BBC
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