Global Covid-19, Health and social care

Covid-19: A view from the bridge: Nordic countries’ responses

Image by Free-Photos from Pixabay

Nordic countries have taken differing approaches to the Covid-19 pandemic, and here we explore how they have done so and the potential repercussions.

At the time of writing this, May has rolled in but the traditional workers day celebrations have a gloomy cloud looming over them. Despite the slowly diminishing restrictions in the Nordics, life is not quite as normal here. The following article will give a look into what has happened in Northernmost Europe since this short insight focusing on Sweden. Whilst Sweden is continuing effectively on its chosen path of aiming to achieve herd immunity with very few restrictions, the other Nordics are all taking unique steps in protecting their citizens from the virus.

Norway and Denmark both went into nationwide lockdown in early to mid-March, closing their borders for non-nationals and residents. After the month long lockdown, both countries are now easing measures, and reopening businesses and local services.

In Denmark, Easter marked the end of national lockdown. The country was among the first in Europe to adopt lockdown measures, which 80 per cent of the population backed. Imposing these measures almost two weeks ahead of the UK, but without a strict stay-at-home order, and with many shops remaining open. Google’s mobility data shows that the general mobility in the country dropped dramatically compared to the baseline. Denmark’s beloved Queen Margrethe II went as far as cancelling her 80th birthday celebrations, stressing to the nation the importance of social distancing. Now, as for other countries seeking to ease lockdown measures, Denmark is facing difficult decisions. Opening schools has sparked strong disagreement amongst parents, who fear their children being “thrown to the frontline” and facing another wave of the virus as “guinea pigs”. However, the schools are not opening up as normal; pupils are, for example, not seated closer than two metres from each other and school-provided lunch is cancelled – meaning the students have to bring their own. Small Danish businesses, such as hairdressers, have also now been allowed to open their doors again and gatherings are still restricted to up to 10 people until 10 May. In total 475 have died of Covid-19 in Denmark (updates daily).

Norway has also opened its preschools again and lifted the so-called “cabin ban”, which restricted the Norwegians from travelling to their holiday homes – with a hefty fine of £1165 given to anyone not following the rule. Despite the lockdown measures being eased, officials still encourage everyone to stay at home and avoid all unnecessary travel, which most Norwegians have done. Sporting events and other public gatherings have been cancelled until mid-June. Norway is predicted to be among the top countries to have a good chance of recovering from the crisis economically, followed by Denmark and Finland.

Finland has reacted to the crisis much in the same way as Denmark and Norway. For the first time in history, the government authorised an emergency law, limiting citizen’s movement and congregation. However, the most drastic move was when Finland closed its capital region, Uusimaa, on 17 March. With the reopening of society, discussion in Finland has also started to include the trouble in store for local government. Worries include the  future of the municipalities that are responsible for providing healthcare, social services and education. The local government budget deficit has been showing historic low before the crisis and Covid-19 has obviously placed an enormous amount of unforeseen stress on them. The government has put together a 1 million euro help package to help the municipalities get back on their feet and continue provision of services as usual. For municipalities, prioritising where future cuts and investment will be directed is going to be a puzzle. Local healthcare centres that were already in financial trouble are at the top of the list facing cuts. Many of those now facing unemployment are covered by public health insurance, provided by their employer. But in the case of becoming unemployed, all of these will move to the public health care system. All of this could create an even more unequal healthcare system, where many of those with the strongest need for public healthcare will suffer.

The small nation of Iceland has also gaineda lot of attention globally for its extensive testing approach. It is true that the island state has the population of a little over 360,000, but their tasting stands at 12 per cent this far and only 10 people have died of the virus. Iceland imposed similar restrictions as the other Nordics (apart from Sweden), but its focus was on extensive testing from the beginning. Iceland’s prime minister Katrín Jakobsdóttir has also said that the partnership between public and private sectors has been key in the country’s quick response to the pandemic. Restrictions in Iceland are, according to the Prime Minister, being lifted on 4 May but could be reinstated in the case of a second wave.

Last but not least, Sweden remains strange among the Nordic nations in tackling the pandemic crisis. It has the highest number of Covid-19 deaths among the Nordic countries, by a large margin, yet official restrictions, let alone lockdown measures, are still absent. The National Healthcare Agency still relies on recommendations and the chief epidemiologist Anders Tegnell who insists that Sweden’s strategy is working. This is even though a lot of criticism has been expressed especially concerning the large number of cases of infection in care homes; something Tegnell and his agency were reluctant to admit at first. Eldercare is something that the local government is responsible for providing and the dramatic numbers of cases in care homes has prompted investigations on why the spread has been so quick in these settings. Especially in Stockholm where many of care home workers are only part-time workers or short-term employed, and are therefore at risk of potentially carrying the virus from one workplace to another.

In all Nordic countries the local governments have introduced emergency funds to help the municipalities and businesses struggling with their economies. A point that has been raised several times concerning Sweden’s unique response to the pandemic is its potential to bounce back economically better than other nation. However for local government the future looks rocky, and Sweden’s municipalities and regions (SKR) have just stated in their annual financial report that “not since the Second World War has welfare been affected at such a rapid rate as during this spring”. Municipalities and regions are at the core of offering essential welfare services and they are now demanding the government compensate their additional costs for health and social care provision. According to SKR, the social economy might take until 2023 to fully recover, and they predict SEK 6 billion deficits for regions this year. Even though the crisis has really brought regions together in finding solutions to get through the crisis, for example creating double the number of ICU beds, as well as sourcing additional protective materials when it seemed impossible, all of this has come with a high cost. In addition, the regions have been losing about SEK 1 billion per month since the crisis started because there are simply no tourists.

Without question, Nordic countries show us an interesting mix of approaches to the Covid-19 outbreak. There are nations that stand out with their remarkably different level of action; Sweden with its lack of restrictions and Iceland with the speed of introducing large-scale voluntary testing. Everywhere in the world this pandemic has sparked up conversations about the importance of key workers – especially in the healthcare sector, and the Nordic countries are no exception. The vulnerability but importance of small, local healthcare centres has been exposed in the northernmost regions of Sweden, Norway and Finland. Municipalities are being supported by emergency funding from governments so they can continue to bear the brunt of the crisis and continue providing essential services, especially important in many of the northern towns that would usually rely on tourism for income. In Sweden, ski-resort towns such as Åre are among those with the highest increase in unemployment. Unequal access to information and care has gained foothold in the public discussion, highlighting underlying social and accessibility issues that might have otherwise gone unnoticed: those from minority backgrounds seem to be disproportionally affected by the virus. The crisis has even been linked even to a rise in Swedish nationalism – and the consequences of an inability to handle criticism. As this insight into the Nordic responses shows, there are many ways of handling the Covid-19 crisis and it is currently impossible to compare the efforts each country is taking based on numbers alone.

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