Coronavirus Outlier Sweden chooses its own path on face masks

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Sweden is not afraid to stand out from the crowd on the coronavirus, and the latest sign is its refusal to introduce face masks.

The Scandinavian country, known for its more lenient approach to Covid-19 regulation, is one of the few European countries not to recommend the use of face masks after neighboring Norway, Denmark and Finland have all changed. position last week.

“It is very dangerous to believe that face masks would be a game-changer when it comes to Covid-19,” Anders Tegnell, the Swedish state epidemiologist, told the Financial Times.

Mr Tegnell has been called stubborn by some for once again refusing to follow most of the continent. But infectious disease specialists say there are reasons Sweden has so far resisted their use for the general population.

Jonas Ludvigsson, professor of clinical epidemiology at the Karolinska Institute in Stockholm, said one was the way the country was governed. In Sweden, independent bodies such as Mr Tegnell’s public health agency played a “very important role” and elected officials listened to them, he said. “In Denmark and Norway, politicians have a more important role. Politicians in this era of crisis want to look strong and don’t always make evidence-based decisions, ”he added.

The use of face masks in other Nordic countries will also be restricted. In Norway, they are recommended on public transport during rush hour; in Denmark, they will be compulsory from Saturday on public transport but not elsewhere.

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Soren Riis Paludan, an expert on viral infections at Aarhus University, said research had suggested that at Denmark’s current infection rate 100,000 people should wear a face mask properly for a week to avoid infection. .

“If there are very few viruses in the community, the effect is limited. But if you’re in the middle of a hotspot, everything says they can have an effect. In Denmark we compromised and said that face masks could be another tool in the toolbox, ”said Prof Paludan.

Another reason for the Swedish reluctance, according to experts, is the great confidence in the authorities. “When the Swedish Health Agency says there is no reason to wear masks, people are not wearing masks,” Professor Ludvigsson said. “In other countries, where confidence is lower and they don’t recommend wearing masks, people can do it anyway.”

Prof Paludan agreed, but added another element for Denmark: the importance of seeing people’s faces to help build trust. Two years ago, Parliament banned the Islamic burqa, niqab and other full coverings. “It’s tangled up in a very complex debate,” he said.

Nordic experts also point to the lack of hard evidence of the effectiveness of face masks. Many countries as well as the World Health Organization have changed their advice on wearing masks as studies seem to indicate a link between their use and lower infection rates.

But some Nordic experts are still skeptical. Mr Ludvigsson noted that in a WHO meta-analysis of 29 studies that showed face masks to be effective, only three involved their use outside of hospitals and those that had not involved Covid-19. . Still, he said his personal position had changed and he now believed that they should recommend their use on public transport in Sweden, but for a specified period. “It would increase compliance if people knew it was only for three months,” he added.

Mr. Tegnell himself keeps an open mind. “Face masks can complement other things when others are securely in place. But to start with having face masks and then think that you can clutter up your buses or shopping malls – that’s definitely a mistake, ”he said, adding that countries like Belgium and Spain where the Use of masks was widespread still had rising infection rates.

The Swedish public health agency said on Tuesday it was working on proposals for the government in the coming weeks and that it could open up to the use of face masks in specific circumstances such as visits to hospitals or dentists.

Sweden isn’t the only European country skeptical about face masks. In the Netherlands they must be worn on public transport and at airports but are not mandatory elsewhere. Government medical advisers said there was “insufficient” evidence that face covers help prevent the spread of the coronavirus, although a panel of 11 behavior and public health experts this month qualified this position of “stubborn”.

The Netherlands recorded more than 4,000 new cases of Covid-19 in the week to August 18, the highest level since the end of April, while the number of infections per capita exceeded that of Sweden. last week for the first time in four months.

People with and without masks in the red light district of Amsterdam, the Netherlands © REUTERS

Ben Coates, author of Why the Dutch are different, said wearing masks had become a “totemic” issue and was linked to a wider debate over personal freedom in the Netherlands. “There is a libertarian trend in the Netherlands that values ​​personal freedom – where people are not educated on how to behave by government, but trusted to act for the public good,” he said. -he adds.

Prof Paludan said public acceptance was crucial in the Nordic region and, for example, forcing people to wear them on the streets would likely be resisted. “For the Danes and the Scandinavians, things have to make sense to impose them,” he added.

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