Anger in Sweden as elderly pay price for
coronavirus strategy
Staff with no masks or sanitiser fear for residents as
hundreds die in care homes
Richard
Orange
Published
onSun 19 Apr 2020 08.12 BST
It was just
a few days after the ban on visits to his mother’s nursing home in the Swedish
city of Uppsala, on 3 April, that Magnus Bondesson started to get worried.
“They [the
home] opened up for Skype calls and that’s when I saw two employees. I didn’t see
any masks and they didn’t have gloves on,” says Bondesson, a start-up founder
and app developer.
“When I
called again a few days later I questioned the person helping out, asking why
they didn’t use face masks, and he said they were just following the
guidelines.”
That same
week there were numerous reports in Sweden’s national news media about just how
badly the country’s nursing homes were starting to be hit by the coronavirus,
with hundreds of cases confirmed at homes in Stockholm, the worst affected
region, and infections in homes across the country.
Since then
pressure has mounted on the government to explain how, despite a stated aim of
protecting the elderly from the risks of Covid-19, a third of fatalities have
been people living in care homes.
Last week,
as figures released by the Public Health Agency of Sweden indicated that 1,333
people had now died of coronavirus, the country’s normally unflappable state
epidemiologist Anders Tegnell admitted that the situation in care homes was
worrying.
“This is
our big problem area,” said Tegnell, the brains behind the government’s
relatively light-touch strategy, which has seen it ask, rather than order,
people to avoid non-essential travel, work from home and stay indoors if they
are over 70 or are feeling ill.
The same
day prime minister Stefan Löfven said that the country faced a “serious
situation” in its old people’s homes, announced efforts to step up protections,
and ordered the country’s health inspectorate to investigate.
Lena Einhorn,
a virologist who has been one of the leading domestic critics of Sweden’s
coronavirus policy, told the Observer that the government and the health agency
were still resisting the most obvious explanations.
“They have
to admit that it’s a huge failure, since they have said the whole time that
their main aim has been to protect the elderly,” she said. “But what is really
strange is that they still do not acknowledge the likely route. They say it’s
very unfortunate, that they are investigating, and that it’s a matter of the
training personnel, but they will not acknowledge that presymptomatic or
asymptomatic spread is a factor.”
The
agency’s advice to those managing and working at nursing homes, like its policy
towards coronavirus in general, has been based on its judgment that the “spread
from those without symptoms is responsible for a very limited share” of those
who get infected.
Its advice
to the care workers and nurses looking after older people such as Bondesson’s
69-year-old mother is that they should not wear protective masks or use other
protective equipment unless they are dealing with a resident in the home they
have reason to suspect is infected.
Otherwise
the central protective measure in place is that staff should stay home if they
detect any symptoms in themselves.
“Where I’m
working we don’t have face masks at all, and we are working with the most
vulnerable people of all,” said one care home worker, who wanted to remain
anonymous. “We don’t have hand sanitiser, just soap. That’s it. Everybody’s
concerned about it. We are all worried.”
“The worst
thing is that it is us, the staff, who are taking the infection in to the
elderly,” complained one nurse to Swedish public broadcaster SVT. “It’s
unbelievable that more of them haven’t been infected. It’s a scandal.”
Einhorn was
one of 22 researchers who on Tuesday called for Sweden’s politicians to break
with the country’s tradition of entrusting policy to its expert agencies, and
to seize control of Sweden’s coronavirus strategy from the agency.
She argues
that the reason why Sweden has a much higher number of cases in care homes than
in Norway and Finland is not because of the homes themselves, but because of
Sweden’s decision to keep schools and kindergartens open, and not to shut
restaurants or bars.
“It’s not
like it goes from one old age home to another. It comes in separately to all of
these old age homes, so there’s no way it can be all be attributed to the
personnel going in and working when they are sick. There’s a basic system fault
in their recommendations. There’s no other explanation for it.”
Tegnell’s
colleague AnnaSara Carnahan on Friday told Sveriges Radio that the number of
deaths reported from old people’s homes was “probably an underestimate”, as
regional health infectious diseases units were reporting that many elderly who
died were not being tested.
Bondesson’s
mother, who has dementia, is worried, he says. “She is aware of most things
that you talk about, it’s just that she might have bad short-term memory, on
and off,” he said. “She had also been questioning the lack of face masks. She
thinks it’s really sad to have to be there constantly for weeks and not to know
when it’s going to end.”
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