Marta Paterlini:

The approach has sharp critics. Among them are 22 high-profile scientists who last week wrote in the Swedish newspaper Dagens Nyheter that the public-health authorities had failed, and urged politicians to step in with stricter measures. They point to the high number of coronavirus deaths in elder-care homes and Sweden’s overall fatality rate, which is higher than that of its Nordic neighbours — 131 per million people, compared with 55 per million in Denmark and 14 per million in Finland, which have adopted lockdowns.

The strategy’s architect is Anders Tegnell, an epidemiologist at Sweden’s Public Health Agency, an independent body whose expert recommendations the government follows. Tegnell spoke to Nature about the approach.

Can you explain Sweden’s approach to controlling the coronavirus?

I think it has been overstated how unique the approach is. As in many other countries, we aim to flatten the curve, slowing down the spread as much as possible — otherwise the health-care system and society are at risk of collapse.

This is not a disease that can be stopped or eradicated, at least until a working vaccine is produced. We have to find long-term solutions that keeps the distribution of infections at a decent level. What every country is trying to do is to keep people apart, using the measures we have and the traditions we have to implement those measures. And that’s why we ended up doing slightly different things.

The Swedish laws on communicable diseases are mostly based on voluntary measures — on individual responsibility. It clearly states that the citizen has the responsibility not to spread a disease. This is the core we started from, because there is not much legal possibility to close down cities in Sweden using the present laws. Quarantine can be contemplated for people or small areas, such as a school or a hotel. But [legally] we cannot lock down a geographical area.