30% Excess Mortality in Sweden’s Retirement Homes During COVID-19 Crisis
First published: Sunday June 7th 2020
Last updated: Thursday June 25th 2020
A joint investigation between Ratsit and SVT – the Swedish national public television broadcaster – shows excess mortality at 30% during the coronavirus pandemic in the nation's retirement and nursing homes. In Stockholm County, Sweden’s capital region, the investigation found excess mortality of 100%.
Sweden has been the focus of much international news coverage during the global coronavirus pandemic, as its strategy for handling the crisis – avoiding national lockdown with a goal of reaching herd immunity through “controlled spread” – is unique in the world. The small Scandinavian nation currently has one of the highest numbers of confirmed COVID-19 deaths per million people in the world, much higher than its Scandinavian neighbors.
The average number of daily deaths per million since the first COVID-19 death case in each country until June 25, 2020.
Source: Our World in Data
Swedish authorities believe Sweden has the right strategy
Many Swedes, its government, and the Public Health Agency of Sweden (Folkhälsomyndigheten) believe that this strategy is the right choice. However, criticism has been levied against the Swedish coronavirus strategy domestically as well, especially about the spread of the virus in nursing and retirement homes throughout the country.
Thomas Lindén, a department director at the National Board of Health and Welfare (Socialstyrelsen), told Swedish newspaper Sydsvenskan in May that the numbers are “similar every year” (link in Swedish) during flu season, effectively trying to downplay the pandemic’s toll on the country.
Investigation shows: Deaths in 2020 not similar to other years
SVT, the Swedish national public television broadcaster (similar to the BBC in the UK), decided to investigate whether or not Lindén’s statement was true and sought Ratsit’s help to do so. The investigation analyzed the ten most intense weeks of the coronavirus pandemic in the country: March 2nd through May 10th of 2020.
In their analysis, SVT’s reporters cross-referenced lists of retirement and nursing home addresses from data providers Infotorg (a Bisnode company) and Retriever with data on registered deaths of persons residing at those same addresses – i.e. their patients – from Ratsit. They then compared this to the number of deaths from the same period during 2017-2019.
The result? A nationwide excess mortality rate of 30% in 2020.
Excess mortality is a measurement of how many more people on average die during a certain period of time. While it is not proof of COVID-19 related deaths, it is useful as an indicator of where the pandemic has spread. As retirement and nursing home residents are old and often ill, they are especially at risk during this pandemic.
Some of the most important findings of the investigation follow below.
Stockholm County, a national epicenter of the pandemic, saw excess mortality of 100%.
April 15th was the deadliest day in Sweden’s nursing and retirement homes. It is also the day on which the most people in Sweden died from COVID-19, according to government statistics.
The deadliest three-day period in nursing and retirement homes was April 15-17 – the days after Easter weekend.
There are large differences around the country. For example in Malmö, Sweden’s third largest city, the mortality rate fell with 14% during the same period.
Contrary to Lindén’s statement, the National Board of Health and Welfare’s own numbers show an even higher nationwide excess mortality of 40%, when verified by SVT’s reporters.
The most populated county, Stockholm, saw excess mortality of 100%
Some Swedish counties fared better, and some fared significantly worse. Stockholm County, a national epicenter of the pandemic and the most heavily populated area of Sweden, saw excess mortality of 100%. Other regions that stand out are Västmanland County with 62% excess mortality, Östergötland County with 41%, Jämtland County with 39%, and Södermanland County with 37%.
SVT further identified around 40 individual facilities where excess mortality was over 100% during the analysis period. The majority of these facilities are located in the Stockholm area, but others were also found in cities in other parts of the country like Borlänge, Göteborg, Gävle, and Linköping.
“While avoiding a lockdown may have spared the Swedish economy to an extent and may work well for most Swedes, it is alarming and deeply tragic that our institutions have failed to protect some of our most vulnerable” said Anders Johansson, CEO of Ratsit.
The investigation showed no significant difference in excess mortality rates between publicly and privately-owned retirement and nursing homes.
The National Board of Health and Welfare's own numbers are even higher
After receiving access to the National Board of Health and Welfare’s own numbers, SVT found that those indeed show excess mortality on the national level as high as 40%, an even higher number than found during the investigation with Ratsit.
Despite much media coverage and a lively debate both in Sweden and around the world, many Swedes still believe in their government and its agencies, and that the decision to not shut the country down was, and still is, the way to go. But there is also growing consensus that Sweden has failed to protect its elderly during the coronavirus outbreak, and realized it far too late.
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