Scandinavia: The Surprising Coronavirus Hot Spot
WHY YOU SHOULD CARE
Northern Europe, not Italy, could be an early warning for the rest of the world.
By Pallabi Munsi
In America’s health care debates, the region often looked to as a model is Scandinavia. When U.S. News & World Report ranked best health care systems in the world earlier this year, Denmark, Sweden and Norway were second, third and fourth, respectively. The United States came in 15th. It makes sense that Scandinavia is a world leader in this area — the region’s social care system and universal health care has long seen its nations ranked at or near the top of human development indexes.
Now, however, the region widely hailed for its social democracy and health standards is at the center of an unlikely test of its abilities as a health care model.
Scandinavia has reported the most cases of coronavirus per capita of all multi-nation geographic regions in the world.
While China, Italy, Western Europe, Iran and South Korea have generated the most headlines for the explosion in cases, Scandinavia — Sweden, Norway, Iceland and Denmark — is battling an unmatched surge. As of March 22, Iceland, with a population of 350,000, has recorded 568 cases; Norway, with a population of 5.3 million, has had 2,257 cases; Denmark, with a population of 5.6 million, has had 1,512 cases; and Sweden, with a population of 10 million, has had 1,934 cases. Together, the four countries, with a population of 21.3 million — that of Florida — had, as of Saturday, reported a total of 6,271 cases. That’s more than double America’s current per capita rate of infection, and three times that of China. If one compares individual countries, a citizen of Iceland has a 60 percent higher chance of contracting the virus than a counterpart from Italy, according to the latest rates.
Those high numbers could in part be due to the fact that Scandinavian nations are testing people more thoroughly than other countries, say experts. South Korea, another country with a high per capita number of recorded cases — 8,897 for a population of 52 million — is also testing extensively. But if that’s the case, Scandinavia is a warning to the rest of the world that the number of already infected people who haven’t been tested could be multiples of the figures seen thus far.
“You have some countries, like the United States, that have very few cases but they have not been testing extensively,” says Johan von Schreeb, a professor of global disaster medicine at Sweden’s Karolinska Institute.
In Stockholm; Oslo, Norway; and Aarhus, Denmark, drive-through testing facilities are being set up outside hospitals. Iceland, the most isolated country in Scandinavia, is testing a higher proportion of its population than anywhere else in the world — a feat that could provide crucial data on what percentage of the cases are asymptomatic and point the rest of the world toward what may be coming and how to control the spread of the virus.
The high rate of recorded cases in Scandinavia could also be about who lives there and how they live, says Dr. Aneel Advani, an associate professor at the Johns Hopkins Bloomberg School of Public Health. “There are some populations where susceptibility is higher, and that could be because of genetic predisposition, the way they live — probably in close proximity — or the age structure of the population,” he says. Older people are also thought to be more susceptible to COVID-19, and World Bank data from 2018 found that while just 11 percent of China’s population is over 65, that number is 20 percent in Sweden and Denmark.
As a precaution, the Swedish government-owned railway operator SJ is running routes at reduced capacity — 1 in 4 trains across the country have been canceled. MTRX, which runs train services between Stockholm and Göteborg, has a new offer for all passengers booking tickets from now through April: an unoccupied seat next to them. Denmark and Norway, meanwhile, have closed their borders.
According to Advani, China’s recent success in controlling the number of new patients — last Wednesday, the country recorded zero new local cases — has been built around “stopping all activity.” However, the question remains, he says, “when the economy starts again and people can go out and talk to each other, whether the virus will come back.”
Another indication that Scandinavia’s health care system is doing its job: the relatively low numbers of COVID-19 deaths so far. Despite the high number of cases, only 42 have been fatal: seven in Norway, 13 in Denmark, 21 in Sweden and one in Iceland. That amounts to a mortality rate about half that of that seen in U.S. cases.
Amid the crisis, Scandinavia’s response might be showing yet again why it’s a role model when it comes to caring for the health of its people.
- Pallabi Munsi