Coronavirus: Has Sweden's COVID-19 approach paid off?

At the very beginning of the pandemic Sweden received huge amounts of attention for its unique approach to COVID-19. 

While other countries implemented strict lockdowns in an effort to stop the spread of the virus, Sweden instead relied on voluntary social distancing. 

Businesses and schools were allowed to remain open but large public gatherings were banned. 

This approach received widespread criticism, however the Public Health Agency's lead epidemiologist Anders Tegnell defended it at the time, saying the country was simply taking a different approach. 

"Sweden has gone mostly for voluntary measures because that's how we're used to working," Tegnell told CNBC in April. 

"And we have a long tradition that it works rather well. So far, it's been working reasonably well."

But how has that approach stood up over time? 

While recently the daily death rate has been dropping as well as the number of new cases, University of Auckland microbiologist Siouxsie Wiles says this doesn't mean Sweden's approach is working. 

"There are lots of reasons why the death rate may have fallen, including that doctors have been getting better at treating the disease," she said. 

"It's also the case that much of Sweden has been on holiday for the last few weeks, so we may see cases start to rise again as people return to work and schools reopen."

Wiles also warned that Sweden's approach risks the lives of vulnerable people and fails to take into account the long term health impacts. 

"It is very difficult to protect all those who would be vulnerable to having a severe COVID-19 infection, so comes with the risk that many people will die unnecessarily."

"Another problem is that there are more and more reports coming out of people experiencing symptoms for months and months and the risk that even a mild infection could cause long term health problems. It's a very risky approach."

And while the death rate has been dropping, 5802 people have still died from the virus and there are 85,411 confirmed cases. This is close to six times worse per capita than Denmark and about 12 times worse than Norway, both of which implemented lockdown measures. 

Long term health implications is a concern shared by University of Otago professor of public health Michael Baker who said the perceived benefits don't outweigh the risks. 

"Taking a 'herd immunity' approach would result in large numbers of deaths and people left with severe chronic illness."

One of the biggest arguments in favour of looser lockdowns is the economic benefits of allowing businesses to operate freely. But Baker said lockdown measures, like New Zealad's, are actually less disruptive to business than being in a constant state of lockdown like areas overseas. 

"Elimination offers economic benefits by providing a return to near-normal functioning of the internal economy and a degree of business certainty."

However, University of Auckland senior lecturer of Epidemiology Dr Simon Thornley told Magic Talk on Wednesday that Sweden's approach shouldn't be written off.

Thornley, who is the part of the COVID Plan B group which has raised concerns about New Zealand's lockdown, says when compared to other countries Sweden is not doing too badly. 

"There are a number of us [people who are sceptical of lockdowns] who think that the Swedish model of opting for social distancing and protecting the elerdely is the best approach." 

"Swedish is not doing as badly as a number of other countries that have had harsh lockdowns.

"It's very hard to trash Sweden's approach...the UK has had much higher per capita deaths and cases from COVID than Sweden and yet no one is pointing the finger at them."

He pointed to the falling death rate as a sign of the country's success. 

"If you look at the deaths in Sweden the outbreak is almost over now. Deaths have been very low and you can see the curve has gone up and now it has come down and they are not facing the prospect of long border closures and long lockdowns," Thornley said. 

Thornley isn't alone in his views with professor of infectious disease and epidemiology at Stockholm's Karolinska Institute, Joakim Dillner, telling ABC Sweden's approach has worked. 

"We've had a rather open society, based on recommendations. We've not really had draconian measures, but it's still obvious that it worked."

Dillner did however acknowledge that the country should have tested more at the beginning of the pandemic. 

"There was no screening of the healthcare workers in homes for the elderly, and I think at least in the scientific community, we're upset about that," he told ABC. 

"We feel that when the WHO said 'test, test and test again' -- we should have done that."

But Dillner said it will take time to see whether Sweden's approach has paid off or not.

"This is the big worry, no-one knows what will happen in the future," he told ABC.

In April University of Canterbury professor of epidemiology Dr Arindam Basu warned that if New Zealand adopted an approach similar to Sweden, and even a conservative 10 percent of the population caught COVID-19 that would still be 500,000 people which could overwhelm hospitals. 

Instead New Zealand went into a strict lockdown and Auckland has since been placed in a second alert level 3 lockdown in an effort to stop the virus from spreading. 

New Zealand has a total of 1,649 confirmed cases and 22 deaths.