Sweden coronavirus press conference, April 6, 2020

As is traditional, they start by emphasizing: it’s looking really bad in the US. Today they also add that it’s getting better in Europe.

On this day, there are 1.25 million cases worldwide. The US is responsible for most of the new cases, they mention straight off. In Sweden, there are 7206 cases. The number of new people place in the intensive care is still pretty constant (the black line in the graph). There are 477 people who have died.

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There are fewer new cases over the last few days, but that’s because cases are always under-reported on the weekends. We have to wait till tomorrow to see what it ends up looking like.

Today, the main person talking is Anders Tegnell, the chief national epidemiologist.

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He showed a graph that shows cases of regular flu during the last two years (the purple and marigold lines below) compared to this year (the turquoise line), and says the quick decline in the turquoise line during the last two weeks shows the measures put in place are having an effect.

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Anders Tegnell: We think we have flattened the curve. We at least see the effect of our measures. And we still have enough hospital beds.

Anders Tegnell continues: Our biggest trouble is we have the infection spreading in retirement homes in Stockholm and in the west. So everyone involved in that has to think about how to do better. Any staff with the mildest symptoms should stay home, and there should be more testing among the retirement homes. The spread in retirement homes is a big reason for the increase in fatalities in Sweden. When talking to my Nordic colleagues, they don’t have this same problem. Whether it’s a matter of time or if they’re doing something better, is something we’ll have to discuss.

Then he comments about masks: the biggest way to stop infection is by staying home when you’re sick and washing hands, not protective material — at least when it comes to retirement homes.

Question: how many of the deaths can be linked to retirement homes?

Anders Tegnell: No, yes … I think it’s too much to say that much of the coronavirus spread is in retirement homes, it’s not like that; most of the infection spread is through community spread. But many of the deaths are linked to them. We are looking at that. In the coming days, we are going to look carefully at the deaths among old people and see which ones actually had an address in a retirement home. We will share that information in a few days.

Question: so again, what about face masks? [while a reporter in a face mask sits right there]

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Anders Tegnell: No, we still say that face masks should be used where they are needed, in hospitals, because there you can have situations where the best way to stop infectious spread is through protective material. Out and about in the community, however, there’s no evidence that they help. I know in some countries there’s discussion that you should have a face mask, but still, that’s so you don’t infect anyone else. But here in Sweden, we don’t say that. Rather, we say that if you have symptoms, you should stay home. In these other countries, they’re saying if you have symptoms, you should just wear a face mask [are other countries really saying that?] and personally, I think it’s more effective to just stay home rather than wear a face mask of doubtful quality.

Questioner continued: but what about if you are infected but have no symptoms? Couldn’t you then infect others if you go out and about without wearing a mask?

Anders Tegnell: “I think it’s very important to remember what is important to do. That which is important to do is to stay home if you’re sick.” The number of people who get sick from asymptomatic carriers is very small in all the studies — somewhere around 10%. The most important thing is not that we get rid of all infection, but that we get rid of enough infection so that our medical services don’t collapse.

Question: why don’t you think that protective material can’t solve the problems of the spread in retirement homes? (asked by a journalist with a scarf-made face mask)

Anders Tegnell: Because you have to look at the complex situation of the spread of coronavirus in retirement homes in its entirety. If you think you can solve it through more face masks, then you will be entirely wrong. You have to look at how well trained the staff are, if they are able to stay home when they are sick, if you can test them, how you can isolate sick patients.

Question: could we have avoided some of the spread in retirement homes if we had tested more of the staff?

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Sharp questioning by a reporter

Anders Tegnell: It’s a good question. We’re looking at different retirement homes to see if that makes a difference. There’s indications of that. My Nordic colleagues have tested a lot in the retirement homes, and they have fewer problems than what we have, so absolutely, as soon as we can test a little more, it will be a priority to test more staff and patients at the retirement homes. We test everyone who comes into the hospital, and there we have good control, we don’t see infections spreading there. So in retirement homes, it might help, too. But yet again, it can’t solve the situation all by itself, we have to look at the situation in its entirety.

Question: what about libraries? Some have closed. What do you think?

Anders Tegnell: I personally think it’s important to read and get books. But it’s the same conditions as for other public spots — things to do to reduce infection. Make sure it’s not too crowded, etc. If the libraries can follow that, then I think it’s good for them to stay open.

Then, the press conference was over, and it was back to the studio:

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This lady mentioned how, contrary to what Anders Tegnell was pushing for, in the US, the authorities are encouraging increased use of face masks; people are even making their own, even if they’re not medical-grade masks.

Then there was an individual interview with Anders Tegnell:

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Anders Tegnell

Question: let’s start with good news, the curve appears to have flattened out quite nicely. Can you say something more about that?

Anders Tegnell: Well, we have to look at it very carefully. We have to remember the latest numbers are from the weekend and are not complete yet. The even better news is that incidences of regular flu have gone down a lot. This means that our measures have been effective.

Question: When do you think the peak will come? Some other expert said in 3 weeks.

Anders Tegnell: We have a lot of people modeling this in different ways. They are all indicating that we might reach the peak of new cases this week. Then it would take another week for those new cases to start showing symptoms. So somewhere in that range. More and more are in agreement about this now.

Question: The report about the available capacity of intensive care units seems to show that Sweden is pretty well-prepared. Is that also your evaluation?

Anders Tegnell: Yes, I think so. We have had a pretty flat curve of the number getting admitted into intensive care for a long time. And now we are getting to the point where a lot of people are getting better and being discharged from the intensive care. So I’m hopeful that we’ll be able to keep up with the intensive care capacity. And we should have great respect for the great efforts people have made to open up the intensive care capacity, they’ve done a large job. But it looks like it’s going to work.

Question: How should people celebrate Easter?

Anders Tegnell: most important, do not celebrate with your old relatives. Also, don’t travel from hard-hit cities like Stockholm to other places. So be careful, stay outside as much as you like.

Question: You mentioned that infection is spreading quickly in the retirement homes. There’s a lot of old people in retirement homes who maybe visit hospitals. Is there evidence that that’s how the infection spread into retirement homes? Or what else do you think was the biggest factor?

Anders Tegnell: We don’t know. We’re looking at it. I don’t really think that if old people had chanced to visit in a hospital that that would have made a big difference. It’s not so normal right now that people have been going from retirement homes to hospitals. People have been trying to avoid visits to hospitals. And we also have very good control of the infections in hospitals, so I don’t think that’s the biggest source.

Question: Clarify about face masks again.

Anders Tegnell: Yes, it should be used in hospitals. No, it should not be used out and about. If you’re feeling sick, you should stay home.

Question: A study out from China shows that there’s been a lot of infection from people without symptoms. What do you think of that paper?

Anders Tegnell: Yes, but those cases of infection are not the majority. In most studies, the number of people who are infectious without symptoms is very low.

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