Officers in Halmstad municipality, Sweden, lately compelled a instructor to take away their masks and prohibited the usage of masks and all types of PPE in colleges. The municipality mentioned there was no scientific proof for carrying masks, citing the Swedish public well being company. On the time, company steering acknowledged that there have been “nice dangers” that masks could be used incorrectly. This steering has since been eliminated.
To somebody unfamiliar with the Swedish response to COVID-19, this masks ban may sound surprising. In any case, whereas masks usually are not foolproof, there may be proof that signifies that they do assist scale back the unfold of COVID-19, particularly in conditions the place sustaining distance is not possible – similar to colleges.
The municipality finally backed down. However new examples of masks bans preserve popping up in Sweden. Librarians within the prosperous city of Kungsbacka, for instance, have been instructed to not put on masks.
How on earth did we find yourself on this state of affairs? Properly, every thing the Halmstad and Kungsbacka officers have mentioned about masks is in step with the Swedish public well being company’s statements. These native masks bans are a logical product of 9 months of constant anti-mask statements by the Swedish state, which we argue is an instance of poor danger communication.
A European outlier
Outdoors of Sweden, most Europeans at the moment are used to carrying masks indoors whether or not within the grocery store, on public transport or when visiting the physician. It has turn out to be such an ingrained behavior that we will simply overlook that, for the primary months of the COVID-19 pandemic, many people weren’t carrying masks in any respect. In these early days, the principle message was the slightly easy “wash your fingers” and the slightly tougher “don’t contact your face”.
The European Centre for Illness Management first advisable the general public use of masks as early as April, although it was not till June that the World Well being Group (WHO) adopted swimsuit. England waited till July, and at last in August, Norway, Denmark and Finland introduced in masks necessities.
Sweden, as we’ve got seen, selected a unique path. The Swedish public well being company has persistently acknowledged that masks are ineffective and that their use may really enhance the unfold of COVID-19 – a typical view originally of the pandemic however a uncommon one now.
In July, the well being minister, Lena Hallengren, defined that the Swedish authorities didn’t have a tradition or custom of constructing choices about protecting clothes similar to masks, and that her authorities wouldn’t overrule the general public well being company.
Sweden’s masks coverage even went past its nationwide borders, into worldwide anti-mask activism. In April, the nation’s chief epidemiologist, Anders Tegnell, wrote an e mail to the European Centre for Illness Management (which occurs to be primarily based in Stockholm), warning it to not suggest the usage of masks. The reasoning was that this “implies the unfold is airborne”, which might “significantly hurt additional communication and belief”.
How did we get right here? Again in spring 2020, when SARS-CoV-2 was nonetheless a brand new and poorly understood virus, the Swedish communication round COVID-19 was a easy and constant tripartite mantra: wash your fingers, preserve distance, keep dwelling in case you are sick. This shall be acquainted to folks in lots of different international locations, and is a textbook instance of efficient danger communication, which needs to be clear, simple and simple to behave upon.
The WHO pointers for efficient danger communication in public well being crises emphasise that uncertainties needs to be explicitly acknowledged, that the knowledge is constant and simple to know, and that the messaging incorporates particular and sensible advisable actions.
The preliminary levels of Swedish danger communication ticked two of those containers, whereas failing to speak uncertainty, which was the case in lots of international locations which additionally selected quite simple messages.
As scientific understanding of the virus developed, nevertheless, the Swedish danger communication round masks didn’t change. In August, for instance, when mask-wearing was turning into widespread in different European international locations, Tegnell mentioned that the proof for mask-wearing was “astonishingly weak” and that their use may enhance the unfold of the virus.
A muddled masks mandate
Swedish authorities maintained their anti-mask place till December, when the prime minister, Stefan Lofven, introduced a U-turn on the usage of masks on public transport.
However Lofven’s new coverage was not a easy rule to put on masks when travelling. As an alternative, it recommends the usage of masks from 7am to 9am and 4pm to 6pm, for these born “in 2004 and earlier than” who wouldn’t have a reserved seat. If this sounds overly sophisticated, that’s as a result of it’s.
It’s maybe unsurprising, then, that compliance has been low, with solely half of commuters really carrying masks throughout rush hour.
And it’s not simply most people. Two weeks after the advice was launched, the director of Sweden’s public well being company, Johan Carlson, was noticed with out a masks on a bus throughout rush hour. When requested about his failure to conform along with his personal suggestions, he mentioned, “I merely failed to note that the time had turn out to be commuting time,” which properly illustrates the issue with overly advanced danger communication.
Complicated and complicated
If the top of the general public well being company is incapable of following his personal guidelines, one can hardly blame the general public for his or her lack of compliance.
At first of the pandemic, the Swedish authorities’s preliminary danger communication (the tripartite mantra) was simple and simple to know. However by December, authorities had been warning of the dangers of mask-wearing for months. So the general public transport announcement was not solely complicated as a result of its complexity but additionally as a result of the truth that its content material straight contradicts the masks steering from March till December.
On this context, it’s no surprise that libraries and colleges in Sweden are sending blended messages about whether or not folks ought to put on masks.
It’s the product of months of dangerous danger communication on a easy public well being measure that has been extensively adopted elsewhere. This failure to speak may have very worrying outcomes: probably elevated an infection in a rustic which is getting ready to a 3rd wave.