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Sweden spared surge of virus cases but many questions remain

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STOCKHOLM (Net) — A train pulls into the Odenplan subway station in central Stockholm, where morning commuters without masks get off or board before settling in to read their smartphones.
Whether on trains or trams, in supermarkets or shopping malls — places where face masks are commonly worn in much of the world — Swedes go about their lives without them.
When most of Europe locked down their populations early in the pandemic by closing schools, restaurants, gyms and even borders, Swedes kept enjoying many freedoms.
The relatively low-key strategy captured the world's attention, but at the same time it coincided with a per capita death rate that was much higher than in other Nordic countries.
Now, as infection numbers surge again in much of Europe, the country of 10 million people has some of the lowest numbers of new coronavirus cases -- and only 14 virus patients in intensive care.
Whether Sweden's strategy is succeeding, however, is still very uncertain.
Its health authorities, and in particular chief epidemiologist Dr. Anders Tegnell, keep repeating a familiar warning: It's too early to tell, and all countries are in a different phase of the pandemic.
That has not stopped a World Health Organization Europe official from saying the continent could learn broader lessons from Sweden that could help the virus battle elsewhere.
"We must recognize that Sweden, at the moment, has avoided the increase that has been seen in some of the other countries in western Europe," WHO Europe's senior emergency officer, Catherine Smallwood, said Thursday. "I think there are lessons for that. We will be very keen on working and hearing more from the Swedish approach."
According to the European Center for Disease Control, Sweden has reported 30.3 new COVID-19 cases per 100,000 inhabitants in the last 14 days, compared with 292.2 in Spain, 172.1 in France, 61.8 in the U.K. and 69.2 in Denmark, all of which imposed strict lockdowns early in the pandemic.
Overall, Sweden has 88,237 reported infections and 5,864 fatalities from the virus, or 57.5 deaths per 100,000 inhabitants since the beginning of the crisis.
The way Sweden's strategy was viewed outside the country seems to depend largely on what stage of the pandemic the observer was experiencing at the time. Initially, many abroad were incredulous at images of Swedes dining with friends in restaurants or sipping cocktails on the Stockholm waterfront. Some were envious that Swedish businesses were not forced to close.
Then came shock as the virus ripped through the country's nursing homes and hospices.
By mid-April, more than 100 deaths were reported each day in Sweden, while mortality rates were falling elsewhere in Europe.
Today, as fears of a second wave grow across Europe, it's fashionable to praise Sweden, with reporters from France, the U.K. and elsewhere traveling to Stockholm to ask about its success.
But a Swedish government commission investigating the handling of the pandemic will, undoubtedly, have hard questions to answer: Did authorities wait too long to limit access to nursing homes, where about half of the deaths occurred? Were they too slow to provide personal protective equipment to staff in those homes when shortcomings in the elderly care sector had long been known? Why did it take so long to set up wide-scale testing?
Tegnell also refuses to rule out a second wave of coronavirus infections in Sweden. A particular concern is the return of students to high schools for the first time since March.
That view is echoed by Hallengren, the health minister, who doesn't totally dismiss the effectiveness of masks and sees their usefulness in cases of severe local outbreaks. At the same time, she rejects blanket rules for the entire country.
"People will not wear masks for years," she said.