The emergence and spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that causes the coronavirus disease 2019 (COVID-19), have been one of the defining global health crises of this century. As a result, the SARS-CoV-2 outbreak was declared a pandemic by the World Health Organization (WHO) on March 11, 2020.
Study: Social Distancing Policies in the Coronavirus Battle: A Comparison of Denmark and Sweden. Image Credit: Aleksander Mijatovic / Shutterstock.com
The efficacy of social distancing
Social distancing was adopted as the main strategy to reduce the spread of SARS-CoV-2 throughout the world. Various social distancing strategies were implemented, the most common being nationwide lockdown.
Notably, these measures simultaneously mitigated the spread of the influenza virus throughout the pandemic as well. Unfortunately, however, there is little evidence on the effectiveness of many social distancing measures.
The current study included the national response of Denmark and Sweden to the COVID-19 pandemic. Denmark and Sweden are neighboring Scandinavian countries that share many economic, political, and cultural characteristics. However, their responsiveness to COVID-19 was found to be strikingly different.
Denmark, for example, was found to have a faster response to the COVID-19 pandemic. This nation implemented mandatory social distancing measures and other restrictions such as limiting the gathering of people, closure of the national border, and closure of bars and restaurants.
Comparatively, Sweden took voluntary measures that emphasized people’s willingness to maintain social distancing measures. This country was criticized for its relaxed strategy that led to the extensive spread of the virus that inevitably increased hospitalization and mortality rates, particularly when compared to Denmark's.
The current study, published in the International Journal of Environmental Research and Public Health, involved a comparative analysis of Denmark’s more common strategy and Sweden’s more unusual strategy that further helped understand the factors that affect the adoption of policies by governments. In addition, the study aimed to identify, compare, and analyze the different social distancing policies that Denmark and Sweden adopted in response to the COVID-19 pandemic.
About the study
The current study involved the analysis of officially published documents describing both countries' social distancing public policies from March 2020 to October 2020. The documents included executive orders, laws, general guidelines, news, as well as press releases.
The study involved comparative research, as it could provide general conclusions beyond single cases. It also helps to provide differences and similarities based on the contextual condition of the cases.
Policy measures are defined as actions that are carried out for the implementation of a public policy. Policy measures can be categorized into three types, including sticks, sermons, and carrots.
Sticks, also known as regulations, are mandatory measures requiring people to follow what is ordered. Sermons, which are also known as information, are voluntary and non-binding recommendations that attempt to influence people by transfer of knowledge, persuasion, and argument. Carrots, also known as economic measures involve grants and subsidies for the removal or provision of material resources.
The current study also involved several steps of data collection and analysis. At first, the government, parliaments, and authorities involved in adopting social distancing policies were identified.
Following this, policy measures were identified, retrieved, and mapped onto a table or matrix. The documents from each of the countries were updated and revised as new measures were continuously implemented. Finally, the documents from Denmark and Sweden were compared, analyzed, and discussed by the researchers over Zoom meetings.
Comparison of the general types of policy measures
Three types of policy measures for social distancing were identified in both Denmark and Sweden. The measures of Denmark included executive orders, laws, recommendations, and travel advice, while the three measures of Sweden included executive orders, laws, and general guidelines and recommendations.
Denmark was found to use a larger number of sticks as compared to Sweden, where sermons were found to be more common. The policy measures in both countries were updated several times, depending on the information of the spread of SARS-CoV-2. Notably, the sermons were later found to convert into sticks in Sweden.
Comparing social distancing policies
In both Denmark and Sweden, the categories of social distancing policy measures were highly consistent with the previously published taxonomy. However, the restrictions of Denmark were stricter as compared to Sweden.
Denmark implemented the closure of schools, workplaces, shopping malls, restaurants, cafes, and areas where mass gatherings occur. Anyone who had COVID-19 or was assumed to have COVID-19 was suggested to isolate themselves. Travel restrictions were imposed and only those with legitimate purposes were allowed to travel.
However, in Sweden, the closure of schools and workplaces did not take place. Mass gatherings that exceeded 500 people were canceled, which was later adjusted to 50 people. People over 70 years of age were advised not to use public transport, especially during rush hours; however, no restrictions were imposed on the rest of the people. Thus, although most of the policy measures were following Rashid et al., few measures existed in both the countries that did not fall under this taxonomy.
Comparison of policy adopters
The key policy adopters of Denmark were the Danish Government and the Parliament. Several ministries were also involved; however, most of the recommendations and advice were adopted by the Danish Health Authority.
In contrast, the government and parliament of Sweden were found to be less active in the adoption of policies and measures. The Public Health Agency was responsible for the adoption of policy measures in Sweden.
Comparison of time of adoption
Both Denmark and Sweden adopted policy measures in March 2020. However, the policy measures were stricter in Denmark during the early stages of the pandemic as compared to Sweden. This allowed better control of COVID-19 in Denmark as compared to Sweden.
Comparison of policy implementers
The role of the implementers included implementation of policy measures, monitoring and controlling of the measures, and providing support to facilitate compliance with the measures.
The organizations responsible for implementing the adopted policy measures involved both public and private authorities in both countries. However, many more policy measures were compulsory in Denmark compared to Sweden, which suggests greater monitoring and controlling in Denmark.
Comparison of policy target groups
The policy target groups were quite similar in both Denmark and Sweden. It involved the general population, as well as specific subgroups such as healthcare professionals, individuals belonging to the older age group, travelers, individuals belonging to certain risk groups, and employees in public and private organizations.
Since the implementation of policy measures was less strict in Sweden as compared to Denmark, this nation experienced a higher rate of hospitalizations and deaths during the study period.
The Swedish Government was criticized for its lack of leadership during the pandemic. However, during the second wave of the pandemic, a Pandemic Law was developed. This law adopted many more sticks, thus making Sweden’s strategy ultimately similar to that of Denmark’s.