Is Sweden’s “No Lockdown” Covid-19 strategy feasible in the Philippines?

While the countries in the world are closing their doors as part of a strategy to respond to Coronavirus disease (Covid-19), Sweden maintains a middle ground between lockdown and pure laissez faire. Unfortunately, this “Swedish approach” is not possible in developing countries like the Philippines.

While the countries in the world are closing their doors as part of a strategy to respond to Coronavirus disease (Covid-19), Sweden maintains a middle ground between lockdown and pure laissez faire. While keeping the economy is a reason, the principal objective really is to try to control the virus through “herd immunity”. Hence, businesses are still open, and younger children can still go to playgrounds or go to school.

According to WebMD, “Herd immunity, or community immunity, is when a large part of the population of an area is immune to a specific disease. If enough people are resistant to the cause of a disease, such as a virus or bacteria, it has nowhere to go.”

Herd immunity can be achieved either naturally — that is, exposing the body to virus or bacteria to enable the body to develop antibodies that will eventually fight off the infection — or through vaccines. But while experts from other countries including the World Health Organization (WHO) are taking a swipe at Sweden claiming the latter’s policy as unscientific and careless, the Scandinavian country continue to stick to its policy and with moderate restrictions on physical distancing and crowd gathering.

In terms of results, Sweden has a relatively lower number of Coronavirus cases compared to other countries in Europe. As of May 16, Sweden has 29,677 with 3,674 deaths. Despite this number, a flattening curve is already evident, recoveries are high, and the number of newly confirmed cases are decreasing. For context, the Covid-19 Ground Zero moved from China to Europe so the number of positive cases and deaths are really in five and six digits. The European country with the highest Covid-19 cases is Spain with 274,367 followed by United Kingdom with 236,711.

Despite the number of COVID-19 cases, the Swedish population has high trust in their health authorities in handling the coronavirus. In March, Kantar Sifo even noted an increase in the government’s trust ratings from 65% to 74% and is expected to be the same, if not further increase, at this time. So, while the rest of the world is on an economic slump, Sweden’s economy is working, albeit slow, and it is one of countries whose Covid-19 cases are plateauing. Possibly, it is also one of the countries (if not the only country) whose citizens have developed (or are developing) antibodies against the current strand of Coronavirus.

Sweden’s approach, while enticing, does not stand a chance in the Philippines. The risks are very high and this is because of the following:

The approach of Sweden is built on the mutual trust — the people trusts the government as evidenced by the survey of Kantar Silo, and the government trusts its people. As Sweden’s state epidemiologist, Anders Tegnell, puts it, social distancing is a matter of self-regulation and the government trusts the judgment of their citizens.

In the Philippines, while President Rodrigo Duterte appears to enjoy a high popularity ratings, the survey results could not find translation in the actions of the most Filipinos. In the distribution of Social Amelioration Program fund, for instance, a simple social distancing could not be observed because all wanted to be the first in the line and secure the amount. The reason: Because of corruption in government, the beneficiaries are still in doubt that they will really receive economic assistance fund and in full. Clearly this indicates the lack of trust in the government.

Another indication is the increasing number of people posting in social media threatening the life of the President. Whether these are jokes or not, or a means to gain attention, uttering or publishing words below the belt is a clear indication of unsatisfaction and mistrust.

The lack of trust is further fueled by the uneven implementation of laws, rules and guidelines. While lower class Filipinos who violate the law are immediately apprehended and penalized, law makers and law enforcers who break the law either get away with it or are meted with delayed punishments. Remember a Senator who violated quarantine regulations last March? He still remains at the comfort of his home while  a total of 17,039 persons who violated the rules and were not even Covid-19 positive were arrested. Although most were released, a significant number were also fined. And the general who held a birthday party in the midst of the enhanced community quarantine? Well, he might face an investigation soon (not immediately) and that became a decision only after the Netizens complained in the social media for unfair treatment. Earlier, the Phillippine National Police’s top brass defended the general by immediately prejudging the case saying that there is no violation.

Conversely, there are also indications that the government do not trust its people. Heavy regulation is one such indication. When the government tries to enact law for every action of the people — including how many cups of rice to eat, or how heavy a child’s bag should be — simply shows that the government does not believe the judgment of its people. Or, if not, the government could be hiding something. As Tacitus once said, “When the state is more corrupt then laws are most multiplied”.

All Swedes have access to health care regardless of their income or ability to pay. While the Philippines brag a universal health care, it can only cover a certain amount. Those at the lower tier of the economic strata, because they lack other insurance packages, are forced to shell out more money compared to those at the upper tiers for the same illness.

Corollary with the above is the presence of quality health care. As reported by the Organisation for Economic Co-operation and Development (OECD),

The quality of health care in Sweden is generally good. Rates of avoidable hospitalisation for chronic conditions such as asthma (22.2 per 100 000 population) are among the lowest in the OECD (average 45.8) and 90% of people using primary care in Sweden said they were treated with respect and consideration by staff.  Sweden’s quality registers, which track the quality of care that patients receive and outcomes for several conditions, are among the most developed across the OECD.

In the Philippines, while there are institutions that also offer quality health care, these are not accessible to majority of the citizens. According to studies, around 70% of the population can access only the rural health units (RHUs) — — and these are generally noted for their poor facilities and services. A segment of the population even die without seeing a doctor in their whole life. And the major indication of mistrust in the health system — reliance on voodoos and quack doctors.

Next, a non-draconian approach to Covid-19 is also very risky in the country whose President believes that the police and military always have a role in everything. Aside from appointing generals in major government posts, the President also put to task the armed government entities in responding to health issues such as Coronavirus pandemic and the war on drugs.

Lastly, socio-cultural behavior also matters a lot. In Sweden, the average age of individuals who leave their homes is 18.5. As such, the household size is only 1.8 or, in simple terms, more than half of the houses in Sweden only has one resident. On the other hand, Filipinos are known for strong family ties and still practice living together similar to colonies. With this behavior, social distancing is not feasible. Add the poverty and you’ll find people living together like a pack of sardines in a can. Note that “herding mentality” is different from the concept of “herding immunity”.

In sum, the “no lockdown” policy while enticing, is only applicable to Sweden and is risky to be applied in the Philippines because of the differences of the two countries, their government, and their people.

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