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AFTER LOCKDOWN: Are Denmark's and Norway's restrictions now like Sweden's?

The Local Denmark
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AFTER LOCKDOWN: Are Denmark's and Norway's restrictions now like Sweden's?
Crisis, what crisis? People snuggle up in the sun in Stockholm's trendy Södermalm district. Photo. Jonathan Nackstrand/AFP

As Denmark and Norway start lifting restrictions after a month of lockdown, are their coronavirus strategies shifting to the less restrictive approach their neighbour Sweden has had from the start?

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As Denmark's and Norway's schools, hairdressers and sports clubs start to open up again after more than a month of lockdown, it's certainly tempting to see their coronavirus strategies reverting to that of their neighbour Sweden.
 
After all, in Sweden schools, kindergartens, hairdressers and many sports clubs have been open all along. 
 
"Several countries, among them Denmark, are now starting to follow the Swedish path by opening schools and pursuing a gentler model," Sweden's state epidemiologist Anders Tegnell told Danish state broadcaster DR over the weekend. 
 
We've taken a closer look on how the various restrictions put in place have varied across the three Scandinavian nations, and how they still differ today.
 
Even now, Sweden's regime seems more liberal. Here's a graphic summing up the differences. 
 
 
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Who followed who? 
 
Norway's government has at times looked as if it has been simply following the lead of the faster-moving, more decisive government led by Mette Frederiksen down in Denmark. Denmark announced it was closing schools on March 11th, Norway on March 12th. Denmark imposed strict border controls on March 13th, Norway on March 15th. 
 
Over the last few weeks, Norway's government has again announced and enacted the reopening of schools and other institutions shortly after Denmark made similar moves.  
 
But while Norway has followed Denmark, it has tended to go a little further.
 
Denmark has banned gatherings of more than 10, Norway has banned gatherings of more than five. Denmark never stopped people from travelling or staying away from home within Denmark, although it encouraged them to stay at home over Easter.
 
While Denmark banned foreigners from entering Denmark unless they were cross-border workers or residents, Norway also forced anyone arriving from abroad, including Norwegian citizens, into two weeks of quarantine.  
 
Denmark never issued restrictions on travel within its borders. Norway's cabin-ban, lifted this week, effectively meant Norwegians had to stay in the municipality where they were registered as living. Finland went even further, and put the whole of the Uusimaa region around the city of Helsinki into quarantine. 
 
The odd one out
 
The Public Health Agency of Sweden, which has largely set Sweden's policy, has in contrast, consistently dismissed Sweden's neighbours' school closures and border controls as coming too soon, of being counterproductive, and of being impossible to maintain for the long haul. 
 
Sweden has never closed elementary schools or kindergartens, only shifting upper secondary and university students to distance learning. 
 
It has only banned gatherings of more than 50 people, and it has only stopped travel to Sweden from countries outside the EU, EEA, or Switzerland. Even those travelling from other countries can still enter Sweden if they are a Swedish citizen or resident, or if they have "important grounds" for travel. 
 
Within its borders, Sweden has issued recommendations that people avoid non-essential travel, particularly to and from the major cities. Although not legally enforced, mobile phone data showed a significant reduction in travel including over the Easter holiday weekend.
 
In other areas, Sweden's authorities have tended to issue recommendations rather than bans or restrictions, leaving it up to individuals, businesses and clubs to decide precisely how to reduce infection. 
 
It is difficult to know to what extent the differences in restrictions are responsible for the differences in hospitalisation and death rates in the three countries.
 
But Sweden's death rate due to coronavirus has since March 30 begun to significantly outpace those of its Nordic neighbours, as you can see in this graph showing the seven-day rolling average.  
 
 
Christian Wejse, Associate Professor at the Aarhus University's Department of Infectious Diseases, argues that while Sweden's restrictions have been lighter touch, they have nonetheless had a significant impact.  
 
"It seems like those restrictions have been sufficiently effective to stop the transmission of the virus from spreading to a catastrophic level," he says.
 
He argues that Sweden has so far managed to achieve what the Danish health authorities call the "green curve", suppressing the pandemic to the extent that the health services can cope, but still allowing it to peak and decline naturally as the population becomes more immune. 
 
"There's been more spread, but it's been less than I would have thought, and actually Sweden has also managed to hit what we call 'the green curve'. It's at a higher level than Denmark and Norway, but it's still a green curve. The healthcare system has not collapsed." 
 
He stresses, though, that even after the recent lifting of restrictions in Norway and Denmark, Sweden's regime remains much more liberal. "I definitely think it's still stricter in Denmark than it is in Sweden."
 

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So are kindergartens and schools in Denmark and Norway now the same as in Sweden? 
 
Not really.
 
In Denmark, children returning to schools are being asked maintain their distance, desks have been placed at a distance from one another. Students have been divided them into smaller groups and classes, and drop off and collection times have been staggered. 
 
READ ALSO: 
Norwegian schoolchildren will face a similar regime when the first schools open on Monday. 
 
In kindergartens, parents are not allowed into the buildings, children are split into small groups which maintain a distance from one another, hand sanitiser is available in almost every room, toys are limited and frequently washed. 
 
If a child shows any potential symptoms of coronavirus, they must be kept home in both Denmark and Norway, and if a member of a child's family has confirmed coronavirus in Norway or Denmark, the child must also be kept home. 
 
In Sweden, the key recommendations have focused on what happens if a child is sick, with staff and pupils asked to keep a close look out for potential symptoms, and to send children home if symptoms appear. 
 
Schools have also been asked to put up posters reminding children to wash their hands, to instruct children in hand-washing if necessary, to inform children about Covid-19, to try, if possible, to increase the distance between desks, and to avoid too many children gathering in the same place. 
 
Unlike in Denmark and Norway, children in Sweden can still attend school or kindergarten even if a parent is sick with coronavirus. 
 
An employee at a kindergarten in Oslo washes sandpit equipment. This has not happened in Sweden. Photo: Pierre-Henry Deshayes/AFP
 

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What about restaurants, bars and nightclubs? 
 
It's not just on schools and borders that Sweden has been an outlier.
 
The country has allowed bars and restaurants to continue operating almost as normal, and the same goes for most sports and cultural activities. 
 
The Public Health Agency of Sweden has issued an order to restaurants, asking them to make sure that there is no crowding of people, and that customers can keep their distance. This means customers in bars and restaurants must sit at tables rather than mingle at the bar. But there is no specific distance requirement. 
 
Establishments that fail to follow the new regulations risk closure, but there are widespread reports that these restrictions are not always being adhered to. 
 
In Norway, restaurants, pubs which serve food and cafés have also been allowed to stay open, but they have had to change their layouts dramatically, putting at least two metre distance between tables. Oslo's city government has banned pubs and restaurants from serving alcohol. Buffets are also banned. 
 
The Confederation of Norwegian Industry worked closely with health authorities to develop guidelines, which limit the number of people who can sit at one table to five, bans guests from fetching their own cutlery, coffee, or condiments, and advises serving staff to wear rubber gloves. 
 
In Denmark restaurants, bars and cafés are only allowed to offer takeaway services. 
 

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What about shops? 
 
In Denmark, most shopping malls have closed, with food shops, pharmacies, and specialist healthcare shops te only ones to remain open. 
 
In both Norway and Sweden, all shops have been allowed to remain open. According to the Norwegian Confederation of Industry (NHO), however, between 30 percent and 50 percent of shops in Norway decided to close down anyway because of the dramatically reduced footfall.
 
The NHO worked closely with the Directorate of Health on guidelines for how different sorts of shops would be able to operate while reducing the risk of spreading infection. Guidelines were posted on shop windows.
 
Many shops limited the number of people who could enter to as few as five or eight, and posted guards outside to enforce this, and also to hand out disposable plastic gloves to shoppers. Other shops positioned alcohol gel near the door.  
 
In Norway, shops have marked the floor to ensure those inside keep a distance of at least one metre from one another. 
 
These measures have now largely been lifted, and most of the shops which closed down in Norway have reopened over the past week. 
 
In Sweden, the Swedish Trade Federation, which represents most shops in Sweden issued its own guidelines, based on the general guidelines issued by the Public Health Agency of Sweden. 
 
These recommend putting markers on the floor to ensure that customers keep a distance of 1.5m from one another, and also making an employee responsible for closing the doors if the shop gets too crowded. 
 
What about sports? 
 
Denmark and Norway both this week (see here and here) said that group sports activities could start to resume.
 
But fitness centres, swimming pools, water parks, and amusement parks remain closed. 
 
In addition, players in both countries are advised to maintain a distance of at least two metres, ruling out many team sports. They also advised to limit their activities to groups of ten in Denmark and groups of five in Norway. 
 
The authorities in Denmark have also asked players not to use shared facilities such as showers and changing rooms. 
 
Norway's ruling also allows for scouts, youth politicians, marching bands and others to start to meet and practice for the first time, but only if they do so in groups of under five. 
 
In Sweden, the Public Health Agency on April 16th requested that competitive matches and league games for adult players of any sport should be postponed or cancelled.  
 
These followed guidelines for sports issued in mid-March, which advised practitioners to "reduce the amount of close physical contact", and to refrain from sharing mouthguards or water bottles, and also to try to reduce crowding. 
 
What about hairdressers, tattooists, dentists and dermatologists? 
 
Hairdressers, tattooists, dentists and dermatologists all opened in Denmark this week.
 
In Norway, one-on-one medical practitioners, such as dentists, psychologists, physiotherapists, and chiropodists also opened this week.
 
Their non-medical equivalents, such as hairdressers and beauticians, will however have to wait until next week. 
 
At hairdressers that have opened in Denmark, customers have often been given disposable tunics to reduce the risk of infection. 
 
In Sweden, all of these services have continued operating throughout the crisis, although they have been advised to follow social distancing guidelines, and also to offer facilities where customers can wash their hands. 
 
Some dental chains in Sweden, particularly those run by regional authorities, have limited themselves to emergency treatment. 
 
Who's the best at social distancing? 
 
In Denmark and Norway, the respective Prime Ministers -- Mette Frederiksen and Erna Solberg -- have both from the start used their strong communication skills to prepare the public for lockdown, and to emphasise the various restricting measures. 
 
In Denmark, this message was further strengthened by a rare and very well-received address by Denmark's Queen Margrethe II attacking the "recklessness" of those flaunting public guidelines. 
 
In Sweden, on the other hand, state epidemiologist Anders Tegnell and his colleagues at the Public Health Agency have largely been left to inform the public.  
 
Prime Minister Stefan Löfven has taken a secondary role, although in recent weeks he has become more active, warning Swedes not to relax their social distancing efforts. (King Carl XVI Gustaf has also addressed the nation, but did not make as much impact as Margrethe II.
 
Björn Olsen, professor of epidemiology at Uppsala University and a critic of Sweden's strategy, believes the role taken by the Prime Ministers has played a role in making Danes and Norwegians take the crisis more seriously.  
 
"Politicians are better communicators, and it's more understandable if the PM takes a step forward and says 'this is what we do'," Olsen said. "That's exactly what Mette Frederiksen did in Denmark, she was extremely clear, and also Erna Solberg." 
 
The tough measures imposed in Denmark and Norway have also, he argues, sent a powerful message to the public  in and of themselves, making more people realise that tackling coronavirus requires a drastic change in their behaviour. 
 
This is a message he argues has not filtered through to everyone in Sweden.
 
So even after the toughest restrictions are lifted, he suspects that people in Denmark and Norway might be more likely to maintain social distancing than those in Sweden. 
 
So will Denmark and Norway's openings slowly push the rate of infections up towards Swedish levels? 
 
Not according Wejse, although he believes the relaxation of restrictions will inevitably raise the rate of infection above what it would have been if they had remained in place. 
 
"There is a simple equation: the more contact, the more transmission of virus. So as more and more people get in contact with one another. As children meet one another in school and so forth, I would expect, because of that correlation, to see more transmission in society." 
 
What is in question is whether this increased transmission will be enough to reverse the declines in the number of infected people seen in Denmark and Norway over the past two weeks. 
 
"It's a very controlled opening focused on where the opening will have least impact on disease," he says of Denmark. "But we don't know, it's a test, you could say, it's a trial. We might end up with a new wave of infections, but I'm most inclined to think that we will not." 
 
Wejse says he believes that even as they lift restrictions, the infection curves in Denmark and Norway will most likely continue to decline.

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Anonymous 2020/04/24 19:05
This is factually incorrect “In Denmark, the only shops allowed to stay open have been supermarkets, food shops, pharmacies, and a few specialist healthcare shops.”<br /><br />Only those businesses with close proximity - such as hairdressers etc had to close. (Those are now open). <br />Other larger or busier venues had to close such as bars, restaurants, malls, gyms - are still closed. Restaurants can still sell takeaway. <br />But there has been no order closing other shops. Many small shops have remained open throughout. In my neighbourhood alone there are bike shops, home decor, electronics, phone shops, photo stores, florists — all open.

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