Officers in Halmstad municipality, Sweden, just lately compelled a trainer to take away their masks and prohibited the usage of masks and all types of PPE in faculties. The municipality said there was no scientific proof for sporting masks, citing the Swedish public well being company. On the time, company steerage said that there have been “great risks” that masks can be used incorrectly. This steerage has since been eliminated.
To somebody unfamiliar with the Swedish response to COVID-19, this masks ban would possibly sound stunning. In any case, whereas masks are not foolproof, there’s evidence that signifies that they do assist cut back the unfold of COVID-19, particularly in conditions the place sustaining distance is unimaginable – corresponding to faculties.
The municipality eventually backed down. However new examples of masks bans maintain popping up in Sweden. Librarians within the prosperous city of Kungsbacka, for instance, have been instructed not to wear masks.
How on earth did we find yourself on this state of affairs? All the things the Halmstad and Kungsbacka officers have stated about masks is consistent with the Swedish public well being company’s statements. These native masks bans are a logical product of 9 months of constant antimask statements by the Swedish state, which we argue is an instance of poor threat communication.
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A European outlier
Outdoors of Sweden, most Europeans are now used to sporting masks indoors whether or not within the grocery store, on public transport, or when visiting the physician. It has grow to be such an ingrained behavior that we will simply neglect that, for the primary months of the COVID-19 pandemic, many people weren’t sporting masks in any respect. In these early days, the principle message was the reasonably easy “wash your fingers” and the reasonably tougher “don’t contact your face.”
The European Heart 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) followed suit. England waited till July, and eventually in August, Norway, Denmark, and Finland introduced in masks necessities.
Sweden, as we’ve seen, selected a distinct path. The Swedish public well being company has persistently said that masks are ineffective and that their use might really enhance the unfold of COVID-19—a standard view initially 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 culture or tradition of constructing choices about protecting clothes corresponding 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 antimask activism. In April, the nation’s chief epidemiologist, Anders Tegnell, wrote an email to the European Heart for Illness Management (which occurs to be based mostly in Stockholm), warning it to not suggest the usage of masks. The reasoning was that this “implies the unfold is airborne,” which might “severely 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, maintain distance, keep house in the event you are sick. This might be acquainted to folks in lots of different international locations and is a textbook instance of efficient threat communication, which must be clear, simple, and simple to behave upon.
The WHO guidelines for efficient threat communication in public well being crises emphasize that uncertainties must be explicitly said, that the knowledge is constant and simple to know, and that the messaging incorporates particular and practical advisable actions.
The preliminary phases of Swedish threat communication ticked two of those packing containers whereas failing to speak uncertainty, which was the case in lots of international locations that additionally selected quite simple messages.
As scientific understanding of the virus developed, nevertheless, the Swedish threat communication round masks didn’t change. In August, for instance, when mask-wearing was turning into widespread in different European international locations, Tegnell stated that the proof for mask-wearing was “astonishingly weak” and that their use might increase the spread of the virus.
A muddled masks mandate
Swedish authorities maintained their antimask place till December, when the prime minister, Stefan Lofven, announced 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 touring. As a substitute, it recommends the usage of masks from 7 a.m. to 9 a.m. and 4 p.m. to six p.m., for these born “in 2004 and earlier than” who do not need a reserved seat. If this sounds overly difficult, that’s as a result of it’s.
It’s maybe unsurprising, then, that compliance has been low, with solely half of commuters really sporting 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 no masks on a bus throughout rush hour. When requested about his failure to conform along with his personal suggestions, he said, “I merely failed to note that the time had grow to be commuting time,” which properly illustrates the issue with overly advanced threat communication.
Complicated and sophisticated
If the pinnacle 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.
Initially of the pandemic, the Swedish authorities’s preliminary threat 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 attributable to its complexity but additionally attributable to the truth that its content material instantly contradicts the masks steerage from March till December.
On this context, it’s no marvel that libraries and faculties in Sweden are sending blended messages about whether or not folks ought to put on masks.
It’s the product of months of unhealthy threat communication on a easy public well being measure that has been extensively adopted elsewhere. This failure to speak might have very worrying outcomes: probably elevated an infection in a rustic that’s on the brink of a third wave.