Book review: The Herd: How Sweden Chose its Own Path Through the Worst Pandemic in 100 Years, by Johan Anderberg

posted: October 5, 2024

tl;dr: What happens in a pandemic when you actually follow the science...

When in trouble or in doubt

Run in circles, scream and shout

That’s one of my favorite bits of bad advice, as I mentioned in The best life advice ever, because so often it's the way that humans react to a novel situation. It definitely applied in the United States and many other countries during the COVID-19 pandemic. Yet what would have happened if we in the U.S. had instead followed my favorite bit of good advice: “Don’t Panic!”? That’s mostly what Sweden did, as documented in The Herd by journalist Johan Anderberg.

To me, the most reassuring aspect of The Herd is that Anderburg builds the case that it was Sweden, not the United States and elsewhere, that actually followed the science. There is no large body of science that supports the school shutdowns and lockdowns that were implemented in the U.S. and elsewhere. The science is also weak on the benefits of community masking with cloth masks for a highly transmissible respiratory virus. Many mortality models were produced on-the-fly, and proved to be woefully inaccurate. These models were nothing more than junk science.

Meanwhile in Sweden, their public health experts followed the pre-existing science about how to manage pandemics, which cautions against severely disrupting society. The Swedish scientists got many things right from the beginning. They understood the difference between Case Fatality Rate (CFR) and Infected Fatality Rate (IFR), and did not overreact to the high CFR figures early in the pandemic, before widespread testing for the virus was possible. For testing, they knew it was important to try to measure how many people had already been infected with the virus, by testing for antibodies. From early days they knew that the virus was much more deadly in older people with pre-existing conditions, e.g. the frail, who are also the main victims of flu.

A white book cover containing the author's name, the book's title and subtitle, as well as one blurb, along with a drawing of dozens of small people in colorful shirts forming a group that is shaped like a blob

Additionally, the Swedes intuitively understood the harms of lockdowns. They didn’t need a long-term study of how grade schoolers attending Zoom school performed on aptitude and mental health tests to know that shutting schools would harm children. Also, if the kids stayed home a parent would have to stay with them, which would disrupt workplaces including Sweden’s healthcare system. They knew that people needed to get outside and exercise to maintain their health. They also knew that COVID-19 was but one of many diseases that killed people, and that focusing on it too much would cause deaths in other areas, for example through missed cancer screenings.

The primary heroes of The Herd are Anders Tegnell, Sweden’s state epidemiologist, and Johan Giesecke, Tegnell’s former boss who came out of retirement to help during the pandemic. The primary villain is Neil Ferguson of the U.K.’s Imperial College, who early in the pandemic made wildly inaccurate projections of 510,000 deaths in the U.K. and 2.2 million deaths in the United States. Other villains are all the politicians around the world who panicked over the output from Ferguson’s computer model, and other scientists who also overestimated the impact of the SARS-CoV-2 virus and advocated for severe restrictions that had little impact on the overall death rate (or made it worse), and came with massive social costs. Meanwhile in Sweden, Tegnell, Giesecke and other Swedish scientists calmly went about uncovering the flaws in Ferguson’s study and refusing to panic.

The Herd is a book-length piece of journalism. There are no footnotes, although a bibliography is provided. It’s not a definitive, scientific work that can be said to conclusively prove that Sweden chose a better path than other nations. But by the time The Herd was published in late 2021, Sweden had already distinguished itself by posting a lower per-capita excess death rate than most other countries in the developed world. That out-performance has continued to this day.

We (the United States) screwed up royally. Among other bad outcomes, an entire generation of U.S. children have had their educations adversely impacted. Sweden did a much better job of following the science, and prioritizing liberty and the lives of the young, than we did. Whether we learn from these lessons when the next pandemic hits remains to be seen.