Published: 07-09-2022 09:20 | Updated: 07-09-2022 09:29

Review and commentary on the national COVID-19 commission inquiry

Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a national Commission to examine the management of COVID-19 in Sweden. In a review, Professor Jonas F Ludvigsson summarizes and comments on the findings of the commission inquiry. The review is published in Acta Paediatrica.

Jonas Ludvigsson. Photo: Alexander Donka
Professor and pediatrician Jonas Ludvigsson. Photo: Alexander Donka

The COVID-19 pandemic affected many aspects of daily life in Sweden and led to a dramatic loss of human life, especially among older and poorer residents. It also caused unprecedented disruption to family life, work, schooling, the care continuum and society and no one escaped its impact. In late June 2020, the Swedish Government established a national COVID-19 Commission to examine how Sweden handled the pandemic. Interim reports were published in 2020 and 2021 with a final report in February 2022.

–I think the Swedish COVID-19 commission inquiry is a well-written summary and critique of how Sweden approached the pandemic. The pandemic disrupted society and drawing lessons from the report is crucial for our future pandemic preparedness. Despite the importance of the inquiry, I have so far not met any colleague who has actually read the 1700 pages, and that is why I wrote this review, to make the conclusions of the commission inquiry accessible to more people, says the author of the paper, Professor Jonas F Ludvigsson, pediatrician at Örebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

In Sweden, the death rates were high in spring 2020, but overall excess mortality in 2020-2021 was +0.79%, which was lower than in many other European countries.

–While the commission is often critical of the management of the pandemic in Sweden, they also underline that voluntary measures that were adopted, including keeping schools open, were appropriate and maintained Swedes’ personal freedom during the pandemic, adds Ludvigsson.

–However, they also conclude that more extensive and earlier measures should have been taken, especially during the first wave, he continues.

The paper by Ludvigsson focuses on health aspects of Sweden’s COVID-19 strategy, but also includes an overview of social care in Sweden, the Commission’s recommendations for elderly care, a review of postponed and delayed healthcare in 2020 (for instance diagnosed myocardial infarctions and certain cancer screening decreased), and the commission’s recommendations to strengthen pandemic preparedness. Finally, the review by Ludvigsson also includes a clinical overview of how COVID-19 was treated at Swedish hospitals during the third wave in spring 2021.

Conflict of interest

Dr Ludvigsson has coordinated a study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from the Janssen Corporation.


How Sweden approached the COVID-19 pandemic: summary and commentary on the national commission inquiry.
Ludvigsson JF
Acta Paediatr 2022 Sep 6.