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Deaths in Swedish nursing homes hidden by municipalities

In the "humanitarian superpower" Sweden, the management of the Covid-19 pandemic by public health authorities has defied the most basic sense of medical ethics.

Published: May 22, 2020, 8:14 am

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    At least 90 percent of the total Covid-19 deaths in Sweden are people aged 70 and older, and that half of these occurred in nursing homes. Several municipalities in Södermanland County on the southeast coast of Sweden, claim that they do not know how widespread the infection is among the elderly. But that is not true.

    Eight out of nine municipalities in Södermanland have stated that they do not know how many people are infected in their elderly care. Sadly, however, municipalities knew but have deliberately withheld the information in order to prevent media scrutiny and public transparency.

    The fact that the virus has made its way into elderly care is a failure that the Swedish Public Health Authority has admitted to. And Swedish Health and Social Care Inspectorate (IVO), has identified elderly care in Södermanland as the worst affected in the country.

    In order to give the public access to the scope of the problem and the authorities’ ability to protect the residents, the Ekuriren newspaper has repeatedly asked the municipalities how extensive the spread of infection is in nursing homes.

    The municipalities first rejected the newspaper’s request citing confidentiality, even though the newspaper did not want to have personal information but a number of the infected. When the newspaper asked for the information in writing, the reason for rejecting the request suddenly changed.

    “According to the Freedom of Expression Regulation, Chapter 2, §§ 2, such a compilation, which the request relates to, can not be made available with routine measures. It is therefore not stored at the authority and it is not a public document,” it was said.

    Thus, the municipalities do not know how extensive the spread of infection is and cannot find out, either, they maintain. In addition, the answers of the different municipalities have been strikingly similar.

    A major problem has been the lack of protective clothing. Several reports have surfaced after staff became ill: they lacked protection when they cared for Covid-19 cases in nursing homes. In Stockholm, a preliminary investigation is being conducted into the deaths.

    E-mails sent by the municipalities before Easter to the crisis management staff at the county administrative board in Södermanland suggest sheer desperation. Several municipalities lack approved mouthguards, surface disinfection and long-sleeved protective coats. Katrineholm, which has the largest spread of infection, demanded help from the neighboring municipalities.

    The serious situation moved the governor on April 8 to appeal for protective equipment in an e-mail to the National Board of Health and Welfare. “The county has municipalities where we reported that some equipment is completely out of stock. Easter will be very strained … and it is imperative that every effort be made to assist.”

    It appears as though the information was available about the spread of infection, but the municipalities decided not to inform the public – thus ignoring a firm principle in the Swedish constitution.

    On April 14, that is, the same date that the municipalities began to reject the newspaper’s request, the following was noted in the county administrative crisis management report: “Infection is found in nursing homes in most of the municipalities, total infection found in 23 of the county’s nursing homes.”

    According to the rules, suspected infected persons are tested and when infected, the head of operations or unit manager is informed. He must then inform the medically responsible nurse in each municipality.

    The newspaper has talked to middle managers in the elderly care department who have told them that they monitor the spread of infection closely in the municipalities and make compilations to have control over the need for protective equipment.

    In addition, on April 15, the National Board of Health and Welfare opened its national reporting tool for ordering protective clothing. The municipalities are asked to report on the access to protective material as well as how many are infected in their elderly care operations.

    The newspaper has confirmed that all municipalities in Södermanland have used the reporting tool, most from the start. However, it is unclear if all have reported figures on the spread of the infection.

    In one particular e-mail, the County Administrative Board states that several municipalities are considering not reporting figures on the number of infected persons. It mentions one municipality that deliberately chose to omit the number of infected persons after a decision made at a meeting with all municipality managers in order to avoid media scrutiny.

    The unwillingness to report the number of infected persons may have affected the safety of medical workers. The purpose of the National Board of Health and Welfare’s tools is to make it easier for municipalities and county councils to be assisted with protective equipment, explained David Söderlund, employee at the National Board of Social Affairs’ special organization for Covid-19.

    Marcello Ferrada de Noli, Swedish professor emeritus of public health sciences and former Research Fellow at Harvard Medical School, told RT that Sweden’s political and healthcare leaders have a lot to answer for.

    Sweden now hold the unenviable record of the highest number of confirmed daily Covid-19 deaths per capita reported over a seven-day consecutive period.

    British daily, the Telegraph reported on how a local Stockholm politician, Bjorn Branngard, who got a call the care home where his mother was staying. The nurse asked Branngard for permission to move his mother: “Because it’s only her and one other person who is still alive. Everyone else is dead,” she said. Branngard’s mother also died a few days later.

    The Swedish professor emeritus cited the example of Nurse Latifa Lofvenberg who had witnessed the “horrible” demise of many elderly patients who were denied oxygen to aid their respiratory problems. She was fired after her comments were posted on YouTube.

    A professor of geriatric medicine, Yngve Gustafson, in an interview on TV Channel 4, admitted that elderly were prescribed palliatives, including both morphine and midazolam which suffocate the patients, “because both drugs deteriorate breathing”.

    Complaints about patients being denied treatment at intensive care units (ICU) at hospitals in the Stockholm Region, despite places being available, are described as “serious”.

    The newspaper Expressen reported on this issue: “We are concerned about the process of selection for respiratory care among patients with severe Covid-19 infection in the Stockholm region. We have repeatedly found that those patients who are deemed to be in need of respiratory care for a long time (a couple of weeks) are denied intensive care with the argument that a younger patient with better prognosis may need the place in a few days.”

    During Wednesday’s press conference with the Public Health Authority, it was noted that the number of deaths in Sweden in Covid-19 increased by an additional 88 people to a total of 3 831 dead. Some 724 new confirmed cases of the coronavirus SARS-CoV-2 were also detected, which means that a total of 31 523 cases were confirmed in Sweden.

    However, the number of deaths continues to lag in the reporting by about 10 days, so the actual number of deaths is considerably higher, just as those confirmed to be infected with the Coronavirus are overwhelmingly only those individuals who are actively seeking medical care for their coronary-related symptoms.

    When asked by one of the journalists on site why Sweden has had the most deaths per capita in the world over the last seven days, state epidemiologist Anders Tegnell replied: “You have to relate these numbers to a number of different things. You have picked the death figures per day, it is not a relevant figure. And the countries are in completely different stages of this infection.”

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