Covid-19: Sweden considers tougher restrictions as ICU beds near capacity

Health officials in Sweden have warned that intensive care units (ICUs) in and around Stockholm are under severe pressure and close to capacity for the first time during the pandemic.

Although the city’s hospitals could increase the number of beds allocated to ICUs, there are insufficient specialist staff to support them, said Björn Eriksson, director of Region Stockholm Healthcare.

He told The BMJ, “So far, we have been one step ahead of the virus by continuously opening more care places so that they’re available when the need arises. Now, healthcare staff are so hard pressed and the margins are so tight that on 10 December I formally asked the National Board of Health and Welfare for more specialised staff.”

One option being considered is “borrowing” trained staff from private care providers, he said.

The Swedish government changed its approach to the pandemic last month when it introduced tougher restrictions on social interactions after cases started to rise.1 The soft approach the government had adopted, based on recommendations and voluntary behaviour of citizens, has shifted as cases of infection with SARS-CoV-2 have continued to surge along with hospitalisations and deaths.

This week Prime Minister Stefan Löfven announced that the ban on gatherings of more than eight people would extend to the Christmas holidays, while secondary schools have been told to switch to distance learning for the rest of the term. The government has also asked the parliament to grant it more authority to implement new measures such as closing shopping malls and gyms.

On 10 December, Sweden reported a daily record of 10 464 cases, bringing its overall total of confirmed infections to 320 098. There have been 7514 deaths to date, 2836 of them in the capital and its environs.

There are 1989 people with covid-19 in Sweden’s hospitals with 258 in ICUs, 78% of the country’s capacity.

Stockholm and the surrounding region are particularly hard hit and have seen cases soar to 756 per 100 000 inhabitants in the past 14 days, much higher than neighbouring Scandinavian countries. By comparison, cases per 100 000 are 434 in Denmark, 116 in Finland, and 97 in Norway.

Johan Styrud, chairman of the Stockholm Medical Association and chief physician at Danderyd Hospital, one of Stockholm’s main facilities, told The BMJ that he would like to see stricter adherence to government guidelines to help relieve pressure on the healthcare system.

However, Karin Tegmark Wisell of the Public Health Agency, which manages pandemics in Sweden, claimed at the weekly press conference on 10 December that data show that Swedes were adhering to recommendations and are moving around the country less.