Sweden is an exception. Although the search for "herd immunity" cannot be the official definition of its strategy, Sweden remains to date the only state that did not impose a lockdown on its population. Breaking with the Scandinavian countries’ approaches (and Denmark’s, in particular), this strategy now seems to be contested: on June 4, 2020, the death toll for 100,000 inhabitants (45.8) exceeded that of France (43.2), Sweden now ranking fifth in all of Europe. Incidentally, Sweden is also going through recession, expected to reach 6.1% of GDP in 2020. That is less than what is expected, on average, within the European Union (-7.7% for 2020), but worse than in Austria (-5.5%) or Poland (-4.3%), whose lockdown measures allowed for a better protection of the population.
At the crossroads of the Italian and Swedish approaches, a way to sustain economic activity while saving as many lives as possible could have been to impose lockdown only on those who were at risk. Widely debated in several European countries, the targeted lockdown of people over the age of 65 was never implemented: only the canton of Uri, in Switzerland, tried to impose this measure before being warned against it by the federal government. In Switzerland, however, as in other European countries, the coronavirus victims’ average age is around 80.
The resilience of health systems
All European countries pursued the same objective, more or less immediately: namely, to flatten the contamination curve in order to avoid saturation of the healthcare system. In this context, the solidity of each country's healthcare system, and specifically the number of hospital beds available, played a key role in the ability of states to fight the epidemic.
In this respect, the emergence of the virus led to the questioning of several certainties. For example, the French social model had, until then, enjoyed a particularly positive reputation in Europe: the coronavirus outbreak revealed that Germany held five-times more intensive care beds, with a similar share of health expenditure to GDP in both countries. For many states, the Covid-19 crisis marked the end of illusions: Spain, convinced that it had the "best health system in the world", had its healthcare system saturated. The country now has one of the highest human death rates on the continent: 58.6 deaths per 100,000 inhabitants, not far behind the United Kingdom (61.1), but still far behind Belgium (84.1). These figures should nevertheless be viewed with caution, as the methods of calculation may differ between countries.
While the strength of hospital systems has been important in managing the epidemic, the main lesson of the crisis remains one of humility. The analysis of the Italian situation, particularly when comparing the strategies implemented in Lombardy and Veneto, confirms once again that an approach based on prevention, namely, in this case, targeted screening, is more effective than the extensive recourse to emergency hospitalization.