Ask Sweden’s former chief epidemiologist Anders Tegnell whether fewer Swedes would have died back in 2020 if he hadn’t chosen a less-restrictive path in reaction to the COVID-19 pandemic, and he hesitates.

“I don’t even think with the data we have today we can answer that,” the Swedish newspaper Svenska Dagbladet quoted him as saying a few weeks ago, “because we still know very little about the effects the measure had.”

That’s an important point as, in this country at least, the long and troubling pandemic now ends. The House and Senate both have voted to officially end the COVID-19 national emergency, and President Joe Biden has said he won’t veto the measure.

Now it’s time to begin sifting through lessons, if that’s even possible.

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What mistakes were made? What was done right? Can any of this be evaluated free of current politics?

Sweden made headlines in the early days of COVID-19 by going the opposite direction of the rest of the world. There were no mandatory lockdowns. Schools stayed open. Masks were not enforced. 

Two years ago, critics in Sweden were lamenting that the policy put elderly people at risk. I wrote that this experiment was playing with the life of my wife’s uncle, an octogenarian living in Eskilstuna, Sweden.

Well, he turned 90 a few weeks ago and was feeling fine when we called him.

That still doesn’t mean the Swedes were right. We might never know if they were.

That’s because the way we look back on the pandemic depends on how we measure things and what we deem important, and everyone seems to be picking the metric that makes them look best.

Dagbladet claims Sweden did exceptionally well, at least when you look at the number of deaths above and beyond the normal mortality rate. The country expects about 90,000 deaths a year. In 2020 it had about 98,000, in 2021 it had 92,000 and in 2022 it had 95,000. That’s the lowest excess death total in the European Union, the paper said.

But if you look at the rate of COVID-caused deaths per million population, as compiled by the world statistical website, the picture looks different. Sweden had 264,331 COVID-19 cases per million, and 2,331 deaths. That’s a smaller case rate than much of Europe, but the death rate was much higher than neighboring, and more restrictive, Norway, with 946 deaths per million.

On the opposite end of that scale, Utah’s political leaders like to brag that the state did great during the pandemic because the state’s death rate was just 1,658 per million. But the case rate, at 340,841, was among the nation’s highest. 

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Utah has a young population, which may have been better at weathering the virus. But more cases translates into more long-term side-effects, which are nothing to gloss over. 

So, which metric is best? Cases per capita or deaths? Peru had among the worst death rates in the world, at 6,524. It rapidly closed its borders and imposed strong control measures. But, as the world global health and vaccine organization Gavi reported, Peru’s informal workforce made it hard for people to stay home, and its economic system meant that people had to continue standing in lines at grocery stores and in banks.

So, maybe the answer is, it depends?

Clearly, other factors affected outcomes. Norway, The Wall Street Journal noted, has a “sense of communal solidarity that goes back centuries …” Many Utahns, like their counterparts throughout the United States, viewed lockdowns and everything presidential medical adviser Anthony Fauci said with suspicion and distrust.

But there are other important measures of public health, as well. British cabinet secretary Simon Case, stating what now should be obvious, told The Telegraph that lockdowns were bad for “jobs, education, social cohesion, mental health etc.”

Lisa Diamond, a professor of developmental psychology at the University of Utah, recently told the Deseret News/KSL editorial board that the pandemic’s long-term effects go far beyond symptoms of the virus alone.

Under normal circumstances, when an emergency strikes, “what do humans naturally do in that circumstance? We clutch. We come to our close people,” she said. “And this virus said, Oh, no, no, no, no, you can’t do that. Don’t touch grandma. ... So, for the human nervous system, the disconnection that the pandemic brought out was the worst thing for us. 

“I think that we’ll be seeing the effects of that for at least a decade. I’m seeing it in the mental health rates in adolescents and young adults. The students at the U. are not the same students. My sister is a second grade teacher. Her students are not the same students.”

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The choice for any future generation dealing with a pandemic, then, is complicated. Whose interests matter most, and how are those decisions made when medical professionals are trying to understand the virus as it’s spreading?

In Norway, The Wall Street Journal said, officials were frank with people from the beginning, explaining the uncertainties and disagreements. They closed schools for about six weeks, telling people the evidence for doing so was weak but reasonable. Then they changed their minds and reopened them.

“By expressing that uncertainty, they gained much trust from the population,” said Lt. Gen. Rune Jakobsen, a Norwegian military leader.

Or, as Sweden’s Tegnell said, “You have to understand how a society works.”

As we’ve learned over the past three years, that’s not easy to do.