Nils Anders Tegnell (born 17 April 1956)[1] is a Swedish civil servant and physician specialising in infectious disease. From 2013 until his resignation in March 2022 he was Sweden's state epidemiologist.[2][3]

Anders Tegnell
Anders Tegnell in 2020
State Epidemiologist of the Public Health Agency of Sweden
In office
2013 – 14 March 2022
DeputyAnders Wallensten
Preceded byAnnika Linde
Succeeded byAnders Lindblom
Personal details
Born
Nils Anders Tegnell

(1956-04-17) 17 April 1956 (age 68)
Uppsala, Sweden
SpouseMargit Saskia Neher
Children
  • Emily
  • Saskia
  • Annemiek
ResidenceVreta Abbey
Alma materLund University
Linköping University
ProfessionPhysician,
epidemiologist,
civil servant

Tegnell had key roles in the Swedish response to the 2009 swine flu pandemic and COVID-19 pandemic.[4][5] During the Covid pandemic in 2020, he became a divisive figure in Sweden and internationally due to his and the Public Health Agency of Sweden's opposition to lockdowns, travel restrictions and face masks for general use, which were widely adopted in most countries to curb the spread of the virus, as well as for his leading role in Sweden's controversial approach.

Biography

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Tegnell was born in Uppsala and grew up in Linköping, where he attended Katedralskolan. He studied medicine at Lund University in 1985, subsequently interning at the county hospital in Östersund, and later specialised in infectious disease at Linköping University Hospital.[6] In that capacity, in 1990 he treated the first patient in Sweden with a viral hemorrhagic fever, believed to be a case to be either the Ebola or the Marburg virus disease.[7]

From 1990-93 he worked for the WHO in Laos to create vaccination programs.[8] In an interview with Expressen, he describes his on-site work for the WHO with a Swedish expert team during the 1995 Ebola outbreak in Kikwit, Zaire as a formative experience.[9] From 2002-03 he worked as a national expert for the European Commission to prepare, at the EU level, for public health threats such as anthrax, smallpox and other infectious diseases.[6][2]

Tegnell obtained a research-based senior medical doctorate from Linköping University in 2003 and a MSc in Epidemiology from the London School of Hygiene & Tropical Medicine in 2004.[10][11] Tegnell then worked at the Swedish Institute for Communicable Disease Control (Smittskyddsinstitutet) 2004–5 and the National Board of Health and Welfare from 2005.[10]

From 2010–12 he served as head of the Department for Knowledge-Based Policy.[10][12] He was department head at the Institute for Communicable Disease Control 2012–13.

He was state epidemiologist of Sweden,[10] a title granted by the Public Health Agency of Sweden, from 2013 until 2022.

2009 swine flu pandemic

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As head of the Infectious Disease Control department at the agency, he had a key role in the Swedish large-scale vaccination program in preparation for the H1N1 swine flu pandemic,[2] which was declared by the WHO in June 2009.[13] Tegnell was embroiled in controversy due to his role in the mass vaccination scheme of 5 million Swedes against swine flu, which caused about 500 children to develop narcolepsy.[14][15][16] Tegnell was reported as saying of Pandemrix, the vaccine that had been known to cause neurological issues in the UK and was not approved by the US FDA, that it would have been highly unethical not to vaccinate people because hundreds of Swedes risked dying.[14][17][18]

COVID-19 pandemic

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On 2 April 2020, while the COVID-19 pandemic was widespread in most Western countries, of which many had imposed quarantine measures, Canadian newspaper The Globe and Mail reported there were "no lockdowns, no school closures and no ban on going to the pub" in Sweden.[19] However, some restrictions had been imposed, for example secondary schools and universities were recommended to physically close and transfer to distance education on 17 March,[20] and on 24 March cafés, restaurants and bars were ordered to allow table service only.[21] Moreover, gatherings of more than 50 people had been banned in Sweden as of 27 March.[22][23]

Sweden's pandemic strategy has been described[citation needed] as trusting the public to act responsibly: instead of wide-ranging bans and restrictions, authorities advised people to remote work if possible, maintain good hand hygiene, and practice social distancing, while those over 70 were urged to self-isolate as a precaution.[24]

Some Swedish scientists, medical practitioners and physicians were highly critical of Tegnell and the public health authority. Lena Einhorn contacted Tegnell in January 2020 to express her concern over the contagiousness of the virus, and said she was "exasperated" by the lack of measures in Sweden.[25] A group of 22 Swedish scientists published an op-ed in April that called for tougher restrictions.[26] At the time, these criticisms received substantial backlash in Swedish media.[25] In April 2020, the group suggested that 105 Swedes were dying per day from COVID-19. Tegnell disputed the numbers.[27] Several months later, revised government data showed that the critics' calculations were correct.[28]

'"It has been so, so surreal," [said] Nele Brusselaers, a member of the Vetenskapsforum and a clinical epidemiologist at the prestigious Karolinska Institute (KI). It is strange, she [said], to face backlash "even though we are saying just what researchers internationally are saying. It's like it's a different universe."'[25]

 
Tegnell during the daily press conference during the COVID-19 pandemic in April 2020.

Another flashpoint of criticism was Tegnell's position that there was no need to restrict travel over the school spring break, when thousands of Swedes traditionally travel to European ski resorts and other destinations. In an interview in February 2020, Tegnell said:[29]

When it comes to this type of travel, there is absolutely no need for concern about the coronavirus. In the Alps and southern Europe, for example, there is no spread at all.

Despite scepticism and criticism from a number of doctors and medical experts, as well as international news media, Sweden defended its strategy, with Prime Minister Stefan Löfven referring to "common sense" and Tegnell saying that the strategy is rooted in a "long tradition" of respecting "free will", as well as the high level of trust and respect Swedes have for public authorities.[19] According to a survey conducted by Sifo, the population's confidence in the Public Health Agency increased from 65% to 74% between 9–12 March and 21–25 March.[30] A March 2020 survey showed 53% of the Swedish population had trust in Tegnell, a higher number than for any of the leaders of the Swedish political parties, while 18% said they didn't trust him.[31] In an April survey, the share who said they trusted Tegnell had increased to 69%, while the number who said they didn't trust him had fallen to 11%.[32][33]

The strategy was commonly attributed to Tegnell,[23] who was quoted as saying:[19]

We have so far not had very much of a spread [of the virus] into old age homes and almost no spread into the hospitals, which is very important... We know that [with] these kinds of voluntary measures that we put in place in Sweden, we can basically go on with them for months and years if necessary. [The economy] has the potential to start moving as usual very, very quickly once these things are over.....

On 2 April 2020, Dagens Eko reported that significant spread of COVID-19 had occurred in retirement homes in at least 90 municipalities.[34] Previously, the government and the public health authorities had strongly advised against external visits to retirement homes, with several municipalities outright banning them. A nationwide ban on external visits to retirement homes came into force on 1 April.[35]

On 21 April 2020, Tegnell was interviewed by Marta Paterlini of Nature.[36] During the interview he said that:

Closing borders, in my opinion, is ridiculous, because COVID-19 is in every European country now....closing schools is meaningless at this stage. Moreover, it is instrumental for psychiatric and physical health that the younger generation stays active.

On 28 April 2020, Tegnell was interviewed by USA Today. During the interview he "denied that herd immunity formed the central thrust of Sweden's containment plan"[clarification needed]. Tegnell says rather that:[37]

We are trying to keep transmission rates at a level that the Stockholm health system can sustain... We are not calculating herd immunity in this. With various measures, we are just trying to keep the transmission rate as low as possible... Any country that believes it can keep it out (Ed. note: by closing borders, shuttering businesses, etc.) will most likely be proven wrong at some stage. We need to learn to live with this disease... At a glance it looks to me that Sweden's economy is doing a lot better than others'. Our strategy has been successful because health care is still working. That's the measure we look at... What the crisis has shown is that we need to do some serious thinking about nursing homes because they have been so open to transmission[38] (Ed. note: more than a third of Sweden's COVID-19 fatalities have been reported in nursing homes) of the disease and we had such a hard time controlling it in that setting.

Tegnell's statements that the Public Health Agency was not pursuing a strategy of herd immunity have been challenged, however, after media uncovered email communication where he appears to confirm that herd immunity was indeed the chosen strategy.[39]

Tegnell was skeptical of recommending face masks during the COVID-19 pandemic, sending several emails to the European Centre for Disease Prevention and Control criticizing the publication of advice recommending masks for general use in April.[25] In January 2020, he said in an interview with Dagens Nyheter:[40]

There is no evidence that use of face masks by the public would help reduce the spread of the virus.

Sweden began recommending face masks on public transport in December 2020, as Stockholm's healthcare system became seriously overwhelmed.[41]

A surge in COVID-cases and deaths occurred during the winter of 2020 in Sweden. King Carl XVI Gustaf and Prime Minister Löfven admitted they felt that Sweden's response was a failure due to the high number of deaths. Löfven said that many experts in Sweden had failed to predict or prepare for the severity of the winter surge.[42][43] Public confidence in Tegnell in Sweden fell from 72% to 59%.[44] Political party Sweden Democrats called for his resignation over deaths in care homes.[45]

His positions on COVID gave him unwelcome fame.[45] People had his face tattooed on their skin.[46] Swedish hip-hop artist Shazaam composed and released a song titled "Anders Tegnell" on April 7, 2020, portraying his stance on important issues for the Swedish society and youth.[47] He had been frequently invited for interviews by opponents of lockdowns in US and UK media.[44] Tegnell reportedly advised British prime minister Boris Johnson in September 2020, who is outside Johnson's usual circle of advisers, as the government debated introducing new restrictions in the UK.[48]

In September 2021, Tegnell said in an interview that he remained confident in Sweden's approach.[49] Analysts found that though Sweden's death rate remained lower than most countries in Europe, Sweden faced a far higher death toll than neighbouring Norway, Denmark and Finland and failed to protect the most vulnerable people.[49][50] On Dec. 21, 2021, Tegnell noted that "Omicron won't change Sweden's Covid strategy."[51]

Personal life

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Tegnell lives with his Dutch-born wife Margit in Vreta Kloster (outside of Linköping). He has three children.[52][2]

Honours, decorations, awards and distinctions

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Selected publications

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  • Brouwers, L.; Cakici, B.; Camitz, M.; Tegnell, A.; Boman, M. (2009). "Economic consequences to society of pandemic H1N1 influenza 2009 – preliminary results for Sweden". Eurosurveillance. 14 (37). doi:10.2807/ese.14.37.19333-en. PMID 19761738.
  • Cauchemez, Simon; Ferguson, Neil M.; Wachtel, Claude; Tegnell, Anders; Saour, Guillaume; Duncan, Ben; Nicoll, Angus (2009). "Closure of schools during an influenza pandemic". The Lancet Infectious Diseases. 9 (8): 473–481. doi:10.1016/S1473-3099(09)70176-8. PMC 7106429. PMID 19628172.
  • McVernon, Jodie; Mason, Kate; Petrony, Sylvia; Nathan, Paula; Lamontagne, Anthony D.; Bentley, Rebecca; Fielding, James; Studdert, David M.; Kavanagh, Anne (2011). "Recommendations for and compliance with social restrictions during implementation of school closures in the early phase of the influenza A (H1N1) 2009 outbreak in Melbourne, Australia". BMC Infectious Diseases. 11: 257. doi:10.1186/1471-2334-11-257. PMC 3190378. PMID 21958428.

References

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  1. ^ Sveriges befolkning 1980, CD-ROM, version 1.00 (Sveriges Släktforskarförbund 2004).
  2. ^ a b c d Mahmoud, Alexander; Delin, Mikael (11 March 2020). "Statsepidemiolog Anders Tegnell: Sverige har väldigt svårt att acceptera risker". Dagens Nyheter (in Swedish).
  3. ^ "Anders Tegnell to international vaccine commission [Anders Tegnell till internationellt vaccinuppdrag]" (in Swedish). Solna: Public Health Agency of Sweden. 9 March 2022. Retrieved 24 March 2022.
  4. ^ "Vem är Anders Tegnell och vad gör en statsepidemiolog?". MåBra (in Swedish). 20 March 2020. Retrieved 27 March 2020.
  5. ^ Nilsson /, Johan (27 March 2020). "Tegnell svarar på norsk kritik: 'Gör det lätt för sig'". Svenska Dagbladet (in Swedish). Retrieved 27 March 2020.
  6. ^ a b "Curriculum Vitae – Anders Tegnell" (PDF). European Centre for Disease Prevention and Control. Archived from the original (PDF) on 13 April 2020. Retrieved 4 April 2020.
  7. ^ "Mötte första patienten med blödarfeber". Västerviks-Tidningen. 18 April 2016. Retrieved 26 April 2020.
  8. ^ Delin, Mikael (11 March 2020). "Statsepidemiolog Anders Tegnell: Sverige har väldigt svårt att acceptera risker". Dagens Nyheter. Retrieved 24 March 2020.
  9. ^ Börjesson, Robert (2 April 2020). "Okända tragedin som formade Anders Tegnell". Expressen. Retrieved 2 April 2020.
  10. ^ a b c d e Anderson, Björn (2016). Kungl Krigsvetenskapsakademien. Svenska Krigsmanna Sällskapet (till 1805), Kungl Krigsvetenskapsakademien. 20 år med akademien och dess ledamöter 1996–2016. Stockholm: Kungliga Krigsvetenskapsakademien. p. 61. ISBN 978-91-980878-8-8..
  11. ^ Tegnell, Anders (2002). The epidemiology and consequences of wound infections caused by coagulase negative staphylococci after thoracic surgery. Linköping: Linköping University. ISBN 91-7373-186-2..
  12. ^ Sveriges statskalender 2010. Stockholm: Fritzes. 2010. p. 254..
  13. ^ "WHO declares swine flu pandemic: Sweden". The local. SE. Agence France Press. 11 June 2009.
  14. ^ a b "Tegnell defends vaccination that gave 500 young Swedes narcolepsy". Archived from the original on 6 April 2020.
  15. ^ "Hundratals unga fick narkolepsi av vaccin". Sydsvenskan. 24 March 2019.
  16. ^ "Swine flu shots linked to narcolepsy in Sweden". The local. SE. 9 February 2011.
  17. ^ Doshi, Peter (20 September 2018). "Pandemrix vaccine: why was the public not told of early warning signs?". BMJ. 362: k3948. doi:10.1136/bmj.k3948. PMID 30237282. S2CID 52308748.
  18. ^ Clarke, Toni (7 March 2013). "Narcolepsy link to Glaxo vaccine poses challenge for FDA". Reuters.
  19. ^ a b c Waldie, Paul (2 April 2020). "Why is Sweden staying open amid the coronavirus pandemic?". The Globe and Mail Inc.
  20. ^ Dahlqvist, Maria (17 March 2020). "Gymnasieskolor och universitet rekommenderas stänga". SVT Nyheter (in Swedish). Retrieved 7 April 2020.
  21. ^ "Table service only: Sweden's new restrictions for bars and restaurants". The Local. 24 March 2020. Retrieved 7 April 2020.
  22. ^ "Sweden bans public gatherings of more than 50 people: PM". Reuters. 27 March 2020. Retrieved 12 April 2020.
  23. ^ a b Brolin, Mark (3 April 2020). "Sweden is risking a lot as its coronavirus experiment comes under strain". The Telegraph. Archived from the original on 12 January 2022.
  24. ^ Modig, Karolina; Smith, Saphora (1 April 2020). "Sweden defies lockdown trend, bets on residents acting responsibly". NBC News. Retrieved 7 April 2020.
  25. ^ a b c d Vogel, Gretchen (6 October 2020). "'It's been so, so surreal.' Critics of Sweden's lax pandemic policies face fierce backlash". Science | AAAS. Retrieved 23 December 2020.
  26. ^ "DN Debatt. "Folkhälsomyndigheten har misslyckats - nu måste politikerna gripa in"". DN.SE (in Swedish). 14 April 2020. Retrieved 23 December 2020.
  27. ^ "Sjukdomsfall per dag (number of cases per day)". Folkhälsomyndigheten - antal fall av Covid-19 i Sverige. Stockholm: Public Health Agency of Sweden. Retrieved 26 January 2021.
  28. ^ "The Swedish COVID-19 Response Is a Disaster. It Shouldn't Be A Model for the Rest of the World". Time. Retrieved 26 October 2021.
  29. ^ Bengtsson, Tomas (8 February 2020). "Viruset stoppar inte sportlovsresandet – Kuriren". kuriren.nu (in Swedish). Archived from the original on 6 May 2021. Retrieved 6 May 2021.
  30. ^ Wennö, Jonathan. "Allmänhetens tillit, tankar och beteende under coronakrisen" (PDF) (in Swedish). Kantar Sifo. Retrieved 7 April 2020.
  31. ^ "Mer än hälften av svenskarna har förtroende för Anders Tegnell – Nyheterna". www.tv4.se (in Swedish). Retrieved 18 April 2020.
  32. ^ "DN/Ipsos: Stort förtroende för Anders Tegnell". Dagens Nyheter (in Swedish). 2 May 2020.
  33. ^ Baker, Sinéad. "7 people in Sweden told us why they think their government made the right call in having no coronavirus lockdown". Business Insider.
  34. ^ "Virus på äldreboenden i stora delar av landet". 2 April 2020.
  35. ^ Malmén, Joel (31 March 2020). "Besöksförbud införs på Sveriges äldreboenden". SVT Nyheter. Retrieved 7 April 2020.
  36. ^ Paterlini, Marta (2020). "'Closing borders is ridiculous': The epidemiologist behind Sweden's controversial coronavirus strategy". Nature. 580 (7805): 574. Bibcode:2020Natur.580..574P. doi:10.1038/d41586-020-01098-x. PMID 32317784. S2CID 216073655.
  37. ^ Hjelmgaard, Kim (28 April 2020). "Swedish official Anders Tegnell says 'herd immunity' in Sweden might be a few weeks away". Gannett Satellite Information Network. USA Today.
  38. ^ Henley, Jon (3 June 2020). "We should have done more, admits architect of Sweden's Covid-19 strategy". The Guardian – via www.theguardian.com.
  39. ^ "FHM:s tidiga strategi var flockimmunitet". Aftonbladet (in Swedish). 5 November 2020. Retrieved 6 May 2021.
  40. ^ "Därför skyddar inte munskydd mot virus". Dagens Nyheter (in Swedish). 28 January 2020. Retrieved 6 May 2021.
  41. ^ Kennedy, Rachael (18 December 2020). "Sweden switches strategy and calls for face masks on public transport". euronews. Retrieved 23 December 2020.
  42. ^ "Coronavirus: Swedish King Carl XVI Gustaf says coronavirus approach 'has failed'". BBC News. 17 December 2020. Retrieved 23 December 2020.
  43. ^ Henley, Jon (17 December 2020). "King of Sweden blasts country's 'failed' coronavirus response". The Guardian. ISSN 0261-3077. Retrieved 31 March 2022.
  44. ^ a b Orange, Richard (20 December 2020). "As Covid death toll soars ever higher, Sweden wonders who to blame". The Observer. ISSN 0029-7712. Retrieved 23 December 2020.
  45. ^ a b Milne, Richard (11 September 2020). "Anders Tegnell and the Swedish Covid experiment | Free to read". Financial Times. Retrieved 26 October 2021.
  46. ^ "Anders Tegnell and the Swedish Covid experiment". Financial Times. 11 September 2020. Retrieved 11 September 2020.
  47. ^ "Rap artist Shazaam's tribute to Anders Tegnell". ABC News. 30 June 2020. Retrieved 5 January 2021.
  48. ^ Payne, Adam; Colson, Thomas. "Boris Johnson took advice from Sweden's no-lockdown scientist before rejecting tougher coronavirus restrictions". Business Insider. Retrieved 26 October 2021.
  49. ^ a b Guenot, Marianne. "The architect of Sweden's no-lockdown COVID-19 response said the approach was basically correct". Business Insider. Retrieved 26 October 2021.
  50. ^ "Sweden saw lower 2020 death spike than much of Europe - data". Reuters. 24 March 2021. Retrieved 26 October 2021.
  51. ^ "Anders Tegnell: 'Omicron won't change Sweden's Covid strategy'". December 2021.
  52. ^ Westerlund, Torbjörn (18 April 2016). "Mötte första patienten med blödarfeber – Västerviks-Tidningen". VT (in Swedish).
  53. ^ Tegnell, Anders (2007). "Pandemiernas påverkan på samhället" (PDF). Kungl. Krigsvetenskapsakademiens Handlingar och Tidskrift. 5/2007: 76–79.

Bibliography

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