Stockholm City’s Elderly Care and Covid19: Interview with Barbro Karlsson

Abstract

Upwards of 70% of the Covid19 death toll in Sweden has been people in elderly care services (as of mid-May 2020). We summarize the Covid19 tragedy in elderly care in Sweden, particularly in the City of Stockholm. We explain the institutional structure of elderly care administration and service provision. Those who died of Covid19 in Stockholm’s nursing homes had a life-remaining median somewhere in the range of 5 to 9 months. Having contextualized the Covid19 problem in City of Stockholm, we present an interview of Barbro Karlsson, who works at the administrative heart of the Stockholm elderly care system. Her institutional knowledge and sentiment offer great insight into the concrete problems and challenges. There are really two sides to the elderly care Covid19 challenge: The vulnerability and frailty of those in nursing homes and the problem of nosocomial infection—that is, infection caused by contact with others involved in the elderly care experience. The problem calls for targeted solutions by those close to the vulnerable individuals.

Full text

GLOBAL SOCIETY
Stockholm City’s Elderly Care and Covid19: Interview
with Barbro Karlsson
Charlotta Stern
1
&Daniel B. Klein
2
#Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Upwards of 70% of the Covid19 death toll in Sweden has been people in elderly care services (as of mid-May 2020). We
summarize the Covid19 tragedy in elderly care in Sweden, particularly in the City of Stockholm. We explain the institutional
structure of elderly care administration and service provision. Those who died of Covid19 in Stockholm’s nursing homes had a
life-remaining median somewhere in the range of 5 to 9 months. Having contextualized the Covid19 problem in City of
Stockholm, we present an interview of Barbro Karlsson, who works at the administrative heart of the Stockholm elderly care
system. Her institutional knowledge and sentiment offer great insight into the concrete problems and challenges. There are really
two sides to the elderly care Covid19 challenge: The vulnerability and frailty of those in nursing homes and the problem of
nosocomial infection—that is, infection caused by contact with others involved in the elderly careexperience. The problem calls
for targeted solutions by those close to the vulnerable individuals.
Keywords Covid-19 .Sweden .Stockholm .Elderly care .Nursing homes .Nosocomial
JEL Codes I18 .I38 .H4
Nursing homes have been Covid19 hotspots. In many coun-
tries upwards of 40, 50, and 60 percent of the deceased taken
were in the elderly care system. In Canada it is upwards of 80
percent. This paper is focused on Sweden, where it is upwards
of 70%, and more specifically our focus is the City of
Stockholm (henceforth “Stockholm city”(stad) as opposed
to Stockholm county (län)).
The elderly care tragedy must be studied. Errors must be
understood and corrected.
Sweden has not imposed general lockdowns. Its relatively
permissive approach has drawn worldwide attention. People
ask whether Sweden would have suffered fewer deaths if it
had locked down more.
Stockholm is the nation’s capital and largest city. The
county of Stockholm accounts for 50% of Sweden’s
Covid19 deceased (16/5/2020), the Stockholm city accounts
for 20% of Sweden’s Covid19 deaths (11/5/2020). Whereas
the rate of deaths per million population for the whole of
Sweden is 323, it is 697 for Stockholm city (11 May 2020
1
).
The city’s Covid19 death rate is more than twice that of the
country’s.
Most Covid19 victims are elderly. In Sweden the percent-
ages of the deceased as of 16 May 2020 are 22% in their 70s,
41% in their 80s, and 25% in their 90s. Altogether that makes
88% aged 70 or over (see Fig. 1).
Notice in Fig. 1that the vast majority of the aged 80+
deceased never went to intensive care. Turning now to Fig.
2, we see that comorbidity is extremely common among the
deceased.
The former chief epidemiologist of the Public Health
Agency of Sweden Johan Giesecke says bluntly that Sweden
has failed in protecting those in elderly care. In some of the
1
The data for Stockholm city comes from: https://platz.se/coronavirus/?city=
Stockholm&lang=en, showing 669 deaths as of May 11, 2020. The data for
Sweden comes from: https://www.worldometers.info/coronavirus/#countries,
showing 3256 deaths as of May 11, 2020.
*Daniel B. Klein
dklein@gmu.edu
Charlotta Stern
lotta.stern@sociology.su.se
1
Department of Sociology, Stockholm University, SE-106
91 Stockholm, Sweden
2
Mercatus Center, George Mason University, Fairfax, VA 22031,
USA
https://doi.org/10.1007/s12115-020-00508-0
Published online: 19 July 2020
Society (2020) 57:434–445
Content courtesy of Springer Nature, terms of use apply. Rights reserved.