COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges

Sweden's use of soft response measures early in the COVID-19 pandemic received a good deal of international attention. Within Sweden, one of the most debated aspects of the pandemic response has been COVID-19 testing and the time it took to increase testing capacity. In this article, the develo...

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Autores principales:	Mio Fredriksson, Anna Hallberg
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	COVID-19 testing COVID-19 policy mass testing population-wide testing Sweden government steering Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/269fce6fd5084560906c4b1a646989f0
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spelling	oai:doaj.org-article:269fce6fd5084560906c4b1a646989f02021-11-19T05:35:24ZCOVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges2296-256510.3389/fpubh.2021.754861https://doaj.org/article/269fce6fd5084560906c4b1a646989f02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.754861/fullhttps://doaj.org/toc/2296-2565Sweden's use of soft response measures early in the COVID-19 pandemic received a good deal of international attention. Within Sweden, one of the most debated aspects of the pandemic response has been COVID-19 testing and the time it took to increase testing capacity. In this article, the development of and the debate surrounding COVID-19 testing in Sweden during 2020 is described in detail, with a particular focus on the coordination between national and regional actors in the decentralised healthcare system. A qualitative case study was carried out based on qualitative document analysis with a chronological presentation. To understand COVID-19 testing in Sweden, two aspects of its public administration model emerged as particularly important: (i) the large and independent government agencies and (ii) self-governing regions and municipalities. In addition, the responsibility principle in Swedish crisis management was crucial. Overall, the results show that mass testing was a new area for coordination and involved a number of national and regional actors with partly different views on their respective roles, responsibilities and interpretations of the laws and regulations. The description shows the ambiguities in the purpose of testing and the shortcomings in communication and cooperation during the first half of 2020, but after that an increasing consistency among the crucial actors. During the first half of 2020, testing capacity in Sweden was limited and reserved to protect the most vulnerable in society. Because mass testing for viruses is not normally carried out by the 21 self-governing regions responsible for healthcare and communicable disease prevention, and the Public Health Agency of Sweden stated that there was no medical reason to test members of the public falling ill with COVID-like symptoms, the responsibility for mass testing fell through the cracks during the first few months of the pandemic. This article thus illustrates problems associated with multi-level governance in healthcare during a crisis and illustrates the discrepancy between the health service's focus on the individual and the public health-oriented work carried out within communicable disease control.Mio FredrikssonAnna HallbergFrontiers Media S.A.articleCOVID-19 testingCOVID-19 policymass testingpopulation-wide testingSwedengovernment steeringPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 testing COVID-19 policy mass testing population-wide testing Sweden government steering Public aspects of medicine RA1-1270
spellingShingle	COVID-19 testing COVID-19 policy mass testing population-wide testing Sweden government steering Public aspects of medicine RA1-1270 Mio Fredriksson Anna Hallberg COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
description	Sweden's use of soft response measures early in the COVID-19 pandemic received a good deal of international attention. Within Sweden, one of the most debated aspects of the pandemic response has been COVID-19 testing and the time it took to increase testing capacity. In this article, the development of and the debate surrounding COVID-19 testing in Sweden during 2020 is described in detail, with a particular focus on the coordination between national and regional actors in the decentralised healthcare system. A qualitative case study was carried out based on qualitative document analysis with a chronological presentation. To understand COVID-19 testing in Sweden, two aspects of its public administration model emerged as particularly important: (i) the large and independent government agencies and (ii) self-governing regions and municipalities. In addition, the responsibility principle in Swedish crisis management was crucial. Overall, the results show that mass testing was a new area for coordination and involved a number of national and regional actors with partly different views on their respective roles, responsibilities and interpretations of the laws and regulations. The description shows the ambiguities in the purpose of testing and the shortcomings in communication and cooperation during the first half of 2020, but after that an increasing consistency among the crucial actors. During the first half of 2020, testing capacity in Sweden was limited and reserved to protect the most vulnerable in society. Because mass testing for viruses is not normally carried out by the 21 self-governing regions responsible for healthcare and communicable disease prevention, and the Public Health Agency of Sweden stated that there was no medical reason to test members of the public falling ill with COVID-like symptoms, the responsibility for mass testing fell through the cracks during the first few months of the pandemic. This article thus illustrates problems associated with multi-level governance in healthcare during a crisis and illustrates the discrepancy between the health service's focus on the individual and the public health-oriented work carried out within communicable disease control.
format	article
author	Mio Fredriksson Anna Hallberg
author_facet	Mio Fredriksson Anna Hallberg
author_sort	Mio Fredriksson
title	COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
title_short	COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
title_full	COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
title_fullStr	COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
title_full_unstemmed	COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges
title_sort	covid-19 testing in sweden during 2020–split responsibilities and multi-level challenges
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/269fce6fd5084560906c4b1a646989f0
work_keys_str_mv	AT miofredriksson covid19testinginswedenduring2020splitresponsibilitiesandmultilevelchallenges AT annahallberg covid19testinginswedenduring2020splitresponsibilitiesandmultilevelchallenges
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COVID-19 Testing in Sweden During 2020–Split Responsibilities and Multi-Level Challenges

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