
Spanish flu helped create Sweden's modern welfare state - notlukesky
https://www.theguardian.com/cities/2018/aug/29/how-spanish-influenza-helped-create-sweden-modern-welfare-state-ostersund
======
Yetanfou
> The 1918 pandemic ravaged the remote city of Östersund. But its legacy is a
> city – and country – well-equipped to deal with 21st century challenges

Had they written this 30 years ago this would certainly have been true, Sweden
as a nation had heeded Baden Powell's motto "Be Prepared". A large part of
this preparation was realised through the unusual but effective way the
country had organised its defence which was integrated into most parts of
society. The system was called 'Totalförsvaret' (literally 'the total
defence') and integrated armed forces, civilian institutions and parts of
industry into an organisational structure which was designed to be resistant
against the loss of one or more of its arms. There were large stockpiles of
material and supplies scattered around the country, these included amongst
other 50 mobile field hospitals with 2100 respirators, fully equipped
operating theatres, etc. The country had stockpiled food supplies which could
last for a maximum of 2 years.

But... nearly all of this was disbanded, given away, thrown away, sold off or
demolished in the years after the demise of the Soviet Union. The field
hospitals went to the Baltic states, the respirators (new, unused) were given
away or thrashed. The food supplies are gone, Sweden has gone from 2 years of
supplies to about 16 days, i.e. whatever is in the distributor's warehouses
and on the road at the moment.

Before the 90's Sweden had access to about 3600 respirators, now the number
seems to be around 520 - seems to be because the "government" has decided this
number is critical to the nation's security and as such is not published. The
country has the lowest number of hospital beds per capita in the OECD after
Portugal.

Maybe SARS2 will help to rebuild this part of the Swedish state? Time will
tell.

~~~
jacobush
Maybe 25 years even. (After that, it went downhill fast.)

The defense was truly remarkably in depth and at all levels prepared to
continue operations without a remaining chain of command. A Soviet invading
force would have of course "won" within weeks, but not before suffering huge
losses thanks to always-at-the-ready 200 state of the art fighter bombers
using highways all over the country for runways, with a ground crew of only 5
per plane, and a handful of the worlds best (for littoral waters) submarines.

When the coastal artillery would be neutralized, presumably with nukes or
speznas, the mobile artillery would retreat inland. The cities were assumed to
be nuked, but a large fraction of the city population had underground shelter.

Even with Air and Naval forces depleted, the real struggle for a would be
invader would only begin. There were weapons and food stored all over the
countryside, and the communicated doctrine was _" if you hear about a
surrender from anyone, even the prime minister, it's false news. Keep fighting
until the country is liberated."_

It would have been like Afghanistan, except the insurgents would have had
access to better weapons.

All of this had the purpose of deterring the Soviet command from full on
ground invasion. Perhaps only nuke the larger cities, destroy some strategic
assets and kill the government. In a WW3 scenario, that would have been a win
for Sweden.

~~~
mongol
I wonder what happened with risk awareness. I know many who even at the time
thought it was insane to decommission so much of preparedness. Could it have
been a generational thing? Or just a huge sigh of relief after the cold war
ended? I think risk awareness decreased approximately in the same pace
conscription numbers decreased.

1980: 50 980 new conscripts trained

1986: 45 572

1990: 41 349

2000: 16 658

2005: 10 169

2008: 6 804

2010: conscription paused

[https://www.forsvarsmakten.se/sv/information-och-
fakta/var-h...](https://www.forsvarsmakten.se/sv/information-och-fakta/var-
historia/artiklar/varnplikt-under-109-ar/)

~~~
vidarh
To a large extent it was realised that the cold war preparedness was
collective madness: In retrospect we know that the Soviet leadership in many
respect were posturing because _they were terrified_ of a Western first
strike. Reagan wrote about his realisation after Able Archer 83 that the
Soviets genuinely seemed to think NATO was a threat, rather than see it as a
defense; both sides saw it as inconceivable that _their side_ would start a
war.

The point being that even at the height of the cold war, the threat was
massively overblown, largely because of lack of understanding of how the other
side was thinking.

The threat of Russia today is much smaller - for all of Russia's threats to
some countries, it is contained to a threat against countries with Russian
minorities, and there's no realistic scenario where Russia is suicidal enough
to attack an EU country.

And this kind of preparedness was a massive economic drain. Now one can
certainly argue that some of the _civil defense_ in terms of field hospitals
etc. ought to have been kept up, for a tiny fraction of the cost, and that
would be a separate issue.

I grew up in Norway during the cold war, with similar levels of preparedness;
air raid siren tests on a regular basis, bomb shelter at our school etc.. The
assumption that there was a real threat of invasion was there until Gorbachev,
basically, and then it evaporated as the increasing openness and eventual
collapse of the Soviet Union showed that the threat assessments throughout the
cold war had been completely wrong, and vast amounts of resources that could
have gone to e.g. better healthcare had basically been thrown away.

EDIT: This is from Reagans memoirs (taken from [1]), regarding his realisation
of the Soviet view of the US:

"Three years had taught me something surprising about the Russians: Many
people at the top of the Soviet hierarchy were genuinely afraid of America and
Americans. Perhaps this shouldn't have surprised me, but it did...During my
first years in Washington, I think many of us in the administration took it
for granted that the Russians, like ourselves, considered it unthinkable that
the United States would launch a first strike against them. But the more
experience I had with Soviet leaders and other heads of state who knew them,
the more I began to realize that many Soviet officials feared us not only as
adversaries but as potential aggressors who might hurl nuclear weapons at them
in a first strike...Well, if that was the case, I was even more anxious to get
a top Soviet leader in a room alone and try to convince him we had no designs
on the Soviet Union and Russians had nothing to fear from us."

Likewise the West kept posturing on the basis of a belief that the Soviet
Union might well decide to attack. The regular air raid siren tests in Norway
were not for fun. The regular NATO exercises were not for fun. There was a
genuine fear. Only, as it turns out both sides were certain the only party
that would be evil enough to strike first was the other side.

[1]
[https://en.wikipedia.org/wiki/Able_Archer_83#American_reacti...](https://en.wikipedia.org/wiki/Able_Archer_83#American_reaction)

~~~
jacobush
It _was_ madness, yet for Sweden and Norway to prepare that way was a local
optimum and a rational choice. (Not the only choice, but not a crazy choice.)

Nobody _wanted_ to start a great war, but at least during a couple of
incidents things came to close to start by accident. And once started, war
takes on a life of its own.

~~~
vidarh
It was a rational choice based on a totally flawed understanding of the other
side, is the point. When you believe the other side is out to destroy you,
then yes, that is how you respond.

But _that belief_ was driven on both sides by an underlying belief on both
sides that they were the good guys and the other side were cartoonish
villains.

Neither side questioned the belief that the other side were war mongerers with
a crazy willingness to sacrifice to expand, and both sides saw proxy wars as
evidence of that while they saw their own involvement as protecting themselves
by building alliances and creating buffers.

We see this up to and including Reagan describing the Soviet Union as an "evil
empire", only to then get reality thrown in the face by the Soviet response to
Able Archer 83 in particular (and I generally have little respect for Reagan,
but he _does_ deserve credit for actually coming to that understanding and
acting on it in what was one of the biggest foreign policy about faces in
modern history).

It was _understandable_ , though, in that both sides had seen the nazis, and
both sides saw the nazis as a model for the other side - the Soviets seeing
the nazis as not fundamentally different from capitalist imperialists, and the
West seeing the Soviets as not fundamentally different from nazi
authoritarianism.

But it was nevertheless in retrospect terrifyingly flawed. It stands as one of
the biggest foreign policy fuck-ups in human history that the world for half a
century was shaped by the two biggest blocks fundamentally misjudging the
intentions and motivations of the other side, despite the vast amount of
"intelligence" both sides believed they had about each other.

It makes me terrified to think about, because of the implications it has for
what stupid mistakes we're probably still perpetuating when we try to infer
the motivations of the major powers.

~~~
jacobush
I agree, but also want to add more of the outsider perspective. Norway was
part of NATO. Sweden was not. Even if Sweden would have had insight into that
both NATO and Soviet had mistaken beliefs about each other, it would _still_
had made sense for Sweden to prepare for total war. If these two sides fought,
Sweden better have been prepared.

And there is some indication that Sweden actually had a slightly more nuanced
perspective. Olof Palme wanted a nuclear free zone in the Baltic Sea.

This was seen in NATO as a conceit to the Soviets, and maybe the other way
around in Soviet command.

------
mscasts
Swede here.

Our government was extremely slow to act and didn't shut down anything which
let the COVID-19 virus spread rapidly in Sweden and now we have an
uncontrolled spread with no testing except for the groups at risk.

The article is basically clickbait, Sweden has one of the lowest amounts of
hospital beds and respirators per capita in EU.

We have much fewer ICU-spots than Italy, lower hospital beds etc so we will
certainly have a worse time than Italy if we cannot contain the spread
somewhat.

The government still hasn't imposed a lot of restrictions compared to other
countries. If this is good or bad, will be determined in the future.

~~~
azepoi
I think that Sweden is regarded as a country with good healthcare quality. The
problem here is that western governments thought misleadingly that they were
safe because their healthcare systems ranked high in a number of rankings. But
here we face what really is a quantitative problem, not a qualitative problem.
We can provide good care at an individual level, and the virus is often benign
at the individual level. It really becomes a quantitative problem and we are
on the exponential phase of the epidemic.

~~~
rurban
No, Sweden was considered a country with a good healthcare system under the
former socialist governments. But now that the capitalists are ruling Sweden
and Denmark, the ship turned towards the US and UK systems. With its known
problems.

Their healthcare system is now the 2nd worst in the EU. Social problems are
rising right and left.

~~~
capableweb
> Their healthcare system is now the 2nd worst in the EU

WHAT? Now I haven't been to every European country, probably around 30% of
them, would be my guess. But literally the country with the best healthcare
system of them all, that I've visited a hospital in, have been Sweden.

You got any numbers to backup this claim? Spain, Italy and Greece clearly have
a worse healthcare system, and those are just three examples I can think of
quickly. Surely lots of countries in eastern europe has it worse than Sweden.

One source showing the opposite of what you're saying:

> Sweden is ranked third by the Commonwealth Fund, with a high proportion of
> doctors, above-average healthcare spending, and relatively low prescriptions
> of drugs.

From [https://www.theguardian.com/society/2016/feb/09/which-
countr...](https://www.theguardian.com/society/2016/feb/09/which-country-has-
worlds-best-healthcare-system-this-is-the-nhs) which is using Commonwealth
Fund as it's source.

~~~
rurban
[https://worldpopulationreview.com/countries/best-
healthcare-...](https://worldpopulationreview.com/countries/best-healthcare-
in-the-world/) per capita.

Behind is only Germany, Finland, Denmark, Slovenia, Poland. Ok, last time I've
looked they were 2nd worst, now 6th.

Italy and Spain do have much better systems, by far. World Top 5. Even Greece
is much better.

~~~
capableweb
Thanks for providing the source. 6th sounds more reasonable indeed.

------
Ephem
This is an article about the city of Östersund written in 2018, the few links
between the Spanish flu and any reform are tenuous at best.

Having said that, I grew up in Östersund and found the article fascinating and
a good read.

One interesting thing is that now, a 100 years later, the tourism of the
region once again brings a pandemic. Swedens largest ski resort Åre, an hour
west of Östersund, has a bunch of Covid-19 cases that has spread through after
ski parties (which has since stopped).

Some context to the article not relating to Covid-19:

Jämtland, the region where Östersund is located, is located in the geographic
middle of Sweden, but is considered to be in the northern parts because the
demographic of the country is heavily skewed south. In the west it borders
Norway and in 1563–1677 it switched between being part of Denmark/Norway and
Sweden 13(!) times. Perhaps as a result of this there is still a strong sense
of regional identity. Among other things Jämtland is a "fake republic" with a
"fake president" which gives a speech during the music festival once a year.
This is just in good fun and the speech is mostly about peace, love and
understanding, but hearing 15k people singing the regional anthem
"Jämtlandssången" after the speech always gives me goosebumps.

Östersund has always been strategically important militarily, in semi-recent
times because the Soviet Union would have to pass it to take Trondheim in
Norway and the harbor there. The article mentions the airbase closing down,
but there were other military units that were disbanded as well. The article
touches on this mentioning the university, but another reason the town is
still successful today is that it also supported newly unemployed military
personel in starting companies. Since one of the units that were
disbanded(/moved?) was the military technical school, the city managed to keep
a bunch of people with higher education which might otherwise have relocated
and now has a few tech-companies and a somewhat entrepreneurial spirit.

This is just some stream of consciousness stuff, while I live in Stockholm now
I got excited "my city" was featured on HN. :)

It is a beautiful city and region with fantastic nature and a very long and
fascinating history, definitely visit it if you have the opportunity!

------
roenxi
The title is basically clickbait; there is no link mentioned between the
Spanish Flu and Sweden's welfare state except both happened in Sweden in the
last ~100 years.

I suspect they aren't linked. Societies have generally changed a lot in the
past 100 years. Pre- and Post- WWI Europe are different beasts.

~~~
AdrianB1
"Social inequality in the city meant the Spanish flu hit all the harder." That
is another statement without any support, like the entire article. It is not
clickbait, it's propaganda.

~~~
collyw
It's the Guardian, it's to be expected.

~~~
collyw
Do the downvoters honestly find the Guardian objective in its reporting?

------
fsiefken
If so, you would think their government would have asked the population
physical distancing already and work from home where one can.
[https://www.government.se/articles/2020/03/s-work-in-the-
are...](https://www.government.se/articles/2020/03/s-work-in-the-areas-of-
public-health-medical-care-social-care-and-social-insurance-with-regard-to-
the-covid-19-virus/)

~~~
samvher
I'm living in Sweden at the moment (am Dutch myself) and am quite disappointed
with the response to the crisis. I live in a shared house (12 people) and many
are still going to work as normal. One works in social services and sees
dozens of asylum seekers every day, she has gotten very little guidance and
there has been very little action in terms of prevention even though they have
had people getting sick with COVID-19 already. Others are on paid leave now
but it doesn't seem consistent across the board. The speech of the prime
minister yesterday was very mild, basically just counting on citizens'
personal responsibility.

Not that I think the Netherlands is doing much better though. Overall I think
it's very frustrating to see the extremely slow response in both Europe and
the US after seeing multiple countries deal with the pandemic more or less
successfully.

~~~
Lewton
It's really depressing looking at how Sweden is handling it when sitting in
Denmark. The contrast is pretty extreme

Sweden seem to be prioritizing the economy heavily.

Comparing the two responses is going to be interesting once this all blows
over

~~~
marvin
Ditto in Norway. I'm shaking my head. Hope you guys over there will get
through this okay.

------
plastic_teeth
I hope covid-19 wakes up America the same way because it's time for a change

~~~
mschuster91
If there will be much of America remaining. Over 600k unemployment claims and
an infection graph that looks way scarier than Italy where the situation is
disastrous, combined with a lack of tests and many people still going to
work...

------
piokoch
Strange, I always thought that welfare state enabler were natural resources
(like iron ore), the fact they had made through the II World War untouched and
hard work of the post-war generation.

The association between the flu and that what happened 30-40 years later
sounds a little bit like a click bait.

