Sweden's health watchdog said on Tuesday it had uncovered "serious shortcomings" in COVID-19 care for residents of nursing homes where thousands have died, turning the spotlight on the country's light-touch pandemic strategy.
Nursing homes were ravaged by the initial wave of the coronavirus, prompting Prime Minister Stefan Lofven's sombre admission in May that the country failed to protect its elderly.
Known for its rejection of lockdowns and masks, Sweden has suffered many times more COVID-19 deaths per capita than its neighbours - though fewer than countries such as Spain - a failure authorities have in part blamed on inadequate controls and care at nursing homes.
The Health and Social Care Inspectorate (IVO), a government agency supervising healthcare and social services, has spent months investigating care at nursing homes after a flood of complaints from relatives and staff.
"In its investigation, IVO has identified serious short-comings at regional level when it comes to the care provided to people living in nursing homes," Sofia Wallstrom, the watchdog's director general, told a news conference.
"This is without question very serious," Lofven said in a statement to Reuters. "All people have the right to individually adapted care, regardless of where you live or how old you are."
"It's important all regions take this seriously and make the necessary changes. I expect this to be already underway."
The watchdog said none of Sweden's 21 regions had taken sufficient responsibility for the treatment of infected nursing home residents, with a fifth of patients having received no individual assessment by doctors.
Less than one in ten COVID-19 patient had been examined face-to-face by a doctor with the vast majority of assessments consisting of consultation between nurses and doctors alone, sometimes with primary information stemming only from orderlies.
The probe did not single out individual facilities or staff.
While the failings were identified as "systemic", IVO's decisions for the individual regions showed some had operated under instructions to avoid hospitalising nursing home patients. One region prescribed end-of-life treatment for any resident with COVID-19 symptoms.
After a lull during the summer, cases have shot up again at elderly care facilities during a second wave of the pandemic, raising fears of a repeat of the deadly spring. Nursing home residents account for nearly half of Sweden's more than 6,400 deaths among COVID-19 patients.
The watchdog urged regional authorities to carry out measures to improve care and present them no later than Jan. 15 next year and said it would be carrying out a further review of patient records.
"The lowest level (of care) is quite simply too low," Wallstrom said. "Even during a pandemic."
(Additional reporting by Simon Johnson and Johan Ahlander; Editing by Giles Elgood)
