Management of the emergency response to the SARS-CoV-2 (COVID-19) outbreak in Stockholm, Sweden, and winter preparations
Mikael Ohrling 1 , John Øvretveit 2 5 , Ulf Lockowandt 3 , Mats Brommels 4 , Vibeke Sparring 11 Stockholm Health Care Services, Region Stockholm (SLSO), Torsplan, Stockholm, Sweden
2 Stockholm Health Care Services, Region Stockholm (SLSO) and LIME/MMC, Tomtebodavägen 18A. Karolinska Institutet, Stockholm, Sweden
3 Division for Special Operations, Stockholm Health Care Services, and Stockholm Health Care Services, Emergency Management Team, Region Stockholm (SLSO), Torsplan, Stockholm, Sweden
4 LIME/MMC, Tomtebodavägen 18A. Karolinska Institutet, Stockholm, Sweden
5 Corresponding author. Email: jovretbis@aol.com
Journal of Primary Health Care 12(3) 207-214 https://doi.org/10.1071/HC20082
Published: 29 September 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution 4.0 International License
Abstract
INTRODUCTION: Sweden is unique in adopting a ‘no-lockdown’ public health approach to the SARS-CoV-2 (COVID-19) outbreak. There were fears that health services would not be able to care for high numbers of COVID-19 patients.
AIM: To describe and review the emergency response of a public primary and community health-care organisation in Stockholm, Sweden, to the demand for care for COVID-19 and non-COVID-19 patients during March–July 2020, and summarise preparations for the months to follow.
METHODS: This was a rapid implementation action research case study, which also draws on one author’s experience as Chief Executive Officer and other members’ experience in an emergency management group.
RESULTS: Sweden experienced similar mortality per million population to the UK, despite the different public health strategy used to address the COVID-19 outbreak. The Stockholm-integrated public primary and community health-care service, serving a population of 2.3 million, made many changes quickly. One change included coordinating non-acute private health-care services, following the local government emergency directive to do so.
DISCUSSION: It is possible that the fast and effective response by management and services in primary and community health care reduced infection and hospital demand, which contributed to a lower mortality than otherwise expected. The actions and preparations described for Stockholm’s response may provide ideas for other health-care systems. The partnership research approach between the Karolinska Medical University and the Region Stockholm health-care system used in this project shows that rapid research methods have advantages for both partners in an emergency situation.
KEYwords: COVID-19; SARS COV-2; Emergency response; Primary Healthcare; Integrated health system; Implementation
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