World Medical Association called to investigate human rights violations in Sweden’s management of COVID-19 epidemic

I, Dr Jon Tallinger of Sweden, appeal to the World Medical Association to intervene, and make an independent investigation into what’s happening in Sweden.

On the 9th of April, in an interview with Svenska Dagbladet, Prime Minister Stefan Löfven said: “Sweden has not succeeded in protecting it’s elderly”.

Mr Löfven also said we had to prepare for, possibly, up to thousands deaths.

The PM’s statement it deeply saddens me. As a doctor, I do my best to protect my patients, regardless of age.

But confronted with official directives for the elderly, I cannot possibly condone this. Not only as a doctor, but also as a parent, and the child to my parents whom I value and respect.

I want to inform fellow Swedes and people abroad about these official directives [English translation, document found at bottom of this article],  which includes one directive sent out by the region of Gävleborg titled “Oxygen Therapy in COVID-19 Palliative Care” [Swedish], dated 17th of April.

They should be viewed alongside other official directives for elderly people in all regions of Sweden, and what is happening generally here concerning Covid-19 patients.

Official statistics are affected by many factors, especially directives and their implications –which the public is not expected to know.

Ethical issues

Most importantly, I want you to understand certain primary ethics which doctors swear to uphold, while treating patients as people.

There is a proper perspective for medical knowledge, which is why I refuse to “care-plan” the 2000+ patients that are under my supervision. Not only that, they trust me to do everything I can to save their lives. This is why I find the Swedish directives to be absolutely abhorrent.

Those directives are, essentially, asking me to get rid of anyone who is sick.
Is it ethical to instruct doctors to first prescribe morphine, rather than oxygen?

Is it ethical to deny elderly patients oxygen in most situations? How would you feel if you find out that your parent in the nursey home will not be given critical care, or curative care, or oxygen therapy, because they are deemed “irrelevant”?

Do you know the difference between simple oxygenation and ICU-related procedures which can involve ventilators?

Are you aware Sweden has five factories producing oxygen, hence supplying oxygen outside of a hospital setting should not be an issue?

As of today, many people outside Sweden do not know getting tested for Covid-19 in Sweden has severe limitations.

Sweden’s  Public Health Agency (Folkhälsomyndigheten, FHM) has testing priority restricted to hospitalised patients and people working in healthcare, or people working in care of the elderly.

Patients displaying Covid-19 symptoms should not be tested until they are hospitalised. This information was also noted by a Swede who has lived in USA for several years and returned to Sweden for their parent. Naturally, they were outraged.

If we compare the average weekly mortality of Sweden for January to May, against the past 5 years from 2015 to 2019, what will the data reveal? What information do we currently have, to extrapolate any conclusions?

Triage

Many doctors at Karolinska University hospital in Stockholm have told Dagens Nyheter triage has been made so difficult, “we are being forced to let patients die in front of our eyes,” says one doctor.

Aftonbladet saw official documents instructing that patients aged 60 and above with multiple conditions, and patients aged above 80, will be denied ICU care which raises questions for the rationale of such documents.

When at least one-third of nursey homes have Covid-19 cases  and Sweden apparently has plenty of ICU beds.

In a briefing on April 15, Anders Tegnell (Sweden’s state epidemiologist) claimed: “It is not a failure for the overall strategy, but it is a failure to protect our elderly who live in care homes.” In the same briefing, he also said Sweden’s healthcare system has not been overwhelmed, and there are plenty of ICU beds available.

He has claimed herd immunity is not a policy but an achievable status, this despite the World Health Organization saying such a strategy is highly sceptical. Yet Tegnell is quoted saying: “We want as few people to get infected as possible, at a slow pace, so the health system can cope.”

Wearing masks, gloves or other protective equipment in public has not been recommended.

In Västernorrland region, a news report claimed most of the deaths were not treated in a hospital despite availability of ICU beds.

Out 15 deaths during most recent, as of 17 April, 10 happened without medical attendance. What was the conscious strategy implemented here?

Cases

According to UK’s ICNARC report dated 24 April 2020, approximately 1/3 of elderly Covid-19 patients aged 80 and above with access to ICU care survive. What are the stories of Sweden’s elderly survivors, or the stories of those who passed away?

96-year-old Eva Alinder died in a nursey home, because staff refused to take her to the hospital. Her daughter asked and received a reply along the lines of Eva being “too old”.

Eva was left to choke to death, gasping for air all night, until she died. The only treatment staff offered was an Aspiring and leaving the window open.

Her daughter Catharina tried to get her tested for Covid-19 but because there was supposedly no time or staff available, so that never happened. To add further insult to injury, Eva will not even be included in Sweden’s Covid-19 mortality numbers. This because they refused to take her to the hospital.

Catharina Alinder said: “They let my mother suffer for so many hours without oxygen, without being admitted to a hospital. She worked all her life, paid taxes, and this is the thanks she got”.

She was down to 60% breathing capacity. It was horrible for me and my sister to see her suffer in her last 24 hours.”

81-year-old Hanna Altinsu did not have underlying medical conditions, but when he caught Covid-19 and his symptoms worsened, he was denied respiratory care despite available ICU beds outside Stockholm.

With such tragedies reported in Swedish media, it is not surprising to hear the story of Turkey airlifting 47-year-old Turkish citizen Emrulah Guluksen out of Sweden, and back to Turkey for treatment of Covid-19. His daughter Leila Gulusken posted a call for help on Facebook after her father was supposedly denied treatment.

Can you explain the rationale for instructing doctors or nursey home staff to administer morphine, while denying oxygen to elderly patients with Covid-19?

Are there any other countries with such specific shocking directives for their nursey homes or elderly patients?

I interviewed Latifa Löfvenberg for a witness statement, which I have shared on my Youtube channel 3 May 2020. There is also an upload with excerpts of my interview done by The Indicter Channel on the same day. Latifa is a nurse who worked in a government-funded nursey home in Gävleborg, and is no longer employed there due to her testimony.

She has testified to old people being left to choke to death for days on end. 65-year-old patients struggling with breathing difficulties, but being refused oxygen.

She explained being instructed to administer Morphine and a muscle relaxer, Midazolam, which helps relieve anxiety while the patients slowly suffocate, sometimes taking days to die.

If an elderly patient eventually loses the fight with Covid-19, I say as a doctor that it is far more humane to let them die of narcosis and carbon dioxide after we have done our best to save the patient, instead of resorting primarily to morphine and breathing complications when they have contracted Covid-19.

All while denying them oxygen therapy and necessary medical attention.

There are specific definitions and ethical considerations in the medical field which I wish to point out, that many are unaware of.

These are fundamental reminders of why doctors do our best for our patients as people, and not statistics.

Palliative care is not solely end-of-life care. Palliative care has specific definitions, principles and requirements.

According to the World Health Organisation (WHO), palliative care includes:

~ Affirms life and regards dying as a normal process

~ Intends neither to hasten or postpone death

~ Offers a support system to help patients live as actively as possible until death

~ Uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated

~ Will enhance quality of life, and may also positively influence the course of illness

I also wish to raise the issue of principle of double effect in bioethics, also known as PDE.

PDE is strongly utilised in specific situations, such as euthanasia, abortions when the mother’s life is in danger, and civilian deaths in war.

Euthanasia is illegal in UK. Passive euthanasia is legal in Sweden since 2010, but there are limiting criteria.

A health care professional can legally cease life support upon request from a patient, only if the patient understands the consequences stated by their health care provider.

Informed consent from the patient is crucial. It is illegal to administer lethal substances.

When our politicians say they’ve done everything imaginable to decrease fatalities, it is a blatant lie.

The Guardian reported on the 19th of April that as per official guidelines, nursey home staff weren’t using even the most basic protective gear.

Voices of Swedish professors

Only occasionally have mild critical opinions of Swedish professors been published/broadcasted in Sweden. Scientists with in-depth and relevant criticism to central aspects of Sweden’s strategy are dismissed ad-hominem by our most established media. Instead of answering the content of their criticism, this media has even called them nation-saboteurs. That particular stance by the Swedish media is internationally unlawful, considering that infringes the freedom of expression “beyond frontiers” as established in the Universal Declaration of Human Rights –of which Sweden was a signatory.

These academics have been forced to turn to international outlets to be heard. For instance, Professor Cecilia Söderberg-Nauclér, a virus-immunology researcher at the Karolinska Institute, had to turn to The Guardian. Or Professor emeritus of Public-Health Epidemiology, Marcello Ferrada de Noli, who had his critical opinion pieces about the treatment of the elderly published in RT.

Norwegian state epidemiologist, Frode Forland, confirms that Swedish outlets do not seem interested in publish in-depth critical opinions of Sweden’s strategy. He explained his experience with the Swedish media as following:

“I’ve been interviewed by several of them, and they all ask questions about things supporting Sweden’s strategy. It feels like they want to support their own government, but Sweden is going against the entire world on this.”

I suppose it is for this reason Swedish experts in virology felt compelled to speak out about Anders Tegnell’s epidemiological deeds in a secret e-mail thread, rather than going public with their thoughts.

Covid-19 is not a terminal illness, is treatable and not intractable in First World Countries despite lack of a vaccine at this point and mortality rates in countries such as Italy and USA, and not a definite death sentence for the elderly if they contract the virus causing Covid-19.

106-year-old British survivor of 2 world wars Connie Titchen spent 3 weeks in hospital under the care of dedicated staff and recovered.

93-year-old Indian Thomas Abraham and his 88-year-old wife Mariyamma in Southern India both recovered from Covid-19 with ICU care.

On Senicide

Why people in Sweden have reached me, asking for help?

Should Sweden’s current approach to Covid-19 be adopted by any other country?

Please consider the details in this summary, with relevant comparisons.

We should compare Greece and Israel to Sweden, instead of Sweden with other Nordic countries.

Population of Greece is approximately 10.72 million and Israel’s population is 9.136 million, on the eve of 2020.

Sweden is approximately 10.327 million people, on the eve of 2020.

Sweden’s population density in 2019 is 24 people per km2, Greece is 81 people per km2, Israel is 386 people per km2.

Sweden is currently at 31,523 cases of infection and 3831 deaths.

Greece is currently at 2850 cases of infection and 166 deaths.

Israel is currently at 16, 667 cases of infection and 279 deaths.

What do these numbers tell you about Sweden’s approach, in context of unavoidable facts I have shared in this open letter here?

If Sweden’s population density is the same as Israel or Greece, what would be the respective numbers, at those population densities?

I invite the experts to do the maths for these questions.

According to Statista for 2019, approximately 40% of households in Sweden are single-person households without children.

What are our decades of taxes being used for?

Where is the science for Sweden’s current approach?

Why are these directives issued and instituted, since Sweden supposedly has enough resources?

Who drafted and finalised them?

What is fundamentally wrong or lacking with our systems for health or welfare or other fields and for how long, which every Swedish citizen needs to know, in light of such horrific circumstances implemented for our elderly?

I am strongly appealing to international journalism

BBC released a recent article titled “What is going wrong in Sweden’s care homes”, where above-mentioned nurse Latifa Löfvenberg was interviewed.

Please contrast the details of that article with letters such as “I live in Sweden. I’m not panicking” published in the New York Times.

Andreia Rodriguez is a pre-school teacher outside Stockholm, who claims Swedish schools are not practicing strict distancing measures or hygiene measures, including wearing of masks.

What kind of articles are necessary and accurately informative of what is happening now in Sweden?

Are personal opinions lacking vital details affecting the general populace and specific groups necessary? Or instead articles shedding light for non-informed people in every country about the various problems that Sweden’s current approach to Covid-19 entails?

The lives of people are not statistics, sound bites or experiments. What are Sweden’s real mortality rates? And is herd immunity through natural infections the method to pursue?

The highest number of Covid-19 deaths per capita in Europe and this current approach to our elderly is nothing to be proud of but should be loudly condemned for change and accountability, especially if you tout yourself as a Swede who is proud of Sweden’s First World Country reputation.

Given the long-term impact of SARS on the health of patients, what are the long-term effects for people who have lived through Covid-19?

Is the virus mutating in significant ways posing greater threats, when allowed unfettered access to humans without any significant protective measures?

What’s happening in China?

I am in the profession of saving lives, not politics.

But confronted with horrible truths and people I cannot save lives unless something changes urgently and completely regarding our elderly and people needing medical attention for Covid-19, in Sweden?

I am rethinking whether my views about politics needs to change, and I am being forced to ask myself many questions, some of which I have shared in my Facebook page.

I appeal to journalists in any country and the global public to please help me share these truths, so you can see Sweden’s official statistics with sufficient context instead of too many articles providing inadequate context or details.

Please help me change ongoing policies in Sweden’s nursey homes and hold accountable those who are creating grossly criminal human rights violations through these absurd directives, to help everyone in Sweden.

 

This text was submitted by the author 22 May 2020.