JON TALLINGER, a Swedish family doctor from the small town of Eksjö has often been quoted in Croatia as a scientist lately. In a rather alarming article published in Vecernji list, Tallinger states that he's witnessing "a humanitarian catastrophe and human rights violations because people are being denied their right to treatment" in his country. Tallinger claims to have received guidelines instructing him not to provide treatment to elderly patients with COVID-19, but to provide palliative care instead.
"The guidelines say that I have to plan which patients of mine will receive palliative care. If an elderly patient has difficulty breathing, the recommended treatment is morphine, not oxygen. I have about 2000 patients, and they all trust me. The region wants me to prepare a care plan. I will not put any patient on such a list because they all have the right to oxygen, not just morphine, which only makes breathing more difficult and sedates people to death," Tallinger states for the Vecernji list.
Such disturbing information, presented by the said Croatian daily under the title "There is no oxygen for the elderly! Give them morphine," would raise public outrage in any civilized country. Physicians and competent state and public institutions would have to explain what is being done and why the elderly are denied adequate care.
No one in Sweden is writing about this doctor
In Sweden, however, no relevant media – national television, national radio program, leading Internet portal, or daily – has written a word about Tallinger's allegations. They don't mention him at all. Several similar texts of Tallinger's have been published, but only on a couple of obscure extreme right-wing portals. Is it possible that in Sweden, known for its democratic traditions and freedom of the media, there is a conspiracy of silence on such an important topic? Are the leading Swedish media avoiding sensitive issues that could call into question Swedish methods of fighting the coronavirus?
Through our research, we found that not a day goes by that the national media do not question and openly criticize the chief Swedish public health strategist Anders Tegnell and the policy of the Institute of Public Health. Sweden already has more than 3,000 deaths and at least 25,000 infected, which ranks it among the ten most affected countries in the world according to population size. The criticism is mostly substantiated, and sometimes very harsh. Several Swedish scientists and opponents of Tegnell's approach recently publicly called the state epidemiologist an "untalented official." If that's the case, what is stopping them from acknowledging the "humanitarian catastrophe" Tallinger is talking about?
The doctors from the Stockholm region recently reported to the powerful Health and Social Welfare Inspectorate (IVO) that during the corona crisis, they were forced to deny the best available care to some patients even though there were free beds in intensive care units. It seems that hospital chiefs were reluctant to fill the units due to fear that new patients in an even more difficult condition would appear, and the hospital would have no room for them. The inspectorate immediately said that such a practice was unacceptable and extended the investigation to all Stockholm hospitals, with the results still pending. Hospital officials, on the other hand, claim that triage criteria have always been the same and have not changed due to coronavirus. According to the Institute of Public Health, although some hospitals are overcrowded, about 30 percent of beds in intensive care units at the national level are still vacant.
The guidelines only state that not everyone will benefit from oxygen treatment
However, no one has yet requested an investigation into Tallinger's findings. Layman's reading of the allegedly controversial guidelines about the oxygen treatment for the elderly with comorbidities, published in mid-April by the Swedish Gävleborg County, reveals nothing controversial or alarming. The document clearly states that each case should have an individual approach, as well as that it is possible that the elderly with severe cases of COVID-19 and comorbidities will not be able to benefit from oxygen treatment and intensive care. It is strongly recommended that the decision to switch to palliative care be made jointly by two physicians in agreement with the patient and their family.
A Croatian doctor in Sweden: There's nothing controversial in the guidelines
Since there are always possibilities of abuse, distorted interpretations, and concealment of controversial practices, we asked several Croatian doctors in Sweden for their opinion on this document as well as on guidelines for the treatment of the elderly and intensive care in general.
"There's nothing controversial in this document, it clearly states that each case should be approached individually and that intensive treatment is not a universal solution suitable for every patient. I don't know how it works in other hospitals, but no one in Sweden has ever told me not to put an elderly person on oxygen or not to place them in the intensive care unit. I would be the first to refuse such a thing. Besides, I don't think there is a hospital in Sweden that currently doesn't have a person over 80 years of age on oxygen or in intensive care," said a Croatian anesthesiologist working in central Sweden, while his colleague from another Swedish hospital stated:
"We have been instructed to give morphine, not oxygen, to patients who have difficulty breathing and are already in palliative care. It has been scientifically proven that morphine alleviates their ailments better than oxygen. Any patient that is not palliative will be received and treated with oxygen if needed, regardless of their age.
"I think that the intensive care unit is often seen as a magic wand that can solve every health problem. Intensive care is not suitable for all patients because it often has severe consequences on the body, which is why the Swedish health system is currently opening special wards for patient recovery after intensive care." pointed out the third Croatian doctor we contacted on this issue.
The media are full of testimonials from recovered elderly people
Furthermore, the Swedish media are full of testimonials from 90-year-olds or even older people, who say that they recovered from COVID-19 thanks to excellent hospital care during which they received - oxygen. Of course, not everything is great, and there are also entirely different stories regarding controversial medical assessments and delayed reactions, as well as cases of patients whose state worsened suddenly and who didn't even make it to the hospital. However, the overall statistics indicate that the Swedish healthcare system (which should not be equated with Swedish measures against the pandemic) is not failing in the treatment of COVID-19, especially when it comes to intensive care.
"Seven out of ten patients admitted to geriatric wards because of coronavirus in the Stockholm region recovered from COVID-19 and were discharged. Among other treatments, they received oxygen, antibiotics, and nutritional supplements," the Swedish National Television website wrote in late April. Lately, the Swedish National Television, along with most Swedish media, has been more concerned with the question of why the coronavirus spread so easily and quickly to nursing homes across Sweden.
Finally, let us mention that Dr. Tallinger, or Dr. Whistler, as he likes to call himself, saw an opportunity to make money in his concern for the treatment of the elderly. Fifteen days ago, as an entrepreneur and an owner of a private practice, he sent an open letter to Swedish Prime Minister Stefan Löfven and offered to deliver oxygen treatment systems to Swedish hotels and nursing homes for a reasonable fee. The price? Only 600,000 euros for the first six systems...
Let us mention at the end that Dr. Tallinger, or Dr. Whistler, as he likes to call himself, saw an opportunity to make money in his concern for the treatment of the elderly. Fifteen days ago, as an entrepreneur and an owner of a private practice, he sent an open letter to Swedish Prime Minister Stefan Löfven and offered to deliver oxygen treatment systems to Swedish hotels and nursing homes for a reasonable fee. The price? Only 600,000 euros for the first six systems...