The Hammer vs Mitigation-A comparative retrospective register study of the Swedish and Danish national responses to the COVID-19 pandemic in 2020

In the efforts to dampen the COVID-19 pandemic, governments are compelled to outweigh disease control efforts to the possible negative consequences of closing large parts of society. Although Denmark and Sweden are alike in political organization and health care, national responses to the 2020 COVID-19 epidemic differed noticeably. Denmark initiated a hard lock down followed by an outbreak control strategy (the so-called "hammer and dance" strategy), while Sweden's strategy was based on advising on social distancing, while keeping society open (a so-called mitigative strategy). The objective of this study is to describe national epidemic control strategies in Denmark and Sweden in 2020, and compare the epidemic dynamics in the two countries, with respect to number of COVID-19 cases, admissions to intensive care and mortality. Data on epidemic control efforts and COVID-associated morbidity/mortality were downloaded from official government and epidemic surveillance webpages and comparatively described using basic statistics. Overall, we found "the hammer" resulted in better epidemic control during 2020 with less COVID-19-associated admissions to intensive care and lower mortality.