Finland, ‘Prepper Nation of the Nordics,’ Isn’t Worried About Masks

https://www.nytimes.com/2020/04/05/world/europe/coronavirus-finland-masks.html

Version 5 of 25.

STOCKHOLM — As some nations scramble to find protective gear to fight the coronavirus pandemic, Finland is sitting on an enviable stockpile of personal protective equipment like surgical masks, putting it ahead of less-prepared Nordic neighbors.

The stockpile, considered one of Europe’s best and built up over years, includes not only medical supplies, but also oil, grains, agricultural tools and raw materials to make ammunition. Norway, Sweden and Denmark had also amassed large stockpiles of medical and military equipment, fuel and food during the Cold War era. Later, most all but abandoned those stockpiles.

But not Finland. Its preparedness has cast a spotlight on national stockpiles and exposed the vulnerability of other Nordic nations.

When the coronavirus hit, the Finnish government tapped into its supply of medical equipment for the first time since World War II.

“Finland is the prepper nation of the Nordics, always ready for a major catastrophe or a World War III,” said Magnus Hakenstad, a scholar at the Norwegian Institute for Defence Studies.

Though year after year Finland has ranked high on the list of happiest nations, its location and historical lessons have taught the nation of 5.5 million to prepare for the worst, Tomi Lounema, the chief executive of Finland’s National Emergency Supply Agency, said on Saturday.

“It’s in the Finnish people’s DNA to be prepared,” Mr. Lounema said, referring to his country’s proximity to Russia, its eastern neighbor. (Finland fought off a Soviet invasion in 1939.)

In addition, most of its trade goes through the Baltic Sea. That, Mr. Lounema said, is considered a vulnerability because, unlike Sweden, which has direct access to the North Sea on its west coast, Finland has to rely on the security conditions and the running of maritime traffic in the Baltic.

“If there is some kind of crisis, there might be some disturbance” in the supply chain, he explained.

Two weeks ago, as the country’s coronavirus cases ticked up — by Sunday, the country had recorded more than 1,880 cases and 25 deaths — the Ministry of Social Affairs and Health ordered that stored masks be sent to hospitals around the country.

“The masks are old — but they are still functioning,” Mr. Lounema said by phone.

There is little publicly available information on the number of masks and other supplies that Finland has or where exactly they are stored.

“All information considering those warehouses is classified,” Mr. Lounema said.

But though details are kept a state secret, the authorities confirmed that the stockpiles are kept in a network of facilities spread across the country and that the current system has been in place since the 1950s.

That has placed Finland in a more solid position to confront the pandemic.

As officials in other countries like the United States lament the shortage of masks, ventilators and gowns and the global coronavirus cases increased to more than 1.2 million by Sunday, with more than 64,000 deaths, tales abound of international skulduggery and domestic price gouging. Nations are competing for medical supplies and racing to create a vaccine.

French officials said they were outbid at the last minute by unknown American buyers for a stock of masks on the tarmac of a Chinese airport.

And German officials previously said the Trump administration had attempted to persuade a local firm developing a possible coronavirus vaccine to move its research to the United States, where presumably any inoculation would be available first.

Perhaps in response to the threat of shortages, the European Commission, the executive branch of the European Union, announced on March 19 that it was creating its first ever stockpile of medical equipment “to help E.U. countries in the context of the Covid-19 pandemic.”

Several E. U. countries have also passed new legislation banning the export of essential materials.

When the medical device company Mölnlycke Health Care, based in Gothenburg, Sweden, tried to send masks and rubber gloves several weeks ago to desperate hospitals in Italy and Spain from its central storage center in Lyon, France, it was blocked by France’s export ban.

“It’s very disturbing; nothing that is sent into France can be sent out of the country,” Richard Twomey, the chief executive of Mölnlycke Health Care, told the Swedish public broadcaster Sveriges Radio.

One French newspaper described the conflict between the Swedish producer and the French authorities as the “War of masks between Sweden and France.”

On Saturday, however, Sweden’s foreign minister, Ann Linde, said on Twitter that after pressure from Sweden, France had finally relented on the export restrictions on masks from Mölnlycke. It was “very important that the internal market works even in times of crisis!” she said.

In Sweden, which has been accused of moving too slowly in its anti-coronavirus measures, supplies were diminished over the past three decades because of a shift in thinking after the Cold War, according to Fredrik Bynander, director at the Center for Societal Security at the Swedish Defence University.

“The ‘eternal peace’ had arrived, and we no longer were going to need these stockpiles,” he said, adding that the government saw an opportunity to sell them, including the medical and health supplies.

Updated June 12, 2020

So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

Sweden’s accession to the European Union in 1995 also played a part. Since then, the Swedish health and medical care system has been built around “just in time” deliveries, with hospitals stocking supplies to last only two or three days, said Anders Melander, an analyst with the Swedish Defence Research Agency.

“We expected with the free market we would always be able to purchase what we needed,” Mr. Melander said by phone.

The privatization of the state pharmaceutical monopoly in 2009 also increased Sweden’s vulnerability. Until then, the government pharmacy had maintained the country’s supply of medicine for times of crisis. No agency took over responsibility for national stockpiles afterward.

“It’s not really a great plan,” Mr. Melander noted. “It’s like saying: ‘I don’t have to have a fire extinguisher. I can run out and buy a fire extinguisher when the fire starts.’ It shows that this free market is only free when everything is fine.”

The Swedish public service broadcaster SVT Nyheter reported on Sunday that hospitals were running out of the anesthetic Propofol, a drug used during surgery and, in some cases, to treat Covid-19 patients on ventilators.

But though Sweden may have neglected the country’s stockpiles, it has encouraged residents to create their own private stores. The recommendations in the brochure “If Crisis or War Comes,” delivered to residents’ mailboxes almost two years ago, covered food, water, warm clothes and candles, and encouraged stocking up on hand sanitizer and extra medicine.

Norway used to be more resilient and equipped to be self-sustaining in a national crisis, according to Leif Inge Magnussen, associate professor of leadership at the University of Southeastern Norway. But a risk analysis last year by the Norwegian Directorate for Civil Protection concluded that pandemics and medicine shortages were key concerns, he said.

Audun Haga, director of the Norwegian Medicines Agency, said the country could exhaust supplies of essential medicine within weeks, since much of it comes from China, which is only just beginning to reopen its factories.

“Society has become very dependent on other countries and just-in-time supply chains,” Mr. Magnussen said.

Some Nordic countries that have not prepped like Finland are scrambling for alternatives to reorganize domestic production of medical supplies.

In Norway, the medical equipment company Laerdal and a partner promised to deliver 1,000 emergency ventilators by the end of May.

In Denmark, the pump manufacturer Grundfos made a prototype for protective gear within 36 hours after a government call for aid.

In Sweden, laid-off employees at Scania, which manufactures commercial vehicles, have been sent to work with a company that makes ventilators. And the vodka-producer the Absolut Company said it was donating ethanol for disinfectant production.

Christina Anderson reported from Stockholm, and Henrik Pryser Libell from Oslo. Constant Méheut contributed reporting from Paris, and Christopher F. Schuetze from Berlin.