Sweden's excess mortality in 2020-2022 and reporting in the media.

Aim: The aim was to scrutinize the report in March 2023 that Sweden's excess mortality was lowest in 2020-2022 compared with other European Union and Nordic countries, a report that received great national and international attention.

Study design: Comparison of excess mortality in Sweden and Norway.

Methods: Excess mortality for 2020-2022 was calculated for Sweden and Norway, the country with per-capita excess mortality closest to Sweden's, compared with the average mortality for 2017-2019 in the respective country, following the definitions by Statistics Sweden reported in a daily newspaper.

Results: Excess mortality is a measure with low misclassification compared with other pandemic outcome measures. Following the definitions, total excess mortality for the years 2020-2022 was 11,897 individuals in Sweden and 6089 in Norway. However, the distributions of excess mortality across the 3 years strongly differed. In Sweden, 60% of excess mortality was observed in 2020, 8% in 2021 and 32% in 2022. In sharp contrast, 0% of excess mortality was observed in Norway in 2020, 20% in 2021 and 80% in 2022. If the relative distribution of excess mortality in Sweden had been the same as in Norway in 2020-2022, approximately 7000 individuals who died in 2020 would instead have died as excess mortality in 2022, saving approximately 14,000 person-years in Sweden.

Conclusions: The report disregards residual confounding due to the broad definition of the period 2020-2022. Mass media should avoid one-sided reporting.