Deaths in the frontline: Occupation-specific COVID-19 mortality risks in Sweden

Abstract

At the onset of the COVID-19 pandemic, governments in Europe and the US almost universally implemented lockdown measures designed to force social distancing between individuals and thus flatten the curve of COVID-19 infections. Frontline and essential workers nevertheless continued leaving their home and going in to work. We investigate whether there are inequalities in Swedish COVID-19 mortality based on working in frontline occupations or the degree of exposure—measured through contact with others, physical proximity and exposure to disease and infection. Sweden provides a unique case study because it was the only Western country to not employ strong measures but instead rely on recommendations and widespread compliance of its population. We use data the Swedish authorities organized as an early release of all recorded COVID-19 deaths in Sweden up to May 7, 2020, which we link to administrative registers and occupational measures of exposure. Taxi and bus drivers had a higher risk of dying from COVID-19 than other workers, as did older individuals living with service workers. Our findings suggest however that these frontline workers and older individuals they live with are not at higher risk of dying from COVID-19 when adjusting the relationship for other individual characteristics. We also did not find evidence that being a frontline worker in terms of occupational exposure was linked to higher COVID-19 mortality. Our findings indicate no strong inequalities according to these occupational differences in Sweden and potentially other contexts that use a similar approach to managing COVID-19.