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Doctors in Uppsala, the Swedish region hit hardest by Covid-19, tell CNN they are frustrated with the lack of tougher coronavirus measures, and Swedes not adhering to government recommendations.

“Forceful measures in other places, other countries, it’s effective in reducing spread,” Dr. Rafael Kawati, head of intensive care at Uppsala University Hospital, told CNN.

Sweden is well into a second wave of cases: It’s a scenario that health authorities said in the spring they hoped to avoid, by emphasizing personal responsibility over mandatory lockdowns.

Comparatively more deaths: The country has now recorded more than four times as many Covid-19 deaths than its three Nordic neighbors combined — 6,340 as of Thursday.

The second wave “is not a surprise,” Kawati said. “We should have been able to do much better than that, regarding spread in the society.”

What are the authorities doing: The Swedish government has moved closer to advocating a de-facto lockdown — but in recommendation only, not mandate.

At a news conference this week, Prime Minister Stefan Lofven could hardly have been clearer: “Don’t go to the gym, don’t go to the library, don’t have dinner, don’t have parties. Cancel.”

Advice not followed: At a central Stockholm gym this week, it was plain for a CNN crew to see that many were happy to ignore that advice, filling a room for a dance aerobics class. Participants kept their distance, but were mask-less for the hour-long class.

Dr. Fredrik Sund, head of the infectious diseases department at the hospital, was one of the first to raise the alarm about the November surge.

“I think if people were to follow the recommendations, it would be sufficient, because then more or less we would have a lockdown,” he said. “But since we are in this situation we are now — no, it’s not enough.”

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