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Coronavirus Exposes Holes in Sweden’s Generous Social Welfare State

In the popular imagination, Sweden does not seem like the sort of country prone to accepting the mass death of grandparents to conserve resources in a pandemic.

Swedes pay some of the highest taxes on earth in exchange for extensive government services, including state-furnished health care and education, plus generous cash assistance for those who lose jobs. When a child is born, the parents receive 480 days of parental leave to use between them.

Yet among the nearly 6,000 people whose deaths have been linked to the coronavirus in Sweden, 2,694, or more than 45 percent, had been among the country’s most vulnerable citizens — those living in nursing homes.

That tragedy is in part the story of how Sweden has, over decades, gradually yet relentlessly downgraded its famously generous social safety net.

Since a financial crisis in the early 1990s, Sweden has slashed taxes and diminished government services. It has handed responsibility for the care of older people — mostly living at home — to strapped municipal governments, while opening up nursing homes to for-profit businesses. They have delivered cost savings by relying on part-time and temporary workers, who typically lack formal training in medicine and elder care.

This is how the nursing staff at the Sabbatsbergsbyn nursing home in the center of Stockholm found itself grappling with an impossible situation.

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Credit…Felix Odell for The New York Times

It was the middle of March, and several of the 106 residents, most of them suffering dementia, were already displaying symptoms of Covid-19. The staff had to be dedicated to individual wards while rigorously avoiding entering others to prevent transmission. But when the team presented this plan to the supervisors, they dismissed it, citing meager staffing, said one nurse, who spoke on the condition on anonymity, citing concerns about potential legal action.

The facility was owned and operated by Sweden’s largest for-profit operator of nursing homes, Attendo, whose stock trades on the Nasdaq Stockholm exchange. Last year, the company tallied revenue in excess of $1.3 billion.

On weekends and during night shifts, the nurse was frequently the only one on duty. The rest of the staff lacked proper protective gear, said the nurse and a care aide, who spoke on condition of anonymity for fear of being fired. Management had given them basic cardboard masks — “the kind house painters wear,” the nurse said — while instructing them to use the same ones for days in a row. Some used plastic file folders and string to make their own visors.

By the time the nurse quit in May, at least 20 residents were dead, she said.

“The way we had to work went against everything we learned in school regarding disease control,” the nurse said. “I felt ashamed, because I knew that we were spreaders.”

The lowest-wage workers — who are paid hourly and lack the protection of contracts — continued showing up for shifts, even after falling ill, because government-furnished sick pay did not cover all of their lost wages, the care aide said.

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Credit…Felix Odell for The New York Times

“This is an undervalued part of the labor market,” said Marta Szebehely, an expert in elder care at Stockholm University. “Some care workers are badly paid, badly trained and have really bad employment conditions. And they were supposed to stop a transmission that nobody knew anything about, and without much support.”

Vulnerability in another area was central to the devastation: Over the last two decades, Sweden has substantially reduced its hospital capacity. During the worst of the initial outbreak, elderly people in nursing homes were denied access to hospitals for fear of overwhelming them.

When nursing home residents displayed Covid symptoms, guidelines in force in Stockholm in the initial phase of the pandemic encouraged physicians to prescribe palliative care — forgoing efforts to save lives in favor of keeping people comfortable in their final days — without examining patients or conducting blood or urine tests, said Dr. Yngve Gustafson, a professor of geriatrics at Umea University. He said that practice amounted to active euthanasia, which is illegal in Sweden.

“As a physician,” Dr. Gustafson said, “I feel ashamed that there are physicians who haven’t done an individual assessment before they decide whether or not the patient should die.”

In the United States, some 40 percent of total coronavirus deaths have been linked to nursing homes, according to a New York Times database. In Britain, Covid has been directly blamed in more than 15,000 nursing home deaths, according to government data.

But these are countries characterized by extreme levels of economic inequality. An estimated 45,000 Americans die every year for lack of health care, according to one report. Britons endured a decade of punishing austerity that battered the national health system.

Sweden is supposed to be immune to such dangers. Yet this country of only 10 million people has been ravaged by the coronavirus, with per capita death rates nearly as high as the United States, Britain and Spain, according to World Health Organization data.

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Credit…Elisabeth Ubbe for The New York Times

One element appears to have substantially increased the risks: Sweden’s decision to avoid the lockdowns imposed in much of the rest of Europe as a means of limiting the virus. Though the government recommended social distancing, and many people worked from home, it kept schools open along with shops, restaurants and nightclubs. It did not require that people wear masks.

“There’s been more society transmission, and it’s been more difficult to hinder it from entering the care homes,” said Joacim Rocklov, an epidemiologist at Umea University. “The most precious time that we lost, our mistake was in the beginning.”

Those who operate private nursing homes in Sweden assert that residents have been the victims of the government’s failure to limit the spread of the virus.

“It’s the total transmission in society, that’s the key,” said Martin Tivéus, chief executive of Attendo, the company that owns the Sabbatsbergsbyn home in Stockholm.

Investigations by Swedish media have concluded that private nursing homes suffered lower death rates than their public counterparts. But experts say private and public homes are governed by the same decisive force: Municipalities handle elderly care, and taxpayers have been inclined to pay less.

For decades aggressive public spending was the rule in Sweden, rendering joblessness a rarity. By the beginning of the 1990s, a sense had taken hold that the state had overdone it. It was subsidizing industries that were not internationally competitive. Wages were rising faster than productivity, yielding inflation.

In 1992, Sweden’s central bank lifted interest rates as high as 75 percent to choke off inflation while preventing a plunge in the national currency, the krona. The next year, amid a tightening of credit, Sweden’s unemployment rate surged above 8 percent. The economy contracted, depleting municipal tax revenues.

This played out just as the policy sphere became infused with the thinking of economists like Milton Friedman, whose neoliberal principles placed faith in shrinking the state and lowering taxes as a source of dynamism.

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Credit…Felix Odell for The New York Times

From the middle of the 1990s through 2013, Sweden dropped its top income tax rate to 57 percent from 84 percent while eliminating levies on property, wealth and inheritance. The net effect was a reduction in government revenue equivalent to 7 percent of national economic output.

Under a 1992 law, Swedish elder care shifted from a reliance on nursing homes to an emphasis on home care. Part of the alteration was philosophical. Policymakers embraced the idea that older people would better enjoy their last years in their own homes, rather than in institutional settings.

But the shift was also driven by budget imperatives.

As a share of its economy, Sweden spends 3.2 percent a year on long-term care for the elderly, according to the Organization for Economic Co-operation and Development, compared with 0.5 percent in the United States and 1.4 percent in Britain. Only the Netherlands and Norway spend more.

But that expenditure is now spread across a population with greater needs. With home care the rule, nursing homes are reserved for older people suffering from complex ailments.

Attendo said it had enough protective gear to satisfy Swedish guidelines, and more than public nursing homes had, but not enough to manage the pandemic. When the company realized it needed more, it confronted a global shortage.

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Credit…Associated Press

“It took five or six weeks to get the volumes outside of China,” said Mr. Tivéus, the Attendo chief executive.

The shortages at Swedish nursing homes underscore the extent to which budget math has taken precedence over social welfare, say those who have watched the refashioning.

“What this pandemic has done is demonstrate a number of system errors that have gone under the radar for years,” said Olle Lundberg, secretary general of Forte, a health research council that is part of the Swedish Ministry of Health and Social Affairs. “We totally rely on the global production chain and just-in-time delivery. The syringes we need today should be delivered in the morning. There is no safety margin. It may be very economically efficient in one way, but it’s very vulnerable.”

Mia Grane was unaware of the systemic issues when she moved her parents into the Sabbatsbergsbyn home in the summer of 2018.

In their younger days, her mother had been an Olympic swimmer. Now, she was descending into Alzheimer’s. Her father used a wheelchair.

The home sat in the center of Stockholm, a 15-minute bike ride from her apartment, with lovely gardens that were used for midsummer parties.

“It was a perfect place,” said Ms. Grane, 51. “They felt at home.”

But her confidence evaporated as the pandemic spread. When she asked the nursing home staff how it planned to manage the danger, it reassured her that everything was fine.

“I thought, ‘If this virus gets into this place,’” she said, “‘a lot of people are going to die.’”

A week later, she read in a local newspaper that a prominent Swedish musician had died. He had lived in the same ward as her parents. She called the home and was told that her father was suffering cold symptoms. A test showed that he had contracted Covid.

Ms. Grane urged the staff to transfer her father to the hospital. It told her that no one was making that journey, she said.

Nursing homes lack advanced medical equipment like ventilators, and hospitals were effectively off limits to nursing home residents.

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“We knew that Sweden had fewer intensive care beds per inhabitants than Italy,” said Dr. Michael Broomé, a physician at an intensive care unit in Stockholm. “We had to think twice about whether to put elderly people with other conditions on ventilators.”

This forced the nursing home to administer comfort care, easing the pain with opioids as death approached.

Ms. Grane’s father died on April 2. “He was all alone,” she said.

She begged the staff to save her mother — “the most important person in my life.” But she wasn’t eating. A week later, her mother died, too.

Ms. Grane struggles to make sense of it — the staff not having proper masks, the hospital deemed off limits, the lack of concern about the nature of the threat.

“For me, it’s clear that they wanted to save costs,” she said. “In the end, it’s the money that talks.”

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The Age of Electric Cars Is Dawning Ahead of Schedule

FRANKFURT — An electric Volkswagen ID.3 for the same price as a Golf. A Tesla Model 3 that costs as much as a BMW 3 Series. A Renault Zoe electric subcompact whose monthly lease payment might equal a nice dinner for two in Paris.

As car sales collapsed in Europe because of the pandemic, one category grew rapidly: electric vehicles. One reason is that purchase prices in Europe are coming tantalizingly close to the prices for cars with gasoline or diesel engines.

At the moment this near parity is possible only with government subsidies that, depending on the country, can cut more than $10,000 from the final price. Carmakers are offering deals on electric cars to meet stricter European Union regulations on carbon dioxide emissions. In Germany, an electric Renault Zoe can be leased for 139 euros a month, or $164.

Electric vehicles are not yet as popular in the United States, largely because government incentives are less generous. Battery-powered cars account for about 2 percent of new car sales in America, while in Europe the market share is approaching 5 percent. Including hybrids, the share rises to nearly 9 percent in Europe, according to Matthias Schmidt, an independent analyst in Berlin.

As electric cars become more mainstream, the automobile industry is rapidly approaching the tipping point when, even without subsidies, it will be as cheap, and maybe cheaper, to own a plug-in vehicle than one that burns fossil fuels. The carmaker that reaches price parity first may be positioned to dominate the segment.

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Credit…Philip Cheung for The New York Times

A few years ago, industry experts expected 2025 would be the turning point. But technology is advancing faster than expected, and could be poised for a quantum leap. Elon Musk is expected to announce a breakthrough at Tesla’s “Battery Day” event on Tuesday that would allow electric cars to travel significantly farther without adding weight.

The balance of power in the auto industry may depend on which carmaker, electronics company or start-up succeeds in squeezing the most power per pound into a battery, what’s known as energy density. A battery with high energy density is inherently cheaper because it requires fewer raw materials and less weight to deliver the same range.

“We’re seeing energy density increase faster than ever before,” said Milan Thakore, a senior research analyst at Wood Mackenzie, an energy consultant which recently pushed its prediction of the tipping point ahead by a year, to 2024.

Some industry experts are even more bullish. Hui Zhang, managing director in Germany of NIO, a Chinese electric carmaker with global ambitions, said he thought parity could be achieved in 2023.

Venkat Viswanathan, an associate professor at Carnegie Mellon University who closely follows the industry, is more cautious. But he said: “We are already on a very accelerated timeline. If you asked anyone in 2010 whether we would have price parity by 2025, they would have said that was impossible.”

This transition will probably arrive at different times for different segments of the market. High-end electric vehicles are pretty close to parity already. The Tesla Model 3 and the gas-powered BMW 3 Series both sell for about $41,000 in the United States.

A Tesla may even be cheaper to own than a BMW because it never needs oil changes or new spark plugs and electricity is cheaper, per mile, than gasoline. Which car a customer chooses is more a matter of preference, particularly whether an owner is willing to trade the convenience of gas stations for charging points that take more time. (On the other hand, owners can also charge their Teslas at home.)

Consumers tend to focus on sticker prices, and it will take longer before unsubsidized electric cars cost as little to drive off a dealer’s lot as an economy car.

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Credit…Samuel Zeller for The New York Times

The holy grail in the electric vehicle industry has been to push the cost of battery packs — the rechargeable system that stores energy — below $100 per kilowatt-hour, the standard measure of battery power. That is the point, more or less, at which propelling a vehicle with electricity will be as cheap as it is with gasoline.

Current battery packs cost around $150 to $200 per kilowatt-hour, depending on the technology. That means a battery pack costs around $20,000. But the price has dropped 80 percent since 2008, according to the United States Department of Energy.

All electric cars use lithium-ion batteries, but there are many variations on that basic chemistry, and intense competition to find the combination of materials that stores the most power for the least weight.

For traditional car companies, this is all very scary. Internal combustion engines have not changed fundamentally for decades, but battery technology is still wide open. There are even geopolitical implications. China is pouring resources into battery research, seeing the shift to electric power as a chance for companies like NIO to break into the European and someday, American, markets. In less than a decade, the Chinese battery maker CATL has become one of the world’s biggest manufacturers.

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Credit…Felix Schmitt for The New York Times

The California company has been selling electric cars since 2008 and can draw on years of data to calculate how far it can safely push a battery’s performance without causing overheating or excessive wear. That knowledge allows Tesla to offer better range than competitors who have to be more careful. Tesla’s four models are the only widely available electric cars that can go more than 300 miles on a charge, according to Kelley Blue Book.

On Tuesday, Mr. Musk could unveil a technology offering 50 percent more storage per pound at lower cost, according to analysts at the Swiss bank UBS. If so, competitors could recede even further in the rearview mirror.

“The traditional car industry is still behind,” said Peter Carlsson, who ran Tesla’s supplier network in the company’s early days and is now chief executive of Northvolt, a new Swedish company that has contracts to manufacture batteries for Volkswagen and BMW.

“But,” Mr. Carlsson said, “there is a massive amount of resources going into the race to beat Tesla. A number, not all, of the big carmakers are going to catch up.”

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Credit…Felix Odell for The New York Times

The traditional carmakers’ best hope to avoid oblivion will be to exploit their expertise in supply chains and mass production to churn out economical electrical cars by the millions.

A key test of the traditional automakers’ ability to survive will be Volkswagen’s new battery-powered ID.3, which will start at under €30,000, or $35,000, after subsidies and is arriving at European dealerships now. By using its global manufacturing and sales network, Volkswagen hopes to sell electric vehicles by the millions within a few years. It plans to begin selling the ID.4, an electric sport utility vehicle, in the United States next year. (ID stands for “intelligent design.”)

But there is a steep learning curve.

“We have been mass-producing internal combustion vehicles since Henry Ford. We don’t have that for battery vehicles. It’s a very new technology,” said Jürgen Fleischer, a professor at the Karlsruhe Institute of Technology in southwestern Germany whose research focuses on battery manufacturing. “The question will be how fast can we can get through this learning curve?”

Peter Rawlinson, who led design of the Tesla Model S and is now chief executive of the electric car start-up Lucid, likes to wow audiences by showing up at events dragging a rolling carry-on bag containing the company’s supercompact drive unit. Electric motor, transmission and differential in one, the unit saves space and, along with hundreds of other weight-saving tweaks, will allow the company’s Lucid Air luxury car — which the company unveiled on Sept. 9 — to travel more than 400 miles on a charge, Mr. Rawlinson said.

His point is that designers should focus on things like aerodynamic drag and weight to avoid the need for big, expensive batteries in the first place. “There is kind of a myopia,” Mr. Rawlinson said. “Everyone is talking about batteries. It’s the whole system.”

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Credit…Felix Schmitt for The New York Times

When Jana Höffner bought an electric Renault Zoe in 2013, driving anywhere outside her home in Stuttgart was an adventure. Charging stations were rare, and didn’t always work. Ms. Höffner drove her Zoe to places like Norway or Sicily just to see if she could make it without having to call for a tow.

Ms. Höffner, who works in online communication for the state of Baden-Württemberg, has since traded up to a Tesla Model 3 equipped with software that guides her to the company’s own network of chargers, which can fill the battery to 80 percent capacity in about half an hour. She sounds almost nostalgic when she remembers how hard it was to recharge back in the electric-vehicle stone age.

“Now, it’s boring,” Ms. Höffner said. “You say where you want to go and the car takes care of the rest.”

The European Union has nearly 200,000 chargers, far short of the three million that will be needed when electric cars become ubiquitous, according to Transport & Environment, an advocacy group. The United States remains far behind, with less than half as many as Europe.

But the European network is already dense enough that owning and charging an electric car is “no problem,” said Ms. Höffner, who can’t charge at home and depends on public infrastructure.

Price and infrastructure are closely connected. At least in theory, people won’t need big, expensive batteries if there is a place nearby to quickly recharge. (Charging times are also dropping fast.)

Lucid’s first vehicle is a luxury car, but Mr. Rawlinson said his dream was to build an electric car attainable by the middle class. In his view, that would mean a lightweight vehicle capable of traveling 150 miles between charges.

“I want to make a $25,000 car,” Mr. Rawlinson said. “That’s what is going to change the world.”

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Imint is the Swedish firm that gives Chinese smartphones an edge in video production

If your phone takes amazing photos, chances are its camera has been augmented by artificial intelligence embedded in the operating system. Now videos are getting the same treatment.

In recent years, smartphone makers have been gradually transforming their cameras into devices that capture data for AI processing beyond what the lens and sensor pick up in a single shot. That effectively turns a smartphone into a professional camera on auto mode and lowers the bar of capturing compelling images and videos.

In an era of TikTok and vlogging, there’s a huge demand to easily produce professional-looking videos on the go. Like still images, videos shot on smartphones rely not just on the lens and sensor but also on enhancement algorithms. To some extent, those lines of codes are more critical than the hardware, argued Andreas Lifvendahl, founder and chief executive of Swedish company Imint, whose software now enhances video production in roughly 250 million devices — most of which come from Chinese manufacturers.

“[Smartphone makers] source different kinds of camera solutions — motion sensors, gyroscopes, and so on. But the real differentiator, I would say, is more on the software side,” Lifvendahl told TechCrunch over the phone.

Smart video recording

Imint started life in 2007 as a spin-off academic research team from Uppsala University in Sweden. It spent the first few years building software for aerial surveillance, just as many cutting-edge innovations that find their first clients in the defense market. In 2013, Lifvendahl saw the coming of widespread smartphone adaptation and a huge opportunity to bring the same technology used in defense drones into the handsets in people’s pockets.

“Smartphone companies were investing a lot in camera technology and that was a clever move,” he recalled. “It was very hard to find features with a direct relationship to consumers in daily use, and the camera was one of those because people wanted to document their life.”

“But they were missing the point by focusing on megapixels and still images. Consumers wanted to express themselves in a nice fashion of using videos,” the founder added.

Source: Imint’s video enhancement software, Vidhance

The next February, the Swedish founder attended Mobile World Congress in Barcelona to gauge vendor interest. Many exhibitors were, unsurprisingly, Chinese phone makers scouring the conference for partners. They were immediately intrigued by Imint’s solution, and Lifvendahl returned home to set about tweaking his software for smartphones.

“I’ve never met this sort of open attitude to have a look so quickly, a clear signal that something is happening here with smartphones and cameras, and especially videos,” Lifvendahl said.

Vidhance, Imint’s video enhancement software suite mainly for Android, was soon released. In search of growth capital, the founder took the startup public on the Stockholm Stock Exchange at the end of 2015. The next year, Imint landed its first major account with Huawei, the Chinese telecoms equipment giant that was playing aggressive catch-up on smartphones at the time.

“It was a turning point for us because once we could work with Huawei, all the other guys thought, ‘Okay, these guys know what they are doing,’” the founder recalled. “And from there, we just grew and grew.”

Working with Chinese clients

The hyper-competitive nature of Chinese phone makers means they are easily sold on new technology that can help them stand out. The flipside is the intensity that comes with competition. The Chinese tech industry is both well-respected — and notorious — for its fast pace. Slow movers can be crushed in a matter of a few months.

“In some aspects, it’s very U.S.-like. It’s very straight to the point and very opportunistic,” Lifvendahl reflected on his experience with Chinese clients. “You can get an offer even in the first or second meeting, like, ‘Okay, this is interesting, if you can show that this works in our next product launch, which is due in three months. Would you set up a contract now?’”

“That’s a good side,” he continued. “The drawback for a Swedish company is the demand they have on suppliers. They want us to go on-site and offer support, and that’s hard for a small Swedish company. So we need to be really efficient, making good tools and have good support systems.”

The fast pace also permeates into the phone makers’ development cycle, which is not always good for innovation, suggested Lifvendahl. They are reacting to market trends, not thinking ahead of the curve — what Apple excels in — or conducting adequate market research.

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Despite all the scrambling inside, Lifvendahl said he was surprised that Chinese manufacturers could “get such high-quality phones out.”

“They can launch one flagship, maybe take a weekend break, and then next Monday they are rushing for the next project, which is going to be released in three months. So there’s really no time to plan or prepare. You just dive into a project, so there would be a lot of loose ends that need to be tied up in four or five weeks. You are trying to tie hundreds of different pieces together with fifty different suppliers.”

High-end niche

Imint is one of those companies that thrive by finding a tough-to-crack niche. Competition certainly exists, often coming from large Japanese and Chinese companies. But there’s always a market for a smaller player who focuses on one thing and does it very well. The founder compares his company to a “little niche boutique in the corner, the hi-fi store with expensive speakers.” His competitors, on the other hand, are the Walmarts with thick catalogs of imaging software.

The focused strategy is what allows Imint’s software to enhance precision, reduce motion, track moving objects, auto-correct horizon, reduce noise, and enhance other aspects of a video in real-time — all through deep learning.

About three-quarters of Imint’s revenues come from licensing its proprietary software that does these tricks. Some clients pay royalties on the number of devices shipped that use Vidhance, while others opt for a flat annual fee. The rest of the income comes from licensing its development tools or SDK, and maintenance fees.

Imint now supplies its software to 20 clients around the world, including the Chinese big-four of Huawei, Xiaomi, Oppo and Vivo as well as chip giants like Qualcomm and Mediatek. ByteDance also has a deal to bake Imint’s software into Smartisan, which sold its core technology to the TikTok parent last year. Imint is beginning to look beyond handsets into other devices that can benefit from high-quality footage, from action cameras, consumer drones, through to body cameras for law enforcement.

So far, the Swedish company has been immune from the U.S.-China trade tensions, but Lifvendahl worried as the two superpowers move towards technological self-reliance, outsiders like itself will have a harder time entering the two respective markets.

“We are in a small, neutral country but also are a small company, so we’re not a strategic threat to anyone. We come in and help solve a puzzle,” assured the founder.

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European VC firm Pale Blue Dot plans to fund 40 ‘planet-positive’ startups

Pale Blue Dot, a newly outed European venture capital firm focused on climate tech, announced this week the first closing of its debut fund at €53 million.

Targeting pre-seed and seed stage startups, the firm says it will consider software and technology investments with a strong positive climate impact. Current areas of focus include food/agriculture, industry, fashion/apparel, energy and transportation, with plans to back up to 40 companies out of fund one.

Founding partners Hampus Jakobsson, Heidi Lindvall and Joel Larsson are stalwarts of the Nordic tech ecosystem and beyond: Jakobsson co-founded TAT (The Astonishing Tribe), which was sold to Blackberry in 2012, and is a prominent angel investor in Europe, most recently a venture partner at BlueYard Capital . Lindvall is the former head of accelerator and investment team at Fast Track Malmö, with a background in human rights and media. Larsson was previously managing director at Fast Track Malmö, with a technical background and prior fund management experience.

I put questions to all three, delving deeper into Pale Blue Dot’s remit and the firm’s investment thesis. We also discussed the macro trends that warrant a fund specializing in climate tech and why Europe is poised to become a leader in the space.

Pale Blue Dot is a new VC fund specializing in climate tech, but in a sense — and to varying degrees — isn’t every venture capital fund a climate tech fund these days?

Heidi Lindvall: We think all funds should be “planet-positive” and working for a better world, but it will take time until it is a focus. Still, most funds look at a potential positive impact late in their assessment and will not decline the deal if the startups wouldn’t be significantly pulling the world in a good direction.

Hampus Jakobsson: Focus has both upsides and downsides.

The negative part with being niche is that we won’t do investments in amazing people or startups that we don’t think are “climate-contributing enough” or that the founders aren’t doing it in a genuine way (as the risk of them to paying attention to the impact might lead them to become a noncontributing company).

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