The conventional critique of institutional theory, and especially historical institutionalism, is that it is incapable of coping with change. We argue for the importance of political conflict as a means of initiating change in an institutionalist framework. In particular, conflict over ideas and the underlying assumptions of policy is important for motivating change. We demonstrate the viability of this argument with examples of institutional change.Before Socrates there were two dominant philosophers whose writings attempted to explain the natural world. On the one hand Parmenides stressed permanence and the persistence of elements of the world. On the other hand, Heraclitus argued that "all is flux" and that the world is constantly changing. In many ways the study of public policy has progressed little since that time. One body of literature in policy studies emphasizes the persistence of policy and its "path dependency," while another equally important, if smaller, body of literature stresses the need to understand policy change. Both of these literatures are necessary for understanding policy, as there are definite elements of stability and change in most policy areas.The dominant strand of thinking in political science has assumed equilibrium, stability, and some ease in reaching consensus. This emphasis on equilibrium is true of approaches as disparate as much of rational choice analysis, systems theories, and a good deal of the international relations literature. Our concern in this paper is the way in which the persistence of institutions masks underlying dissensus over policy and programs. In theoretical terms the central analytic notion of "path dependency" in historical institutionalism may mask the dissensus that may exist beneath the surface of a program, or organizational field, and thus produce some neglect of the forces for change. Given that theory at once helps

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Crisis management, Governance, Dichotomies, Comparative public policy,

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Sweden’s strategy to contain the COVID-19 pandemic stands out internationally as more liberal in terms of not ordering a complete lockdown of society. Sweden kept its primary schools, daycare centers and industries largely open. The government financially supported furloughed workers and increased its support to regional and local governments delivering healthcare and elderly care. However, the death toll in Sweden which passed 4000 by late May 2020 stands in stark contrast to those of other, comparable countries, raising questions about the design of the strategy, and its appropriateness. The paper argues that key assumptions sustaining the strategy, for instance that symptom-free people do not carry, and cannot transmit the Coronavirus, or that local and regional government staff had the necessary training and equipment to tackle the pandemic, along with problems associated with coordinating a decentralized healthcare system, may explain the poor performance of the Swedish containment strategy.

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