Corona measures: the failure of the Swiss strategy

IIn Switzerland, the corona situation threatens to escalate, but the government continues to decide against issuing a nationwide lockdown. At its meeting on Wednesday, the Federal Council decided not to tighten the measures, but instead dealt with the aid package for the economy, the volume of which is to be more than doubled from CHF 400 million to CHF 1 billion.

Switzerland remains the only open country in an environment full of strict measures: Germany, France, Austria and Italy, the governments of all the large, bordering countries sent their populations into nationwide lockdowns. In Zurich alone, restaurants and bars close at 11 p.m. and no more than 50 participants are allowed at events. Although the cantons can impose stricter regional restrictions – and in some cases have done so – Switzerland remains the country with the loosest Corona precautionary measures.

Source: WORLD infographic

This laissez-faire strategy has been hotly debated in the country and beyond for weeks. Rightly so, because it is increasingly proving to be ineffective. The government apparently does not succeed in slowing the spread of the corona virus simply by appealing to the population.

The infection and death numbers are going through the roof and on Tuesday the Swiss Society for Intensive Care Medicine (SGI) issued a warning all in one Brandschreibenthat the intensive care beds in the country are fully utilized. France offered weeks ago to admit intensive care patients from the neighboring country in an emergency.

A closer look at the figures shows how dramatic the situation actually is: In a European comparison, Switzerland has the most daily new infections per one million inhabitants (current weekly average) with 670 new cases per day. For comparison: In Germany there are 219 cases, in Italy 580 and even in the Czech Republic only 596 cases.

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The share of positive tests in the total test volume is also extremely problematic: in Switzerland this was recently 24.7 percent, in Italy, however, 16.3 percent and in Germany only 8 percent. The Czech Republic alone is worse off with a positive rate of 26.3 percent.

In addition, there is a threatening increase in the number of deaths. Since Tuesday, Switzerland has left Italy and France behind with this negative indicator and reports 9.6 corona deaths per million inhabitants every day, a figure that is currently only exceeded by Belgium and the Czech Republic in Europe.

Highest excess mortality in ten years

The Swiss “Tagesanzeiger” published a Analysiswhich proves an “exceptionally high excess mortality” in the country. As a result, in the week from November 2nd to 8th, the deaths of people over 65 were “well above the long-term expected value”: The Federal Statistical Office predicted 1,136 deaths for this period, but 1,702 people died, a whole 50 percent more . It is the highest value since data collection began ten years ago. The conclusion of the newspaper: “Now it is clear: The second corona wave is more deadly than the first wave.”

The statistics already show a clear excess mortality during the first wave – at that time a strict lockdown strategy was still being pursued. In one week it had exceeded the expected value by 46 percent, but shortly afterwards the lockdown took effect and from April 20, the death rate began to fall again. This time, with no lockdown in sight, the death toll is unlikely to decline anytime soon.

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The appeal of the intensive care physicians from the SGI, who warn that the 876 certified and recognized intensive care beds that are normally available in Switzerland for the treatment of adults, are “currently practically fully occupied”, must be taken accordingly seriously.

In Germany – especially on Twitter – the rumor is circulating that triages have to be carried out in Switzerland. So weighing up which patients have the highest chances of survival and who must be denied intensive treatment due to a lack of space. It supports you items in the “Neue Züricher Sonntagszeitung” from the end of October, which describes the overloading of a hospital in Sion in southwest Switzerland, which is not an isolated case.

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When asked, the SGI informed the WELT that the “Guidelines for triage in the event of a scarcity of resources in intensive care units (…) are currently not applicable”. In fact, triages are currently not taking place. This is confirmed by the press departments of hospitals in Bern and Geneva on request.

In the cantons, however, the situation is currently very tense. And the spokesman for the Insel Gruppe, which operates six hospitals in the canton of Bern, points out that it is not just beds and medical instruments that are becoming scarce, but also that there is a lack of additional staff to handle more Intensivbetten to be able to provide adequate support.

The SGI further explains that so far it has only been possible to prevent bed capacities from being overloaded because “in many places non-urgent interventions and treatments have been postponed.” In addition, capacities have been expanded. The intensive care physicians warn: “However, it is of the utmost importance to contain the Covid-19 pandemic now and to postpone non-urgent interventions and treatments throughout Switzerland in order to prevent quality losses in intensive care treatment.”

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While the triages are not yet taking place, Switzerland has held a debate over the past few days about updating the relevant guidelines. This is now complete.

In March 2020, the Swiss Academy of Medical Sciences and the SGI published guidelines for triage in the event of a scarcity of resources in intensive care units. The document has now been updated to take into account scientific knowledge and experience. It still only applies to admission and treatment in intensive care units, not to other areas of health care. The guidelines are not yet applied.

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