Jürg Utzinger is the Director of Swiss TPH and a Professor of Epidemiology at the University of Basel. His research and teaching focuses on neglected tropical diseases and the health effects of large-scale projects in low- and middle-income countries. He spoke to the University of Basel about Switzerland's handling of the pandemic so far from an epidemiological perspective.
During the COVID-10 crisis, Switzerland did a lot right – but not everything. When the first patient succumbed to SARS-CoV-2 just over a year ago, the virus was still largely unknown. Transmission dynamics and health implications had to be understood before measures could be devised to protect individuals and prevent the disease from spreading among the population.
After a few weeks, it was clear that face coverings were an effective way to slow the transmission of the virus. Why did Switzerland take so long to make a decision and only make face coverings mandatory on public transport at such a late stage? Then came calls to support digital tracking of transmission chains – but even the very best tracing app is of little use if people don’t install it on their smartphones and use it consistently.
And: Recommendations can only have the intended effect if they are accepted by and adhered to by the population. When and how they are announced by authorities and experts is just as important as the measures themselves. At times, however, it was difficult for people to keep track.
Another issue that merits examination is individual responsibility that the Swiss are so fond of invoking. It is hard to put much stock in recommendations if different rules apply in a neighboring canton. The credibility of a given measure can be seriously compromised if a few miles down the road it is applied in a different way or not at all. Over the past year, measures at the national and international level would have been both desirable and necessary.
Switzerland’s federal system of government often served as a scapegoat for ineffective measures, but it could actually be regarded as an advantage: Until we have a clearer idea of which combination of measures has the greatest impact, each of the 26 cantons could serve as a potential role model, with pitfalls and successes from which the others can learn. This would, however, depend on rapid and efficient exchange of data.
Decisions are a constant trade-off between the need to contain the virus and the unwanted side-effects of the measures themselves. It is not enough to merely focus on infection statistics, availability of intensive care units, fatalities and reproduction values. School closures during the first lockdown left slower learners behind. Remedying such disparities is no easy task. Countless livelihoods are at threat from shutdowns in the hospitality industry, in culture and retail. We have seen a sharp increase in psychological health issues. The pandemic has shown just how important it is to take a holistic view of health and well-being, so as to avoid not just serious illness and fatalities, but also the unwelcome side-effects of measures designed to contain the pandemic.
Besides individual responsibility, we would do well to focus on our collective responsibility, too. Although research, innovation and cooperation have paved the way for an unprecedented achievement – the development and regulatory approval following rigorous scrutiny of multiple vaccines within less than a year – wealthy nations have secured extensive vaccine stockpiles, while African countries are at risk of coming away empty-handed. Although Switzerland’s rapid progress in vaccinating risk groups and healthcare professionals is good news, ensuring the supply of vaccines to the world’s poorest nations should also be a priority. Limited resources such as vaccines must be fairly distributed in a pandemic, as this is the only way for it to be swiftly and effectively overcome. COVID-19 anywhere is COVID-19 everywhere.
Note: This article was written in February 2021 and is based on developments up to that date.