Confederation knew gaps – could Switzerland have been better prepared for Corona?
As early as 2018, an analysis revealed the problem areas at the Federal Office of Public Health. The result was gaps in specialist knowledge and expertise.
The virus and its consequences have hit Switzerland hard. But not unprepared. A pandemic has been one of the biggest risks in Switzerland for years. The authorities prepared for the disaster, crisis teams practiced the state of emergency. And there was the Epidemic Law, in which the rules are just in case.
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When the crisis actually came, the experts at the federal government knew grosso modo what they had to do. But they also knew what they could not know – because they lacked the expertise to do so: there were some technical gaps in the responsible Federal Office of Public Health (BAG). There was a lack of expertise in some areas, and access to specialists was lacking. A 217-page analysis of the Epidemic Act came to this conclusion in 2018.
Political scientist Christian Rüefli from the Vatter advisory office and health lawyer Christoph Zenger, on behalf of the BAG, examined how good a “special” or “extraordinary situation” according to the Epidemic Act – the Federal Council has explained in the case of the corona virus – the federal and cantonal authorities could work together.
The overview of the situation in Switzerland:
In such situations, competences are transferred from the cantons to the federal government. In Bern it is decided whether the schools will be closed. Which interventions the hospitals can still make. What retailers can and can’t sell. There are profound decisions in the everyday life of everyone, but they are far away from federal officials.
Although suddenly up to date, the study received little attention in the corona crisis. But now that the state of emergency is gradually coming to an end, it helps to put the theory through a practical check. What lessons can be learned from the sometimes inadequate crisis preparedness? On what bases did the federal government base its measures? And did he get the experts on board to watch the outbreak of the pandemic?
Corona virus – the situation worldwide:
The fact is: for weeks, epidemiologists, virologists and other researchers complained that Bern did not involve them. “The FOPH does not involve us scientists in combating the epidemic,” criticized Marcel Salathé, an ETH epidemiologist from Lausanne, in this newspaper in March. A full 35 days passed after the first confirmed corona case in Switzerland until the federal government convened a scientific advisory board in the first week of April.
Epidemics were poorly networked internationally
The analysis of 2018 revolved largely around conflicts of competence. The distribution of tasks in the event of a crisis. Legal aspects. However, the authors also examined whether the BAG “has the necessary skills and technical expertise to perform the tasks”.
To do this, they conducted thorough surveys. On the one hand, they spoke to the BAG officers, above all with Daniel Koch, head of the communicable diseases department for many years and now a delegate for Corona. On the other hand, they interviewed cantonal doctors and employees of cantonal health directors.
The main finding: There are “gaps in terms of specialist knowledge and expertise” in subject areas in which the BAG is not responsible in a normal situation. If necessary, the authority can acquire the knowledge by talking to research, in specialist networks or via working groups. “According to the statements made in this regard, however, there are difficulties with regard to the availability of suitable specialists and due to the BAG’s lack of or insufficient involvement in specialist networks at international, especially European, level,” the analysis says.
Rather advise and recommend, do not take action and dispose
The study authors advised a clean layout order. Plague fighters in the Federal Office of Public Health should record where there is a lack of expertise and where there is no access to external experts. If there are gaps and weaknesses, the authority should build up a system that could quickly provide access to technical resources in a crisis. “For this purpose, suitable institutions and specialists would be designated as contact points, for example.”
Did the BAG implement this recommendation? Given that the federal government allowed several weeks to elapse before calling a scientific committee, there are some doubts. The BAG left a request for comment unanswered on Monday and Tuesday.
The analysis also provides an unvarnished look. How far should the federal government’s competencies go in the event of a crisis? The cantonal representatives attested to the BAG a high level of expertise to take over coordination or formulate recommendations in the event of an epidemic. When asked what their expectations of the federal government were, they remained vague. Because of the hypothetical nature of this question, it was sometimes difficult for them to formulate specific expectations, the study authors state.
At the same time, the BAG managers were extremely cautious about the extent to which they would order measures. Two years ago, when it was just a matter of a future danger, many things still seemed unthinkable. In pre-corona times, federal officials were used to “soft instruments” – making recommendations, setting general conditions for enforcement. In other words, health officials preferred to advise rather than crack down. Recommend rather than dispose.
According to the analysis, the BAG cannot generate any expertise from its own resources that it normally does not have. He lacks experience in areas for which the BAG is normally not responsible. It is hard to judge which is the best solution that is equally practicable for all cantons. School closures or protective measures, for example, would therefore probably not be available.
The federal government did not trust school closures
Study author Christian Rüefli said when asked by this newspaper that in discussions with those responsible for the BAG, the respect for the task was felt: «The BAG is far from topics like school. That explains his reluctance to make binding decisions in such areas. » Added to this is the fact that measures such as school closures entail a whole new breed of follow-up questions, for example on childcare or equal opportunities.
Nevertheless: On March 13 this year, the Federal Council closed all schools in the country for several weeks. He initiated a whole cascade of measures against the spread of the coronavirus.
How effective school closings actually are is still controversial in research. Some believe that this measure was more political than scientifically based.
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