Definitely no “let’s go back to business as usual”

Since last December, the coronavirus has caught not only China cold, but now the whole world. Who could have expected that the pandemic would affect us to such an extent that our social life would be at a standstill for weeks, if not months? Nevertheless, there were unmistakable signs and harbingers; in the meantime, there is agreement across all borders that the pandemic is a caesura of unimagined force, after which much, if not everything, will no longer be as it was before.

Harbinger “SARS”

In 2002 and 2003, the first pandemic of the 21^st century, originating in China, spread throughout the world, causing severe acute respiratory syndrome (SARS), which was declared defeated by the WHO in May 2004. A good 8,000 cases occurred worldwide, with almost 800 deaths and 7,200 recoveries.¹

Planning games in Switzerland…

Among other things, this event may have prompted those responsible to run through scenarios in order to be better prepared for the future, for example in Switzerland and also in Germany. All 26 cantons were involved when it was announced in 2014 that a new type of influenza virus originating from Central Asia and with a high lethality rate was spreading across the globe at lightning speed. This exercise showed that the prevention plans were not up to date. A new national pandemic plan was developed, but when in May 2018 the head of the Department of Defence, Civil Protection and Sport (DDPS), Guy Parmelin, asked how well the cantons were now organised in this respect, it turned out that they had not done their homework. When Viola Amherd took over the DDPS in January 2019, other tasks were at the top of the priority list: defence against international terrorism and the procurement of new fighter jets. Then the corona pandemic spread at a speed that nobody had expected. The assumption was that in the globalised world economy, necessary raw materials such as ethanol and medical technology products such as face masks could be imported within a useful period of time. But then the cantons responsible for this were faced with the problem of supply bottlenecks. In other words, the plans were in place, but there was a lack of implementation because at the time of the exercise and afterwards, the focus was firstly on hospital planning, which had to deal with overcapacity and rising healthcare costs, and secondly on the constantly rising health insurance premiums.²

…… and in Germany

Similarly in Germany an analysis of 2013, commissioned by the German government, assumed much more drastic, actually unrealistic conditions than we currently find in the corona pandemic: All age groups are affected to the same extent in the model, and the mortality rate is much higher. It is therefore explicitly emphasised that the reality of this scenario is limited. As far as the economic and social consequences are concerned, the developments are similar to those we are now experiencing: Stock market prices are falling dramatically, entire sectors of the economy are facing a veritable collapse, states are investing billions of euros, the EU is facing a test of endurance because the economically depressed countries of Italy and Spain feel abandoned by the richer North. The affected countries are facing massive supply bottlenecks for medical products.³

There will always be epidemics:
What is to be done?

The WHO registers about 200 epidemics worldwide every year. There is a constant risk that one of them will turn into a pandemic with unforeseeable consequences for the economy, health and society worldwide. This is the reality that humanity must face now and in the future.
Responsibility across the board by each state for its citizens is therefore the motto. What is to be done in concrete terms? Health systems must be developed in such a way that they are better equipped to deal with the scenarios that threaten them. Concrete proposals for Switzerland, which can also be transferred to other states, have been made by Ruth Humbel, a health policy expert from the Canton of Argovia and a member of the National Council (CVP)⁴: Thorough revision of existing pandemic plans and reliable guarantee of their implementation in the event of a crisis. According to Ms Humbel, the production of important medicines should once again take place entirely in Switzerland. Of course, this also means no more sales abroad of companies that are essential for reliable health care here: The former serum and vaccine institute Berna Biotech was sold to a Dutch company in 2006.⁵
In addition, plans to reduce hospital capacity need to be reconsidered. This is symbolised by a decision of the Frauenfeld Cantonal Hospital: the demolition of the 200-bed high-rise building (a new building has been constructed) has been postponed. The population often vehemently opposes the closure of regional hospitals, as was the case in Affoltern am Albis in May 2019, when almost three-quarters of voters voted in favour of maintaining the hospital. And last but not least, the Swiss Army, which provides indispensable services, must be maintained and cared for: The Border Guard Corps helps to secure the national border, and paramedics, 8,000 in number, provide support in the hospitals – an indispensable contribution in the current situation.

Unleashed globalisation no cure

And finally: definitive abandonment of the illusion that globalisation is merely a blessing for humanity, since everything that is economically viable – especially for global players – is of benefit to the world population. Of course, it is not only companies that benefit in terms of costs if they can produce their goods at locations all over the world and distribute them worldwide. We as end consumers also benefit when prices are low and consumer goods are available almost everywhere. But we also enjoy the fact that we can buy products that have been manufactured under conditions that we know and can approve of. With our buying behaviour we like to promote the prosperity of our region.
Every state bears responsibility for the well-being of its citizens, for the best possible health care and for the promotion of medical and pharmaceutical science. A pure focus on cost-effectiveness and profit orientation would be irresponsible, now and in the future.

Relaxation, but no all-clear

In the meantime the situation has eased somewhat: The number of hospitalizations for corona diseases is declining in Switzerland and Germany. Here in Switzerland as well as in Germany, there are enough free hospital beds due to precautionary measures in a special situation; the Covid-19 intensive care beds in Zurich, Basel as well as in the cantonal hospitals of St. Gallen, Lucerne and Argovia are not fully occupied.⁶ Fortunately, shortages are nowhere to be found, and that is a good thing. However, Rolf Gilgen, President of the Swiss Hospital Directors’ Association, emphasises that it is too early to give the all-clear. In the event of a renewed wave of infection, hospitals should be able to ramp up capacity for corona patients within two to three days.⁷ We can only concur with this view.        •

1  https://www.who.int/csr/sars/country/table2004_04_21/en/
2  “Pandemie-Übung 2014: Die Schweiz war gewarnt” (“Pandemic exercise 2014: Switzerland was warned”). In: Aargauer Zeitung from 28 March 2020.
3  “Das könnte eine Pandemie für Deutschland bedeuten” (“This could mean a pandemic for Germany”). In: Welt online from 26 February 2020, https://www.welt.de/wirtschaft/article206119443/Coronavirus-Das-bedeutet-eine-Pandemie-fuer-Deutschland.html
4  “Aargauer Gesundheitspolitikerin Ruth Humbel: ‘Musste Vater überzeugen, dass ich einkaufe’” (“Aargau health politician Ruth Humbel: ‘I had to convince my father that I am doing the shopping’”). In: Aargauer Zeitung from 30 March 2020.
5  Ibid.
6  Neue Zürcher Zeitung from 16 April 2020.
7  Aargauer Zeitung from 16 April 2020.

(Translation Current Concerns)