Kategorie: #versusvirus

Key findings

Epidemiological situation

There was and is no comprehensive Swiss public health strategy to protect risk groups in pandemics. In addition, elements of the Swiss pandemic plan 2018 were neglected during the crisis.

Data acquisition, reporting and harvesting is not standardized at all. Available resources are not utilized to their potential. Governments have not been data driven in their decision making.

Lack of reliable data minimizes the predictive value of epidemiological models. They are not a viable decision-making basis. Unfortunately, some models are coded sloppily.

Google trend data for respiratory infection symptoms (fever, cough, headache, tiredness, shortness of breath) is a consistent early warning system for respiratory pandemic deaths by about 2-3 weeks. This is evident when combined with excess mortality data (euromomo).

Switzerland is not an extraordinary case in terms of the dynamics of the pandemic.

People have voluntarily practiced social distancing, regardless of government interventions. There is no clearly identifiable impact of public health measures on epidemiological parameters of various countries.

Risk persons

Shielding risk persons from infections lowers the death toll and capacity usage of the health care system. Tailored measures for risk persons might avoid another lockdown should a second wave occur.

Roughly 50% of deaths with Covid-19 occur in nursing homes that only make up 1% of the population in countries all over the Western world. This quota of deaths has stayed relatively stable over the timeframe of the pandemic. Nursing home residents are only rarely hospitalized for Covid-19 or other severe conditions since they often have no significant chance of improvement. Palliative care is the usual and ethical choice. This has profound consequences for hospital capacity planning. Nursing homes have always represented about 50% of deaths of over 65-year-old persons in Switzerland in the timeframe 2010-2018. Half of male inhabitants of nursing homes die within 1 year of arrival.

Excess mortality only occurred in the over 65 years old age group. The median age of death is 84 in Switzerland. Therefore, risk for severe Coivd-19 outcomes is extremely tilted towards senior citizens. Children are fortunately very rarely affected.

Covid-19 risk factors are outlined in significant detail in the Covid-19 ordinance No. 2 Annex 6 of the Swiss federal government. It is unfortunate to place such important information hidden deeply in a legal document. We found that the list is too restrictive, inflexible, and incomplete. Individual doctor’s certifications of being at risk might be more appropriate.

Certain risk conditions may be worked on in health improvement programs that include physical exercise, diet, supplementation, and fine tailoring of medications. Voluntary participation in preventative medicine studies might yield scientific discoveries.

Economic consequences of lockdown in general and for the hotel industry specifically

Lockdowns are economically unsustainable and have negative health consequences.

The global economy was turning down before the pandemic emerged. Many underlying economic conditions like overindebtedness and trade barriers have been supercharged by the lockdown. The lockdown, not “the virus”, has caused unprecedented market distortions in labor, finance, retail, tourism, services, literally anything non-essential for that matter. Demand will shift in patterns that are very difficult to predict.

Estimates for worldwide international tourist arrivals by the World Tourism Organization (UNWTO) project a decline of at least 58% for 2020. This is unprecedented and dwarfs any previous crisis. This would equal a lost global tourism revenue of at least 910,000,000,000 US Dollars, more than 1% of global GDP.

The Institute for Tourism of HES-SO Valais-Wallis estimates that the entire Swiss hotel industry will lose 1,700,000,000 to 2,700,000,000 CHF in revenue between March and June 2020.

The Swiss hotel industry is suffering tremendously and will not recover quickly. Relying only on domestic visitors cannot make up for the absence of international demand whose share is above 50%. 25% of businesses see a significant risk of bankruptcy.

Realization of Corona Reduit

Concepts resembling Corona Reduit were realized in parts of the USA, Canada, Japan, and South Africa. Some were coordinated with government support, others were entirely private. Private realizations are epidemiologically less effective and exclude economically disadvantaged persons. We want to stress, though, that participation should be voluntary.

Hygiene requirements can be adopted from existing concepts for hotels, nursing homes, and hospitals. The biggest challenge are asymptomatic virus carriers. Symptomatic persons are identifiable with fever measurements and self-reporting.

The Corona Reduit registration website should be low barrier and easy to use to facilitate access by seniors.

The maximum potential savings for unemployment insurance not having to pay short-term work subsidies (“Kurzarbeit”) due to Corona Reduit is estimated to be 319,200,000 CHF over a period of 6 months.

The project should be transferred to and strategized with Corona Reduit stakeholder associations: seniors, pre-existing conditions, hotels, tourism, and governmental bodies at all levels of the federal system (federal, canton, county).

Summary of complex challenges and solutions

Several complex challenges were identified for which solutions were developed and proposed. All this is collected in a comprehensive 150+ page research paper that is still being worked on.

  1. Isolation/shielding of risk persons is necessary to lower the health impact

In case of a second wave, Corona Reduit offers a voluntary means to slow the spread among risk persons while the low risk majority acquires herd immunity. This concept (in combination with other targeted measures) is superior to universal lockdown both medically as well as socially, economically, and politically. It leads to less cases with severe outcomes and a drastically reduced economic burden

2. Insufficient statistical data

The project team has collected large volumes of worldwide data from conventional and innovative sources. This improves general understanding of the pandemic and the political responses to it. It also makes the high-risk group more clearly identifiable. Extensive analysis of risk groups and epidemiological data from conventional and innovative sources beyond common visualizations is a byproduct of Corona Reduit that was used by other hackathon participants/teams and scientists outside of the hackathon framework.

3. Risk factors are not well identified

Evaluation of global data pool and extensive scientific literature review provided valuable, multivariant insight into risk factors. This information will be shared with interested parties.

4. Scope of Swiss risk group

Was estimated via a collection of demographic data for Swiss populations concerning pre-existing conditions and socio-economics circumstances.

5. Prevention and reduction of risk factors

Certain risk conditions may be worked on in health improvement programs that include physical exercise, diet, supplementation, and fine tailoring of medications. Voluntary participation in preventative medicine studies during Corona Reduit might yield scientific discoveries.

6. Hygiene best practices are needed to minimize infection risk

Hygiene requirements can be adopted from existing concepts for hotels, nursing homes, and hospitals. The biggest challenge are asymptomatic virus carriers. Symptomatic persons are identifiable with fever measurements, virus testing and self-reporting.

7. Participants need a means to register

The Corona Reduit registration website should be low barrier and easy to use to facilitate access by seniors. Hotels need a registration form as well.

8. General economic activity is depressed due to lockdown, affecting the hotel industry enormously

Corona Reduit creates a WIN/WIN situation instead of the government paying the hotel industry to NOT work, i.e. a lose/lose situation. Risk persons are protected while the paralyzed hotel and tourism industry is enabled to generate positive value instead of being effectively shut down and entirely dependent on government support. If risk persons are protected individually, a general lockdown is avoidable.

9. Financing of Corona Reduit

The costs should be largely financed by the federal government with a cost sharing quota for risk persons. Compared to universal lockdown, the cost for the government would be negligible.

10. Legal framework

The preparation of blueprints for legal documents should be organized on the level of stakeholder associations. This course of action is crucial in order to achieve codification of best practices and low transaction costs. Neither risk persons nor individual hotels should have to contemplate much on legal matters.

11. Complexity of the concept requires coordination

The concept should be transferred to and strategized with Corona Reduit stakeholder associations: seniors, pre-existing conditions, hotels, tourism, and governmental bodies at all levels of the federal system (federal, canton, county). The initiators are offering voluntary, free of charge support.

Comparison of universal lockdown and targeted protection of risk persons

The following table compares the implementation of Corona Reduit together with targeted isolation by individual risk in comparison to a universal lockdown:

Scope of countermeasuresuniversal lockdown(voluntary) isolation by individual risk profile
Epidemiological impactuncertainherd immunity among low risk majority
effective reproduction numbergenerally somewhat loweredselective by risk profile
Spread impactmidly suppresiveselective herd immunity among low risk persons
overall death toll (longterm)higher (non selective infection)lower (herd immunity eventually slows spread to high risk persons)
health care system capacity usagehigher (non selective infection)lower (selective spread to low risk persons)
impact on next wavenext lockdown needed, no immunity(degree of) herd immunity limits spread and severity
Social impactuniversal isolationmostly intergenerational
share of population affectedeveryonehigh risk persons (voluntary)
childrenstuck at home with parentsin regular education and caretaking environment
working agelargely stuck at home (with children)working
seniorsstuck at homevoluntary isolation with specific services to take care of their needs
Economic impactdevastatinglimited (mostly retirees)
GDP growth> -25%mildly negative (consumption by retirees subdued)
labor marketcollapses, needs life supportbarely affected (mostly retirees at risk)
global tradecollapses, supply chains disruptedbarely affected (mostly retirees at risk)
government debtexplodes, deficits > 10% GDPrises slightly (expenses for risk person protection)
pension systemcollapses (negative returns)barely affected (mostly retirees at risk)
Political impactstate of emergencylimited, no state of emergency
division of powersceremonialregular operations
fundamental rightsmassively restrictedminimal restrictions
regulatory burdenmicromanagementstandard framework
organisational readinessoverwhelming complexityachievable (pandemic plan)

Dashboards

We gathered, analysed, and visualized the most relevant statistics to Covid-19 risk group persons in Switzerland. Find out our key findings by exploring the interactive dashboards below. Click the blue buttons with titles to navigate from one dashboard to another.

Corona Reduit registration website prototype

As part of the #versusvirus Hackathon deliverables, we have created a prototype for the registration of risk persons (demand) and hotels (supply). The focus was on the demonstration of functionalities, aesthetics is deemed secondary at the current stage.

Design principles applied were:

  1. Lowest possible access barriers for seniors and digital newbies (font size, intuitive menus, simple structure)
  2. A friendly, positive atmosphere
  3. Keeping distractions to a minimum

The following screens illustrate how the user requirements for a risk group person may be satisfied. Interact with the prototype below by clicking on one available link per page.

User Requirements

User requirements were defined as follows

As a hotel owner, I would like to be able to:

  1. Register my hotel by creating an account
  2. Apply for hygiene training and certification by a local health authority
  3. Manage room availability in my hotel
  4. Accept / reject applications
  5. (Nice to have) Bill services to the financing authority (federal government or insurance)

As an admin, I would like to be able to:

  1. View dashboards on reduit usage and availability for reporting
  2. (Nice to have) Perform bulk registration on behalf of hotels
  3. (Nice to have) Perform bulk application on behalf of risk group persons

As risk group person, I would like to be able to:

  1. Get an overview of the concept (FAQ, Video, terms and conditions, reduit contract etc).
  2. Fill out a survey to identify accommodation category (reduit / pre-reduit quarantine / barrier-free)
    • Questions to ask in a survey?
      • Do you live alone? (if not pre-reduit)
      • Do you have household members who does not work from home?
      • Do you have household members who recently travelled in high-risk countries?
      • Have you felt sick in the last two weeks?
      • Have you been to a hospital / outpatient clinic in the last week?
      • Do you need barrier-free accommodation?
  3. Select a mode of transportation to travel to the reduit
  4. Search for possible accommodations based on location and date
    • Filter list of locations based on the certain criteria
      • Maximum Altitude
      • Accessible Bedroom
      • Accessible Bathroom
      • Garden
      • Prepared meals
      • Common kitchen
      • Restaurant
  5. Apply for an accommodation for myself by entering details
    • Basic – name, birthday, gender, address, height and weight
    • Identification – swiss ID no or residence permit, health insurance
    • Health – GP name, existing conditions (multiple choice)
    • Partner’s name – name of legal partner to share the reduit

As a system, I would like to be able to:

Assess the suitability for participation based on BMI and pre-existing conditions.

Due to time constraints, the realization of the prototype was limited to the pages related to the user requirements of a risk person.