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.
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).