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Switzerland is debating triage among unvaccinated people

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The neighbors looked slightly surprised at Switzerland. The government began to relax the requirements early on – during the third wave of coronavirus. Now the number of new infections has risen rapidly. And the Swiss clinics are already on the verge of their limits. This is reported by the newspaper “Blick”, among others. Some have already had to move patients to other hospitals because the intensive care units are full.

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One reason: in no other country in Western Europe have fewer people given an injection against the virus – the rate of fully vaccinated people in Switzerland is only 51 percent. In Germany, where the vaccination campaign is currently stalling, the figure is 62 percent. In the country with around 8.5 million inhabitants, a heated debate has broken out as to whether vaccination status should be a criterion for any triage procedures.

As the “Blick” writes, according to the latest official figures, the intensive care units nationwide are 80.3 percent full. A good third of the beds are occupied by Covid 19 patients – almost all of them are not vaccinated. If the numbers continue to rise, there is a risk of overloading the clinics, the Federal Council warned on Friday following a meeting with the party leaders.

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At the beginning of the last week of August, the Swiss Federal Office of Public Health (BAG) classified the situation as worrying. “We have to describe the current situation as the fourth wave,” says Patrick Mathys, Head of Crisis Management and International Cooperation at the BAG.

The number of new illnesses and hospital admissions are at a level as seen in the third wave, and the situation in the intensive care units can be classified as tense. A relaxation is not foreseeable in view of the stagnating vaccination numbers. “The vast majority of people hospitalized are not vaccinated,” said Mathys.

Stephan Jakob, head of intensive care medicine at Bern’s Inselspital, said the “Blick” report: “An intensive care unit must never be used to full capacity.” 70 percent of all patients in the clinic come as emergencies, for which capacity must be kept free. The utilization of an intensive care unit should be a maximum of 75 percent.

Despite the high number of infections, the government initially decided a few days ago not to tighten the corona requirements. “The number of hospital admissions of corona patients is still high, but has not increased in the last week,” said the government on Wednesday. A stabilization of the number of infections is emerging. In addition, more people were vaccinated again. Therefore, a tightening will be refrained from for the time being.

Now the government is apparently turning around again. As the “Sunday newspaper” reports, there should now be more editions – similar to the 3G rule in Germany. The so-called Covid certificate requirement is to be expanded on Wednesday. The Swiss Federal Council will then decide this. Health Minister Dies Alain Berset announced this at the meeting with the leaders of the Federal Council parties, the report says.

The cantons have long been demanding that access to restaurants, fitness centers, cinemas or theaters should only be allowed to those who have been vaccinated, those who have tested negatively and who have recovered. According to the report, Berset wrote in a letter with the support of the party leaders calling on the cantons to provide more hospital beds and to make progress with vaccinations. The Federal Council therefore hopes that the number of people vaccinated could be increased significantly with additional mobile deployments.

The seven-day incidence in Switzerland was around 170 on Sunday. For comparison: In Germany, the number of new infections per 100,000 inhabitants in seven days, according to the Robert Koch Institute, was 83 on Sunday morning.

In total, the Alpine country has so far recorded 11,011 Covid-19 deaths and 785,696 infections. So far, there have been 1,293 Covid-19 deaths and 92,255 confirmed cases in Switzerland per one million inhabitants. For comparison:

Covid-19 deaths / confirmed infections per million people (Source Johns Hopkins University):

  • Italy 2142 / 75.559
  • France 1722 / 103.167
  • Austria 1220 / 78.572
  • Germany 1114 / 48.414

The virologist Isabella Eckerle, who comes from Germany, referred on Sunday to a tweet by the journalist Marc Brupbacher from the Swiss “Tages-Anzeiger”, who had written: “Swiss intensive care units are most heavily used with Covid patients in Western Europe.”

Eckerle, who heads the Infectious Diseases Department at the University Clinics in Geneva, commented on this by pointing out that only 51 percent of citizens in Switzerland were fully vaccinated and wrote: “No will to contain the 4th wave. The start of school & the first cold days will soon heat the situation even further. “

Other experts in the country had previously sounded the alarm. “What else do you need?” Asked the Bern vaccination chief Gregor Kaczala (46) on Friday, according to the “Blick”. “It is no longer only people over 65 who will die of Covid. It will be fathers, mothers and fellow athletes. ”These are unnecessary and avoidable losses. With this attitude, increasing numbers and a further burden on the hospitals would be unavoidable. “I hope we don’t have to make triage decisions,” he said. “If so, I fear worse cards for non-vaccinated people.”

The pediatrician explained that in the case of triage, not only age and frailty would be criteria. Because the patients who are now in the intensive care unit are 20 to 50 years old. “The vaccination status would certainly be taken into account. “If you say A in life, you also say B.”

The Swiss Academy of Medical Sciences (SAMS) had already adjusted its guidelines for patient triage at the end of last year. It is intended to be a guide for the medical profession in deciding whose life cannot be prolonged. “The doctors will then first treat those who have the best chance of survival,” said Bernese health director Pierre Alain Schnegg (58). “That is more likely to be the vaccinated.”

The Zurich health director Natalie Rickli had expressed herself even more clearly. “Anyone who opposes vaccinations should actually fill out an advance directive in which they confirm that they do not want hospital and intensive care in the event of Covid disease. That would be real personal responsibility, ”she told the“ Tages-Anzeiger ”. Unvaccinated people would put a strain on the health system.

The medical ethicist Ruth Baumann-Hölzle, however, has major concerns. “It would be a highly problematic paradigm shift to suddenly qualify an illness as guilt,” said the 64-year-old, the medical ethicist, according to the “Blick” report. If people were assessed as more or less worth living solely because of a vaccination, this would contradict Switzerland’s humanitarian tradition. “Such threats could also have an impact on social coexistence,” Baumann-Hölzle pointed out.

Schnegg argued against it that already today triages have to be carried out regularly in the intensive care units. Because of the bottlenecks, operations would have to be postponed again and again. “And you can ask yourself: Is it correct if we refuse someone an operation just because we need space for an unvaccinated Covid patient?” Schnegg continues: “People have to understand that the situation is serious. I have no understanding for those who do not get vaccinated, fly on vacation, go to party and are then surprised when they end up in the intensive care unit. There is a simple recipe against it: the vaccination! “

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