The number of new infections has been rising again since the beginning of June – Switzerland is in the midst of a corona summer wave. How do you assess the situation, Mr Günthard?
Huldrych Gunthard: We have to accept that the pandemic is not over yet. The summer wave has really picked up speed. Although we do not yet see a flood of patients coming to our CHU because of Covid, we are testing more and more people in our health establishments positive for the virus. We will probably reach the summit in two to four weeks.
Is Omikron BA.5 more dangerous than previous variants?
In countries like Portugal and South Africa, which caught the summer surge a bit earlier, severe prices have been shown not to rise. People who come to the CHU because of the Covid often have long medical records or are older.
How has the clinical picture changed?
We rarely have the typical pneumonia that we had to deal with at the start of the pandemic. Apparently, a basic immunity has developed in the population. Either you are infected or vaccinated or both; we also have early therapies for high-risk patients. In all cases, the number of antibodies decreases over time. It is therefore correct that the Federal Vaccination Commission has now recommended the booster for people over 80 years of age. Rather late, but still.
Personally
Huldrych Günthard (61) is an infectious disease specialist at the University Hospital of Zurich and chief physician of the clinic for infectious diseases and hospital hygiene. He is one of the most important experts in the country. Since the start of the pandemic, he has been committed to protecting his patients, advocating for forced vaccinations, rapid recalls and the establishment of a permanent corona crisis management team.
Huldrych Günthard (61) is an infectious disease specialist at the University Hospital of Zurich and chief physician of the clinic for infectious diseases and hospital hygiene. He is one of the most important experts in the country. Since the start of the pandemic, he has been committed to protecting his patients, advocating for forced vaccinations, rapid recalls and the establishment of a permanent corona crisis management team.
Once again, the hesitations of the vaccination committee and the high age limit are surprising.
We can discuss at length where to draw the age limit. An Israeli study published in May shows that the second booster from the age of 60 already leads to a reduction in hospitalizations and mortality. From a medical point of view, there is no reason to set age limits as rigid as the Commission on Vaccination does. You also need to consider the signal you are sending with.
What do you mean?
It’s a little confusing when authorities make vaccination the silver bullet and then skimp on things. Today, those who go on vacation must pay for their vaccinations themselves. Why? Or think of health workers who want to protect themselves, but sometimes even have to pay for vaccinations themselves. It just doesn’t fit the overall concept.
Apart from the recall press conference last week, things have become eerily quiet at the Federal Office of Public Health…
I understand that after more than two years of the pandemic, everyone is tired: the authorities, the population, the hospitals. The huge loss of work and the numerous restrictions have worn down the company. This is exactly why there needs to be clear and ongoing communication about the status of the pandemic, what action is being taken or not being taken and why. The BAG does not currently have such a concept. This can lead to uncertainty in the population and minimization of infection.
From the infectious disease specialist’s point of view: What role should the FOPH play?
A crisis management team made up of BAG experts and external specialists who communicate regularly and clearly is absolutely necessary. Previously, the working group assumed part of this function. If a new wave forms, the population must be informed within two or three days and told what is happening. It needs short decision-making processes and positions of responsibility. The virus shows no respect for our rigid political processes.
Apparently, Switzerland is far from it.
Apparently! The BAG should in fact have a budget for emergencies which can be discussed at short notice by an expert council so that we can search for new pathogens better and faster. Groups of university specialists could then treat viral diseases such as monkeypox or Covid and collect important data on the infection and the course of the disease.
The nature of the researcher: he always wants more money.
Yes and? After all, we want to discover new things, understand diseases and develop therapies. This is not possible without financial resources. Do you remember the second wave?
Very well. The death toll rose rapidly.
It was a dramatic situation. When you see how the hospitals are filling up, when people are fighting for their lives, when you have hardly any effective therapies at first, when a lot of people are suffering and dying, it’s very stressful for everyone. We were so exhausted that it was also difficult to research. But we still managed to do a lot, also in Switzerland. Unfortunately, politicians often acted hesitantly and barely helped us financially.
What triggered it in you?
Frustration that I cannot afford. I want solutions, not excuses. I just want to do my job.
In view of autumn and winter: What is our starting position?
The new Omikron vaccines are expected to be marketed in early fall. Moderna’s, at least that’s what I’ve read in previous posts, apparently significantly increases the degree of immunity to omicron. It makes me confident. This allows us to break new waves faster and better protect the vulnerable part of the population. But we must not forget: vaccinations never completely immunize us against new infections. That’s why we have to take precautions.
As?
We already have to think about how to get the new vaccine as quickly as possible to the people when it becomes available. The ball came back into the hands of the BAG and then the cantons. You need a clear strategy.
A simple and inexpensive measure that would come into effect immediately would be to reintroduce the obligation to wear a mask.
The BAG should find out how many long-lasting Covid cases could have been prevented with another mask requirement. Most healthcare facilities quickly reintroduced the requirement to wear masks. I myself wear a mask again on public transport. No need to be hysterical, but now it’s about pushing the tide so there are fewer lost workdays and fewer long-term Covid patients. It is in the interest of the whole country.
We now know that vaccination protects above all against severe developments, but not against Long Covid. Shouldn’t that be better communicated?
Vaccination somewhat reduces the risk of Long Covid. It also appears that Omicron has about 50% fewer long-term Covid cases than Delta, but that data isn’t solid yet. What worries us is the number of infections. If 100,000 people are infected every day and, according to conservative calculations, 5% have long-term Covid symptoms, then we are talking about around 5,000 people every day with long-term consequences. They can sometimes not work for months and become a special medical case. There is currently no specific treatment. We must not take this lightly.
The federal government has neither set up a national long-Covid registry nor donated money for research in this area, as patient organizations and specialists have long demanded. Can you explain this indiscriminate theft taking place?
To my knowledge, the BAG has not yet recognized the Long Covid as a priority problem and has not defined it as such. For this reason, no major financial resources have been made available to those wishing to research the long Covid. At the CHU, we also take care of many long-term Covid patients with varied consultation hours. However, it is difficult to do this optimally with existing resources, since we are already working at full capacity. One cannot casually treat a disease which has serious public health consequences and which we understand very little.