7 ms·

Switzerland's lockdown has sharply reduced the cases of Covid-19

53 points by deepaksurti 6y ago

_nalply 6y ago
Living in Switzerland: People changed behavior drastically. Hand shaking completely disappeared, oncoming walking people making a bend to guarantee the distance of 6 feet, hand sanitizers for everybody everywhere, businesses and associations have to publish government-approved conceptions of protection against infections before re-opening and many other little changes. However relatively little face masks, no curfew and as of today life is going on not quite as before. For example, next week swimming courses for children resume, but parents are asked to send the children already clothed for swimming and are warned if they don't follow the guidelines they and their children will be excluded. In the local hospital all visitors are given face masks to be worn without exception by a Securitas (a private police) employee.
- naavis 6y ago
  Sounds very similar to Finland. We've been under similar lockdown for two-ish months now, and we are down to maybe 25 new confirmed cases per day.
  - H8crilA 6y ago
    Do most people use masks in Finland? I'm kind of shocked how few people use them in Switzerland. Not that I know for sure how much do masks help, but it's so cheap to get them! And the supply is now plentiful. Talk about cost/reward, especially when compared to debilitating costs of things like shutdowns ... In either case, Europe is cool for now. Let's see what will the Autumn and Winter bring.
    - znd 6y ago
      Mask use is quite rare here. The government had a group of researchers do a literary review of evidence for mask use and found the evidence lacking. The review has been (rightfully) critiqued, but there is no formal recommendation for mask use. Hopefully they will reconsider especially if the infection rate starts rising again. The epidemic has been concentrated near the capital with around 80% of cases found there in the last few weeks. I for one would advocate mask use around there even now to keep the rates declining.
    - _nalply 6y ago
      After having been half a day at a hospital with a face mask I realize it's just «Gewöhnungssache» (a matter of getting used to something). I am sure when about half of the population experienced half a day with a face mask on, then the majority will adapt. Face masks are just simply something which needs some getting used to. When really many people wear face masks then nobody will eye them warily. And Switzerland probably never will pass this threshold.
- saiya-jin 6y ago
  > People changed behavior drastically. That's a massive overstatement. I live in Geneva, one of the worst hit cantons (they say around 10% infection rate). Way too many people for a long time simply didn't care, the list of personal anecdotes is way too long to post here. We all were seeing what is happening few kms south from our border, and government did nothing for almost 2 weeks. It was seriously ridiculous, all restaurants and concerts packed, when 50km south Italian hospitals were already flooded and news was everywhere. There was vote on top level of government which ended up in favor of keeping business opened, because money. People rarely using face masks, even during hardest hits not even half of supermarket shoppers wore masks, on streets barely anybody. Most of the supermarket staff didn't use any mask either. Generally German-speaking parts were much less affected, I've heard many personal stories from friends that were verbally attacked and mocked on streets and shops for wearing masks (locals mockingly start coughing behind them in shop and rest of the staff having a blast). I know of several people that were fired back in march/april because they came to work in simple face masks due to them being immune-deficient, and management decided to fire them on spot for 'spreading panick', no discussion (if you are blue collar foreigner here, sometimes locals treat you like disposable piece of shit and don't even try to hide it). Once laws were changed people started behaving a bit more sane, but far from ideal - many people on streets and parks completely ignoring 2 meter rule (even 1 meter). I saw an old guy sitting on bench in the park, coughing like hell, no mask, while on phone having laughs how other people avoided him, even police patrol which didn't even bother to talk to him. How well this country fares now, despite all of this gives me hope that it ain't that bad with covid. Swiss didn't 'beat' it due to great behavior they showed, in contrary. My home country was much more prudent and restriction were quick and followed by almost eveyrbody, and they ended up with 5% of the Swiss infection rate, despite being of similar size. Of course it could be that it was still stellar behavior en Suisse compared to what common Italians or Spaniards showed, this I can't compare.
  - piquadrat 6y ago
    Zurich resident (and Swiss citizen) here. I agree that in the beginning, a lot of people and politicians didn't recognize the seriousness of the situation. The fact that the Swiss political system isn't really made for quick decisions from a central authority probably didn't help either. But once people realized that this is going to be real bad if it continues unchecked, behaviour changed a lot IMO, even in regions that had very little virus activity. True, mask wearing is still a problem, and you could see lots of people doing outside activities even during the worst part of the lock down. But as luck would have it, outside infections seem to play almost no epidemiological role. Turns out not wearing masks on the street or going for a Sunday hike on crowded paths isn't a big deal, and in retrospect I'm glad that our lock-down wasn't quite as limiting as in other parts of Europe. I wish masks were mandatory on public transport, though.
nicc 6y ago
I don't understand why people keep wasting time with this. Governments are both not doing widespread testing to see how many people have the virus, and taking draconian measures to contain its spread. From what we know, 90% of the population already could already have it. Every time I read of somebody testing a big group of people a huge percentage has it, but the virus is so mild that they didn't even know—since it caused no symptoms. Looks like there are many other diseases and problems that cause dozen of times more deaths, so either there's a reason why this is getting special treatment, or it's just a complete loss of common sense here, in my opinion.
- kgwgk 6y ago
  > Every time I read of somebody testing a big group of people a huge percentage has it Really? Any examples?
  - daenz 6y ago
    Not OP, but NYC estimates 20% have had it based on N=3000[0]. This was back in April. 0. https://thehill.com/policy/healthcare/494324-27m-new-yorkers-have-had-coronavirus-preliminary-data-shows https://thehill.com/policy/healthcare/494324-27m-new-yorkers...
    - wereHamster 6y ago
      NYC is a drastically different city than even the largest city in Switzerland. NYC has six times higher population density than Zurich. People behave differently, in Switzerland they are far more accepting the social distancing measures than people in the US. You can't compare two cities (or countries) just like that.
      - deleted 6y ago
        [deleted]
    - ekianjo 6y ago
      NYC is peak COVID, and 20% is pretty far from 90%.
harryf 6y ago
Other than the number of cases, a key metric is ICU load. There's a good visualisation here https://covid.visium.ch/ https://covid.visium.ch/ ... the peak ICU load at the end of March / early April was 62% (the source of this data is described here: https://github.com/schoolofdata-ch/swiss-hospital-data https://github.com/schoolofdata-ch/swiss-hospital-data ) ... in other words hospitals weren't overloaded the way they were in Italy for example. IMO some of the main reasons for that were; - Switzerland has an effective / working healthcare system - Personal health is taken pretty seriously; there's a general emphasis on fitness and good diet - Switzerland has one of the lowest obesity rates in Europe for example https://en.wikipedia.org/wiki/Obesity_in_Switzerland https://en.wikipedia.org/wiki/Obesity_in_Switzerland - Measures like shutting schools and working from home were implemented pretty quickly at the beginning of March. - As a whole people behaved sensibly. Advice from the government was taken. There was no panic but largely people adapted to the new situation very quickly - Finally, in general, the social systems works well here. There aren't large numbers of homeless and most people furloughed or who lost their job will have received at least 80% of their normal salary, so you don't have large numbers of people living in unhealthy conditions that would help a virus spread
- mattmanser 6y ago
  As far as I know here in the UK we never went above 60%, and yet still had lots of deaths, so how is this a key metric?
  - Arnt 6y ago
    There are others factors... obesity has been mentioned many times and might be part of the answer to your question, so I looked at the Wikipedia link posted and see that Switzerland has Europe's lowest obesity rate. The UK, OTOH: "Obesity in the United Kingdom is a significant contemporary health concern, with authorities stating that it is one of the leading preventable causes of death."
  - ben_w 6y ago
    The various NHS Nightingale hospitals have a distinctly Potempkin feeling to them, given how few patients went into the London one before it was dismantled. I doubt the value of statistics distributed by the UK government.
huhtenberg 6y ago
A couple of graphs to visualize it - https://interaktiv.tagesanzeiger.ch/2020/wuhan-schweiz/ https://interaktiv.tagesanzeiger.ch/2020/wuhan-schweiz/ However keep in mind that there's just 8.5 mil people in Switzerland. That's around the same as New York City and 2/3 of the size of Moscow.
wosk 6y ago
I'm an author of this study (and long time lurker), happy and surprised to see it posted here. Some findings HN readers might find interesting, I'm referring to figures in the manuscript[1] and it's appendix. - R0 has started to decrease before the government measures (Fig 2). It even reaches 1 simultaneously to the main "lockdown" measure. - Mobility (from google mobility reports) also started to decrease before the measures (Fig. 3), but R0 also started to decrease before even mobility (Fig. 3). - People awareness seemed to rise before government measures and mobility decrease, consistent with google trends (Appendix Fig. 14). Might explain why R0 starts to decrease so early. - The appendix contains an interesting data analysis of hospitalization processes, with data on env. 1'000 patients. The length of stay in ICU are incredibly long. To answer the question: How long ?, we performed a survival analysis. It's necessary as estimates (such as the mean) are biased towards shorter stays. - A serology study is conducted at the moment in Geneva. It seems that our estimates of seroprevalence (Fig. 5: only 3% country wide by April 24) are consistent with the study (Appendix Fig. 7). We were quite proud of that, as these results were unknown to us at the time. - Method wise: There is different way of estimating R0 given hospitalization, death, cases: (i) Most estimates are done with methods "deconvoluting" the data using the distributions (Cori et al, Wallinga and Teunis, implemented in the EpiEstim R package). It can works very well, but it's tricky to have unbiased estimates (see [2]). (ii) Other methods involve choosing a breakpoint and calibrating to R0: before and after breakpoint. Variations of this method involve calibrating the breakpoint date, choosing a shape (e.g spline) and calibrating all the parameters. These method rely on some assumptions on the decrease. A incorrect assumption leads to biased estimates. E.g it would seem reasonable to assume R0 to decrease on the day of the government measures. But from what we estimated it wasn't the case in Switzerland. So your estimate of R0 post-measure would be lower than what it is really (to catch-up). The method used here uses the full timeserie and no assumptions. First we built an hidden-markov model of COVID-19 transmission and hospitalization (see diagram Appendix Fig. 4). We performed frequentist inference (using [3]) of relevant parameters. Last, we "filter" R0 as a state of our model: R0 is a random walk, with calibrated variance and using particle filter we keep only R0 timeseries that support the underlying data. Therefore we impose no assumption on R0. [1] https://smw.ch/article/doi/smw.2020.20295 https://smw.ch/article/doi/smw.2020.20295 and Appendix [2] https://github.com/keyajoshi/Pan_response https://github.com/keyajoshi/Pan_response [3] https://en.wikipedia.org/wiki/Iterated_filtering https://en.wikipedia.org/wiki/Iterated_filtering
known 6y ago
I think wearing masks and gloves reduced cases, not lock down per se

53 points by deepaksurti 6y ago

Living in Switzerland: People changed behavior drastically. Hand shaking completely disappeared, oncoming walking people making a bend to guarantee the distance of 6 feet, hand sanitizers for everybody everywhere, businesses and associations have to publish government-approved conceptions of protection against infections before re-opening and many other little changes. However relatively little face masks, no curfew and as of today life is going on not quite as before. For example, next week swimming courses for children resume, but parents are asked to send the children already clothed for swimming and are warned if they don't follow the guidelines they and their children will be excluded. In the local hospital all visitors are given face masks to be worn without exception by a Securitas (a private police) employee.

naavis 6y ago
Sounds very similar to Finland. We've been under similar lockdown for two-ish months now, and we are down to maybe 25 new confirmed cases per day.
- H8crilA 6y ago
  Do most people use masks in Finland? I'm kind of shocked how few people use them in Switzerland. Not that I know for sure how much do masks help, but it's so cheap to get them! And the supply is now plentiful. Talk about cost/reward, especially when compared to debilitating costs of things like shutdowns ... In either case, Europe is cool for now. Let's see what will the Autumn and Winter bring.
  - znd 6y ago
    Mask use is quite rare here. The government had a group of researchers do a literary review of evidence for mask use and found the evidence lacking. The review has been (rightfully) critiqued, but there is no formal recommendation for mask use. Hopefully they will reconsider especially if the infection rate starts rising again. The epidemic has been concentrated near the capital with around 80% of cases found there in the last few weeks. I for one would advocate mask use around there even now to keep the rates declining.
  - _nalply 6y ago
    After having been half a day at a hospital with a face mask I realize it's just «Gewöhnungssache» (a matter of getting used to something). I am sure when about half of the population experienced half a day with a face mask on, then the majority will adapt. Face masks are just simply something which needs some getting used to. When really many people wear face masks then nobody will eye them warily. And Switzerland probably never will pass this threshold.
saiya-jin 6y ago
> People changed behavior drastically. That's a massive overstatement. I live in Geneva, one of the worst hit cantons (they say around 10% infection rate). Way too many people for a long time simply didn't care, the list of personal anecdotes is way too long to post here. We all were seeing what is happening few kms south from our border, and government did nothing for almost 2 weeks. It was seriously ridiculous, all restaurants and concerts packed, when 50km south Italian hospitals were already flooded and news was everywhere. There was vote on top level of government which ended up in favor of keeping business opened, because money. People rarely using face masks, even during hardest hits not even half of supermarket shoppers wore masks, on streets barely anybody. Most of the supermarket staff didn't use any mask either. Generally German-speaking parts were much less affected, I've heard many personal stories from friends that were verbally attacked and mocked on streets and shops for wearing masks (locals mockingly start coughing behind them in shop and rest of the staff having a blast). I know of several people that were fired back in march/april because they came to work in simple face masks due to them being immune-deficient, and management decided to fire them on spot for 'spreading panick', no discussion (if you are blue collar foreigner here, sometimes locals treat you like disposable piece of shit and don't even try to hide it). Once laws were changed people started behaving a bit more sane, but far from ideal - many people on streets and parks completely ignoring 2 meter rule (even 1 meter). I saw an old guy sitting on bench in the park, coughing like hell, no mask, while on phone having laughs how other people avoided him, even police patrol which didn't even bother to talk to him. How well this country fares now, despite all of this gives me hope that it ain't that bad with covid. Swiss didn't 'beat' it due to great behavior they showed, in contrary. My home country was much more prudent and restriction were quick and followed by almost eveyrbody, and they ended up with 5% of the Swiss infection rate, despite being of similar size. Of course it could be that it was still stellar behavior en Suisse compared to what common Italians or Spaniards showed, this I can't compare.
- piquadrat 6y ago
  Zurich resident (and Swiss citizen) here. I agree that in the beginning, a lot of people and politicians didn't recognize the seriousness of the situation. The fact that the Swiss political system isn't really made for quick decisions from a central authority probably didn't help either. But once people realized that this is going to be real bad if it continues unchecked, behaviour changed a lot IMO, even in regions that had very little virus activity. True, mask wearing is still a problem, and you could see lots of people doing outside activities even during the worst part of the lock down. But as luck would have it, outside infections seem to play almost no epidemiological role. Turns out not wearing masks on the street or going for a Sunday hike on crowded paths isn't a big deal, and in retrospect I'm glad that our lock-down wasn't quite as limiting as in other parts of Europe. I wish masks were mandatory on public transport, though.

nicc 6y ago

I don't understand why people keep wasting time with this. Governments are both not doing widespread testing to see how many people have the virus, and taking draconian measures to contain its spread. From what we know, 90% of the population already could already have it. Every time I read of somebody testing a big group of people a huge percentage has it, but the virus is so mild that they didn't even know—since it caused no symptoms. Looks like there are many other diseases and problems that cause dozen of times more deaths, so either there's a reason why this is getting special treatment, or it's just a complete loss of common sense here, in my opinion.

kgwgk 6y ago
> Every time I read of somebody testing a big group of people a huge percentage has it Really? Any examples?
- daenz 6y ago
  Not OP, but NYC estimates 20% have had it based on N=3000[0]. This was back in April. 0. https://thehill.com/policy/healthcare/494324-27m-new-yorkers-have-had-coronavirus-preliminary-data-shows https://thehill.com/policy/healthcare/494324-27m-new-yorkers...
  - wereHamster 6y ago
    NYC is a drastically different city than even the largest city in Switzerland. NYC has six times higher population density than Zurich. People behave differently, in Switzerland they are far more accepting the social distancing measures than people in the US. You can't compare two cities (or countries) just like that.
    - deleted 6y ago
      [deleted]
  - ekianjo 6y ago
    NYC is peak COVID, and 20% is pretty far from 90%.

harryf 6y ago

Other than the number of cases, a key metric is ICU load. There's a good visualisation here https://covid.visium.ch/ https://covid.visium.ch/ ... the peak ICU load at the end of March / early April was 62% (the source of this data is described here: https://github.com/schoolofdata-ch/swiss-hospital-data https://github.com/schoolofdata-ch/swiss-hospital-data ) ... in other words hospitals weren't overloaded the way they were in Italy for example. IMO some of the main reasons for that were; - Switzerland has an effective / working healthcare system - Personal health is taken pretty seriously; there's a general emphasis on fitness and good diet - Switzerland has one of the lowest obesity rates in Europe for example https://en.wikipedia.org/wiki/Obesity_in_Switzerland https://en.wikipedia.org/wiki/Obesity_in_Switzerland - Measures like shutting schools and working from home were implemented pretty quickly at the beginning of March. - As a whole people behaved sensibly. Advice from the government was taken. There was no panic but largely people adapted to the new situation very quickly - Finally, in general, the social systems works well here. There aren't large numbers of homeless and most people furloughed or who lost their job will have received at least 80% of their normal salary, so you don't have large numbers of people living in unhealthy conditions that would help a virus spread

mattmanser 6y ago
As far as I know here in the UK we never went above 60%, and yet still had lots of deaths, so how is this a key metric?
- Arnt 6y ago
  There are others factors... obesity has been mentioned many times and might be part of the answer to your question, so I looked at the Wikipedia link posted and see that Switzerland has Europe's lowest obesity rate. The UK, OTOH: "Obesity in the United Kingdom is a significant contemporary health concern, with authorities stating that it is one of the leading preventable causes of death."
- ben_w 6y ago
  The various NHS Nightingale hospitals have a distinctly Potempkin feeling to them, given how few patients went into the London one before it was dismantled. I doubt the value of statistics distributed by the UK government.

huhtenberg 6y ago

A couple of graphs to visualize it - https://interaktiv.tagesanzeiger.ch/2020/wuhan-schweiz/ https://interaktiv.tagesanzeiger.ch/2020/wuhan-schweiz/ However keep in mind that there's just 8.5 mil people in Switzerland. That's around the same as New York City and 2/3 of the size of Moscow.

wosk 6y ago

I'm an author of this study (and long time lurker), happy and surprised to see it posted here. Some findings HN readers might find interesting, I'm referring to figures in the manuscript[1] and it's appendix. - R0 has started to decrease before the government measures (Fig 2). It even reaches 1 simultaneously to the main "lockdown" measure. - Mobility (from google mobility reports) also started to decrease before the measures (Fig. 3), but R0 also started to decrease before even mobility (Fig. 3). - People awareness seemed to rise before government measures and mobility decrease, consistent with google trends (Appendix Fig. 14). Might explain why R0 starts to decrease so early. - The appendix contains an interesting data analysis of hospitalization processes, with data on env. 1'000 patients. The length of stay in ICU are incredibly long. To answer the question: How long ?, we performed a survival analysis. It's necessary as estimates (such as the mean) are biased towards shorter stays. - A serology study is conducted at the moment in Geneva. It seems that our estimates of seroprevalence (Fig. 5: only 3% country wide by April 24) are consistent with the study (Appendix Fig. 7). We were quite proud of that, as these results were unknown to us at the time. - Method wise: There is different way of estimating R0 given hospitalization, death, cases: (i) Most estimates are done with methods "deconvoluting" the data using the distributions (Cori et al, Wallinga and Teunis, implemented in the EpiEstim R package). It can works very well, but it's tricky to have unbiased estimates (see [2]). (ii) Other methods involve choosing a breakpoint and calibrating to R0: before and after breakpoint. Variations of this method involve calibrating the breakpoint date, choosing a shape (e.g spline) and calibrating all the parameters. These method rely on some assumptions on the decrease. A incorrect assumption leads to biased estimates. E.g it would seem reasonable to assume R0 to decrease on the day of the government measures. But from what we estimated it wasn't the case in Switzerland. So your estimate of R0 post-measure would be lower than what it is really (to catch-up). The method used here uses the full timeserie and no assumptions. First we built an hidden-markov model of COVID-19 transmission and hospitalization (see diagram Appendix Fig. 4). We performed frequentist inference (using [3]) of relevant parameters. Last, we "filter" R0 as a state of our model: R0 is a random walk, with calibrated variance and using particle filter we keep only R0 timeseries that support the underlying data. Therefore we impose no assumption on R0. [1] https://smw.ch/article/doi/smw.2020.20295 https://smw.ch/article/doi/smw.2020.20295 and Appendix [2] https://github.com/keyajoshi/Pan_response https://github.com/keyajoshi/Pan_response [3] https://en.wikipedia.org/wiki/Iterated_filtering https://en.wikipedia.org/wiki/Iterated_filtering

known 6y ago

I think wearing masks and gloves reduced cases, not lock down per se