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After the spring experiences, politicians and experts agreed: to fight the pandemic, break the chains of infection and avoid further blockages, the tests must be scaled up. Our data analysis shows that this was only partially true in Switzerland.
A nurse performs a coronavirus test at the Martigny hospital’s Covid detection center.
Testing costs money, a lot of money. The federal government reimburses the coronavirus test with a flat fee of CHF 169. With an average of 17,000 tests per day, this equates to almost CHF 3 million per day. However, renowned economists like the Nobel laureate in economics Paul Romer have repeatedly pointed out that it is worth spending much more money on it. After all, all the alternatives, such as plant closures and quarantine measures, are associated with much higher economic and social costs in the medium term. Economists at the University of Zurich estimated that 13 million tests would be worth running to avoid a week-long lockdown.
In a video for the NZZ in March, Zurich behavioral economist Ernst Fehr called for regular samples of the population to be analyzed to finally obtain reliable figures on the spread of the virus in different population groups and regions.
However, this would have meant two things: on the one hand, people without symptoms would have had to have tests on a large scale. On the other hand, this strategy should have been developed and implemented first together with the cantons and the health authorities.
However, according to the Federal Office of Public Health (BAG), the Swiss testing strategy is based on testing only people with symptoms. International test data also shows that Switzerland apparently has not continuously expanded testing, as has happened in other countries. Many things are tested, especially when the number of infections increases dramatically.
After a peak in summer, Switzerland closed the tests again
The spring starting position was not bad at all: at the beginning of April, Switzerland was still among the top group in Europe in terms of the number of tests per capita. At that time, around 0.7 tests were performed on 1,000 residents. By early July, the number of tests had increased significantly and Switzerland was ahead of countries such as Germany, Sweden and Italy. Since the end of June, the federal government took over the costs of the tests on the recommendation of economists from the Swiss National Covid-19 Scientific Working Group, which was likely a deciding factor in pushing the tests forward.
What happened after that? Switzerland neglected testing in the remaining summer months, apparently without epidemiological justification, because the number of cases was already slowly but steadily increasing. After the end of the summer break, more tests were carried out again: the daily number of tests grew significantly faster in September than the number of new cases. Shortly before the number of cases dropped slightly in late September, according to official reports, testing was closed again. It was only when the number of infections rose significantly in October that the number of tests rose sharply.
With its undulating course, Switzerland is practically alone. There were phases in other European countries where the tests were reduced for a short time. However, it is very clear that most countries have continuously increased the number of tests no later than July, even before the number of cases exploded everywhere in the fall. In Germany and Sweden, for example, the number of tests grew earlier than the number of cases, so these countries should be in a more comfortable position when it comes to quickly identifying people infected in the second wave.
In terms of the number of tests per capita, Switzerland still lags behind
Denmark, in particular, greatly increased the number of tests since the summer. At the beginning of October, more than 8 tests were carried out there for every 1,000 inhabitants, about seven times more than in Switzerland. Belgium, Ireland, Finland, Norway and Austria have also greatly increased the number of tests and have tested two to three times more than Switzerland.
Since the beginning of October, many countries have again significantly increased the number of daily tests, including Switzerland in response to the sharp increase in the number of cases. Now it’s about twice as many tests per capita as at the beginning of the month. Denmark, on the other hand, reduced the intensity of the test a bit, but also had fewer new infections. However, Denmark continues to lead with more than 5 tests per 1000 inhabitants, ahead of Belgium and Great Britain. Although Switzerland was able to catch up a bit in comparison, it is still in the bottom midfield in terms of number of tests per capita.
A comparison of countries in terms of the number of tests in relation to their economic performance is also revealing. Switzerland is one of the richest countries in the world and, with a per capita gross domestic product of around CHF 85,000 (2019), it is ahead of the Scandinavian countries and miles ahead of Germany, France and Great Britain. Switzerland most likely can afford the expensive tests, but it is by far the least tested relative to its gross domestic product. Other small countries like Lithuania, Cyprus and Latvia, on the other hand, proportionally take much more resources in their hands.
High rate of positivity and uncontrolled spread
The currently very high positivity rate or the low proportion of tests and confirmed cases is also likely to be related to an insufficient number of tests during the summer months and late September. Only the Eastern European countries and Belgium are currently testing even less per case. Many cases are no longer recognized as a result. This means that the doors are open to the uncontrolled spread of the virus. Eastern Europe and Belgium, like Switzerland, are now struggling with a particularly steep rise in new infections.
Another consequence of the testing regime: the database required by epidemiologists and statisticians is still highly distorted: the number of cases published daily does not show a realistic picture of the real situation.
It is uncertain whether further testing would have changed the course of the pandemic: upon request, the BAG announced that there was no evidence of this, but it could not be ruled out that fear of quarantine had prevented people from being tested.
Economics professor David Dorn from the University of Zurich and a member of the Swiss National Covid-19 Scientific Working Group does not consider radical solutions such as mandatory testing or testing the entire population in a free state to be feasible, but he also advocates too much testing. perform that very few. In the current regimen, the most important thing is to get the message across that you can get tested even if you only have minor symptoms and to further simplify access to testing.
According to his colleague Marius Brülhart from the University of Lausanne, who is also a member of the task force, cost considerations are probably the main reason why the tests did not expand to a large area in Switzerland. The impression is that some public health decision makers are struggling to adjust to the financial dimensions of the century’s pandemic. “If the economy loses billions, there shouldn’t be a fight for millions in the healthcare system,” Brülhart said.
International test data comes from Our World in Data. The non-profit platform has set itself the task of making knowledge and data about major human problems accessible to the public. For test data, data from the health authorities of 108 countries is regularly compiled and updated.
