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The coronavirus was faster. Reality rolled mercilessly: in the summer of 2019, the Federal Office of Public Health (BAG) commissioned an external investigation. The experts at the consulting firm Bolz und Partner should check how well the epidemic law is being applied. This provides the set of tools that authorities can use to fight communicable diseases and manage crises. Like Covid-19.
Expert fieldwork was well advanced, more than 30 experts from offices and practice were interviewed, a survey of cantonal physicians was completed, and reports were sought; that’s when the largest pandemic in a hundred years spread in the spring. Before the lessons of the investigation could be drawn, the core of the law underwent a tough practical test: crisis management.
So all just for the garbage? Are you kidding? You’re serious when you say that. The results of the investigation are already available. The BAG has just released the analysis to the public. The experience of the crown crisis is not taken into account. This is precisely what makes analysis so valuable – it meticulously documents gaps that have been known for a long time. And so it shows how the authorities slipped into crisis, some with sight.
Chaos has announced
In general, experts come to a positive conclusion. The new Epidemic Law, which has been in force for four years, is basically well executed and implemented. Sometimes, however, the analysis reads like the record of an announced fiasco: Experts speak of a “real lag in implementation” when it comes to digitization.
To what extent the BAG has neglected this was only ruthlessly revealed in the crisis. At the beginning of the pandemic, doctors had to fax their corona cases to the BAG. The result: tall mountains of paper. There was a mess in the reporting system, also because digital and analog data carriers were used for the exchange.
At times, the BAG could no longer properly document the spread of the virus, as research by the online magazine “Republik” in March showed. Meanwhile, the researchers complained of unusable data.
Even before the crisis, with the reports on the attack
Long standard in the BAG: fax machines.
© press service
Anyone reading the experts’ report shouldn’t be surprised. On the contrary: even BAG officials had known for many years that the usual route of reporting by fax or paper and, as a rule, by detouring to the cantonal authorities “was not functional and efficient enough”. That, at the latest, in a crisis situation, it should take a long time to laboriously type data from the paper into the computer. Cantonal authorities and practitioners saw it immediately. The analysis indicates that the procedure is almost unanimously classified as “not optimal” and “no longer up to date”.
With 70,000 communicable disease reports annually, the office has reached the limit of its capacity. Of course, this also corresponds to the pre-crisis situation. For comparison: there are currently more than 9,000 new Corona infections reported per day; the STOCK EXCHANGE once again admitted a delay in recording.
According to experts, the delay is “very critical”
Time and time again, digitization has been pushed into the background. As the analysis reveals, these issues have likely been known for much longer than previously assumed – that is, for the past 15 years. Experts carefully list missed opportunities:
- As early as 2005, the World Health Organization (WHO) apparently described the transmission of reports by paper, telephone and fax as a “weak point in terms of data quality”, as experts reconstruct. Specifically, the “possibility of digitized reports to the BAG” was already proposed at that time.
- In 2009, after the swine flu, the BAG again realized that digitization should be promoted. In 2012, an investigative agency highlighted this in an external evaluation.
- Projects were started, experts were summoned and deadlines were set. Unsuccessfully. The FOPH once assumed that a digital system should be available to all stakeholders, such as laboratories and doctors, by 2014.
- It was later said that the electronic solution would be introduced when the Epidemic Law came into force in 2016 or “at least soon”.
Experts consider the backlog in the reporting system “very critical”. Only labs are gradually shifting to electronic channels. The BAG runs the risk of “not being able to meet the demands of the experts” and “being perceived as insufficiently competent”; that’s exactly what happened in the crown crisis.
Bern data is useless for researchers
There were also gaps in the question of how data is used and processed for a long time. Doctors, hospitals and laboratories complained that the reported data “became too little and very little useful.” These are often barely usable for science, also because the quality sometimes leaves something to be desired. Some even thought that the BAG was “too far from the academy.”
For the experts, it is clear: first, the digitized information is “urgently advanced”. Now “a high level of attention from management” is required. A sobering conclusion. Those responsible for the BAG have missed the digitization of the reporting system, they have even delayed it.
Daniel Koch headed the responsible department at the BAG until April this year.
© Ennio Leanza / Keystone
Spicy: The department responsible for “Communicable Diseases” was in charge from 2008 to April of this year by Daniel Koch. As “Mister Corona” he was initially the face in the fight against the virus. In a statement on the analysis, the BAG states that the “identified strategic need for action” will be resolved.
Did Corona finally bring the push for digitization? Regardless of the crisis, the FOPH has had the department of “Digital Transformation” since April. After the initial chaos, the office relied on workarounds to curb the paper bureaucracy. Doctors can first report their corona cases via encrypted email and then via web form. Meanwhile, it is said, only a few reports are sent by fax.
