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In the Eulachtal nursing home, 56 people were infected with the corona virus, including 25 very old residents. But no one was hurt. The canton doctor speaks of a miracle.
A family doctor demands that the events in Elgg be examined more closely and that residents of the home who have no symptoms no longer have to be tested.
The doctor from the canton of Zurich tells of a miracle, a corona expert at the Zurich University Hospital of an inexplicable phenomenon, and a family doctor from Elgg of a case from which lessons must be learned.
What happened at the Eulachtal spotlight in the small community of Elgg on the eastern edge of the canton of Zurich is not only astonishing to experts. The house experienced two waves of infections since mid-August. A total of 56 people were infected with the coronavirus, 25 of them were very old residents with the corresponding diseases, which made them members of the risk group in various ways.
This is a terrifying starting position for all home managers, because you have to take into account the fact that many of these people become seriously ill and deaths are almost inevitable. But none of this happened in the Eulachtal spotlight. Most of those infected showed no symptoms or only mild symptoms, as confirmed by local director Maria Hofer-Fausch at the request of NZZ. In some residents, the symptoms were slightly more severe, but no one had to be taken to the hospital for treatment and no one died from the disease. All infected people have recovered and been released from isolation, says Hofer-Fausch. “We are happy and grateful that everything went so well.”
What makes Elgg’s case so surprising is the fact that such a large outbreak had dramatic consequences in other households. For example, in the Siviriez health center, Friborg. In early September, it was learned that 38 residents and 28 staff members had been infected there. Of these, 14 people have succumbed to the disease to date. And that is not an isolated case. The corona pandemic in Switzerland last spring caused so many deaths, mostly because the virus was able to spread widely among the elderly population and especially in the elderly and nursing homes. Nowhere else can you find so many vulnerable people in one place.
Therefore, it is not surprising that more than 60 percent of Covid 19 victims in the canton of Zurich died in homes in the first wave of spring. About half of all corona deaths in Switzerland also occurred in nursing homes and nursing homes. The authorities have taken the corresponding tough measures to protect the residents. The houses were literally closed and no outside visitors were allowed for weeks. And the elderly were no longer allowed to leave the centers.
A less aggressive strain of the virus.
Why did events at Elgg take a completely different turn than expected? Hugo Sax, an infectious disease specialist at the University Hospital Zurich (USZ) and chief border physician at Zurich Airport, finds the matter extremely staggering. It could all be a happy coincidence, “but the numbers are so high that they leave one baffled.” From the virological point of view and also from the point of view of public health, it would be very interesting to delve into this case to perhaps find an explanation for this phenomenon, says Sax.
Canton Zurich doctor Christiane Meier also has no explanation as to why no one in the Eulachtal nursing home is seriously ill. “Actually, it borders on a miracle.” Because there is currently no evidence that the virus has weakened overall. The proportion of the elderly in whom the disease has a severe course remains as high as in spring.
Coronaviruses are generally known, Sax says, that they don’t mutate strongly. However, it is always possible for the elements of the virus to change in such a way that the infectivity decreases or the disease causes less damage. Ultimately, it is one of the great hopes that this virus will weaken at some point. So it would be exciting to look in more detail at the strain of the virus that was widespread in Elgger’s nursing home. “
Beat Zürcher is someone who has followed the matter closely from the beginning. Elgger’s family doctor is responsible for caring for an apartment at the Eulachtal care facility and has witnessed both Covid 19 outbreaks.
There was a first wave in mid-August. Residents were then tested and those who tested positive were isolated. At the beginning of September everyone was healthy, it was possible to visit the house again, but only for a weekend. After that, new cases were discovered, retested, and isolated again. “The residents were quarantined for almost five weeks in a row, which was a huge burden on them,” says Zürcher. In view of the fact that no one got seriously ill, one must wonder if this was provided, he finds.
Therefore, Zürcher demands that the Elgg incidents be carefully investigated. “We have to understand why there were no serious illnesses here.” Perhaps a less aggressive virus strain was active, or there is greater resistance to the virus in eastern Switzerland, including Elgg, the family doctor speculates. “I think it would be a great opportunity if we could learn fall and winter lessons from this case and be more differentiated when it comes to testing and isolation.”
From their point of view, it makes no sense to test residents free of symptoms and isolate them if they test positive. The psychological damage it causes is not justified, especially as the often poorly mobile residents are not responsible for the spread of the virus. Rather, she advocates the use of the new corona rapid tests to screen employees at home to prevent the virus from entering.
Homes hardly affected by outbreaks
In general, it can be said that the virus has caused much less damage since the summer than in the spring, and this despite the high number of infections. This becomes apparent when you look at the Zurich Covid 19 statistics. While the number of cases in the canton in recent weeks was only around a third lower than in April’s big peak, the hospitalization rate remained far below. below the value in spring. Since mid-July, this has fluctuated between 20 and 30 cases, in peak hours in April it was up to 200 cases. Even today there are only very few deaths, in some cases there are no victims to complain about for days. In April it was an average of more than four a day.
There are many reasons for a better location. For one thing, many more are being tested. As a result, many infections are diagnosed that would have gone undetected in spring due to weak symptoms. Starting in the summer, a peak was recorded again, especially among people aged 20 to 40, for whom the disease is usually harmless. For the older population and especially for the very old, the values are well below those of spring. Retirement homes are hardly affected anymore, with a few exceptions, such as in Elgg. Since vulnerable people are rarely infected, there are also much less serious cases.
The infectologist Sax sees this as proof of a behavioral change in the population. The elderly in particular have obviously become more cautious, “they know that infection can have serious consequences for them.” Even small adjustments in everyday life could make a huge difference from an epidemiological point of view. “It may be enough to constantly wear the mask, to keep your distance, perhaps to give up going to the gym club.” Younger people appear to be a little less consistent, probably also because they rated the risk as much lower for themselves.
Canton doctor Meier is pleased that homes are hardly affected by major outbreaks. “Obviously the protection measures are working,” he says. The fact that the virus can still wreak havoc in homes in the spring is due to the fact that the virus was already widespread and that measures came too late. But since then it has worked very well. “You have to give a crown to the houses.” The guidelines were well implemented and, in some cases, the home managers were almost too cautious. “Some wanted to prevent Covid-19 infections at all costs; even if the residents suffered a lot from the isolation. “In this sense, they would have heard over and over again criticism from family members,” that in some cases we seek a dialogue with the household management. “In the meantime, however, the matter has good.
But Meier thinks “we have to be vigilant.” Therefore, he sees no reason to deviate from the old nursing home and nursing home testing regimen – that is, to test an entire department in case of suspected cases. “We have had good experiences with him.” After all, people with no or mild symptoms can also transmit the virus.
To avoid jumping on the elderly in winter, it is also important to continue to observe hygiene and distance rules and also to ventilate the interior regularly. And perhaps also giving up one or another big family celebration: “At Christmas, of course, it could be difficult,” says Meier.
Leaning back is also not popular at Elgg. Now you will have to analyze very precisely how the virus entered the home and how it was able to spread, says director Maria Hofer-Fausch. “That has not yet been fully clarified.” They would then recheck the protection measures in detail and, if necessary, apply more. And yet some normality is also returning: “It is a blessing to the residents that the quarantine period is over and they can finally see their family members again.”
