How the crown crisis changed Switzerland



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Epidemiologists like Christian Althaus and Marcel Salathé warned of the crown pandemic. Daniel Koch made them appear as alarmists. Who is right?

How investigators became critics of the government in the Corona crisis, and how that changed Switzerland. A reconstruction

The SMI was trading at a record high of 10,884 on Tuesday, January 21, and Christian Althaus sold its shares. Althaus is not a speculator. He is a scientist, more precisely an epidemiologist. You don’t sell because you hope to make as much profit as possible, but to minimize your losses. He feels that the world is facing something that will radically change it: a pandemic.

Three days later, on January 24, Daniel Koch, the highest epidemiologist in Switzerland, gave the SDA news agency an interview about the coronavirus, the germ that had caused the Chinese to close cities with millions of inhabitants in the past days. Koch, who heads the communicable diseases department of the Federal Office of Public Health, says: “There is little or no danger to Europe at the moment.” But it is quite possible that cases will also occur in Europe in the near future. “

In the coming months, “low risk” will become an existential threat. It is transforming Switzerland and its neighboring countries in a way that almost no one would have believed possible. In a few weeks, the relationship between people and politics will change: a federal council that administers will become a body that will lead Switzerland, people who are used to having opinions will become people who willingly obey.

But much more important and sustainable: the weeks of the pandemic fundamentally change the relationship between science and politics. A battle between scientists and officials over the sovereignty of interpretation in the crisis of the century is taking place behind the scenes. Vanities, injuries and generational conflicts arise. Blurred roles. Invisible scientists become public figures who set the tone. But who are they? How big is your influence? And what are your intentions?


The race begins

The year 2020 begins for members of the Christian Althaus research group at the University of Bern in the way that researchers want. With an idea that something is coming. Althaus has been following reports since the WHO reported a new lung disease in China. Wait for the moment when the data will be available. It quickly became clear to him, Althaus says today, that this disease is dangerous in China. Otherwise, they would not have been discovered so quickly.

Investigators are on the prowl. Althaus postdoc Julien Riou is impatient. But Althaus stops him. The data is not good enough. Then appear the first studies that try to estimate how big the epidemic should already be, due to cases reported outside of China. Althaus and Riou begin.

Christian Althaus, epidemiologist

Christian Althaus, epidemiologist

What the two researchers are interested in: How fast does this new virus spread? At this point in the scientific community, it is expected that there will only be a few infected people who infect many more people and others who barely transmit the virus. As with Sars-1 and Mers related viruses. Then the outbreak could be better controlled because it would be easier to track the infections. As a further comparison, Althaus and Riou use data from an infection with pandemic potential: influenza, which spreads very uniformly and is therefore difficult to control. Althaus remembers the moment Riou showed him the results: “I swallowed empty. There was the graph, and it was clear: it spreads as well as the flu.

Althaus says his work was methodologically nothing special. After all, that was his job as an epidemiologist: to analyze how emerging infectious diseases could spread. But the graphics are a warning. The following day, Althaus sold its shares.

Althaus is also concerned at this time: Several international studies conclude that the death rate with coronavirus is significantly higher than with normal influenza. The BAG says in these last days of January that the risk of dying from the normal flu is much higher. In retrospect, Althaus says, “In public, various experts such as virologists or infectious disease specialists at the hospital, who are of course the best in their field, but perhaps do not understand as much about emerging infectious diseases, minimize the danger of the coronavirus.” .

Each crisis has its winners. Figures made for the moment when others stumble. Some of them are speculators, charlatans. False prophets. Others show their strength under pressure and are in their best shape. Fair: who is who?

The public barely heard of epidemiologists before 2020. Althaus himself says that epidemiologist is a broad term, sounding more self-critical than it should be. Althaus studied biology at ETH, but that was too “microscopic” for him. He didn’t want to dedicate his life to “just a calcium ion channel or a surface protein” and went to Berlin, where he found what he was looking for: mathematics and biology combined with computing. Back at ETH, he graduated from Sebastian Bonhoeffer in theoretical biology, where he first came into contact with infectious diseases. But it was only in Utrecht, where Althaus did his PhD, that he became the researcher that he is today: “Very precise, enthusiastic in details, extremely careful in analysis and analysis. If I say something, it is so.

Such self-descriptions are not always well received on the scene. Marcel Tanner is President of the Swiss Academies of Sciences and, therefore, the most important scientist in the country. The 67-year-old man ran the Tropical Institute for years. He was professor of epidemiology at the University of Basel. Tanner says: “There are still many scientists who look too much in the mirror instead of in the window. We have to be more humble, we don’t need science gurus ». Tanner does not name names.

Riou and Althaus’s study will be published in late January. Althaus told his postdoctoral fellow that this would be his most cited job for the rest of his life. At the time, people in Switzerland were still looking at China, where millions of people were suddenly locked in their homes, incredulously watching video recordings showing how workers were building a hospital in a few days.

We don’t know what is being discussed on the upper floors of the BAG these days. Althaus has direct contacts with the Federal Office. He thinks, “This is going to be heavy.” And offers BAG its help in analyzing the spread.

Althaus exchanges ideas with colleagues. One of them later becomes one of the most prominent voices in science and one of the loudest critics of federal strategy in this dispute between politics and administration: Marcel Salathé, ETH Lausanne professor and digital epidemiologist.

Growing up in the role of government critic is one of the curious side stories of this era of coronavirus. Salathé says of himself that he is not really a typical epidemiologist, having been less concerned with infectious diseases in recent years. It was pure coincidence that a colleague asked him to give a conference on epidemiology in February and that he had already decided on the coronavirus.

Salathé and Althaus are known for their studies, they were in the same research group as ETH professor Sebastian Bonhoeffer, Althaus as a master’s student, Salathé as a doctoral student. Meanwhile, Salathé went to Stanford in the USA. USA And he became a digital researcher looking for answers on the spread of infectious diseases on Twitter, but in recent years he has increasingly focused on nutritional problems because “there are many questions.” Now, in January 2020, the coronavirus is bringing it back to epidemiology.

It is still January when France, Germany and Italy report their first cases of coronavirus. Health ministers Alain Berset and Daniel Koch provide information on the situation in Switzerland for the first time on January 28. Appearance fails. The FOPH declares that there are still no infections outside of China; this turns out to be incorrect during the press conference. Two days later, the WHO announced the global health emergency.

Italy prohibits all direct flights to China. Daniel Koch told the media: “Outside of China, it is not currently an epidemic.” Althaus says to the “Tages-Anzeiger”: “The BAG’s reaction is amazing.”

Althaus and Salathé have long realized that the virus can hardly be stopped. You write to yourself. Why nothing happens? Why don’t you take it seriously in Switzerland? Weeks follow in which Switzerland awaits the first cases of coronavirus. Koch says that it is currently impossible to predict future developments. Althaus’ laboratory calculations are now widely discussed in the scientific world.

Marcel Salathé, digital epidemiologist.

Marcel Salathé, digital epidemiologist.

The federal government is focusing on finding contacts these weeks. When visiting concerts, readings or a club, you must provide your contact details in a form. Salathé still does not understand this decision. After all, they knew that the cantons’ ability to trace contacts would not be enough. The BAG argues that the measures save time.

Wouldn’t there be an opportunity for the BAG to attract outside researchers and critics? Koch and BAG want to retain the sovereignty of interpretation. A spokeswoman explains that the Federal Office always bases its work on scientific results and publications. But Althaus and Salathé feel unknown. But: they are no longer part of the generation of researchers who give peace. They both have significant Twitter followers. And they use them from now on. They criticize the federal government and officials. You are convinced: from now on everything is about.


“Giorgio, senti, we have a problem”

Italy reported on several dozen coronavirus patients on Friday, February 21. In Ticino, Christian Garzoni, clinical director and infectologist at the Moncucco clinic in Lugano, picks up the phone and calls the cantonal doctor in Ticino: «Giorgio, senti, we have a problem. Now it begins. Garzoni knows how closely northern Italy and Ticino are intertwined. Almost 70,000 people cross the border every day and come to Switzerland to work here. Garzoni also knows that it is only a matter of time before the problem reaches Ticino.

Christian Althaus and Marcel Salathé are nervous. In late February, they switched their discussion to Slack, a news service that business people use to hold business conversations today. And they invite other researchers to do it. You fast-moving Swiss scientists believe that experts should now specifically brainstorm. They see the pandemic as a competition against time. In his opinion, drastic measures should be taken quickly and the population should be warned. Why doesn’t anyone coordinate this? Salathé wonders. Then they coordinate.

There are institutions in Switzerland that could organize this work in a network. Wouldn’t, for example, Marcel Tanner, president of the Swiss Academies of Sciences, be in a position to ask the sub-associations to work together? He says that scientific dialogue has a more fundamental problem: Some experts wrote a report, made recommendations, and then expected politicians to read them. 15 out of 20 recommendations are generally not feasible. Unfortunately, this is not how it works. «You can’t go to the minister’s office and say: Look, I have something great, now you have to do it. Anyone who thinks this way as a scientist exaggerates his influence.

On February 25, doctors at the Garzoni clinic receive a positive result: a 70-year-old man is the first case of coronavirus in Switzerland. Garzoni and his family sled in Splügen. He immediately returns to Ticino.

From now on, you are tormented by the same question as Althaus and Salathé: how do you clarify the gravity of the situation in the country? But the doctor chooses a different route than that of epidemiologists. He talks to his colleagues at Stato Maggiore, the canton’s crisis team. Together with the BAG, they decide to hold a press conference in Bern and one in Bellinzona. Daniel Koch wants to warn, but don’t panic. Their strategy is still called contact tracing. Anyone who has difficulty breathing, fever, or cough should be quarantined. There is talk of “moderate risk”. But Koch’s carefully chosen words fade away.

Christian Garzoni, clinical director and infectologist at the Moncucco clinic in Lugano.

Christian Garzoni, clinical director and infectologist at the Moncucco clinic in Lugano.

The same day, Christian Althaus gives an interview that fundamentally changes public discussion. The epidemiologist confirmed in an interview with the NZZ that 30,000 deaths could cause the virus in the worst case. What is still important for Althaus to emphasize today: He did not mention the number himself, but the journalist who interviewed him.

In excitement over the number of deaths, Althaus’s accusations of the BAG were almost lost. Althaus says the Federal Office underestimates the danger of the virus. WHO supports drastic measures in China and other countries. In Italy, carnival and other events have already been canceled. Althaus accuses the authorities of ignoring the scientists. When asked by the journalist if he saw technocrats at work, Althaus said: “More like officials. . . »

With Althaus’s criticism, fear of the pandemic is now reaching the general public, and with it the fight for sovereignty over this health crisis, which has so far taken place in secret. Journalists cite Althaus’s statement that “Arena” moderator Sandro Brotz invites the epidemiologist to his show. Althaus accepts first, then again. He was looking for the audience that was troubling him now, he wanted the attention he now threatens to lose control of.

THE BAG is irritated. Patrick Mathys, head of crisis management, feels that the exchange between politics and science is good and intensive. There are always experts who criticize, and that’s fine. But: “The media has enjoyed that people have been very critical of the BAG. I’ve been there for 17 years, I’ve seen Sars, bird flu, and swine flu. ” This time it was not only discussed from a purely scientific perspective. “And we were faced with accusations in which we had to say: the scientific part is one. The implementation and feasibility of the measures is something entirely different. “

Althaus files complaints to the press council against “Blick” and “20 Minuten” that it was wrongly quoted, the number, 30,000, never said. What Althaus can no longer correct is the image that has now emerged in Switzerland: an epidemiologist against public officials, experts against the laity, science versus politics.

But is this impression correct? Or is Althaus a simple expert media researcher who knows how to use the favor of the hour to distinguish himself? Once you think about it briefly, watch what happens, irritated, corrected if necessary. Is he just an alarmist?

In Ticino, Christian Garzoni sees the intensive care beds fill up in his hospital. The Moncucco Clinic is a building without character, but its history goes back more than 100 years. Now he is transforming Garzoni into a Covid 19 hospital as fast as possible. The infectiologist also seeks guidance in the chaos. He knows that the new virus is easy to transmit, the incubation period is long, and the course of the disease is unpredictable. Garzoni is convinced that only aggressive interventions in public life help now. Tracking contacts is no longer enough. Hospitals always report new cases. Stato Maggiore talks about the ban on carnival events in Ticino.

Today Garzoni says that awareness of the need for a blockade has grown in the first week of March. “Faster among doctors, slower among politicians.” But the BAG had trouble understanding the scope of the situation in Ticino. In Italy, less than 80 kilometers away, the population can no longer move, schools are closed and events are canceled.

Italy is also a landmark for Christian Althaus. He has been a passionate cyclist and lover of spring classics since childhood. The main race is Milan – San Remo. When canceled, Althaus realizes what the coronavirus pandemic century event is. For him, the last 30 minutes from Milan – San Remo are “the most exciting 30 minutes of each year”. The race has only been held three times in its history: 1916, 1944, 1945. “You suddenly realize what is going on.”

On March 11, Daniel Koch is in Ticino to clarify the situation on the site. The Federal Council still doubts. However, the Ticino government declares an emergency the same day. Close high schools, universities and vocational schools, but also cinemas, museums, clubs, indoor pools and gyms. Older people should no longer use public transportation. The commitment: restaurants remain open for 50 people, compulsory schools remain open. The FOPH fears that otherwise the grandparents will take care of the children. You want to gradually prepare people for the complete block, which is becoming increasingly inevitable.

The next day, Christian Garzoni wrote a letter to the Ticino government with his colleagues and directors from Moncucco and the Hospital Cantonal Ente Ospedaliero: they had to stop all public activities and close the schools, a lockout was the only inevitable solution.

What applies to Ticino from March 14 applies to the whole of Switzerland three days later. The Federal Council sends the country into a dazzling dream.


Blocking, confrontation and reconciliation?

With the closure, the conflict between politics and research seems to have subsided. Behind the scenes, authorities are trying to resolve the dispute because it threatens to divide Switzerland’s crises into believers in science and politics. And they do it the way you do it here in Germany: trying to engage critical voices. As in 2003, when Christoph Blocher was elected to the Federal Council.

On March 18, the authorities invite some scientists to a meeting at the “Bernerhof” in Bern. First he was “fairly beaten on the table”. This is what someone who attended the hearing said. After that it was a fairly tentative meeting, an approach with “a lot of political singing.” Around ten scientists sit in front of some officials and politicians. Also present: Minister of Health, Alain Berset. You exchange ideas, you will not agree. Three days after the meeting at the Bernerhof, Marcel Salathé wrote on Twitter: “In these weeks, my confidence in politics has been shaken. After the review, what went wrong and how outdated are the processes, there will be no political stone left on the other side. ”

Daniel Koch, former head of the department of

Daniel Koch, former head of the “Communicable Diseases” department of the Federal Office of Public Health

On March 18, something else happens: Inaccessible CEO Daniel Koch becomes a person, and even more than that: it’s the night Koch becomes a popular hero. In the special “Rundschau” broadcast on Swiss television, what rarely happens to an official happens: you can receive it. Tonight, TV Switzerland learns the names of his dogs, Akira, Chili and Buntschi, who is a grandfather and has always been thin. Koch is sitting in the gray-brown suit that is too big in the studio, and when the post about him is over, he says excitedly, “Okay.” A few days later, his sensational style in “Schweizer Illustrierte” continued. Now you know: Buntschi graces the bottom of your tablet.

It’s an unknown role for someone like him, Koch is from the old school, he got involved in something. Daniel Koch is waiting for retirement, Marcel Salathé and Christian Althaus are waiting for the pandemic. The two researchers point out with all their dismay: this crisis is the scene of their lives as scientists. And they are prepared for it.

Nowhere is this better than the way you handle social media: your communication is fast and strong. If the tweets go beyond your environment and area of ​​competition, this is deliberate. They are far from the deliberation of older colleagues. Salathé says: “It is also a matter of generations. And a new way of participating in the discussion ». In doing so, they challenge a decade-long model that has always worked: Scientists collect data and pass it on to authorities. Then the policy decides, there is a press conference, and the matter is resolved. “This world no longer exists,” says Marcel Salathé. Discourse can no longer be easily controlled from above.

On March 31, Daniel Koch will present the new Covid-19 Science working group at a press conference. It is also an attempt to engage critics: Marcel Salathé leads the “Digital Epidemiology” group, Christian Althaus is a member of the “Data and Modeling” group. For them it is a concession to their competition. Your offensive communication worked. Those who no longer comply with the old rules were still listened to. But this does not resolve the basic conflict: what role should scientists play today? How much should they get involved in public discussion and give political advice?

Marcel Tanner, Switzerland’s chief scientist, at retirement age, the motto “retired, but not tired”, has a clear opinion on this. Unlike Althaus and Salathé, Tanner is a classic field researcher: As a PhD student, he drove through villages in Cameroon and operated on node worms under the patients’ skin. Young colleagues’ understanding of roles alienated him. Especially in relation to the Covid 19 pandemic, he had seen scientists giving him the impression that they had to make a little criticism of the federal government in every second sentence. I’m not doing well. As a scientist, you don’t just criticize, you show action options based on scientific facts. ”

Marcel Salathé says: «I will continue to get involved in politics. I am standing d hoor z Bärg when we see politicians and authorities making scientific statements that are not justifiable and science does not comment on it.

In mid-April, Switzerland is hopeful that the new sick curve will flatten, and the Federal Council’s strategy appears to be working. The worst scenarios of the critics have not materialized. Hospitals are not overloaded. Althaus and Salathé were alarmists after all? Or was it exactly his criticism that got BAG on the right track?

The questions cannot be answered today. Salathé says that this is the beginning. A working group with representatives from science, business and politics could have been established in early February. To clarify the questions that still arise today: How do we reduce economic damage? Why don’t we have enough masks? Who should be examined when? And how do we get a vaccine?

Good questions, but now one thing is of particular interest: when does life start again in Switzerland? The fight between researchers and officials for sovereignty seems to have ended in a kind of stalemate. Both sides save face, for now.

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