2. Ensuring sufficient physical infrastructure and workforce capacity
ENSURING SUFFICIENT PHYSICAL INFRASTRUCTURE AND WORKFORCE CAPACITY is crucial for dealing with the COVID-19 outbreak, as there may be both a surge in demand and a decreased availability of health workers. The section considers the physical infrastructure available in a country and where there are shortages, it describes any measures being implemented or planned to address them. It also considers the health workforce, including what countries are doing to maintain or enhance capacity, the responsibilities and skill-mix of the workforce, and any initiatives to train or otherwise support health workers.
2.1 Physical infrastructure
Starting March 13, hospitals in Switzerland had to report on a daily basis how many emergency beds are available for patients with coronavirus. This includes isolation beds, intensive care beds and ventilation beds for children and adults. The Swiss Society for Intensive Care Medicine has certified 82 intensive care units (ICU) in Switzerland with a total of 950 to 1000 ICU beds, 800 to 850 of which are equipped with ventilators. In addition, there are 400 to 450 beds available in intermediate care units, so-called monitoring stations.
In general, hospital capacities in Switzerland have been able to deal with the patient load. To increase available hospital capacity, a ban was introduced on March 13 on all non-urgent (elective) procedures, and cantons were enabled to oblige private hospitals and clinics to admit patients (see section 3.3). At the end of March hospital capacities in the canton of Ticino (at the border to Italy), one of the hardest hit regions, were not yet reached. However, the canton started to transfer patients to the German-speaking part of Switzerland. The canton had prepared early for the pandemic, after the first cases occurred in neighbouring Lombardy. La Carità, a hospital in Locarno, was thus converted exclusively to treat coronavirus patients. The private Clinica Moncucco in Lugano is also heavily involved and has increased its bed capacity for COVID-19 patients.
Staring April 3, the Federal Council obliged the cantons to report on their current material stocks, which includes important therapeutic products and medical goods such as respirators, diagnostic tests, surgical masks or protective suits and certain medicines. The Federal Council has also regulated how the Confederation supports the cantons as well as non-profit organisations, such as the Swiss Red Cross, in the procurement of important medical goods if the need cannot be met through the normal procurement channels. In order to ensure rapid access to new, promising therapies and urgently needed medical products, the Federal Council has also decided on a number of exceptions to existing regulations on therapeutic products.
On April 8, the Federal Council decided to purchase medical protective materials, tests and medications, including about 550 million protective masks, including 330 million for the general population, and 124 million for healthcare workers. The list also includes about 190 million disposable gloves, 48.5 million units of disinfectant, 8 million virus test kits, as well as 1000 new ventilators.
The Armed Forces Pharmacy is responsible for the procurement of missing important medical goods, in particular medical devices and protective equipment, based on the notifications of need from the FOPH. The procurement of drugs, on the other hand, is the responsibility of the FOPH in agreement with the Federal Office for National Economic Supply (BWL).
Starting April 10, the Swiss Federal Council suspended customs duties on medical goods. Due to the rapid spread of the coronavirus demand for medical goods, such as masks, examination gloves, protective clothing, protective goggles and disinfectants increased sharply in Switzerland. No customs duties will apply until October 9, 2020. The aim is to facilitate the supply of hospitals, nursing staff and patients with urgently needed medical equipment. Importers will no longer have to provide proof of origin for duty-free imports under the free trade agreement. In addition, private importers will be put on an equal footing with the federal and cantonal civil protection authorities, which can already import protective material duty-free.
The week of April 27, the Confederation started supplying one million hygienic masks to leading retailers every day for two weeks. Healthcare providers, companies and private households are responsible for the procurement of their own masks. The Confederation is in contact with retailers to ensure sufficient supply of masks in the coming weeks and will gradually expand supply. If procurement cannot be met through normal channels, the Confederation will provide subsidies. To date, the Armed Forces Pharmacy has distributed 21 million hygienic masks to the cantons. The Federal Councils’ current inventory comprises 18 million hygienic and 1.2 million FFP2 masks. These numbers will be continuously expanded.
Until the end of April, the Armed Forces Pharmacy had distributed 35 million facemasks. Of these, 13 million went to the retail sector and 22 million to the cantons. 20 million masks are currently in stock. More masks are continuously coming in. Additionally, fabric masks are also available.
Sources and links:
• Emergency bed availability in Switzerland: https://www.vbs.admin.ch/de/home.detail.news.html/vbs-internet/wissenswertes/2020/200313.html
• Federal measures, ordinance and explanations against Coronavirus: https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-epidemien-pandemien/aktuelle-ausbrueche-epidemien/novel-cov/massnahmen-des-bundes.html
• Provisional regulation on procurement in response to the Coronavirus Pandemic: https://www.newsd.admin.ch/newsd/message/attachments/60847.pdf
• Massnahmen zur Abfederung der Auswirkungen des Coronavirus auf Wirtschaft und Gesellschaft – Zweite Nachmeldung zum Nachtrag 1/2020: http://www.parlament.ch/centers/documents/de/br-bundesrat-2020-04-16-d.pdf
• Bundesrat will 550 Millionen Masken kaufen: https://nzzas.nzz.ch/schweiz/bundesrat-will-550-millionen-masken-kaufen-ld.1552474
• Coronavirus: Bundesrat setzt Zölle für medizinische Güter aus: https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen/bundesrat.msg-id-78743.html