
Switzerland's lockdown has sharply reduced the cases of Covid-19 - deepaksurti
https://actu.epfl.ch/news/switzerland-s-lockdown-has-sharply-reduced-the-cas/
======
_nalply
Living in Switzerland: People changed behavior drastically.

Hand shaking completely disappeared, oncoming walking people making a bend to
guarantee the distance of 6 feet, hand sanitizers for everybody everywhere,
businesses and associations have to publish government-approved conceptions of
protection against infections before re-opening and many other little changes.

However relatively little face masks, no curfew and as of today life is going
on not quite as before. For example, next week swimming courses for children
resume, but parents are asked to send the children already clothed for
swimming and are warned if they don't follow the guidelines they and their
children will be excluded. In the local hospital all visitors are given face
masks to be worn without exception by a Securitas (a private police) employee.

~~~
saiya-jin
> People changed behavior drastically.

That's a massive overstatement. I live in Geneva, one of the worst hit cantons
(they say around 10% infection rate). Way too many people for a long time
simply didn't care, the list of personal anecdotes is way too long to post
here.

We all were seeing what is happening few kms south from our border, and
government did _nothing_ for almost 2 weeks. It was seriously ridiculous, all
restaurants and concerts packed, when 50km south Italian hospitals were
already flooded and news was everywhere. There was vote on top level of
government which ended up in favor of keeping business opened, because money.
People rarely using face masks, even during hardest hits not even half of
supermarket shoppers wore masks, on streets barely anybody. Most of the
supermarket staff didn't use any mask either.

Generally German-speaking parts were much less affected, I've heard many
personal stories from friends that were verbally attacked and mocked on
streets and shops for wearing masks (locals mockingly start coughing behind
them in shop and rest of the staff having a blast). I know of several people
that were fired back in march/april _because_ they came to work in simple face
masks due to them being immune-deficient, and management decided to fire them
on spot for 'spreading panick', no discussion (if you are blue collar
foreigner here, sometimes locals treat you like disposable piece of shit and
don't even try to hide it).

Once laws were changed people started behaving a bit more sane, but far from
ideal - many people on streets and parks completely ignoring 2 meter rule
(even 1 meter). I saw an old guy sitting on bench in the park, coughing like
hell, no mask, while on phone having laughs how other people avoided him, even
police patrol which didn't even bother to talk to him.

How well this country fares now, despite all of this gives me hope that it
ain't _that_ bad with covid. Swiss didn't 'beat' it due to great behavior they
showed, in contrary. My home country was much more prudent and restriction
were quick and followed by almost eveyrbody, and they ended up with 5% of the
Swiss infection rate, despite being of similar size. Of course it could be
that it was still stellar behavior en Suisse compared to what common Italians
or Spaniards showed, this I can't compare.

~~~
piquadrat
Zurich resident (and Swiss citizen) here. I agree that in the beginning, a lot
of people and politicians didn't recognize the seriousness of the situation.
The fact that the Swiss political system isn't really made for quick decisions
from a central authority probably didn't help either.

But once people realized that this is going to be real bad if it continues
unchecked, behaviour changed a lot IMO, even in regions that had very little
virus activity.

True, mask wearing is still a problem, and you could see lots of people doing
outside activities even during the worst part of the lock down. But as luck
would have it, outside infections seem to play almost no epidemiological role.
Turns out not wearing masks on the street or going for a Sunday hike on
crowded paths isn't a big deal, and in retrospect I'm glad that our lock-down
wasn't quite as limiting as in other parts of Europe.

I wish masks were mandatory on public transport, though.

~~~
thu2111
Zurich resident also here. I don't believe behaviour changed much. I see a
small minority of people wearing masks. In the entire course of the epidemic
one person looked at me annoyed for daring to be outside, nobody has ever
crossed the street or taken steps to avoid me or my partner as we walked
outside.

The mask wearers look rather foolish because the data is by now very clear
that this is no worse than any other year's flu. It's just not a dangerous
disease. The hype is illusory, the models were wrong. The barriers in
restaurants and perspex in supermarkets is as far as it goes and even that
looks over the top.

 _as luck would have it, outside infections seem to play almost no
epidemiological role_

But is it luck? Or is it that the Swiss people reached the correct conclusions
much faster than the supposed experts advising the world? As you say, the
behaviour _was_ correct, and the moment the similarities in behaviour to other
common viruses became apparent, that wasn't irrational.

 _I wish masks were mandatory on public transport, though._

Please no. Virtually nobody has been doing this and cases have now hit zero
anyway so why would it have ever mattered? When will we learn that practically
every piece of supposedly expert advice during this pandemic has been wrong?
The wisdom of the crowds is far better here than the wisdom of the academics.

~~~
saiya-jin
I wish that at least 1 positive outcome from the covid once its really over -
people in the west start taking face masks as not something to laugh at, but
as an indication that given person doesn't want to infect others around them
with whatever he thinks he is having.

I saw it long time ago as normal in south east Asia and it looked like a fine
example of compassion towards rest of the population. Compared to usual west
when people often go about their business, not caring much about others ie in
public transport, schools or open offices. Only now it became acceptable in
otherwise advanced place like Switzerland, till now one often faced real
persecution, mocking and overall rejection from large parts of society.

Rest of your comment is unfortunately pure garbage, not worth any feedback.

------
harryf
Other than the number of cases, a key metric is ICU load. There's a good
visualisation here [https://covid.visium.ch/](https://covid.visium.ch/) ...
the peak ICU load at the end of March / early April was 62% (the source of
this data is described here: [https://github.com/schoolofdata-ch/swiss-
hospital-data](https://github.com/schoolofdata-ch/swiss-hospital-data) ) ...
in other words hospitals weren't overloaded the way they were in Italy for
example.

IMO some of the main reasons for that were;

\- Switzerland has an effective / working healthcare system

\- Personal health is taken pretty seriously; there's a general emphasis on
fitness and good diet - Switzerland has one of the lowest obesity rates in
Europe for example
[https://en.wikipedia.org/wiki/Obesity_in_Switzerland](https://en.wikipedia.org/wiki/Obesity_in_Switzerland)

\- Measures like shutting schools and working from home were implemented
pretty quickly at the beginning of March.

\- As a whole people behaved sensibly. Advice from the government was taken.
There was no panic but largely people adapted to the new situation very
quickly

\- Finally, in general, the social systems works well here. There aren't large
numbers of homeless and most people furloughed or who lost their job will have
received at least 80% of their normal salary, so you don't have large numbers
of people living in unhealthy conditions that would help a virus spread

~~~
mattmanser
As far as I know here in the UK we never went above 60%, and yet still had
lots of deaths, so how is this a key metric?

~~~
Arnt
There are others factors... obesity has been mentioned many times and might be
part of the answer to your question, so I looked at the Wikipedia link posted
and see that Switzerland has Europe's lowest obesity rate. The UK, OTOH:
"Obesity in the United Kingdom is a significant contemporary health concern,
with authorities stating that it is one of the leading preventable causes of
death."

------
huhtenberg
A couple of graphs to visualize it -

[https://interaktiv.tagesanzeiger.ch/2020/wuhan-
schweiz/](https://interaktiv.tagesanzeiger.ch/2020/wuhan-schweiz/)

However keep in mind that there's just 8.5 mil people in Switzerland. That's
around the same as New York City and 2/3 of the size of Moscow.

------
wosk
I'm an author of this study (and long time lurker), happy and surprised to see
it posted here.

Some findings HN readers might find interesting, I'm referring to figures in
the manuscript[1] and it's appendix.

\- R0 has started to decrease before the government measures (Fig 2). It even
reaches 1 simultaneously to the main "lockdown" measure.

\- Mobility (from google mobility reports) also started to decrease before the
measures (Fig. 3), but R0 also started to decrease before even mobility (Fig.
3).

\- People awareness seemed to rise before government measures and mobility
decrease, consistent with google trends (Appendix Fig. 14). Might explain why
R0 starts to decrease so early.

\- The appendix contains an interesting data analysis of hospitalization
processes, with data on env. 1'000 patients. The length of stay in ICU are
incredibly long. To answer the question: How long ?, we performed a survival
analysis. It's necessary as estimates (such as the mean) are biased towards
shorter stays.

\- A serology study is conducted at the moment in Geneva. It seems that our
estimates of seroprevalence (Fig. 5: only 3% country wide by April 24) are
consistent with the study (Appendix Fig. 7). We were quite proud of that, as
these results were unknown to us at the time.

\- Method wise: There is different way of estimating R0 given hospitalization,
death, cases:

(i) Most estimates are done with methods "deconvoluting" the data using the
distributions (Cori et al, Wallinga and Teunis, implemented in the EpiEstim R
package). It can works very well, but it's tricky to have unbiased estimates
(see [2]).

(ii) Other methods involve choosing a breakpoint and calibrating to R0: before
and after breakpoint. Variations of this method involve calibrating the
breakpoint date, choosing a shape (e.g spline) and calibrating all the
parameters. These method rely on some assumptions on the decrease. A incorrect
assumption leads to biased estimates. E.g it would seem reasonable to assume
R0 to decrease on the day of the government measures. But from what we
estimated it wasn't the case in Switzerland. So your estimate of R0 post-
measure would be lower than what it is really (to catch-up).

The method used here uses the full timeserie and no assumptions. First we
built an hidden-markov model of COVID-19 transmission and hospitalization (see
diagram Appendix Fig. 4). We performed frequentist inference (using [3]) of
relevant parameters. Last, we "filter" R0 as a state of our model: R0 is a
random walk, with calibrated variance and using particle filter we keep only
R0 timeseries that support the underlying data. Therefore we impose no
assumption on R0.

[1]
[https://smw.ch/article/doi/smw.2020.20295](https://smw.ch/article/doi/smw.2020.20295)
and Appendix

[2]
[https://github.com/keyajoshi/Pan_response](https://github.com/keyajoshi/Pan_response)

[3]
[https://en.wikipedia.org/wiki/Iterated_filtering](https://en.wikipedia.org/wiki/Iterated_filtering)

~~~
lbeltrame
> \- A serology study is conducted at the moment in Geneva, it seems that our
> estimates of seroprevalence (Fig. 5: only 3% country wide by April 24) are
> consistent with the study (Appendix Fig. 7). We were very happy of that.

What about individual regions? I ask because most of the dynamics I've seen
originate around hotspots, and thus it may be interesting to see how
individual regions were affected (because it may drive different responses).

E.g., the Spain seroprevalence study said 5% country wide. But the estimates
per regions can be as up to 3 times that (Madrid itself is ~11%).

~~~
wosk
True. We estimated seroprevalence for cantons ("states" of Switzerland,
ranging from small to very small). As you says, there is some quite some
difference (Fig. 5): Tessin (border with Italia) and French-speaking cantons
(Geneva, Vaud) have a much higher seroprevalence than the rest of the country.

The same has been found by other groups on France.

~~~
lbeltrame
I think it's quite important, because it may drive local public policy
depending on the results: especially if one considers the models of "shield
immunity" (discussed at length in one Nature publication a few weeks ago) in
reducing transmission (no government has taken interest in them, AFAICS).

------
known
I think wearing masks and gloves reduced cases, not lock down per se

------
nicc
I don't understand why people keep wasting time with this.

Governments are both not doing widespread testing to see how many people have
the virus, and taking draconian measures to contain its spread.

From what we know, 90% of the population already could already have it. Every
time I read of somebody testing a big group of people a huge percentage has
it, but the virus is so mild that they didn't even know—since it caused no
symptoms.

Looks like there are many other diseases and problems that cause dozen of
times more deaths, so either there's a reason why this is getting special
treatment, or it's just a complete loss of common sense here, in my opinion.

~~~
logicchains
By pure coincidence our plutocracy is also a gerontocracy. Imagine you're an
overweight rich old man who owns a news media company or runs a country, and
you hear about a disease coming along that is most dangerous for overweight
old men: basic human nature means there's a good chance you'll be eager to
take steps to preserve yourself, regardless of the wider cost.

~~~
andybak
I'm slightly overweight and I'm pushing 50. The risk of death is fairly low
but the risk of having a really horrible few weeks (or potentially longer) is
fairly high.

And there's plenty of unpleasant stories about long term effects. All in all
I'm pretty scared of catching it.

I'm glad you're young and fit and happy to accept the lower risk.

I'm not so happy about your lack of concern for others.

~~~
ben_w
Taking a more positive interpretation of what @logichains wrote: given that
many governments do have a history of letting lots of people die because it’s
to expensive to keep them alive, the only reason this isn’t happening now is
because it will affect those leaders personally.

~~~
logicchains
>given that many governments do have a history of letting lots of people die
because it’s to expensive to keep them alive, the only reason this isn’t
happening now is because it will affect those leaders personally.

AIDS is a good example of this. It's more deadly than coronavirus, but because
it was seen as a disease of gay people, governments initially invested
extremely little in treatment or stopping the spread. According to WHO, 32
million people have died of AIDS since it appeared, and most of those deaths
would have been prevented with easy access to and faster development of the
antivirals now used to treat it in rich countries.

Malaria is another one. It kills hundreds of thousands of people each year
(mostly in Africa), and is largely preventable by relatively simply approaches
like mosquito nets. For a small fraction of the trillions of dollars involved
in trying to stop covid19, most of these fatalities could be prevented.

