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Triage: First Swiss canton considers prioritising vaccinated people in hospitals

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Triage: First Swiss canton considers prioritising vaccinated people in hospitals

Health experts in the Swiss canton of Bern have indicated they may privilege vaccinated people in the triage process during hospital admissions, should ICU bed capacity continue to dwindle.

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If the number of beds is limited, hospital officials will have to decide who will be placed in intensive care units and who will be turned away.

Guidelines issued by the Swiss Academy of Medical Sciences on triage of patients state that the highest priority should be given to those who have a good chance of recovering.

“Doctors will then treat first those who have the best chances of survival. It is more likely that they are people who have been vaccinated”, said Bern’s health director Pierre Alain Schnegg.

"I hope we don't have to make triage decisions," Gregor Kaczala, 46, head of vaccination in Bern, told Swiss tabloid Blick. 

"If we do, I fear worse outcomes for non-vaccinated people.

“Immunisation status would certainly be considered.” 

The Swiss Academy of Medical Sciences (SAMS) updated its triage guidelines at the end of 2020. 

According to the updated guidelines, which do not reference Covid or vaccination directly, those who have the best chance of survival with ICU admission - but who might not have a good chance without it - shall be admitted in the instance of shortages. 

The guidelines are not binding and doctors will have the final say. 

It is as yet unclear as to whether doctors will ask for vaccination status in Swiss hospitals should admissions continue to rise, however the statements from the health experts appear to suggest that those who are openly unvaccinated may rank lower on a priority list in the instance of shortages. 

The sentiment is shared in other cantons, with Zurich Health Director Natalie Rickli saying last week that people who choose to remain unvaccinated should forgo hospital admissions entirely. 

"Anyone who is opposed to vaccination would actually have to fill out a living will, wherein he confirms that he does not want hospital and intensive care treatment in the event of a covid disease. That would be real personal responsibility," Rickli said. 

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What is the situation in Swiss hospitals?

Covid-related hospital admissions have been on the rise in Switzerland, particularly in intensive care units. 

As at the start of September, Switzerland has the highest per capita ICU capacity of any European country. 

Almost all of those in the ICU in Switzerland are unvaccinated. 

In Switzerland, 80.3 percent of intensive care beds are occupied, while the percentage is slightly higher in Bern (81.7 percent). 

READ MORE: Why does Switzerland have the most ICU patients in Europe?

Some Swiss hospitals have already started transferring patients to other hospitals due to having no capacity. 

Several Swiss cantons are already at 100 percent, with more over 90 percent and rising. 

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