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Why hospitalisations in Switzerland are not increasing despite soaring infections

Although the number of Covid cases is skyrocketing in Switzerland, the figures for hospital admissions have remained comparatively stable. This is why.

Swiss ICUs are busy, but the number of Covid-related cases remains stable for now. Photo by Fabrice COFFRINI / AFP
Swiss ICUs are busy, but the number of Covid-related cases remains stable for now. Photo by Fabrice COFFRINI / AFP

Across recent weeks, Switzerland’s daily Covid case rate has continued to break previous records. 

Over the first 20 months of the pandemic, Switzerland had recorded more than 10,000 cases in a 24-hour period only on a small number of occasions. 

Over the past few weeks however, daily infections have almost doubled. On Tuesday, January 4th, new daily infection numbers crossed 20,000 for the first time. 

READ MORE: ‘20,000 cases per day’: Experts draw Covid forecast for Switzerland

Unlike in the early days of the pandemic however, hospitalisation rates have not climbed alongside new infections. 

While ICUs remain close to capacity in several cantons – in Zurich, Geneva, Solothurn, Lucerne and Fribourg have also warned of overcrowding in ICUs, with each seeing a higher than 90 percent occupation rate – non-ICU hospitalisations remain comparatively steady. 

As at January 2nd, 308 coronavirus patients were hospitalised in ICUs in Switzerland — seven less than in the previous week. (However, hospital statistics are not updated daily, so this number may not reflect the situation as it is real-time).

In all, 74.3 percent of the country’s ICU beds are currently occupied, half of which are taken up by Covid patients.

Nearly 26 percent of Switzerland’s total ICU capacity is still free, which translates into 221 beds, according to FOPH.

Why aren’t there more hospitalisations in view of the steadily growing number of infections?

According to health experts, we can thank Omicron, previous immunity and vaccinations.

“The gap between the number of those infected and those hospitalised is widening more than ever before in this pandemic”, Daniel Koch, former head of FOPH’s infectious diseases unit, said in an interview with Watson news platform.

“(The current situation) is less dramatic than what we had feared.

“This has to do with Omicron, but also with the fact that, thanks to the vaccination or a previous illness, many people have a basic immunity that protects them from a serious course of the disease”, he added.

Koch said the new developments illustrated Switzerland needed to avoid putting in place any further drastic measures to stop the spread of the virus – and that all measures should be targeted at protecting the most vulnerable. 

For Didier Trono,  who heads the virology laboratory at the Federal Polytechnic Institute of Lausanne (EPFL), there are also two explanations for this disconnect between the infection and hospitalisation curves.

First, the population is mostly immune to the virus, either by vaccine or by previous contamination.

While it is not certain to what extent vaccines protect against this variant, experience so far has shown that people who had had two shots of either Moderna or Pfizer/Biontech vaccine within the last four months, and especially those who received a booster dose, are only mildly ill if they do catch Covid.

Second, the Omicron virus appears to create less severe forms than the Delta variant, he said.

Is Omicron less severe than known variants?

Omicron, which is more contagious than Delta and spreads more rapidly, is now a predominant variant in Switzerland.

READ MORE: Omicron officially dominant in Switzerland

However, some epidemiologists believe that it is also less virulent, which would imply that most people don’t have severe symptoms after contracting this mutation and don’t require hospitalisation.

The UK’s Guardian newspaper reported on Sunday that six studies completed in several different countries including the United Kingdom, United States, Belgium, South Africa and Hong Kong showed that the virus may do less damage to patients’ lungs than known variants, at least in part because it replicates in the throat rather than in the lungs. 

There are also some indications that those infected with Omicron have a lower viral load than with other variants, which could mean a more mild course of the disease. 

In neighbouring Austria, health officials said over the weekend said that despite the Omicron variant being dominant in the capital Vienna, nobody carrying the variant had been admitted to hospital

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Covid-19: European summer holidays threatened by rise of subvariants

A resurgence of Covid-19 cases in Europe, this time driven by new, fast-spreading Omicron subvariants, is once again threatening to disrupt people's summer plans.

Covid-19: European summer holidays threatened by rise of subvariants

Several Western European nations have recently recorded their highest daily case numbers in months, due in part to Omicron sub-variants BA.4 and BA.5.

The increase in cases has spurred calls for increased vigilance across a continent that has relaxed most if not all coronavirus restrictions.

The first resurgence came in May in Portugal, where BA.5 propelled a wave that hit almost 30,000 cases a day at the beginning of June. That wave has since started to subside, however.

READ ALSO: KEY POINTS: German Health Ministry lays out autumn Covid plan

Italy recorded more than 62,700 cases on Tuesday, nearly doubling the number from the previous week, the health ministry said. 

Germany meanwhile reported more than 122,000 cases on Tuesday. 

France recorded over 95,000 cases on Tuesday, its highest daily number since late April, representing a 45-percent increase in just a week.

Austria this Wednesday recorded more than 10,000 for the first time since April.

READ ALSO: Italy’s transport mask rule extended to September as Covid rate rises

Cases have also surged in Britain, where there has been a seven-fold increase in Omicron reinfection, according to the Office for National Statistics (ONS).

The ONS blamed the rise on the BA.4 and BA.5 variants, but also said Covid fell to the sixth most common cause of death in May, accounting for 3.3 percent of all deaths in England and Wales.

BA.5 ‘taking over’

Mircea Sofonea, an epidemiologist at the University of Montpellier, said Covid’s European summer wave could be explained by two factors.

READ ALSO: 11,000 new cases: Will Austria reintroduce restrictions as infection numbers rise?

One is declining immunity, because “the protection conferred by an infection or a vaccine dose decreases in time,” he told AFP.

The other came down to the new subvariants BA.4 and particularly BA.5, which are spreading more quickly because they appear to be both more contagious and better able to escape immunity.

Olivier Schwartz, head of the virus and immunity unit at the Pasteur Institute in Paris, said BA.5 was “taking over” because it is 10 percent more contagious than BA.2.

“We are faced with a continuous evolution of the virus, which encounters people who already have antibodies — because they have been previously infected or vaccinated — and then must find a selective advantage to be able to sneak in,” he said.

READ ALSO: Tourists: What to do if you test positive for Covid in France

But are the new subvariants more severe?

“Based on limited data, there is no evidence of BA.4 and BA.5 being associated with increased infection severity compared to the circulating variants BA.1 and BA.2,” the European Centre for Disease Prevention and Control (ECDC) said last week.

But rising cases can result in increasing hospitalisations and deaths, the ECDC warned.

Could masks be making a comeback over summer? (Photo by OSCAR DEL POZO / AFP)

Alain Fischer, who coordinates France’s pandemic vaccine strategy, warned that the country’s hospitalisations had begun to rise, which would likely lead to more intensive care admissions and eventually more deaths.

However, in Germany, virologist Klaus Stohr told the ZDF channel that “nothing dramatic will happen in the intensive care units in hospitals”.

Return of the mask? 

The ECDC called on European countries to “remain vigilant” by maintaining testing and surveillance systems.

“It is expected that additional booster doses will be needed for those groups most at risk of severe disease, in anticipation of future waves,” it added.

Faced with rising cases, last week Italy’s government chose to extend a requirement to wear medical grade FFP2 masks on public transport until September 30.

“I want to continue to recommend protecting yourself by getting a second booster shot,” said Italy’s Health Minister Roberto Speranza, who recently tested positive for Covid.

READ ALSO: Spain to offer fourth Covid-19 vaccine dose to ‘entire population’

Fischer said France had “clearly insufficient vaccination rates” and that a second booster shot was needed.

Germany’s government is waiting on expert advice on June 30 to decide whether to reimpose mandatory mask-wearing rules indoors.

The chairman of the World Medical Association, German doctor Frank Ulrich Montgomery, has recommended a “toolbox” against the Covid wave that includes mask-wearing, vaccination and limiting the number of contacts.