“Until the pandemic, this had never happened before”: Swiss hospitals need face masks

In Spain, the current flu wave is pushing healthcare to the limit. Operations are already having to be postponed to make more hospital beds available for flu and Covid patients. In the first week of January, there were 1,000 flu cases per 100,000 inhabitants in Spain.

The flu wave has also started in Switzerland. The trend is clearly pointing upwards, as shown by the number of cases from the mandatory reporting system and the data from the Sentinella reporting system of the Federal Office for Public Health (BAG). This increase does not surprise Simon Ming of BAG. Every year, slightly fewer medical consultations are reported during the holidays, causing the number of cases to stagnate. The flu wave then starts in January and reaches its peak in February.

According to the World Health Organization (WHO), the flu season is considered to start when the weekly number of doctor consultations for flu is above the threshold of 68 per 100,000 consultations. Currently, this so-called ILI value in Switzerland amounts to 107 consultations.

Many people are still sick not because of flu viruses, but because of Sars-CoV-2 and other respiratory viruses. “But we have seen at the University Hospital of Zurich that the number of corona cases has been slowly decreasing for four weeks, while at the same time the number of flu cases is increasing,” says Dominique Braun of the Clinic for Infectious Diseases. This trend is also visible at the University Hospital of Basel, although there is currently a fairly balanced picture, says Caroline Johnson of the University Hospital of Basel.

According to the BAG, the Covid-19 wave exceeded its peak in December and has been declining since then, as shown by the measured viral load in Swiss wastewater. Influenza viruses are currently most commonly found in people with respiratory diseases, followed by Sars-CoV-2 and rhinoviruses.

Compared to the previous year, the number of flu cases is even lower, but comparable to those in the 'pre-pandemic years', the experts from the University Hospital of Basel explain. “However, since the current flu season is not yet over, the number of cases will certainly continue to rise. So far there are no indications that the current season is more difficult than last year.

In Spain, Health Minister Mónica García responded to the strong flu epidemic. Against the wishes of numerous regional governments, it has reintroduced a mask requirement in hospitals and health centers across the country with an exceptional law. To relieve the burden on overcrowded health centers, the Minister of Health also wants employees to be able to take up to three days of sick leave if they have mild respiratory illnesses. Parts of the US and Britain have also introduced a universal mask requirement in hospitals.

And the protective mask also returns in Switzerland. “As we had a lot of Covid cases around Christmas, we implemented this at the University Hospital of Zurich in early January. A protective mask must be worn when in direct contact with patients and in the waiting area,” says infectious disease specialist Braun. The University Hospital of Zurich must be careful because it probably treats the most vulnerable patients there, for example after organ transplants.

Since the end of November 2023, masks have been mandatory for employees and visitors when in contact with patients in all outpatient and inpatient areas of the Basel University Hospital. “Regardless of the current epidemiological situation, it is also recommended that all patients, visitors and employees with cold symptoms wear mouth and nose protection,” explains Caroline Johnson from the University Hospital of Basel. However, there is still no general mask requirement in the cantonal hospital of St.Gallen.

The fact that individual hospitals in Switzerland are reintroducing mandatory mask requirements is a paradigm shift. “As far as we know, this had never happened before the corona pandemic,” explains Simon Ming of the BAG. Dominique Braun has been in the University Hospital Zurich since 2008 and has not experienced this there either. Previously, anyone showing symptoms of a cold would wear a mask. In the past, mask-wearing Asians in Swiss cities were considered 'a bit quirky', says the infectious disease specialist. “Today no one is surprised anymore.”

The hospital etiquette of wearing a mask when coughing is also being implemented much more consistently today than before the pandemic. The universal mask requirement in hospitals is about protecting each other, both patients and healthcare workers, who are not allowed to be absent due to corona or flu. The individual cantons are responsible for ordering masks. However, there is no reason to fear that there will now be a national universal mandatory face mask requirement, for example in public transport. For this to happen, a malicious virus would have to emerge that could cripple the entire healthcare system.