The Swiss authorities should have been more open about what they did and didn’t know about the SARS-CoV-2 virus in the early stages, according to Bertrand Kiefer, doctor, ethicist and editor of the Swiss Medical Review.
Speaking to RTS, Kiefer said he believes the public should be treated like adults. A paternalistic approach to communication in such situations is ineffective, in his view. Switzerland’s Federal Office of Public Health (FOPH) and government trivialised and hid important information in the early weeks, he said.
On 24 February 2020, Daniel Koch, the head of communicable diseases at the FOPH, announced publicly that the mortality rate of SARS-CoV-2 seems to be fairly similar to the seasonal flu, before adding that there was uncertainty around the estimation. In an internal memo of the same date, Koch wrote that the virus is not going to spread as easily as the flu.
These statements contrast starkly with other information available at the time. Seasonal flu has an estimated mortality rate of around 0.13%. However, a preliminary study published on The Lancet on 24 January 2020, included an early mortality rate estimate of 3% for SARS-CoV-2. On 29 January 2020, the WHO mentioned 2% as a mortality rate estimate in a press conference. Then on 4 February 2020, the Chinese government announced an estimated mortality rate of 2%.
Bertrand Kiefer points out how the Swiss authorities failed to communicate the high degree of uncertainty surrounding the understanding of the disease. He thinks earlier communication around this and the potential risks posed would have helped to get the public up to speed with what might happen.
If more information, including the fact that the authorities were dealing with high levels of uncertainty, had been shared with the population, it would have been easier to shift people’s behaviour sooner, days, perhaps even a week earlier, said Kiefer.
Laurent Kaiser, the head of infectious diseases at Geneva’s HUG hospital, was highlighted as someone who was open about the situation and spelt out the risks and high levels of uncertainty around the disease. He expressed this in interviews with the media at the time.
Trying to avoid public fear by conveying comforting but premature conclusions in the face of high uncertainty can easily backfire. High uncertainty increases the risk of being wrong, something which can undermine trust.
In addition, the emotional whiplash that comes from a message quickly shifting from, everything is fine to admissions that an unknown number of people are infected, can induce far greater fear than openly declaring up front that you don’t yet know.