Background information: The COVID-19 pandemic has put a lot of strain on health systems since 2020. The three groups of Swiss health authorities (cantonal doctors, cantonal pharmacists and federal authorities) have undertaken a lot of actions and faced various challenges.
Purpose: To review the actions undertaken by the Swiss health authorities to respond to the first wave of the COVID-19 pandemic and to provide information to improve pharmaceutical management in future health crises.
Method: An electronic survey was sent to all Swiss cantonal doctors (CD) and cantonal pharmacists (CP), as well to the following federal health authorities: Federal Office of Public Health (FOPH), Federal Office for National Economic Supply (FONES) and Swiss Agency for Therapeutic Product (Swissmedic). The questionnaire was organized into ten clusters of questions and covered many topics regarding the management of the COVID-19 crisis. Data collection was conducted from July 20 to September 30, 2020.
Results: Analyses were performed with 33 answers (54%) out of 61 questionnaires sent. Both federal (88 %) and cantonal (65 %) authorities had prepared an internal pandemic plan after the 2009 H1N1 pandemic and before the COVID-19 pandemic. Within the cantonal authorities, 6 of the CPs (67%) and 6 of CDs (64%) used an internal pandemic plan. To decrease the problems of drug shortage during the first wave, some drugs as lopinavir/ritonavir were quickly purchased from the market by the Swiss Armed Forces Pharmacy and delivered to the CPs to distribute them further in the cantons. At the beginning of the crisis, there was a precarious bottleneck of ethanol for hand sanitizers due to the lack of reserves at the Alcosuisse federal warehouse. However, the planning reliability of this product was rated satisfying by 5 (72 %) of federal health authorities and 9 (47 %) of all respondents (n=19). Because of the rapid response of the FOPH that issued a general permit facilitating pharmacies and other stakeholders the manufacturing of biocidal products and their supply, and of the important offer of disinfectant based on the WHO formula from a chemical company for Switzerland. In contrast, professional expertise was frequently not consulted enough during the purchase of Personal Protective Equipment (PPE). Moreover, the responsibility for this material was unclear between the different departments of the Swiss Confederation according to the respondents. The need of PPE for healthcare workers to protect against COVID-19 contamination was assessed by the cantons mostly by email (11; 55 %) or by phone (6; 30 %). The distribution was performed mainly by the watering can principle (9; 45 %) of thanks to the creation of an e-shop (5; 25 %).
Conclusion: Swiss health authorities have encountered many challenges during the COVID-19 disaster and had to find solutions quickly and effectively according to our survey. The majority of respondents advocate the maintaining of stockpilles at wholesalers and in hospital pharmacies for medicines and PPE and at Alcosuisse for disinfectants to manage future crisis. Likewise, the competent authorities desire regular practice of scenarios (simulations) to be better prepared to such crisis.