Lombardy, the region in northern Italy where the coronavirus outbreak first took off in Europe, now has fewer per capita cases testing positive for the virus than some Swiss cantons.

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Recent data from Italy show there were 221 cases per 100,000 in Lombardy. In Ticino, Switzerland’s worst affected canton, there were 477 cases per 100,000, 116% more. Lombardy had 13 times as many cases (22,189 / 1,688 cases) but has 29 times the population of Ticino (10m/0.35m).

Geneva (352), Vaud (319) and Basel-City (312) had Switzerland’s next highest rates per 100,000 and were all higher than Lombardy.

Across Switzerland, the death rate so far, based on the number of deaths and recoveries to date, has dropped significantly. At midday on 27 March 2020 there were 198 deaths and 897 recoveries, a death rate of 18%. Four days ago the same figure was 48%.

Why this rate (18%) is so high compared to some Asian countries in unclear. Currently, the same rates in China (4%), South Korea (3%), Japan (12%), Hong Kong (4%) and Singapore (1%) are far lower than the 18% outcome-based fatality rate in Switzerland. One theory is that the number of cases testing positive in these countries is closer to the real number of infections, while in Switzerland cases testing positive are the tip of a large iceberg of actual infections. There are likely to be other reasons too, such as demographic and healthcare differences. But right now we don’t know.

Differing approaches to testing could significantly affect the number of recorded cases.

By 26 March 2020, South Korea had conducted 364,942 tests, a rate of 7,090 test per million, while Switzerland had conducted 91,400 Covid-19 tests, a rate of 10,665 tests per million.

However, a high per capita rate of testing by itself isn’t enough to control the spread of the virus. Testing needs to be timely and accompanied by thorough tracing of human contact.

There are significant differences in how Switzerland and South Korea have approached testing. South Korea tested earlier, more preemptively and included significant numbers of suspected cases. In Switzerland, testing has been more reactive and focused on high risk highly symptomatic individuals. Many in Switzerland with symptoms remain untested. Many others in close contact with untested symptomatic people have not been tested either.

This means South Korea’s 9,241 case number is likely to be far more complete than Switzerland’s figure, which is likely to be heavily understated and far from the actual number of people infected. In Switzerland it is likely there are far more undetected cases unwittingly spreading the virus than in South Korea.

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