How Switzerland avoided a coronavirus ‘catastrophe’ by protecting cross-border workers

The coronavirus pandemic and the pressure to close borders presented a unique challenge for Switzerland. Daniel Wighton looks at how significant and speedy action was taken to protect the country's legion of cross-border workers and avoid a catastrophe in its health service.

How Switzerland avoided a coronavirus 'catastrophe' by protecting cross-border workers
Switzerland's border with Italy. Photo: FABRICE COFFRINI / AFP

The outbreak of the coronavirus shuttered borders the world over. 

In Europe, an entire generation who had never known a hard border in their own backyard were suddenly separated from friends and family members. For many older residents, it was a reality they hadn’t experienced in decades.

In Switzerland, the impact of shuttered borders had the potential to be especially acute. A landlocked country with a significant economic dependence on its neighbours, Switzerland stood to lose more than most when border controls snapped back in place in Mid-march.

While the European Union put pressure on member states to keep internal borders open, as a non-EU member Switzerland was free to go it alone.

But despite widespread pressure, particularly from the country’s largest political party – the right-wing, nationalist Swiss People’s Party (SVP) – Switzerland did not completely close its borders to foreigners. 

That's because foreign citizens are so important to Switzerland's economy and particularly to its health service, especially in border cities like Geneva.

In 2019, an estimated 325,000 people crossed the border into Switzerland every day to work – 177,000 from France, 76,000 from Italy and 60,000 from Germany.

Some industries and regions rely much more heavily on cross-border workers – known as frontaliers in French, Grenzgänger in German and frontalieri in Italian – than others. They represent one third of the workforce in some cantons. In Geneva some 60 percent of the city's health workers live in France.

In the canton of Ticino, one in five healthcare workers lives over the border in Italy – approximately 4,000 people. Ticino’s population swells from approximately 360,000 people to 440,000 during an average work day due to cross-border workers from Italy.

Swiss health minister Alain Berset at the Geneva Hospital. Photo: SALVATORE DI NOLFI / POOL / AFP

'Loss of foreign workforce would plunge Switzerland into crisis'

Keeping the borders open and enabling employees to get to work, especially in hospitals, would be a crucial element of Switzerland's reaction to the deadly pandemic. 

“It is clear that the loss of this foreign workforce would plunge Swiss hospitals into a crisis. We definitely have to prevent that,” Thierry Fumeaux, head of the intensive care unit at Vaud's Nyon Hospital, said at the time.

In mid-March Switzerland did close dozens of its small border crossings and reduced others to rush-hour opening times, but the government as well as cantonal authorities, private businesses and hospitals quickly implemented measures to ensure cross-border workers and therefor the economy and health system were protected.

The foreign ministries of Switzerland and Italy issued a joint press release in early March, reaffirming the “importance of guaranteeing the continuous opening of the border between the two countries… (and to) respect the need for workers to return to their families on a daily basis, avoiding ‘forced’ overnight stays across the border”.

Switzerland did not categorise workers as essential and inessential. Instead all cross-border permits remained valid.

Even seasonal workers in the agriculture industry, shut out of other European nations and sometimes unable to leave their own, faced no such restrictions in Switzerland. Farmers were allowed to drive their tractors across national borders.

Cross-border workers were protected by Swiss labour law. Those who were furloughed under the Swiss government’s ‘Kurzarbeit’ scheme had their wages guaranteed, regardless of where they lived.

The private sector got in on the act too, with some firms giving cross-border employees paid leave if they could not find replacement childcare in their home countries.

 'A pragmatic and sensible response to the crisis'

Working from home was encouraged by federal and cantonal authorities for anyone who was able to do so, but for this to be possible deals had to be struck quickly between Switzerland and neighbouring countries.

Under normal circumstances a worker who spent more than 25 percent of their working week at home, in France for example, would have to re-register under France's social security system rather than the Swiss one.

Tax treaties between France and Swiss cantons would also be flouted if workers stayed at home rather cross the border into Switzerland.

But agreements were quickly drawn up between France and Swiss authorities that essentially allowed workers to be based at home, rather than travelling to Switzerland without it impacting their social security and tax status.

“The overall principle applied during the border closures is that cross-border workers should continue to be subject to the same tax and social security as if they had continued to work in their normal location, when in fact they were working at home in their country of residence,” said Daniel Foster Director in global mobility services for KPMG, based in Switzerland.

Summing up the importance of the crisis agreements Foster said: “If these concessions to the normal rules had not been agreed, then cross-border workers could have found themselves with unexpected tax bills and unintended changes in social contributions and coverage, and employers would have had onerous and unclear compliance obligations.  

“I believe the agreements reached and guidelines issued are, on the whole, a pragmatic and sensible response to the crisis,” he said.

Erik Boyd, a cross-border an IT Recruitment Specialist based in France and working in Geneva since 2006 put it another way.

“I work from home one day a week. By law, in normal times, I am not allowed to work from home any more than that. It would have been a contradiction in terms to encourage people to work from home – and then penalise them for doing so.”

Those who couldn’t work from home were promised that they would be allowed to continue to cross the border. From the outset, politicians said requiring cross-border workers to remain in Switzerland overnight would be “unacceptable”.

A health worker has her picture taken in Geneva. Photo: FABRICE COFFRINI / AFP

'Monstrous queues at the borders'

With many cross-border workers allowed to remain at home this obviously eased pressure on the border crossings that remained open.

But not everything ran smoothly.

After Switzerland closed some 130 smaller border crossings there were reports of monstrous traffic jams at the border points that remained open.

Boyd said crossing the border every day became a time-consuming exercise, with some waiting for up to three hours, particularly in the early stages.

One French senator Cedric Perrin from the border territory of Belfort complained: “It takes an infinite amount of time for cross-border workers to get to their place of work”.

He claimed there were three to four kilometre tailbacks at crossing points whereas in normal time there was never any jams.

Other cross-border workers however reported a different experience.

Chris Clements, an Aviation Software sales rep based in Allschwil on the French border, said: “In the past few weeks I have been checked at the border more in one day than in the preceding 10 years in total.”

“I generally passed through without any delay and the border guards were always friendly and doing their best to keep the traffic flowing.”

But lengthy traffic jams at borders was a huge concern to Swiss health authorities whose hospitals and care centres are manned by so many cross-border workers and who were facing growing pressure due to rising numbers of coronavirus patients.

Thomas Mathys, a nurse at University Hospital Basel who crosses the border daily from St Louis in France, described the fear among healthcare workers.

“At the beginning of the Covid-19 crisis, it was a horror to have to cross the border for my job as a nurse on a Covid-19 ward in Switzerland, as it seemed like the border could have closed at any time,” Mathys said.

“There was always this tension in the air that, if the border would close completely, I‘d have to take a hotel room in Switzerland to be able to work.

But authorities acted quickly to try to ensure staff could get across the border and would not be forced to stay.

'It would have been a catastrophe'

In Geneva, lanes normally reserved for heavy goods vehicles or car-sharing lanes were handed over to give cross-border workers in health and emergency services priority access.  

The border crossing at Boncourt was reserved entirely for health workers.

To ensure health workers were given priority a car-sticker system was quickly put in place. The stickers, called macarons in French,  contained the words “Covid-19 priority worker”.

Laurent Paoliello, spokesman for Geneva's Departement of Securitéy, employment and health (DSES) told The Local that without the quick agreement to allow cross-border workers to get to their place of work and the priority lanes and car stickers for health workers Geneva's health system would have suffered “a catastrophe”.

“These procedures normally take a long time, but we had to act quickly,” he said. “Everyone knew that people needed to get to work to enable the health system to work.”
Paoliello believes between 10,000 to 20,000 priority stickers were handed out to health workers as well as other cross-border key-workers like firefighters.
There was talk of the stickers being easy to counterfeit but Paoliello says it wasn't a big issue. Each macaron contained a number, the name of the employees company and a phone number border patrol police could call to double check the macaron was in the right hands.
Fines could be given out either to companies or workers if they were found to be abusing the priority system.
The system priority passage for health workers will remain in place until June 15th when borders between the two countries are set to reopen and restrictions eased.
“It worked really well and if it happens again we will put it back in place. Without it health workers would have taken hours to get to work, but that wouldn't be possible because they have to take over from their colleagues,” he said.
He points to the fact hospitals in Geneva were able to treat thousands of non-Covid patients from France as well as numerous coronavirus patients as a sign the city's health service remained in good shape.
But the official also acknowledges that it wasn't just the authorities who found the solutions to keep the health system running. Many health workers simply made personal sacrifices to be able be in a position to treat virus patients.
“Some staff would wake up two hours earlier than normal to ensure they got to work on time”, he said.

Traffic outside Geneva Hospital.: Photo: FABRICE COFFRINI / AFP

‘The importance of guaranteeing the continuous opening of the border’
The system of priority passage for health workers will remain in place until June 15th when borders between the two countries are set to reopen and restrictions eased.

Michael Siegenthaler, a Labour market specialist at KOF Swiss Economic Institute in Zurich said: “The decision to keep the borders open was made because they understood that without them, nothing would work – in some regions especially.”

“If you go to Ticino or Geneva, they make up a third or more of all health sector workers. Without them, the system would have probably broken down – when we needed them most.”

Although Switzerland was not the only country to recognise the value of cross-border workers, it put its money where its mouth was at an early stage.

This was a sentiment that many other European nations didn’t share.

Austria and Slovenia banned all worker entry without a medical certificate. Austria, with a similar population to Germany, also relies on an estimated 60-70,000 workers crossing in from Italy at least once per week.

In Germany, Poland, Czech Republic and elsewhere, borders were completely shuttered to all workers except those considered to be in certain ‘essential categories’, such as medical workers.

What legacy for cross border workers in Switzerland?

The decision to keep Switzerland’s borders open to cross-border workers was met with plenty of resistance with critics pointing to the location of the parts of Switzerland hit hardest by the virus.

At one point, Switzerland had the highest per capita infection rate of anywhere in the world – with Ticino, which borders northern Italy, the initial European epicentre for the virus, the worst hit.

In early June, just under one in five of Swiss coronavirus deaths came from Ticino, while despite the canton only having four percent of the country’s population.

Vaud and Geneva, which have the next two highest number of cross-border workers, were alongside Ticino with the county’s highest death counts.

In the long term, the legacy of the coronavirus could be a more independent, self-reliant Switzerland – with possible repercussions for cross-border workers. The centre-left Social Democrats, usually champions of free movement, have put forward a ‘Switzerland first’ agriculture and manufacturing program.

The populist Swiss People's Party, who remain firmly against the reopening of borders (the party says foreigners “have come to settle in our small country to work or take advantage of our social system”) will continue to fight immigration.

A referenda on curbing immigration, of which there have been 42 since 1970 – was postponed from May due to the pandemic but is scheduled to take place in September.

Although efforts to impose curbs on migration have largely been unsuccessful, the vote is now viewed as having a more likely chance of success due to coronavirus-inspired nationalism.

“What you have (is a perception) that cross-border workers may steal your job, but that’s definitely not the case,”Labour market specialist Michael Siegenthaler says.

“We find that cross-border workers work in created jobs, while improving wages for those who live there (in Switzerland),” said the specialist who has authored a new report on the importance of cross-border workers to Switzerland.

“(The coronavirus showed) it is obvious again that cross-border workers are important for the Swiss labour market – for the healthcare sector they are extremely important – but it’s not entirely clear whether this narrative is going to win.

“People will lose jobs and will want to find a scapegoat for their personal situation, and it could be cross-border workers.”

Confronting Coronavirus: This article is part of a new series of articles in which The Local's journalists across Europe are taking an in-depth look at the responses to different parts of the crisis in different countries; what's worked, what hasn't, and why.
This article has been supported by the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems.
The SJN has given The Local a grant to explore how different countries are confronting the various affects of the coronavirus crisis and the successes and failures of each approach.


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What will a right-wing election victory mean for abortion rights in Italy?

The right-wing parties poised to win Italy’s upcoming general elections have a history of denouncing abortion. Could a new conservative government threaten reproductive rights in Italy?

What will a right-wing election victory mean for abortion rights in Italy?

When Italians go to the polls on September 25th, a coalition of three right-wing parties – Giorgia Meloni’s Brothers of Italy, Matteo Salvini’s League and Forza Italia, led by former premier Silvio Berlusconi – are widely expected to win the vote and secure the opportunity to form Italy’s next government.

READ ALSO: Your ultimate guide to Italy’s crucial elections on Sunday

With all three parties to the right of centre – by quite some way, in the case of Brothers of Italy and the League – activists are concerned about what Italy’s most socially conservative government in years could mean for women seeking to access abortions, as they have had the legal right to do here for over four decades.

Here’s what Italian law says about abortion, what the right-wing alliance has promised it will – or won’t – change, and what all this could mean for people in need of abortion care in Italy.

What is Italy’s law on abortion now?

Abortion – formally referred to in Italian as interruzione volontaria di gravidanza or IVG, ‘voluntary termination of pregnancy’ – has been legal in Italy since 1978.

Passed after years of protests and several other failed bills, Legge 194 (‘Law 194’) decriminalized the procedure and entitled women to request it for any reasons of physical or mental health within the first 90 days after conception.

Women can continue to seek an abortion after 90 days if a significant foetal abnormality is present, or if continuing the pregnancy would endanger the woman’s life.

READ ALSO: The long road to legal abortion in Italy

The procedure is offered free of charge to those who qualify for public healthcare in Italy.

To access it, women first must consult a doctor and discuss options “to help her to overcome the factors which would lead her to have her pregnancy terminated”.

If the patient continues to affirm her original choice, she will be issued a certificate either stating that the termination is urgent and can be carried out immediately, or, if it is not deemed urgent, that she can seek the procedure after a obligatory seven-day wait.

Campaigners in front of a banner reading ‘Don’t touch law 194’. Photo by FABRIZIO VILLA / AFP

In reality, the wait for an appointment is likely to be far longer. Law 194 also affirms the right of health workers to refuse to carry out abortions on the grounds of “conscientious objection”. 

This has translated into serious gaps in coverage across Italy, with some facilities staffed mostly or even entirely by personnel who decline to deliver abortion services.  

READ ALSO: Why abortions in Italy are still hard to access – despite being legal

In fact, a majority of gynaecologists in Italy – 64.6 percent, according to 2020 figures from the Ministry of Health – are registered objectors, as well as 44.6 percent of anaesthesiologists and 36.2 percent of non-medical staff at health facilities. 

In several parts of the country, including the regions of Sicily, Basilicata, Abruzzo, Molise and the province of Bolzano, the percentage of gynaecologists refusing to perform abortions is over 80 percent.

These doctors are probably out of step with public opinion in Italy. A 1981 referendum gave voters the opportunity to reject the new abortion law; 68 percent of them voted to keep it. 

More recently, an Ipsos poll conducted earlier this year found that 73 percent of people surveyed in Italy said abortion should be legal in all or most cases.

What election promises has Italy’s right-wing alliance made about abortion?

No doubt sensing the lack of appetite for a full-scale repeal of Italy’s abortion law, the right-wing coalition has made clear that that’s not on its agenda. 

Abortion doesn’t get a single mention in the joint platform put forward by the Brothers of Italy, League and Forza Italia. 

Law 194 does appear in the Brothers of Italy programme, which promises “full application” of the legislation, “starting with prevention” of abortion.

To this end, it pledges the allocation of funds to support single and economically disadvantaged women to carry pregnancies to term, a proposal echoed by the League and presented by both parties as part of a broader drive to reverse Italy’s plummeting birth rate.

The League’s platform also calls for implementation of Law 194’s provisions on the “effective promotion of life”, including by involving non-profit groups – presumably Catholic and other pro-life ones – in pre-abortion counselling.

Forza Italia, historically the most centrist of the three, hasn’t broached the subject at all. 

READ ALSO: Salvini vs Meloni: Can Italy’s far-right rivals put differences aside?

Both Meloni and Salvini have faced questions on the campaign trail about their position on abortion, given previous comments calling abortion “a defeat for society” (Meloni), loudly professed Catholicism (Salvini) and support for European allies who have restricted access to abortion, such as Hungarian Prime Minister Viktor Orban (both). 

“Law 194 isn’t to be touched,” Salvini told reporters this week. “The last thing Italy needs is a country divided and arguing over the laws in place – which can be improved and updated, but certainly not scrapped.”

Meloni, meanwhile, told a recent interviewer that “I never said I want to modify Law 194, but that I want to apply it”. That includes supporting women who feel obliged to abort for economic or practical reasons, she said – as well as supporting health workers who refuse to provide the procedure. 

Why are activists worried a new right-wing government could threaten abortion rights in Italy?

The problem is that Law 194 perhaps does need an overhaul if it is to guarantee access to safe, legal abortions across Italy. 

Those who support women’s right to choose have long complained that the 44-year-old law – whose primary objective, the Italian Health Ministry’s website states, “is the social protection of motherhood and the prevention of abortion” – is not fit for purpose.

A demonstrator holds a sign reading ‘free to choose’ at a rally in defence of Italy’s abortion law. Photo by FABRIZIO VILLA / AFP

Law 194 “does not establish in a strong sense women’s right to choice and self-determination: it establishes when access to it is permitted and granted,” Chiara Lalli, a writer and academic with a focus on abortion, told Il Post

The multiple doctor visits, mandatory counselling session and seven-day “reflection” period are attempts to interfere with women’s decisions, activists say. 

READ ALSO: ‘Ugly act’: Outrage in Italy over discovery of foetus graves marked with women’s names

Separately, watchdogs including the United Nations Human Rights Committee, Human Rights Watch and the Council of Europe’s committee of social rights have flagged the high rates of conscientious objectors as a persistent barrier to abortion access in Italy.

While authorities are supposed to ensure that women can access terminations and that objecting doctors can’t refuse care beyond the procedure itself, with no mechanisms to enforce these requirements specified in the existing law, in practice women report facing long delays or being denied assistance altogether. 

In the past, both Brothers and Italy and the League have resisted attempts to help the problem, such as by recruiting specifically non-objecting doctors.

While these problems are longstanding, there have been attempts in recent years to put more obstacles between women and abortions – mainly from regional or municipal politicians, who tend to be more explicit in their opposition than those on the national stage.

Many of these have come from members of the three main right-wing parties, which together have governed 14 of Italy’s 20 regions for the past two years.

And with each region largely in charge of managing its own public health service, regional governments have the power to make decisions that significantly affect how and where women can access abortions.

In Le Marche, headed by the Brothers of Italy, the regional government refused to implement 2020 national guidelines from the Ministry of Health that would have extended the window for medical abortions from seven to nine weeks and made it possible for women to obtain abortion pills in outpatient clinics and family planning centres instead of going into hospital. 

Abruzzo, whose council is also led by Brothers of Italy, as well as Piedmont and Umbria, two regions governed by the League, resisted the change too.

Priests join an anti-abortion demonstration on May 21st 2022 in central Rome. The placard reads “Human Rights are born in the womb”. Photo by Alberto PIZZOLI / AFP

Piedmont has further allowed anti-abortion groups to set up stands in public hospitals, and councillors have proposed funnelling public funds to groups that would pay women not to abort

The League-run council in Verona declared it a “pro-life city” and called for funding for anti-abortion projects to be written into the town budget, as well as authorizing anti-abortion groups to display promotional material in council buildings. 

In the wider region of Veneto, such groups are allowed to offer family counselling services alongside those providing neutral information – a move the League’s manifesto suggests extending when it talks about involving non-profits in “the promotion of life”. 

To those who support abortion, it all starts to look like a pattern. “As soon as a right-wing council takes charge, it seems like these issues are at the top of the agenda,” Beatrice Brignone, head of the small left-wing party Possibile, told L’Espresso back in 2020.

READ ALSO: Why an Italian woman was forced to go to 23 hospitals to have an abortion

With threats to abortion access in Italy emerging locally and unchecked at national level, some activists say they would in fact welcome putting Law 194 up for debate under the next government.

“As much to better implement it as to make the necessary modifications … it is time to begin an informed discussion on abortion and free ourselves from the prejudice that the law is untouchable,” comments the Luca Coscioni Association, which advocates for freedom of scientific research and backs abortion rights.

Meloni and her allies have already made clear that such a discussion will not be among their priorities if they win this weekend. 

What do other parties say about abortion?

Abortion isn’t an issue for either the centrists Italia Viva or Azione, nor for the populist Five Star Movement.

The centre-left Democratic Party promises the full application of Law 194 throughout the country, without going into further details.

The only concrete proposals come from much smaller parties on the left: Possibile proposes establishing a quota of at least 60 percent of non-objecting staff in each health facility, as well as tracking the service provided by each region and punishing those who fail to meet minimum standards. 

The Greens and Left Alliance wants to change recruitment rules to hire more non-objecting medical staff, while +Europa suggests partnering with private clinics to expand access and making medical abortion more widely available as an outpatient procedure.