Epidemics Act (EpidA), also known as Federal Act on the Control of Communicable Human Diseases, is a Swiss federal act designed to protect people from infections and to prevent and control the outbreak and spread of communicable diseases. The current version of the Epidemics Act is the result of the revision of September 28, 2012. The revision was necessary because the environment in which communicable diseases occur and pose a threat to public health has changed, and the law needed to be adapted accordingly.
An optional referendum against this revision was initiated by the EDU, the Citizens for Citizens Association (Verein Bürger für Bürger) and the Committee for True Democracy (Wahre Demokratie), and the 50,000 signature quorum was reached within 100 days. As a result, a referendum was held on September 22, 2013, in which the complete revision was approved by 60% of the population.
Development
The Federal Act on the Control of Communicable Human Diseases of September 28, 2012, currently in force, is a complete revision of the Federal Act of December 18, 1970. In turn, this was based on the Federal Act on Measures Against Publicly Dangerous Epidemics (Bundesgesetz betreffend Massnahmen gegen gemeingefährliche Epidemien) of July 2, 1886. The Epidemics Act of 1886 solely addressed public health epidemics, namely smallpox, cholera, typhus and the plague. Any other diseases were a cantonal matter. The typhus epidemic of 1963 in Zermatt, with about 400 cases and several deaths, led to a complete revision of the Epidemics Act of 1886. Previous outbreaks of diseases such as tuberculosis had also led to changes in the Federal Constitution (FC). Between the complete revision of December 18, 1970, and the update of September 28, 2012, there were various minor revisions, most recently in 2006. Almost all of these revisions have significantly increased the scope of the Confederation's powers.
Purpose The revised Epidemics Act aims to swiftly and efficiently coordinate all infrastructures that can aid in the monitoring, prevention, and control of human communicable diseases. The Confederation can promptly declare three levels of severity under the EpidA: normal, special, and extraordinary situations.
During a "normal situation", the cantons are responsible for enforcing the Epidemics Act and the Epidemics Ordinance (Epidemienverordnung or EpV). The Confederation has limited competencies, which include providing information and recommendations, controlling entry and exit, and coordinating with cantons upon request.
In a "special situation",Art. 6 of the EpidA the Federal Council (Bundesrat) may order individual quarantines, restrict capacity at events or even cancel them; it is authorized to close schools; it may require physicians and other health professionals to cooperate to control the then-emerging disease; and it may declare vaccinations mandatory. Regulations can take the form of a specific injunction, such as banning a particular event, or an ordinance, such as prohibiting events throughout Switzerland. The "special situation" is defined as an epidemiological emergency and can be compared to a moderate influenza pandemic, the SARS pandemic, and H1N1. The FDHA coordinates federal measures during a "special situation". The "special situation" occurs when "the ordinary law enforcement agencies are unable to prevent and control the outbreak and spread of communicable diseases".Art. 6(1)(a) of the EpidA Additionally, one of the following risks must also be present:
A high risk of infection and of spread. A special risk to public health. Serious consequences for the economy or for other areas of life.
In an "extraordinary situation",Art. 7 of the EpidA the Federal Council may, on the basis of Art. 185 (3) of the FC, issue an emergency decree without any basis in a federal act passed by parliament, and subject to an optional referendum by the people. Since the Federal Council is already constitutionally empowered to issue these ordinances, Art. 7 of the EpidA is of a declaratory nature. Due to the unpredictability of an acute, serious threat to public health, no specific measures are provided for the "extraordinary situation". In the event of an outbreak, the constitutional emergency law allows the Federal Council to order appropriate measures. According to Art. 7d of the Government and Administration Organisation Act (GAOA), these ordinances shall become invalid if the Federal Council does not submit to Parliament (within six months) a bill for a federal act or a parliamentary emergency ordinance to replace those of the Federal Council. An "extraordinary situation" requires a national threat that endangers Switzerland's external or internal security. Only worst-case pandemics would qualify, such as the Spanish flu or the COVID-19 pandemic.
Content
Detection and monitoring Art. 11 of the EpidA gives the Federal Office of Public Health (FOPH) responsibility for setting up and operating systems for the early detection and monitoring of potential hazards. This is done in close cooperation between the FOPH and the cantons, but also with the Federal Food Safety and Veterinary Office (FSVO) or the Federal Office for the Environment (FOEN). This close cooperation between the FOPH, other federal agencies and the cantons is of great importance. The cantons contribute their proximity to epidemiological events and health-related incidents and their responsibility for enforcement, while the FOPH ensures uniform reporting and evaluation criteria, professional epidemiological data processing and international networking. The involvement of other federal agencies enables a uniform evaluation of the situation and thus uniform enforcement.
The central instrument for this is the reporting obligation under Art. 12 of the EpidA. It stipulates that the medical profession, hospitals, rehabilitation centers, nursing homes, outpatient clinics, organizations or telephone medical hotlines and pharmacies must report communicable diseases to the FOPH or the competent cantonal authority. Diseases associated with an epidemic risk or severe course are monitored. This includes events that are novel or unexpected or for which monitoring is internationally agreed. The reporting obligation is specified in Art. 12 of the EpidA. The diagnosing physicians must report observations of communicable diseases to the cantonal medical services, which in turn forward these reports to the FOPH. In principle, the reports are first sent to the authority responsible for emergency measures. In certain cases, particularly when emergency measures involve more than one canton and international notification is required, reports should also be sent directly to the FOPH. In addition, the Federal Council may order reports on prevention and control measures and their effects, as well as the sending of samples and test results to laboratories designated by the competent authorities.
Prevention
Vaccines The FOPH and the Federal Commission for Vaccination (FCV) regulate vaccination strategies and objectives. To implement them, both bodies issue specific vaccination recommendations. Art. 20(2) of the EpidA states:"Doctors and other healthcare specialists shall assist in implementing the national vaccination plan as part of their activities."According to Art. 22 of the EpidA:"The cantons may declare vaccinations to be mandatory for population groups at high risk, persons who are particularly exposed to infection and persons that carry out certain activities, provided there is a significant risk."In the case of "special" and "exceptional" situations, the Federal Council may also order compulsory vaccination (Swiss: Impfobligatorium). Mandatory vaccination can therefore only be imposed on vulnerable groups and not generally on the entire population. Moreover, this measure is reserved for situations in which all other means have been exhausted. This is because mandatory vaccination interferes with personal freedom.Art. 10 (2) of the FC According to Art. 36 of the Federal Constitution (FC), such restrictions on fundamental rights is only permissible if:
They are based on a sound legal foundation. They are justified in the public interest (in the event of highly contagious diseases with potentially serious outcomes). They are proportionate.
Mandatory vaccination of specific populations may be necessary in the event of a severe, swiftly spreading, and sometimes lethal infectious illness.
Compensation for any pain and suffering resulting from a vaccine adverse event is covered by Art. 64 ff. of the EpidA.
Biosafety The Epidemics Act requires due care (Sorgfalt) to be exercised by anyone handling pathogens or their toxic products. It specifies that all measures must be taken to ensure that no harm comes to humans as a result of this activity.Art. 25 of the EpidA This due care includes the handling of genetic material or microorganisms that could cause disease as a result of genetic modification. Art. 28 of the EpidA states:"Anyone who places pathogens on the market must inform purchasers about the properties and hazards relevant to health and about the necessary precautionary and protective measures."The Federal Council is also authorized to restrict or ban the handling of certain pathogens. The WHO Action Plan for the eradication of poliomyelitis may also require the destruction of polio infectious materials or the prohibition and/or restriction of the handling of polioviruses in closed systems in the long term. Additionally, the Federal Council's competence in the field of biological weapons is within the framework of Switzerland's obligations under international law.
Countermeasures Most measures to safeguard public health have an impact on constitutionally guaranteed freedoms. Consequently, the competent authorities should assume responsibility. Decisions must also be made in cases where adequate scientific assessment is complicated. Since not all hazards can be conclusively defined, the competent authorities have a wide margin of discretion in deciding how to take action. In compliance with the principle of proportionality, these actions are lawful only if all less restrictive actions have been explored.
Based on the varying intensities of these measures, the Federal Council outlines a series of stages as required by law. The least severe measure is medical monitoring.Art. 34 of the EpidA The ban on practicing a profession or activity would have a stronger intrusive effect.Art. 38 of the EpidA Seclusion in a hospital or another appropriate institution is the most restrictive measure,Art. 35 of the EpidA along with an order for medical treatment.Art. 37 of the EpidA The law distinguishes between isolation and quarantine. Isolation refers to the confinement of individuals who are sick and infected, while quarantine refers to the confinement of individuals who are suspected of being sick or infected. The aim of both measures is to stop the transmission of infection. Both measures must be ordered beforehand at the individual's place of residence. Transfer to an alternate facility is only allowed if staying at home is inadequate or ineffective in stopping the continued spread of the disease.
The Epidemics Act provides numerous mechanisms to cantonal authorities to prevent the transmission of communicable diseases. For example, Art. 40 stipulates that events may be either banned or restricted; schools and other public institutions may be closed; and entry to and exit from certain buildings and areas, as well as certain activities in certain places, may be prohibited. According to Art. 41(2), the FOPH is authorized to require individuals entering or leaving Switzerland:
Provide their identity, itinerary and contact information. Provide a vaccination or prophylaxis certificate. Provide information on their health status. Provide proof of a medical examination. To undergo a medical examination.