Tuesday, March 10, 2020

Czech microbiologist on the Covid panic

Dr Václava Adámková is a bacteriologist who recently expressed her shock from the coronavirus hysteria. The Free Universum Radio has recorded a new 30-minute-long interview with her (recorded on Thursday, posted yesterday). She's the senior doctor of microbiology at a big General Faculty Hospital in Prague and the chairwoman of the Antibiotics Center.

Here is... Ms Martina Kociánová, the host and Ladislav Henek behind the scenes. In our "Forward to the Past" program, we will talk about the coronavirus which is by far the most widespread topic of discussions in recent days or weeks. We went through the panic of swine flu, SARS, MERS, so we should be used to them. But it seems that the world has never cancelled this many international congresses, tours, conferences, trade fairs... Politicians talk about the isolation of countries and closure of the borders. Do we stand at the beginning of a global pandemics? Or are we witnessing the powers of the concentrated collaboration between politicians and the media? My guest is... Adámková. I am happy to have you here. Good afternoon.

Good afternoon.

You have said that what the Czech nation is showing is a nice example of hysteria and panic. I understand why there's no reason for a hysteria, it's always wrong. But what about panic? Doesn't it deserve some panic?

I think that the topic deserves attention but not panic. Although I am no psychologist, I think that a panic weakens a human being. The rational attitude is being lost and the person plagued by panic, fear, terror may overlook real things that would deserve the attention. Instead, he focuses on things that don't deserve that much attention.

So do you believe that too much attention is being directed at this topic?

Exactly. I do believe that there's a lot of attention paid to the topic. But it matters what part of the topic. It seems that not much attention is being focused on the medical aspect of the virus. What the virus is, what it can do, what it can't cause. Instead, the attention is focused on certain political aspects that aren't directly linked to the topic. For example, yesterday, I saw that the English Physician-in-Chief – it's embarrassing for a person of his stature to announce that Britons will be dying and in the same sentence, he says that several cases will die. What does it mean "several"? Of course, unfortunately, several people will die. But "several" means a few units. That's irrelevant but it does cause the panic. Before that announcement, Britain wasn't so tense. After that announcement, Britons attacked the shops, something that we see in Czechia, too.

When I think about the steps of the Czech government and ministry of healthcare, would you criticize them for the lack of discussions with experts?

Well, I would criticize them for purposefully and uselessly manipulating with the populace of the laymen. And the tone in which the news are being presented – there is one case here... Well, there's one case here, five cases a day or eight cases a day today. It's 8 cases. During that time, much more serious infectious diseases, viral or bacterial ones, actually kill many more people. And that's something that is not included in the context of that information. So the announcements seem populist, one-sided, and they resemble a politician's campaign before the elections when the politician focuses on one topic and he escalates it.

When I observe the humbug around the coronavirus, and we're not alone, it's present across Europe and outside Europe as well, I tend to think that politicians tend to downplay these threats. Their basic approach seems "avoid panic, don't scare the people". When they behave like this, I think, it might be because they are scared themselves. And maybe there are many things I am unaware of.

It may look in this way, you are right, but this is an even better reason why these politicians should talk to the virologists and other experts and be rationally informed. But the truth isn't sensational. Mankind always wants a sensation. That cannot be found in the true words. Those may be bad or good but never sensationalist. That's an essential thing.

So let's avoid the sensationalist aspect. Let's rationally talk about what the virus can do and what it may evolve to. You are a microbiologist so you also know about resistance and other things. How do you perceive it as an expert?

I am not quite a virologist, closer to a bacteriologist. Anyway, coronaviruses have been with us from the beginning. It is a large group of viruses that cause respiratory diseases, runny nose, cough, exceptionally diseases of the lower respiratory tract. But when we statistically test the coronaviruses every year, they cause up to 18% of respiratory infections. No one talks about it. These viruses attack all age groups, from babies to seniors. That's how things work. Sometimes they appear along with other viruses, most often with influenza viruses. The coronaviruses have always been here, are here, and will be here. When the virus mutates, merges the genes with something, that's how Nature and biology works. They may do whatever seems good in their context. We see it in flu, too.

It's the microorganisms that determine the events of the world [second after strings, of course]. We are visitors to their world, not the other way around. What will happen, I don't know because I am no witch with a crystal ball. So if the virus gets a mutation when it touches the European coronaviruses, I can't rule it out. But why should we predict a supervirus that will kill the white race? It's premature. Let's not terrorize ourselves with a catastrophic speculation.

And how does the Wuhan virus differ?

I don't really believe that it differs. If we look at it from the healthcare perspective, according to symptoms – Covid is mostly about mild symptoms in the upper respiratory tract, especially among young and not immunocompromised people. And even the fatalities described in the context of this virus are compatible with the biology of this virus. Even the other coronaviruses may kill a weakened individual. But the available mortality numbers, let's accept them, simply describe the reality. In comparison with SARS and MERS, Covid has a much lower fatality rate. Nevertheless, SARS and MERS didn't get this much attention.

Of course I am puzzled why it is do. Is it a rehearsal for an election campaign? Or is it an experiment measuring whether mankind may be manipulated? In that case, the outcome of the experiment is self-evidently Yes. And maybe it's a way to manipulate the people by leaking some information to the social networks. Maybe someone wants to know how quickly the economies, human perception may change. Quickly and that's shocking. But who is trying it and why is a speculative issue. But from my biological viewpoint, the unknown motivation is irrelevant.

That is really strange. It would smell of an invariant [whatever she means] that there is a global exercise or drill going on. How, within one month, borders, thinking of people, operating of economies, political establishments may be changed.

It surely is interesting. Some 3 months ago, the WHO was just warning about the infectious disease, most likely a viral and not bacterial one, that may quickly spread due to the widespread travelling. The main WHO virologist just made this speculation. It's interesting that this has happened. It may easily spread, in theory. However, in practice, the propagation of the news occurs much more quickly than the propagation of the virus itself. It is spreading like a computer virus, not a biological virus, because the numbers of infected ones remain low. Around 80,000 Chinese is a tiny fraction of China's 1.4 billion people. If they published how many people have flu or tuberculosis at the same moment, the numbers would be vastly higher. So I think it is like the propagation of a Trojan horse or a computer virus.

I don't want to speculate but similar questions are surely appearing in my head and many others. Even though I ban these questions that I invent soon afterwards, as questions that are too far-fetched. But anyway, if a European country were before the elections, maybe they are earning some political points. If it were just in Europe, I say Maybe, the European Union wants to display its importance. But because it takes place in China which can't be accused of caring about the humans too much, that's something puzzling for me. Why China started to panic in this way? China is behaving in many contexts similarly as we remember from the totalitarian era: everything is swept under the rug, nothing is ever being solved, nothing is happening.

If the data are correct that the epidemics started before it appeared in the global press, we must realize that it's possible to leak the information about China to the global press. So it's questionable that they might sweep everything under the rug. But it's a question why people care about it this much. It could be an economic or macroeconomic issue. Maybe a crisis is getting closer or someone wants to ignite it and make some profit. At any rate, the economic consequences surpass the healthcare ones. That's something we must admit, whether the people like this fact or not. The number of fatalities, however tragic each one is, is low. Infectious diseases sometimes kill people. And there are infectious diseases that kill many more people but no one talks about them. So from my perspective, the main impact is the economic one. Why it's happening, I don't know. I am not even an economist. But I see it as the essential point.

If I ask you as an expert, a microbiologist etc., aren't you afraid of the Covid virus?

I have a respect for it, like for every virus. But honestly, I am much more afraid of a flu virus.

So you consider the flu virus to be much more insidious?

Certainly. And even the healthcare impact is at a different level. In our hospital, inside the Anesthesiology and Resuscitation Department, a whole center is reserved for severe flu cases. They often end fatally. Those patients who need the artificial lung ventillation, connection to an artificial circulation of blood etc., our VFN hospital is the center of choice and the center is filled during each flu season. We observe how much those things may harm people but no one writes about it.

Prof Pirk has said that it would be great for everyone to get infected with Covid, as soon as possible, to get the immunity. Can you agree?

I think it was meant as a hyperbole. On the other hand, most of the population has encountered a coronavirus, probably not this one. Who hasn't had a cold, throw a rock. There is nobody like that. But it's not being monitored, people aren't seeing their physicians because of that. So I wouldn't react too strongly here.

If we try not to be critical about the governments but understand their behavior instead. We have seen many catastrophic movies, Outbreak (1995) etc., the governments tended to downplay the epidemics. And suddenly it was too late to react pragmatically. Shouldn't we see the massage by the media as a positive thing because it slows down the propagation of the virus? People reduce the random flying over the world, to congresses etc.? Some big events are being canceled and it's good?

It could work if the governments had a conceptually clear plan. However, that's not happening. Fans were banned in the Biathlon Championship in Czechia. However, other events will probably take place. Yesterday, on Wednesday, there was the Sparta-Baník soccer match (5-to-0) where the number of viewers is about the same as the Biathlon Championship (one day of it). Concerning the congresses and traveling, it's a question. ISICEM, a conference on Intensive Care, will take place in Brussels in a few weeks. Thousands of (intensivist) physicians should arrive. They are among the exceptions who stood courageously face to face to this topic and Jean-Claude [she meant Jean-Louis LOL] Vincent, the guru of the Intensive Medicine, made a clear announcement: the congress won't be canceled. They try to tame the panic. Finally, clear news were heard from the sphere of experts. It's necessary to approach this problem rationally.

But back to the governments. To prevent the propagation of the diseases, we would need a different political regime, a totalitarian one, to hire the soldiers to enforce the isolation in the whole country. Ideally, this could work in Cuba which is also an isolated island. But a country which is democratic and inside a continent simply cannot ban everything. It can only encourage them to use common sense and behave rationally and lucidly. But that doesn't seem to be what the governments communicate. The panic pushes them to behave differently. A part of the population may deliberately say "to piss them off, let me do it differently, to prove that nothing is happening". That is the result: a part of the people are terrified, another part will completely ignore it or, on the contrary, encouraged to do somewhat dangerous things that they wouldn't otherwise do. That's the problem of the communication of the Czech government and others, too.

Your answer had several layers. You said that the totalitarian regimes are capable of isolating the people. At the same moment, you said that the media are spreading the panic or the feeling that nothing is happening. But look at Iran which seems to obey several conditions from your monologue. The regime is controlling its media rather tightly. They are surely prohibited from spreading fear. But the WHO says that the Covid situation in Iran is serious and deteriorating.

You are right. But from another viewpoint, Iran is trying to be opening to the world. It's a beautiful country, we hear, I don't know because I haven't been there. The country has become much safer than it used to be and tourism has risen. But in recent months, we see some political struggle (not violence) that is being completely hidden by the Covid topic. So I would conclude that the regime is not in control of most things, perhaps with the exception of the media. The groups that operate there, in the relationship to Iraq and the killed general etc. Those things were discussed a month ago but the news have disappeared. So I think Iran isn't a good example of a country that could isolate the people. The writers have some embargo on the news they can write. However, concerning the possible checks, it seems hard so I believe that the cause of the high infection rate in Iran has very different causes. The verification of the infection may be weakened by some internal political struggles.

Do you have an explanation why those major viral diseases came from China? Including the Spanish flu?

China is big, covers several climate zones, and the civilization has been there for thousands of years before Europe. We must understand that there have always been some infections. They can survive for a very long time, e.g. in permafrost in Northern China. When permafrost melts, some old viruses may emerge from skeletons of people who died of God-knows-what thousands of years ago. They may interact with the new viruses, exchange the genetic material, and the propagation will be amplified by tourism etc. China has also opened to the world. Well, the Spanish flu was linked to a big migration wave after the First World War. So I wouldn't blame China as being responsible for these outbreaks. It's due to some biology that determines the high rate. The same thing could happen in American or European tombs affected by erosion of soil, too.

Ms senior doctor, two years ago, we talked about the increasing resistance towards new types of antibiotics. You said that a new disease that is worse than cancer may arrive because people aren't humble. What if Covid is "it"?

You mean that Covid is the Scourge of God?

Haha, I don't know what the right term is but you apparently understand me. I am a layman. But you probably know more.

I simply don't think it is the Scourge of God. I primarily meant a bacterial disease. We are returning to a pre-antibiotics era in which people start to die again of bacterial diseases. And it's happening. The trend is still the same. But concerning the coronavirus, I simply don't see that it is the Scourge of God. In particular, the Chinese data clearly show a declining phase of the epidemics, assuming we trust their numbers. And they're internally consistent so I don't believe that the numbers are too distorted. It corresponds to the natural epidemiology and evolution of any viral disease. It goes up, culminates, and fades away. In China, the new cases per day are much less numerous now. We may assume that elsewhere in the world, it will be roughly analogous. So it doesn't seem like the right Scourge of God that will exterminate or strongly influence mankind. Not yet.

How do you explain the propagation of the virus in the whole world while India and Africa were spared?

Well, you know, let's first return to weekly flu maps in Europe on the pages of the European Healthcare Organization; I will return to your question soon. Up to the 6th week of 2020, Italy had a growing number of flu cases. From the 7th week, when the coronavirus affair began, there's suddenly zero flu. The data are missing. They stopped to investigate flu. They simply focused on Covid.

So why is it in India and Africa? Simply because the people haven't joined the panic (many of them can't even access the Internet) so it's not even being investigated. Someone gets a flu-like disease and doesn't want to travel 50-100 kilometers to a larger city. Maybe they haven't heard of Covid. They're used to cough or fever. So I am not quite sure that it's absent there. And I don't believe it avoids the darker races.

Will we continue to test the people with a runny nose? For how much time? As far as I know, the Covid test is rather expensive.

That is a good question. In Czechia, it's paid from the healthcare insurance. As long as there's some money left, it will be tested. OK, I meant it as a joke. But I think that the tests will continue while the affair will be nurtured by the media. The tests will simply be done on the selected individuals. It's surely not a carpet testing of the Czech population that obeys some WHO conditions. So we should continue to see several or tens of tests a day which we can do easily.

Senior doctor, I am happy you talked to us and lent us your expertise.

Thanks for having me.

Dear listeners, that's it for today. But you know that the Free Universum website has all the previously broadcast episodes. Have a nice life and do something for it because no one else will do it for you. Your Ms Kociánová and a man behind the scenes.

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