## Saturday, April 11, 2020

### Most Czech physicians consider permeation desirable and/or unavoidable

The fake news media have acquired so much influence – and the ordinary people have become so incredibly gullible and robbed of the last traces of critical thinking – that the talking heads are able to confuse a large portion of the Westerners – and perhaps a majority – and make them believe that the laymen's irrational and unscientific superstitions are the solid science and vice versa.

So the inkspillers have persuaded millions that the scientists believe that there is a big problem with quantum mechanics or string theory or a fatal threat posed by climate change. In the context of the coronavirus hysteria, the media have misled millions into believing that the medical experts believe that "Covid-19 is on par with the Martian invasion, not with flu", and that "the lockdown is a must". The reality is pretty much the other way around. The more you know about medicine and biology, the more you realize that Covid-19 is similar enough to flu, and should be thought of (and fought against) as some cousin or variation of flu, and the more you agree with the observation that the society has overreacted and the shutdown of the society is absolutely unjustifiable by this infectious disease i.e. the more you agree that the cure has been worse than the disease.

In recent days, the Czech media have brought us numerous interviews with physicians. I mentioned three of them on Thursday: Roman Prymula, the top Czech public health official; Pavel Bém, Prague's ex-mayor and psychiatrist focusing on addiction; Martin Balík, the boss of ICUs and resuscitation at a large Prague hospital.

All of them agree with me that the disease isn't qualitatively different from flu and doesn't justify the draconian measures.

In fact, one of the most prominent Czech psychiatrists, Cyril Höschl, has agreed with all these things but added some more special points that you have heard from your humble correspondent: This fear+enemy+strong_leader is how dictatorships usually arise. And many people seem to applaud all the restrictions because they are jealous losers who have never gotten the money, success, language skills, or perhaps the skiing skills to go skiing in the Dolomites. So they are happy to join the herd screaming "that's great, let us prevent the rich from making such holidays, let us make them sit on their aßes as we were sitting throughout our šitty lives". Exactly, the restrictions and some people's welcoming attitudes to these restrictions represent a revived model of the communism of the 1970s par excellence.

Very similar comments were also made by Dr Karel Drbal, an immunologist. This man, a big fan of Anders Tegnell who is directing the Swedish algorithm to deal with the virus, also believes that 25% of Czechs (5 week-long periods times 5% average positive rate on tests) have already gone through Covid-19. And pouring lukewarm salted waters through your nose into your mouth (two holes separately) may clean your nosapharynx and reduce your being sick.

Add Ms Václava Adámková, a microbiologist directing a portion of a big hospital, who has been shocked by the ongoing hysteria for more than a month.

Dr Jaromír Bernátek, a nuclear medicine expert, gave an interview as well. He can't imagine to be sweating in a face mask in the summer and his anti-lockdown opinions echo those of other doctors.

Czech VIPs' heart surgeon, Dr Jan Pirk – who impressed many by the plan for "all of us to undergo this minor disease" during a March 5th interview, didn't just talk the talk. He has also walked the walk. On March 7th, he and his daughter and grandkids went to Austria (a congress plus skiing) – this very trip would be considered politically incorrect by the Flat Curve Society – and all of them got Covid-19. The kids have had no symptoms, he had reduced appetite etc. but now he says to "feel great" after "the so-called deadly disease". Of course, it is a wonderful story in which his unimpressed attitude to the virus was confirmed by his and his family's real experience. But media still prefer the story about a pastor who randomly dies with Covid-19.

In fact, I have only heard about one exception, a visible enough Czech physician who opposes the permeation (selectively encouraged in the resilient part of the population, as I first explicitly recommended on March 13th). It is Milan Kubek, the director of the Chamber of Czech Physicians (ČLK). He repeated some of the PC and hysterical, CNN-style untrue clichés about the fatal impact of the loosening etc. However, such apparatchiks don't really control the discourse of the Czech medical professionals. Kubek immediately faced backlash. Mr Jan Zuna, a children's hematologist, immediately urged Kubek not to speak on behalf of all physicians. "I am not aware of an open discussion that has taken place among the Czech physicians. A very significant part of the physicians disagrees with your opinion." Zuna also contradicted Kubek's claim that the Czech healthcare system is in a poor condition. "Our healthcare is in a good shape, better than Italy's or Spain's", Zuna added.

"Faster, but not hasty, loosening of the current restrictions and the acceleration of the rate of the permeation through the population, and one that is primarily focusing on its dominant part that isn't more threatened by this disease than by other common respiratory diseases, is desirable and would be beneficial both from the medical viewpoint as well as the economic and societal viewpoints," Zuna argued.

"Please, let us realize that the economic devastation of the country could be catastrophic if the restrictions were too long and the 'flattening' were too strict, and let us not pretend that we are ready to pay the same price for other, more lethal diagnoses – it would be extraordinarily hypocritical to pretend so," the oncologist shouted.

Ladislav Dušek, the chief of the Medical Information and Statistics Institute (ÚZIS) has supported the permeation and related opinions, too. Immunologist Blanka Říhová agreed. She was initially terrified by the deliberate infection (of herself) but then she figured out it was a good idea.

Immunologist Ms Zuzana Bílková and infectious boss in a hospital Mr Pavel Němec in the Pardubice region are also pro-permeation and estimate the number of infected ones to be 10 times the known number. (It is important to distinguish, and they don't, the people who are currently infected or all people including the cured-and immune, the second group is already larger, I think.) Top epidemiologist in the prestigious IKEM Petr Smejkal says the same. An important epidemiologist Rastislav Maďar has been defending the same view since late March.

Every day costs billions of crowns, "we need the virus to permeate," says also Roman Šmucler, the president of the Chamber of Czech Dentists.

Some top politicians (according to statements, they include PM Babiš and the interior minister Hamáček) still oppose the "permeation" i.e. efforts to controllably achieve the herd immunity (healthcare minister Adam Vojtěch is basically pro-permeation by now). But it is becoming increasingly obvious that these politicians are the laymen who have simply been brainwashed and infected with irrational fear by the fake news media, conspiracy theorists around us, and their own fantasies. The dominance of the pro-permeation view in the Czech medical community seems obvious and I am an optimist. I believe that at the end, the Czech society does prefer to listen to apolitical professionals. I think that we will continue to gradually loosen the restrictions and by the summer, even the characteristically Czech face masks will be largely abandoned.

The alternative catchy phrase to compete with "permeation" is often named "smart quarantine" (chytrá karanténa) in Czechia. This plan assumes the continuation of the restrictive measures, an enhanced protection of the vulnerable ones, and tracing the movement of all people for epidemiological purposes, among other things. These IT-heavy measures (involving the calculation of likely contacts in recent 5 days) have been successful in South Korea and Singapore. I don't really have much against it and I have proposed it myself – but the Big Brother monitoring should be phased out as soon as the disease is mostly hacked.

Even when it comes to the "smart quarantine", i.e. non-permeation approaches to the virus, I feel that the discussion is much more rational and well-informed in Czechia than it is in almost all other Western countries where the dominant discourse still seems to be "mindless hysteria controlled by irrelevant factoids, cherry-picked and fake anecdotes, uncontrolled data, aconspiracy theories, and uncritical worshiping of the Flat Curve Society".

P.S.: On April 13th, a ministry-sponsored Covid-19 interdisciplinary working group of the Czech Society of Anaesthesiology and Intensive Medicine adopted a statement that the virus should be let permeate the nation ("reduction of the population's sensitivity to the virus") while vulnerable groups are selectively protected. I think that all 10 names signed in that document are new, not mentioned in the blog post above yet.