## Thursday, April 09, 2020 ... //

### Prague ex-mayor Bém would open the economy quickly

Prague ex-mayor Pavel Bém, a psychiatrist mainly dealing with addiction, the main political father of the huge Blanka tunnel, and a conquerer of Mount Everest is the only person in the world whom I know "mostly mutually" (well, we did chat for an hour in the Mozart Café in December) and who has been tested positive on Covid-19 – after he returned from Canada and insisted on his test. He has no symptoms.

Here is a 16-minute-long interview he gave to a radio station, Radio Z. Even if you don't understand Czech, I think that you must agree that the host, Ms Helena Šulcová, is much more polite and pleasant than the [beep beep] that you may typically see on [beep beep] such as the CNN.

Pavel Bém, ex-mayor of Prague, a psychiatrist and an an addictologist, is the guest of the Morning with Helena Šulcová. Mr Bém, we learned from the media that you were positively tested on Covid-19. Are you already healthy?

I don't know it yet [LOL, what a nice scientific answer: LM]. I assume that it is possible. But a test would have to confirm it and I will learn the results on Thursday [TRF today].

I see. But you're feeling fine, right?

I have been feeling fine from the beginning, I haven't had a single symptom of the Covid infection. So I don't even have any clinical tool to measure how the infection is evolving within me. So I belong among the lucky X percent – we don't know what the percentage is, I assume it is more likely to be a greater number than a smaller number – but those of us have no symptoms.

Everything will be totally OK, we hope. You are waiting for results of another test. You are spending time in a home quarantine, alone, is that right?

It is exactly right.

So it looks like if you returned from abroad, you wouldn't have gone to any test and you would do the same as 30% of the people, i.e. failed to notice anything.

I am not quite sure. One must appreciate that after all, I am a healthcare worker and I am encountering members of the target group that belongs among the endangered ones, people with chronic psychological problems, addicts, people with weakened immunity. My main reason to undergo the tests wasn't that I was returning from abroad, from Canada – which wasn't dramatically exploding in Covid at that time, it was on par with Czechia and probably better than Czechia. Of course, those are just numbers we know from the media. We will never learn when the epidemics or pandemics actually started because it can hide in the population for a long time and propagate.

But the main reason why I underwent the tests was that I believe that all healthcare workers, employees in social facilities, homes of seniors, and everybody who takes care of the endangered population and seniors should go through the test and become sure that they are not positive. So I did it simply not to pose a threat for my patients.

Mr Bém, can I read this comment as a hint of a criticism saying that this is not normally taking place? That all healthcare workers aren't being tested? There aren't a large enough number of tests? Are you criticizing the Czech government for failing to do that? Or am I reading incorrectly in between the lines?

Well, we have... Let me admit that I would be very unhappy to deliver some baron's advises. We are being confronted with a context that we don't really understand from the epidemiological viewpoint. But it is reality that if we look at the statistics, we see that the fatalities due to Covid-19 are primarily seniors and immunocompromised people. From the logic of the thing, you should immediately figure out that these are the groups that should be protected.

And who is in contact with them? Doctors, nurses, caring staff, and of course other social workers in the senior homes, Alzheimer centers. So this target group should have been tested in the first wave. And I think... and we did waste some time.

Sorry to interrupt you: Who is responsible for that?

Uhm, I don't know. It is a very complex question. Maybe the draconian character of the Czech policies has slowed down the beginning and it gave some extra time to the healthcare system to prepare, get some ventilators, open specialized sections of the hospitals, train the staff etc. It is always easy to look for culprits, a fact that I know very well from many situations during my departure from the top-tier politics. So I won't play the wise man here.

Not even a judge...

It is not that I would be afraid of criticizing anybody. But we were simply exposed to a very complex situation and we forgot about this point.

You are working with addictions. Are addicts, alcohol, cigarettes..., more vulnerable to the virus than others?

There's no doubt that they are more vulnerable than the healthy population. On top of that, those who are chronically ill i.e. fighting the disease for a long time, are also immunocompromised and more vulnerable [he used this very English word in a nicely Bohemized form] and if we add their age, aging users of the substances and our aging seniors with psychical problems are totally a group at risk.

Pavel Bém is still a guest of Radio Zet and you must keep on listening [and reading TRF] because we will continue by discussing the impacts of the coronavirus crisis on the economy of the Czech capital.

Music: Morning guest of Helena Šulcová.

Our guest is psychiatrist and addictologist, ex-mayor Pavel Bém. Mr Bém, you have been the mayor of Prague for many years. What will be the consequences of the coronavirus epidemics for the economy of the capital?

It will greatly depend on the events in coming weeks or months. If these draconian restrictive policies will be kept in place and the life in Prague won't return to the business-as-usual, the impact will be dramatic. Prague currently represents 25% of the Czech economy. It means that the small self-employed people (the OSVČs in the Czech jargon with acronyms) are the first people who are threatened, along with small businesses. But even medium-size companies will be affected at some moment. And after all, even the big corporations may face trouble. Those have the advantage of possessing thicker financial pillows and a higher economic flexibility, as opposed to the small businesses.

But the key to success is, if at least a little bit possible, to return the life in Prague and all greater Czech towns into the normal tracks or at least somewhat normal tracks. So that the economy...

OK, for the economy to start to work. But on the other hand, isn't it too early? For example, our Parliament will vote today about the extension of the state of emergency up to April 30th [it was extended, indeed]. The prime minister said, and so did others, that he estimates the return to normalcy in May or June if people will behave responsibly. Does this timing look wise, fast, slow, or dangerous for the economy of Prague?

No... My real question is What is the argument for it?

Argument to postpone the reopening to May or June?

Right. From the evolution of the pandemics it is self-evident that it will be with us in one week, two weeks, end of April, May. And in fact, what is worse is that the numbers will be dramatically higher. Every day, the number of cases will grow, because some of the tests will be positive, by 200 or 300 people. And these numbers are only this low because the testing capacities are limited by some 10,000 a day. If we were testing thrice as much, we would find thrice as many infections. With a high level of likelihood that borders with certainty, we won't see the peak of the pandemics in 2 weeks or 1 month. On the contrary, we will be in some early stages of a growth – maybe exponential, maybe just arithmetic growth. But the numbers will surely be worse than today. So the reasoning...

If I understand you well, as a physician whose opinion is relevant here, you would just abolish the restrictions now and you would let the virus to soak through the population, as even Dr Prymula, a top epidemiologist, is already saying these days. [Prymula mocked Dr Pirk's suggestions that we needed the herd immunity etc. and was a major lockdown advocate but in recent days, he is really joining Pirk.]

[LM: I used "soak" because I don't know the precise translation but the verb "promořit" – poison-it-through – is surely the hottest verb in the Czech language in the recent week. It sounds like "spread some poison among rats" but it really means to vaccinate the population by letting it undergo the disease, to "stain" the population with the infection. Update: Tavrik propose a simple translation of "promořit": to permeate a nation with the Wuhan flu. It almost looks like a cognate!]

Verbs like "soak" or "actively contaminate" the population may sound terrible. But we won't have another choice. If we look at the probabilities of possible future shapes of the epidemics curve, we of course don't know whether there will be one peak or two, whether there will be a sudden uptick or a sudden slowdown. And in the autumn, the second peak may emerge, those are just speculations. But from the viewpoint of numbers, if we realize that the number of people who are currently infected but unaware of it, is substantially higher than the number of discovered cases, it is very clear that despite the prevention, the epidemics keeps on spreading. You can't turn on the lights. It is likely that the Czech population, perhaps 70% but maybe just 40%, we don't know it, will be soaked with this virus within a year and a half.

And I am asking: Does it mean that for 1.5 years, we will be keeping the draconian restrictions? My answer is: It is simply not possible because the economic...

That is why people are already talking about some deadlines, about May and June. How many percent of businesses, let's talk about pubs which are easy to imagine, will be closed and never opened again?

Again, I will start my answer with a question. Is it possible to imagine that the pubs will reopen today and they will survive the fact that they have been closed for a month. They may even manage to withstand some temporary regime of preventive regulations that they will have to obey even after they reopen: people will clearly be more afraid to go to the pubs, the numbers of guests will drop.

And when they open in late May, how many...?

Wait a minute. It is possible to imagine that they open today and they will have a higher probability of survival than if they open at the end of May? The answer is surely Yes. So I would certainly reopen the businesses. But it's not just the restaurants. It is primarily about the self-employed people, small entrepreneurs. They simply have to restart the work. And then they have a chance to survive. If it won't take place and pubs are closed up to the end of May, the restart will be slow, of course. Suddenly we find ourselves in the autumn and they will be at some 40% of...

So you would reopen the pubs right now?

I would be loosening the restrictive regulations far more quickly and then I could think that the small business people will survive. If the pubs are closed up to the end of May, then I am convinced that 20 or 30 or 40 percent of small Prague entrepreneurs will lose their source of income and their businesses.

Will the capital be liberated from the short-term renting systems, e.g. the Airbnb platform which has had big profits from the renting?

Again, it depends on the timing when the tourism returns to Prague.

It may be a very long time.

I said that Prague is a 25% engine of the Czech economy. But let us realize that up to 40-50 of the income in Prague is linked to tourism in some way. The answer to your question is therefore clear: If and when the tourists return, Airbnb will work again. The same holds for the short-term renting in general. When the tourists won't return, the businesses will disappear.

But wouldn't it be nice if they disappeared? Because they were a big problem for lots of natives who live in downtown Prague or who would like to live there? Tourism has totally gotten out of control here, right? So if we look at it from the other side, cannot the coronavirus crisis be – and I must say that I could 100% survive without this crisis...

Hahaha.

...but cannot be the crisis be a benefit because it will liquidate this business which wasn't quite clear and transparent?

We will certainly learn lessons from the coronavirus crisis. We will learn to be grateful for everything we have, we will be smarter. Maybe we will take care of our health more than we previously did. And maybe we will learn an economic lesson or two, too.

But I don't think that this kind of social constructivism is... Well, yes, it's beautiful that you go to downtown Prague – only you can, I cannot, I am in the personal quarantine, but before that, I was truly enjoying the center of Prague. You go through the center, you meet no one, and it has a special, nostalgic atmosphere.

Exactly. The discussion doesn't depend on any fancy economics. The city simply lives out of tourism. It is one of the oldest and prettiest, culturally most attractive, cities of Europe and maybe in the world. It is logical that tourists will want to return here. It is really hard to defend the city against this desire. Should I think that the shortage of housing in Prague will be solved when Airbnb evaporates from Prague? No, I don't believe this thesis, either. At the end, the real estate is owned by somebody who thinks economically. And he will try – especially after this economic... I would say catastrophe – he will try to return to those profits or, how I should put it, money in circulation, in order to do economically well.

So I do think that the coronavirus is teaching us but I cannot imagine that it will dramatically change the economic thinking of the people. But you are right that the coronavirus infection and the regulations connected with it – which are atypical and we have never adopted them when a big flu pandemics arrived, even when they killed thousands of people a year. So the epidemics is teaching us various things, including the knowledge about the reaction of Europe and the world. And it is highly likely that the world will change.

The only question is whether the world will change for the better or for the worse.

Psychiatrist, addictologist, and ex-mayor Pavel Bém was our guest. Thank you for your visit. Good-bye.

The morning guest of Helena Šulcová, music.

"Herd immunity" really seems to be a near consensus of the Czech physicians by now – after all, the switch of Dr Prymula (formerly a hardcore lockdown defender) to this approach is quite a sign. Another interview was one with Dr Martin Balík, the boss of Anesthesiology, Resuscitation, and Intensive Units at the General Faculty Hospital. He also wants to "soak" the population in the virus as it is futile to resist it, says that it is flu for almost everybody, and politicians are abusing the virus. He expects the final results to be similar in countries with and without lockdowns. In fact, in the final minute, the doctor said he expects the countries that saw a rapid growth of the disease to return to the normalcy more quickly than the countries that were or are "flattening curves".

He is more afraid of the consequences for the economy and democracy. He also said that the Remdesivir which they used for the obese patient wasn't necessarily the reason why the patients got better. We shouldn't be waiting for any miraculous drug, while locked in the basement, he says. No drug will really change the qualitative fact about the existence of the virus. He also agrees that the young people have died because they got a huge viral dose.

I find it obvious that the current disagreements about the continued lockdowns are overwhelmingly between the true professionals such as the typical Czech doctors (and Czech doctors of theoretical physics) on one side, they want to restore the business-as-usual; and the politicians, journalists, and other people obsessed with fear and the manipulation of masses on the other side.

The lady talking to Bém was OK enough but this young guy, while a bit shy, was rather a typical Western SJW journalist. He insisted that the doctors had to wear astronaut-like suits despite the fact that he was just explained why it would threaten the patients, he insisted that the doctors had to criticize the government for most topics, he insisted that the doctors would be afraid of the future, which the doctor wasn't. It's annoying that all such discussions must be between a sensible and not so sensible person. Wouldn't it be more fun to have an interview involving two people both of whom are bright?

They have also discussed the journalists' distortion of a death of a patient below 50. It clearly had nothing to do with Covid, he had some lethal cardiovascular incidents. That is one side of the media manipulation, the physician pointed out. Another part of the similar manipulation is that they have numerous diabetes and other patients who are Covid-19 positive but completely asymptomatic and they're not being talked about in the media. So all the publication bias is in the direction of increasing the hysteria; the doctor also agreed that most of our 100 or so fatalities were just "with Covid but not due to Covid". Some of the diabetes patients are released from hospitals while Covid-19 positive and they will never be counted as "cured" because they will become "negative" when they are no longer monitored.

The doctor also mentioned some particular terror resulting from the special regulations. A female colleague had to pay a fine for jogging because her face mask wasn't kosher. A male colleague went to the river with kids but the cops forced him to take the boat out of the river and move it to another district. Our generation is rather sensitive to such measures, due to our experience with communism, he says and I agree.

Here is the 3-day-old interview with Roman Prymula, a top 2 Czech public health boss. The title says "We will open borders soon, we want to soak the population in the virus, and schools will be reopened with face masks". This former fan of lockdowns has adopted the "herd immunity" approach and his justification is that lockdowns would only make sense if we were waiting for an imminent vaccine or treatment breakthrough but it doesn't seem to be the case. Schoolkids could return to schools in middle May, with face masks. Prymula also says that Italy is near herd immunity, as I said, and he doesn't trust the new Chinese data because the imported cases should grow even there as the disease grew in the world. But they don't grow. So even China has probably not eradicated the disease.