Dr. Grzesiowski: «I did not earn a single zloty for expert statements in the media. The kindness of people is more important »

«The pandemic in Poland and many Western countries has become a hostage of politics and propaganda. Never in modern history has medicine been so mired in the fumes of politics as it is now »- says Dr. Paweł Grzesiowski. In an interview with Medonet, an expert of the Supreme Medical Council on epidemic threats tells what the pandemic has changed in his professional and private life, how he fights against haters and what he has a grudge against politicians.

1. According to Dr. Grzesiowski, immunology and vaccinology (the field of medicine dealing with preventive vaccinations – ed.) Are going through their great times, but pediatrics also face great challenges. One of the reasons is that we have more and more evidence of complications of COVID-19 in children 
2. The doctor draws attention to the fact that many ruling decisions during the pandemic were made through the prism of short-term political benefits. “It was and is my repeated regret to the current authorities that some things are being swept under the rug, brave decisions are not made, because the temporary support of the voters is more important” – he says 
3. Dr. Grzesiowski also shared how frequent media coverage influenced his relations with his family and patients. “It is a gigantic change in my life” – admits the expert
4. You can find more such stories on the TvoiLokony home page

COVID-19 and medicine: “This is the opening of a new chapter”

Paulina Wójtowicz, MedTvoiLokony: Doctor, although the pandemic is still not in sight, after two and a half years of its duration, you can try to summarize it a little. There is a lot of talk about the general condition of medicine, but I am curious about what has changed in your daily fields: immunology and paediatrics.

Dr. Paweł Grzesiowski: Immunology is undergoing a huge development because COVID-19 has turned out to be a de facto immune disease. At the beginning of the pandemic, it was believed that SARS-CoV-2 was a respiratory virus, similar to the flu, because it directly affects the lungs. Today we know that the infection caused by the coronavirus is one huge immunological and inflammatory cascade. We have the activation of the non-specific immune system, the production of autoantibodies in various tissues of the body, their subsequent destruction at various levels, and there is also damage to the vascular endothelium, which causes disseminated clotting.

Recognizing COVID-19 as an inflammatory thrombotic disease has led to a completely different approach to therapy. A change was, for example, the use of steroids and anticoagulants in the acute phase of infection, which are not routinely used in other viral infections. It turned out that when there is an excessive inflammatory reaction, it is necessary to resort to extraordinary measures. Traditionally, steroids have been associated with immunosuppression, but at low doses, they induce immunomodulation that attenuates the inflammatory response and thus reduces damage following viral attack. This experience can be very useful in the treatment of other infections.

Radical changes are also taking place in vaccinology.

COVID-19 has turned vaccine production technology upside down. For the first time on such a large scale, two technologies that have been tested in clinical trials for years: mRNA and DNA vaccines. Of course, the very idea of ​​fighting a pandemic with vaccines is not new, but the methods that have been used are absolutely revolutionary.

This is the opening of a new chapter in vaccinology that will not be over for long as we will soon have more vaccines based on mRNA technology. There is already talk of new vaccines against many infectious diseases, as well as the entry of this technology into the treatment of non-infectious diseases, such as Alzheimer’s disease or some neoplastic diseases. So it appears that the pandemic, itself a tragic phenomenon, has opened up new avenues for technology development. And this is not the end, because we are waiting for second-generation, intranasal vaccines that will inhibit the transmission of the virus.

What is the situation in paediatrics? The issue of COVID-19 in children has gone a winding path: from downplaying infections, through successive waves of mass illness and short-term effects of infection in the form of inflammatory syndrome in children (PIMS), to long-term complications, i.e. long covid or hepatitis, increasingly associated with coronavirus, unknown etiology.

Initially, pediatrics appeared to be an area spared by COVID-19. Today we know that the virus attacks small patients to the same extent as adults. We have gone from wishful thinking that children are safe to believe about the enormous risk that SARS-CoV-2 infection poses to pediatric patients.

Two directions have been noticeable in this area over the past two years. The first, the initial one, indicated that children suffer from COVID-19 rarely and slightly. They are rather carriers of the virus, because the infection passes mainly asymptomatically, so the harmfulness of SARS-CoV-2 in children was simply underestimated. Unfortunately, as the virus mutated and new variants emerged, most notably Alpha and then Delta, we began to see the direct effects of COVID-19 in children. There were cases of severe infection, pneumonia, thrombosis and many serious complications.

What kind?

The easiest to grasp is PIMS, or autoimmune vasculitis that develops within three months of even mild COVID-19. Other serious autoimmune problems include diabetes, which develops around a similar time after recovery.

Another problem is fulminant hepatitis, but there is still no evidence of a link to COVID-19 here. For now, we know that many of these children had a history of SARS-CoV-2 infection in the last months before falling ill. It may not be a direct viral attack on the liver, but some sensitization of the immune system, but it seems the coronavirus is involved in this disease. She for 5 percent. children end with a liver transplant, and for 2 percent. death, so it is a dramatically serious condition that threatens health and even life.

In older children, complications are diagnosed just as often?

Yes, and unfortunately they get sick like adults. I consulted kids who were physically active before the infection, played sports, and after COVID-19 were unable to function due to long covid syndrome, they had to radically change their lifestyle. It has a terrible effect on the psyche of these children. They fall into a downward spiral of depression, stop studying well, have trouble sleeping and learning. They are mutilated and require many months of multi-directional rehabilitation.

“I do my best to be as far away from politics as possible”

This, as we know, is not a priority for the government. As an expert of the Supreme Medical Council on epidemic threats, you have probably learned more than once what is really important for politicians during a pandemic.

I do my best to be as far away from politics as possible, because it is so badly viewed by society that any connection with it translates into a loss of credibility immediately. Unfortunately, keeping your distance is not always possible. The best example of this is the story of the end of my cooperation with the Medical Center of Postgraduate Education or the GIS complaint to the Supreme Medical Council. These were situations involving me in political disputes under the pretext of criticizing the authorities or undermining their credibility.

I have never personally criticized any government representative, but commented on their actions, paying attention to those that, in my opinion, were insufficient or wrong. I have also heard comments many times that since I criticize the government, I am on the side of the opposition. This is complete nonsense. I am not criticizing political parties, but their wrong decisions. Let me remind you that during the swine flu pandemic, I had to leave the National Medicines Institute, in a dispute with the then Minister of Health, Ewa Kopacz – and it was about a recommendation to buy the H1N1 flu vaccine for risk groups.

How do you view the government’s fight against the pandemic today?

The pandemic in Poland and many Western countries has become a hostage of politics and propaganda. Never in modern history has medicine been so mired in politics as it is now. Many representatives of the power of the world’s greatest powers have played down the virus and the pandemic. Then, through disinformation, they tried to cover up the dramatic effects of their delayed decisions. Healthcare is an important area in the fight for voter sympathy, and COVID-19 has only compounded this. The fight against the pandemic has intellectually surpassed many politicians, it has caused serious damage to the health of the society.

In Poland, we have one of the highest rates of excess deaths during a pandemic in Europe, which is why today it is an element of the political game on both sides of the political scene. The effect is that many politicians, although they are aware of the threats, are unable to break through with projects or decisions because they are not politically beneficial. In addition, there were anti-tycovid “extremists”, anti-vaccine representatives, whose representatives in the parliament cynically use the difficult situation to gain political gains.

It was and is my repeated regret to the present political class that important decisions are postponed and that preventive measures are not taken early enough, because voters’ support is more important. It is terrible that having specific solutions in hand and knowing that they will work, they are not used because someone is afraid of social protests, and at the same time, in the middle of a pandemic, the abortion law changes, which leads to mass demonstrations. It is sad that a threat as serious as a pandemic ends in such serious negative consequences, among other things, due to many ideas and decisions being drowned in a political quagmire.

“I have become a pandemic rapporteur”

You have been very active in the public sphere and in the media since the beginning of the pandemic. This is not new to you, but for ordinary Poles the term “expert” has gained your face during the pandemic.

I have been present in the media for over 20 years, I have participated in many information and educational programs. My previous contacts with the media concerned mainly the widely understood dissemination of knowledge about health and diseases. Yes, there have been occasions of commenting on current affairs, for example during the Ebola or swine flu epidemics, but on a much smaller scale.

During a pandemic, my role is completely different. I have become a commentator and translator of current events, a bit like a war reporter describing what is happening on the battlefield. Especially in the first months of the pandemic, when there were several competent “covidologists”. And this is a gigantic change in my life.

My relatives say that in the last two years I have become a pandemic rapporteur, i.e. a man who keeps up to date with epidemiological data and scientific reports, comments on what is happening, describes and explains the process of developing a pandemic during its course. This is a completely new role, because an expert usually speaks post factum, based on an extensive data analysis.

The pandemic meant that, in addition to the role of a classic expert who reads a lot and draws conclusions from medical literature, I had to find myself in the role of an intermediary between the complicated world of viruses, immunology, epidemiology and ordinary people. And I think I have succeeded, judging by the conversations with many patients who emphasize that my statements are understandable. Because many experts forget themselves and use specialized jargon, which means that people without medical training do not understand anything.

Certainly, commenting on everyday life gave a new meaning to my work and meant that not having full knowledge, because there was no place to get it, I had to use my own experiences and knowledge obtained in unofficial circulation, i.e. in social media. And in the pandemic, there was one more task, especially important in the media – predicting the future.

People want to know what awaits us, especially in the context of the development of a pandemic. The question is whether such forecasts make sense.

Predicting the future is very risky, because any mistake means loss of credibility. But in this pandemic, we have all been wrong many times, because the virus has surprised humanity from the very beginning with its many features, and above all its genetic variability.

A very large part of my activity is collaborating with fantastic activists, volunteers who pro bono deal with the monitoring of epidemiological data, their mathematical analysis, imaging and forecasting. This is a Polish phenomenon, because without these analyzes, having only government statistics at our disposal, we would not be able to assess the situation and report to people what is happening. In this regard, the Internet and social media have enabled the free flow of information and cooperation between specialists in various fields.

In my opinion, we can describe several scenarios and prepare appropriate forces and resources for each of them. Short-term forecasts of two or three months are possible, but it is impossible to predict what will happen in five years, for example. Therefore, the pandemic crisis is a challenge for all mankind, as most forecasts have a low degree of reliability.

For example, due to the enormous dynamics of the virus change, the population resistance that many of us hoped to stop transmission of the virus does not work in the case of COVID-19. For now, the virus mutates too quickly, but the rate of mutation will slow down someday and it will be the beginning of the end of the pandemic.

So far, it is possible to get sick several times, and so do vaccinated people. And here is the huge role of the experts who should admit publicly that many of the initial concepts turned out to be wrong. This volatility must be repeatedly reminded so that people are aware that what we say today may be partially out of date tomorrow. After all, the end of the pandemic has been announced several times, “miracle” drugs have been advertised or the effectiveness of masks has been questioned.

I regret the fact that many experts and politicians do not understand this, that in science and medicine, public withdrawal from a false hypothesis not only does not reduce credibility, but builds authority and trust. Many times in the last two years I have had to answer a question asked by a journalist or a patient “I don’t know”. It is required by respect for the recipients, because it is irresponsible to make guesses in the absence of data. Many people who spoke publicly about the pandemic did not know how to approach the phenomenon as a new threat, but tried to confine it to the framework they know from the history of other diseases.

How did this attitude affect your relationship with patients?

The effect of my actions was such that patients began to declare that by listening to my statements, they knew what was happening and what they should do. To this day, I receive many expressions of gratitude. I have great satisfaction hearing from strangers that during the pandemic I was one of the few experts who commented on reality in a rational, repetitive way, and they based their decisions on what I said. It is sometimes an overwhelming responsibility because you have to be careful with every word.

Today the media already has a longer list of people to turn to for their opinion, so my activity in the general media has declined significantly, but I still conduct weekly webinars for professionals. Every Friday from 19 over 600 people participate in them on an ongoing basis, and this has been the case since March 2020. This is the best proof that the topic of the pandemic is not “aging”.

“I know you, from television”

It happens that patients accost you in the street?

Yes, it is not common, but it most often happens outside of Warsaw, where I live and work. Strangers, usually older people, come to the store or train station and say hello. Recently I was in Inowrocław, a man approached me at a wine stand in a supermarket: “Good morning, doctor”. This is the first time I see a man. I think: “Maybe he is a medic?”, But I ask: “Do we know each other?”. «I know you, from television, thank you for taking care of us. And if you are looking for a good red, on the top shelf on the left, good quality and price, I recommend ». And this is the delightful moment when I feel the kindness of people. It gives you wings.

I travel a lot by public transport, it happens constantly in trains that my fellow passengers recognize me, approach me and ask if I would like to talk for a while. And then they ask questions, talk about their doubts, often share dramatic experiences, including the deaths of loved ones due to COVID-19, they regret the fact that the approach to the pandemic in Poland is so reckless.

They ask for a diagnosis?

Very often, but not necessarily on the train or on the street. Every day I consult various ailments, apart from the activities in the clinic. The highest proof of trust are journalists and employees of television crews who consult their families. They can see me up close, in front of the aerial, without makeup.

Besides, my business phone number is not restricted, so all kinds of people call me, including those from the front pages of newspapers, prominent politicians, the so-called VIPs. Believe me, everyone suffered from COVID-19: from presidents and prime ministers, through famous actors, to athletes and entrepreneurs. And everyone has questions, doubts, many, unfortunately, also have significant health problems, because long covid affects people regardless of their financial status.

Haters? «These people get banned and that’s it. We block the account and goodbye »

Speaking of recognition, I have to ask what is the pain of many public figures, i.e. hate. In one of the interviews, you said that since 2007, you have been a constant target of anti-vaccine aggression and therefore you are quite resistant to their actions. Has this immunity remained high during the pandemic?

I have been working in this «industry» for over 30 years. Not like many colleagues who only appeared in the pandemic as public experts and met for the first time with hate. I have been “communing” with him for at least 15 years. Since the first anti-vaccination movements were established in Poland, I am in constant conflict with these people. I even won a criminal libel lawsuit. Anti-vaccines know that I am an “ungrateful” target because I can defend myself using the legal mechanisms at my disposal. I think this also meant that their enthusiasm for me during the pandemic was not as strong as for other “new” experts.

The second thing is the ability to deal with anti-vaccines and haters. I do not engage in polemics with these people at all. Many of my colleagues tried to somehow discuss, convince, talk. Only it doesn’t make any sense at all. These people get banned and that’s it. We block the account and goodbye. Anyway, many of these accounts are not even human, but bots and internet trolls. And even if there are people on the other side, the discussion with them does not make sense anyway, because it does not take place on the substantive level, but on the emotional level.

It is, of course, very unpleasant when we read the worst invectives about ourselves, but on the other hand, responding to this offensive content initiates new ones. I already know that the more valuable my statement and the more accurate conclusions are, the more hate there will be. This should be ignored where possible to disable comments and remove from contact list. And if the border is crossed, for example, there are threats against me or my family, you have to report it to the police.

In the Internet world, it is completely different than in the office. I try to talk to each patient who comes to the consultation, learn about their problems and fears. After an interview, sometimes research, many times I managed to reach with rational arguments and persuade them to change their mind.

People who do not believe in pandemic and vaccines often accuse experts of fueling worrying news because they make a fortune talking about the pandemic.

I did not earn a single zloty for my expert statements in the media. More important than money is the kindness of people. Many people think that we are paid for speaking or airtime, or that we are paid by pharmaceutical companies. Well, all my media activities, like conducting education on the Internet, are pro bono. Many people find it hard to believe, they would prefer to hear that this is a commercial activity, because it would be a catch: oh please, he cares about a pandemic, because he has money from it. Unfortunately, such an objection is completely unsuccessful. I also didn’t take a single zloty of the covid supplement.

Another thing is that our “cooperation” with the media also has its “lows” and “lows”. Today, despite the fact that another wave of infections is taking place, the media less often invite us, experts, to comment on the current situation, because the society is already overloaded with information, other topics “covered” the pandemic. I do not think this is right because it gives the impression that the pandemic is no longer the problem. However, neither the war in Ukraine, nor galloping inflation or the cancellation of the epidemic by the minister of health will change the fact that it is otherwise. It is a pity that the media is following this path, even if they feel that the virus is “bored” to people and information about COVID-19 is not as important to them as it used to be. Educational mission is a very important aspect of a doctor’s work, and the media enable mass influence.

However, frequent presence in the media as an expert has certainly positively influenced the recognition and reach of your content. Due to the pandemic, have you been and are you more often invited to take part in commercial projects?

Before the pandemic, I was a consultant in hospitals and an active lecturer. I have carried out research projects as well as 100-150 lectures and training sessions each year on a wide range of topics including infection prevention. Initially, the pandemic caused a significant decline in this activity, with hundreds of conferences and lectures canceled in the first year, which were then delayed online.

My media recognition helped a lot and helps me reach the participants of the training, who often, curious about me, ensure a high attendance. But if I were to “star” instead of giving a substantive contribution to the training, I would quickly find adequate comments in chat and open discussion forums.

Undoubtedly, for the last two years I have had more invitations to trainings on COVID-19, but this is a difficult moment in my professional career, because I would not like to be an expert on this one disease for the rest of my life. Therefore, on the one hand, I am involved in current covid projects, but on the other, I am trying to return to my “normal” activities in the field of paediatrics, immunology and the prevention of infections and nosocomial infections.

“My private life has completely changed”

Being a public figure has a great influence on private life. How do your relatives perceive your activity in the media?

My private life changed completely during the pandemic. Due to the lockdown, I suddenly became a “homebody”, which was a positive surprise for my family, because before that I traveled a lot around the country, participating in trainings and conferences. However, there was also the other side of the coin: I began to lock myself in a room with a computer much more often. And not only in the room, because often when we were going somewhere together, we stopped because I had to set up the computer and give a few minutes’ comment.

My relatives accepted it quickly and they supported me very much. My younger son started helping me in a purely technical sense. He chose a good microphone for me, we bought a webcam together, he supported me during several screenings and filming for the internet. The most popular was the one for patients, where I compared the effectiveness of protection against COVID-19 with deodorant, a protective mask and a scarf.

The middle son made my tutorial video in which I showed how to use personal protective equipment for medical personnel. My eldest son works with me at the clinic and is organizing a COVID-19 vaccination point.

My wife, on the other hand, became a “co-expert” because lots of relatives and friends called her, knowing that I was busy, and asked about all sorts of things about the virus. The sons also brought questions from school – from classmates, their parents and teachers. Such a family educational mission.

My family certainly experienced the pandemic differently than many other families in Poland. On the one hand, they had up-to-date first-hand information, but on the other hand, they had to deal with the virus every day, because I often took swabs from patients who came to our house. Family and friends support me all the time, understanding the need to share my time and being with me with others. If they had not accepted the fact that the pandemic is not something that can be ignored, and that I cannot not be in it, then it would not be possible.

We encourage you to listen to the latest episode of the RESET podcast. This time Joanna Kozłowska, author of the book High Sensitivity. A Guide for Those Who Feel Too Much »says that high sensitivity is not a disease or dysfunction – it’s just a set of characteristics that affect the way you perceive and perceive the world. What are the genetics of WWO? What are the perks of being highly sensitive? How to act with your high sensitivity? You will find out by listening to the latest episode of our podcast.