Minister of health on whether we are facing the sixth wave, the fourth dose of the vaccine and those responsible for excess deaths [INTERVIEW]

– You can always do better. If someone says no, pride speaks for him. So I will not say that our actions have always been perfect and all of them were on time, and whether there were some delays – assesses the current fight against the pandemic, Dr. Adam Niedzielski, the Minister of Health. In an interview for MedTvoiLokony, he also talks about preparations for the sixth wave of the COVID-19 pandemic, whether Poles will be able to take the fourth dose of the vaccine, and how low health awareness of Poles translated into pandemic deaths.

1. Are we facing the sixth wave of the pandemic? – The forecasts do not show a greater acceleration of the pandemic so far, but of course we cannot rely on them 100%, as the past waves have shown us. Regardless of the forecasts, we are preparing for the worst – says the Minister of Health and indicates when the sixth wave may come
2. One of the reasons for the huge number of excess deaths, Adam Niedzielski points to the lack of patterns in society relating to healthy eating, physical activity, participation in screening programs or the use of preventive examinations.
3. – The anti-vaccine environment has chosen me as a target – I receive threats and threats all the time, some pass public sentences – says Niedzielski, commenting on the role of fake news and anti-vaccination movements in the Poles’ approach to the pandemic
4. More information can be found on the Onet homepage

Anna Zimny-Zając, editor-in-chief of Medonet: Minister, in a few weeks it will be two years since you became the Minister of Health. When we talked shortly after that, you said that “you aged ten years, sleeps little and still sits at work”, and the work of the minister of health is – I quote: “blood, sweat and tears, not profits”. I’m curious how you see your work today.

Dr. Adam Niedzielski, Minister of Health: This is a very interesting buckle, because I can say that basically everything has been confirmed. These two years were a really extreme effort. Two years of the hardest work in my life. It can be said that there are really profits, and God forbid, about the finances, the lack. No matter what we did, there were always contestants and there was always some kind of outrage. Yes, there were also a lot of votes of support, which gave a certain feeling of a well-done task. However, these two years are learning that, unfortunately, you cannot count on the fact that there are solutions that will be universally accepted.

Moreover, often these good solutions in such an objective sense – I am talking about analyzing their advantages and disadvantages – are contested due to the different, rarely objective, interests of communities which they do not like.

The last example is the act on the restructuring and modernization of hospitals, which is extremely necessary, not for the minister, but for patients. The pandemic confirmed that hospitality requires greater coordination and consistency in action, complementarity, and not empty competition for staff. Responsible politics is about making difficult decisions and, unfortunately, this is also the burden of being in this office. According to the proverb “every good deed will be punished with an example”.

Health Minister on Fighting the Pandemic: Not everyone has received the level of care they should

Exactly – a pandemic. It will soon be two and a half years after its announcement. How do you assess the activities of the Ministry of Health at that time? Has the task been successfully completed?

I will not judge my work myself. The Ministry of Health was primarily responsible for the logistical and organizational aspects of the health care system during this period. And this organization meant managing, among others the availability of beds, the creation of new temporary hospitals and their equipment. We managed the system’s efficiency on an ongoing basis.

And from this point of view – I will certainly say it – we have done a good job, often in contrast to other countries. And I am not talking only about the first reports from Lombardy in Italy, but about what happened in Bulgaria, Romania and other countries in our region. We had no beds available for patients. We had no choice of who to connect to the respirator. We did not run out of oxygen. Yes, not everyone can get the care they should, but they do.

The rest of the article is available under the video.

At one point, we had a problem with the emergency medical services when ambulances were actually waiting in the ramps. Please note, however, that in subsequent waves this phenomenon practically did not occur, because we contracted new emergency medical teams, we monitored the arrival time of ambulances, their current availability and the reasons for unavailability. Together with voivodes, we sealed this system. We also analyzed the causes responsible for the deaths in parallel.

It turned out that too late reporting to hospitals or too late call to the emergency services is a big problem. People waited until the last moment, often healing themselves – because they did not heal – with oxygen concentrators. Clinicians alarmed that they see patients who are already in such a condition that it is very difficult to help them. That’s why we introduced PulsoCare as an answer. It was supposed to monitor patients who were unable to catch the moment when they should report to the hospital. We had over 6 in this program. ambulance departures – these are people whose lives were saved by this program, because it was thanks to him that this intervention appeared in a timely manner.

It should be emphasized that in terms of hospital equipment before the pandemic, the average age of ventilators was over 10 years. At the moment, we have hospitals equipped with the latest equipment. It was an activity on a huge scale and billions of zlotys were allocated for it. A qualitative change has also taken place in this respect.

It is a pity that this change was covered by the scandal with respirators, which were purchased by the previous health minister Łukasz Szumowski. Not only that, for a lot of money, they have never reached Polish hospitals yet. Let us return to the topic, however, because you have taken the position that was just vacated by Minister Szumowski.

Shopping in a pandemic, especially at its beginning, was fraught with risk and every country, not only Poland, had to take this risk into account. Today, mistakes are often mentioned by people who have not made any serious decisions in their lives. In a sea of ​​our purchases, the case you mentioned is a minor element. Besides, we have already recovered most of the money. So, taking into account the logistic and organizational aspect, I think that here on the side of the Ministry of Health team, a good job has just been done.

Health Minister on Excess Deaths: There is always something to be done better

I look at the death statistics. Poland was at the top of the ranking of excess deaths in European countries. In 2021, the largest number of people died in Poland since World War II – over 506. This is as much as 40 thousand. more than in the equally tragic year 2020, when over 477 thousand people left Poles, i.e. by 68 thousand more than in the pre-pandemic 2019. In my opinion, these statistics can hardly be considered a confirmation of a job well done.

You can always do better. If someone says no, pride speaks for him. So I cannot say that our actions have always been perfect and all of them were hit on time, or there were some delays. However, this problem of excess deaths needs to be structured. We analyzed it very carefully.

There are some things about excess deaths that are related to the health system’s ongoing response. Here we have to look at the logistics of activities and diagnostics of various diseases, not only COVID-19 itself. As part of these current tools, the limitation of diagnostics resulting from, inter alia, Due to the necessity to increase the potential of beds for patients with COVID-19, as it was unfortunately an urgent need, it influenced in a way this unpleasant statistic of deceased people. But they also influenced her, and it has to be said, lower propensity of people to use health services and limited accessibility at the level of primary health care and outweighing visits to teleportationwhich at some point we had to start fighting. If we are looking for any reasons, it will primarily be this type of limitation in diagnostics and a certain limitation of availability.

In addition to these current tools, there really is a much broader question to ask yourself. Have we lacked strategic health resilience to the impact of a pandemic at the public health level? Have the tools for building social health, which no one has tried to develop until recently, failed?

The Prevention 40 Plus program shows that the level of health awareness in Poland is extremely low

And what will be the answer to them?

We conducted a country-by-country analysis to see if there was anything that made us different from others that could have resulted in relatively more surplus deaths. We looked for relationships between different public health characteristics in different countries. It turned out that the phenomenon of excess deaths is not related to the number of doctors or the number of hospital beds, but to the health awareness of the society, which is still low in Poland.

The parameters we checked were, among others influenza vaccination among people over 65 years of age or the level of obesity in a given society – those elements that reflect health awareness and the approach to prevention.

Does this mean that we can say that the statistical 70-year-old from Poland is less healthy than the 70-year-old in Germany or Italy?

Absolutely yes. And it turns out that his level of health and health awareness, i.e. the extent to which he uses diagnostics and various preventive programs, determines his chances of surviving a collision with an epidemic.

These are the elements that we could not react to on a regular basis, which we were unable to overcome. On the one hand, we can see our negligence, on the other hand, we have a lack of patterns in society relating to healthy eating, physical activity, participation in screening programs or the use of preventive examinations.

These are the things they are about we should realistically take at least five years before a pandemic to prepare for a crisis. In our country, however, no one has acted preventively in this field for over 20 years. We have already started implementing changes. Next school year, we are launching a health education program for grades 1-3. Last year, we implemented the Prophylaxis 40 Plus program, which allows you to get tested for free, without a referral, in any facility. Additionally, we have lifted the limits for specialists.

However, does this program really bring the intended effects? Analyzing the results of the Polish National Health Test 2022, the largest health survey on the Polish Internet, which is carried out each year by Medonet, we do not see a significant increase in the percentage of surveyed people in the group over 40 compared to other age groups.

Paradoxically, this program shows that the level of health awareness in Poland is extremely low. When the Prevention 40 Plus program was launched, we defined the minimum criteria for its success. We decided that it should be a minimum of 2 million people surveyed. In the program, you must first complete a questionnaire and then perform the research. At the moment, we have 1,1 million questionnaires filled, while only 600 thousand of the surveyed. people. It means that we are roughly 3,5 times below the success criterion. And of course this is a reflection of the lack of interest in health, which is surprising especially in the post-pandemic period.

We hope that the new solutions to make this program more attractive will bring the desired effect. The survey conducted by us indicated, inter alia, that GPs were not involved enough in the process. That is why we have prepared solutions that encourage doctors to participate in the program and convince patients to take part in the research. What’s more, in September or October, there will be a lottery for those who took part in the survey, i.e. not only completed the survey, but also tested. The prizes will be sports cards providing access to sports facilities throughout the country.

And how important were fake news and the anti-vaccine movement in the pandemic?

Certainly, some of the responsibility – and this must be said – for the excess deaths is borne by all those who urged not to vaccinate. Undeniably, the risk of severe COVID-19 transition and death in the vaccinated person was significantly lower. Our analyzes showed that the risk of death of an unvaccinated person was 10 times greater than that of a person who received all doses of the vaccine.

The analysis of the results of the National Health Test of Poles from 2021 and 2022 shows that the percentage of opponents of vaccination has not decreased from year to year, but has even increased by as much as 7 pp.

This basically confirms that manipulation is not referring to the facts and objective research that is behind all vaccinations.

I want everyone to know that more than 12 billion doses of the COVID-19 vaccine have been administered worldwide, which means at least several billion people vaccinated. So this is not an experiment as some have tried to convince. These billions of vaccinations show the falsehood of allegations of delayed adverse effects of vaccines.

Please note that this manipulative narrative is constantly changing. At first we heard that it is not known what will happen a few months after vaccination, then – a year after vaccination. When that time had elapsed, voices appeared that it is unknown what will happen in 10 years. It is hard to argue with such arguments, because it is a matter of faith, not knowledge. The pandemic has shown that the susceptibility to manipulation is by no means low, which means that education in every dimension is necessary.

By the way, I would like to thank you, because you have also put a little effort into denying the various stupidities that appear. Only the scale of this phenomenon is, unfortunately, so large that it cannot be fully dealt with – in the sense of answering every post, every article, every saying untruth.

Thank you, we are constantly trying to fight fake news.

The level of evil caused by fake news, manipulations, and hate in the context of the health of Poles and the fight against COVID-19, is simply terrifying.

It resulted in many problems in my life, not only in my business life. The anti-vaccine community has targeted me – I receive threats and threats all the time, and some pass public sentences.

And did we make good use of the periods of summer pandemic calm that we observed in Poland in the previous two years, followed by subsequent epidemic waves?

Logistically, we were prepared for the next waves. We expanded the bed base, built temporary hospitals, unblocked oxygen supplies, expanded the medical rescue teams, made purchases of drugs and equipment, and stocked up supplies at the Government Strategic Reserves Agency. Looking holistically, you could probably have done more, but everything was logistically and organisationally prepared.

During the third wave, there were accusations that the restrictions were introduced too late. However, this was due to the fact that, from wave to wave, we observed that introducing the same restrictions had a much smaller effect than at the beginning of the pandemic. With us, the level of contestation grew like nowhere. It is impossible to put a policeman at all times to obey all the restrictions. If we do not have such a tendency ourselves, if there is no social discipline, the results of introducing restrictions are smaller. This differentiates our population from many other countries where this pandemic discipline was much larger.

In the previous summer months, there were also statements from politicians who, instead of encouraging caution or vaccination when these were already available, “canceled” the pandemic, saying that it was in retreat and there was nothing to fear. This year, fortunately, the rhetoric has changed and Prime Minister Morawiecki has already announced that as soon as such an opportunity arises, he will take the fourth dose of the vaccine. So when will this fourth dose be available?

In April this year, we have already conducted another study on a representative group to check the level of antibodies. It turned out that currently as much as 91 percent. people have antibodies. So this is also a parameter that shows that we are not dealing with a dynamic drop in immunity, which is of course comforting. And the fourth dose will be available as clinical trials are available for it and will be the decision of the European Medicines Agency.

However, it is not yet possible to determine the concentration of neutralizing antibodies that protect against COVID-19 or SARS-CoV-2 infection?

Regardless of these studies, we have our representatives in the EMA and we follow the market all the time. If there is a decision by the Agency introducing the fourth dose, it will of course also be available in Poland.

Nor can there be consent for manufacturers to continue to offer a vaccine for the original version of the virus. There is a declaration that a vaccine targeting Omikron will be available in the fall, but the relevant proposals are not expected to reach the EMA until the end of August.

We do not want to invest in products that do not fit the current pandemic situation, both qualitatively and quantitatively.

The FDA has already approved the vaccination of children over six months old. and in the USA, vaccinations are just starting. Europe still has to wait for the EMA’s decision. But I understand that when the EMA approves the use of this vaccine, vaccination will also start in Poland?

Yes of course.

Health Minister: up to XNUMX infections a day in July

Mr. Minister, when will we have the sixth wave of the pandemic in Poland? Since we’re talking about the fourth dose and immunization of children, one thing is certain – the coronavirus and its subsequent new variants are still a serious problem.

Current forecasts say that in July the number of infections could increase, up to a thousand new cases a day. However, such numbers do not pose a threat to the efficiency of the healthcare system, and this is the criterion for introducing various scenarios. As for September or October, the forecasts do not show any major acceleration of the pandemic so far, but of course we cannot rely on them 100%, as the past waves have shown us. Anyway, regardless of the forecasts, we are preparing for the worst, which means that there may be a significant increase in infections in September and October. But according to our analysis, this increase in infections does not necessarily translate into an increased number of hospitalizations, so this is an unrealistic scenario for problems in the operation of the healthcare system.

Nevertheless, at the level of each voivodship, a specific action plan and locations are prepared for the reconstruction of temporary hospitals. The state administration has learned its lesson in crisis management and at this level we have already trained specific procedures and plans. So we are prepared. Also in terms of equipment and medication reserves or staff training.

We encourage you to listen to the latest episode of the RESET podcast. This time, we asked Orina Krajewska what, according to her, a holistic approach to health is. How to combine the three aspects: body, spirit and mind to enjoy balance and good health? You will hear about this and many other aspects of the topic in the latest episode of our podcast.