Prof. Piotr Kuna: Anyone who wants to survive a pandemic should take care of themselves. The state will not help you in anything

The fourth wave of the COVID-19 epidemic is peaking, with increasing pressure on sanitation and disclosure of unvaccinated people. As if that were not enough, a new coronavirus mutation has emerged. All of this causes many of us to become anxious or already panic. Do we have reasons for it, and if so, what actually threatens us, and what is just a “black people” created by the media or politicians? Once again, prof. dr hab. n. med. Piotr Kuna.

1. Everyone has an unlimited opportunity to get the free vaccine, so treatment is available. However, whether we decide on them should be our conscious choice, not compulsion – says prof. Marten
2. The expert also points out that the vaccine is the only protection we have against the coronavirus
3. Prof. Kuna is of the opinion that the pandemic left a great mark on the health of Poles. – A lot of people die who have not had contact with the coronavirus and this is the biggest problem. There are huge shortcomings in health protection, he says
4. You can find more such stories on the TvoiLokony home page

Monika Zieleniewska, MedTvoiLokony: You receive a lot of e-mails after each interview regarding the coronavirus pandemic. What issues do Poles most often raise?

Prof. dr hab. n. med. Piotr There: A large group are people who are afraid of vaccinations and are looking for a place where they would be vaccinated in a safe way, where they would feel cared for. Let’s be honest that getting vaccinated on a bus or drive through does not guarantee a sense of security. Patients who have been infected with the coronavirus and their families are also writing. Their correspondence reveals the subject of various organizational shortcomings of healthcare, the lack of empathy and supervision over the sick.

The sick feel left on their own?

Some people perceive it that way. And yet a patient with COVID-19 must be constantly monitored in order to adjust the treatment to his state of health on an ongoing basis.

Maybe if the degree of vaccination was higher in our country and the health care system was less burdened, the problem would not exist?

Everyone has an unlimited opportunity to get the free vaccine, so treatment is available. However, whether we choose them should be our conscious choice, not a compulsion. Nobody imposes treatment on people who abuse alcohol or smoke cigarettes, although we all know that both addictions are harmful.

Sooner or later, everyone will encounter the SARS-CoV-2 virus and this is not a revealed truth, but a fact. The only protection against the coronavirus is vaccination. Only.

However, as a doctor, I am aware that the principles of good clinical practice do not allow intervention in people who do not consent to it. The right to be treated is a right, not an obligation. Treatment against the patient’s will is unethical and immoral. We hear voices that those who do not vaccinate harm the vaccinated, and I say that they harm themselves first and foremost.

The rest of the article under the video.

So do you think that you cannot force vaccination by, for example, a special law?

Such a law will be unconstitutional. The patient must always consent to treatment, it is his / her fundamental right. No doctor is allowed to force a sick person into treatment or undergoing medical procedures. There is no point in forcing people to vaccinate.

And it also applies to healthcare professionals – doctors, nurses?

Those who get vaccinated have nothing to fear.

So what about the demand to limit access to public space for the unvaccinated? There are universities in Poland, including medical ones, which admit only people with a covid passport.

It is primarily an expression of care for unvaccinated people. It is not that the vaccinated should be afraid of them, the opposite is true. The vaccine does not protect against infection, it only protects against severe disease, so the unvaccinated who becomes infected may die. On the other hand, the likelihood of the vaccinated person dying is very remote. We need to reverse this problem, understand that by implementing prohibitions and restrictions for unvaccinated people, we do it with them in mind, with their protection in mind.

But the vaccinated can also get sick, recently it has finally been officially admitted.

Things were said that did not come true afterwards, it was a mistake. We thought the coronavirus would be like Heine-Medin disease. We get vaccinated and the disease will go away. Meanwhile, it is just like the flu, because the SARS-CoV-2 virus that causes the COVD-19 disease is a respiratory virus, and we know that these types of viruses mutate very often and we have a new variant of the flu vaccine every year. Another issue – influenza vaccination does not protect against infection 100%, but it protects against its severe course and death, and the point is that people do not die. However, medicine does not have any tools to eliminate viruses that cause respiratory infections. They were, are and will be. Nothing will change here, so you have to approach the problem pragmatically, and don’t panic.

So come to terms with the fact that you will have to get vaccinated at least once a year?

We do not know how often it will be necessary to vaccinate, but all indications are that, as in the case of influenza, not only systematic vaccination will be required, but also systematic modification of the vaccine, adapting it to new variants appearing in the world.

So the voices that the unvaccinated pose a threat to society are spreading panic?

I am a doctor, I am vaccinated, I work with patients and I am not afraid to treat those who are infected. Any sensible doctor who is vaccinated should do this, although I understand that there are doctors who have chronic conditions, are at high risk, and they need extra protection. This applies to older, sick doctors, but certainly not to young, healthy ones.

Meanwhile, we already have the Omikron, another cause for panic …

So far, all vaccines work against all variants. The reason for the positive coronavirus test in the vaccinated is the more infectious Delta variant. However, vaccines still protect against death or pneumonia, so there’s nothing to worry about. There is no need to be afraid of colds. Are we afraid of rhinoviruses? There are 200 of them and we do not have any vaccines, and each of us has a cold twice a year on average. Nobody panics about it. You have to be pragmatic, be knowledgeable and act. There is a medicine, there is free access to it, you only need to agree to treatment. What can I do if someone disagrees? Thread…

However, the fourth wave brings with it a return to restrictions, as is the case in many countries where the number of vaccinated citizens looks impressive.

Such decisions are often politically motivated, based on opinion polls and express social expectations rather than pragmatism, and do not refer to evidence-based medicine. For those who think isolating and shutting down is the way out, let them do so. But I will say this: life shows that sooner or later this virus will make itself known, so perhaps they only postpone the inevitable and do not really prevent anything, but flatten the disease curve.

And after the lockdown is over, the curve soars up?

Usually it soars upwards, with one variant or another. The latest research results show that our resistance to SARS-CoV-2 virus disappears very quickly after taking two doses of the vaccine, hence it is necessary to administer the third dose as soon as possible, and what will happen next, we will see in a few months. In Poland, very few people have done it, and this is a problem. Honestly speaking, I would be more inclined to vaccinate all those who have already received two doses for the third time as soon as possible.

What about the kids?

In the case of the first Alpha variant, children were not in danger, but with the Delta variant, children become infected and transmitted it. I believe they should be vaccinated. I am glad that this decision has been made. Of course, the parents again have to give their consent for the child to be vaccinated.

1. See also: Vaccinating children against COVID-19. Every parent must know this

Perhaps more information campaigns on childhood immunization could be useful?

Information is always needed. However, please remember that published safety studies showed that in a group of 5 In the surveyed children, no side effects occurred after vaccination. The vaccine was even better tolerated than in adults. In children, the symptoms of COVID-19 are usually very mild, resemble a common cold or banal intestinal ailments, and very rarely a full-blown disease develops. If anything, it is mostly in those who have other serious illnesses. This group is at risk and absolutely should be vaccinated. Children, unfortunately, can become infected and can transmit the virus to their parents or grandparents. So we have two options – either vaccinate children or all adults around them. And because we know that a large proportion of the elderly have not been vaccinated, we should vaccinate our children to protect them. If we want to protect grandparents, let us vaccinate the children.

This year we have an additional opportunity to take advantage of the free flu vaccine. Should we?

Absolutely yes. Vaccination against various viruses has been proven to improve our resistance to infection. We become stronger and more resilient, our immune system, subjected to external stimuli, exercises. Just like a player who trains regularly, scores more goals later, he has better form. The immune system becomes more efficient when it is trained. In addition to vaccinations, we should be stimulated with various types of viruses or pathogens. Honestly, isolating yourself does not improve the health of the population. In the long run, it lowers it because it negatively affects our immunity, increasing the risk of other infections. Many people look only temporarily, their imagination does not exceed a month, and while treating a sick person for 20-30 years, I have to wonder what will happen to him after a decade or two. And I know that treating him with various environmental factors, including pathogens, viruses, and bacteria, is better for his health.

Does wearing masks make sense in the long run?

Masks do not work as expected, they mainly serve to make us be careful and keep our distance, because distance works. Handwashing works, and that’s been proven too. Perhaps the research on masks has not been carried out thoroughly enough … So far, there are several dozen of them and no breakthrough has been made. We wear them as decorations and perhaps that is why they are ineffective.

However, they are recommended by WHO, most countries of the world, and we have published texts based on the results of 70 studies that proved that masks work.

Let me put it this way: the research that shows that masks protect is being done in a laboratory, not a real life setting. I refer to clinical trials conducted in real life conditions and real social behavior, so I pay attention to problems with masks – incorrect wearing, inappropriate masks that do not meet medical parameters (because they should be at least category II and III masks), no changing masks. Perhaps this results in the failure of real studies of how many patients wearing or not wearing masks become infected. We should wear masks properly, and we should constantly educate the public about what we mean by this. We must remember that the results of laboratory tests, as well as clinical trials of drugs, often differ from the results obtained in actual work with patients. And it is usually a minus, not a plus. I understand that wearing or not wearing masks is a matter of political correctness, an expression of social solidarity in the fight against cvidem and building an attitude of warning against infection in the sense that we can count on the fact that the person wearing the mask complies with the recommendations and it can be said that he is safer than without a mask. If we are to wear masks, then let us do it properly.

And if the masks protect, and at the same time isolate from pathogens that should build immunity?

They isolate from subliminal doses of other viruses, and our airways also contain bacteria and viruses. When we wear a mask and do not change it, and it should be changed every 2-3 hours, we are growing something that may harm us. The breath cleanses the body, just like going to the toilet cleans it. If we don’t, we’ll get sick because we can’t block certain reflexes.

I think we could use some pandemic health profit and loss account. Is something like this needed?

A post -andemic audit is necessary, but to be reliable, first of all, it takes some more time and distance. Additionally, it should be performed by an institution completely independent of politicians, any politicians, and it must also have an independent source of funding. Our healthcare system is mass-centered. We have a common move, and we lack an individualized approach to the patient and his needs.

Because the interest of the system is different from that of the patient.

Exactly.

In this form, the audit may never be completed …

It should be based on clear rules. You need to know what you are looking for. I will say this: you cannot be satisfied with what we observe in Poland, but please also see that many countries have made all sorts of mistakes. Australia, which is an island, can close easily, and it also benefits from exporting raw materials. Australia should not be compared with Poland, which lives mainly from services and manufacturing, where movement is necessary. You also have to look far ahead. Certainly, the pandemic is not good for Poland, and not because it caused 80 thousand. deaths, because only deaths count, but because of the excess mortality. A lot of people die who have not had contact with the coronavirus, and this is the biggest problem. There are huge shortcomings in health protection. Emotions outweigh pragmatism and evidence-based data, and lost trust is very difficult to rebuild. On top of that, we have incurred a gigantic health debt, by stopping treatment of many chronic diseases, by delaying diagnosis, we have worsened the general health of the whole society. An expression of this will be to shorten our lives, quite simply. Everyone criticized Sweden, and when you compare the result of the policy applied there, we fare worse. However, if you ask me who to follow, my answer is this: I believe that Poland has insufficiently used IT tools to monitor the spread of the virus and impose quarantine on those who had contact with it. What was done in Taiwan, South Korea, where mobile phone transmissions were monitored and new outbreaks were successfully prevented. This was not done in Poland, and it was possible, there were tools. However, our country is organizationally too weak for that.

After the audit, it might be appropriate to organize some form of coordinated care for people after COVID-19.

The state will never replace the citizen in taking care of himself, people should take care of themselves. Coordinated care? After all, we have a family doctor and he should be taking care of it. No one more. It is said that people do not get vaccinated, and I regret that family doctors did not take care of vaccination in the first place and that the National Health Fund allowed them to stop examining and admitting patients. It was a big mistake which is one of the reasons why we have such a high mortality rate. Lack of constant care and the lack of a sense of health security of Poles. I live in a big city, so if my doctor doesn’t see me, I can go to another, but there are many smaller towns in Poland where the sick are sentenced to one or two doctors, and if they refuse to help, what those poor people have to do?

Professor, maybe we will manage to end this conversation on an optimistic note?

In many countries, huge resources have been allocated to the study of viruses that cause infections of the upper respiratory tract, including of course the SARS-CoV-2 virus, and I say that in the next few years we will develop a new generation of antiviral drugs. They work not only against the coronavirus, but also to treat influenza and other respiratory infections. We will make great progress in the next five to ten years. Huge resources have also been invested in research into new genetically modified vaccines, m-RNA, which in turn will be used to treat cancer. Now, maybe we are losing the war, but in the long run we will find new treatment options for disease and we will emerge victorious in the end. It is a pity that these processes do not take place in Poland, but in the richest countries in the world, such as Japan, South Korea, the United States, Germany or Switzerland.

Maybe a few Polish scientists who went to work abroad are co-creating these projects?

There will be a brain drain all the time, everyone is striving for talented and wise scientists. Unfortunately, Poland does not care about wise people. It has always been like this, they had no chance in Poland, so they went to the United States or France, like Marie Curie-Skłodowska, and received a double Nobel Prize. Why did she not conduct research in Poland? Because she couldn’t. And in France she had.

So nothing has changed since her time.

Nothing has changed. We deal with this virus in the same way as with forests, we completely do not understand what health is and how many elements affect it. Our health culture qualifies for a correction, and anyone who wants to survive a pandemic should take care of themselves, not rely on the state. The state will not help you in anything. I do not believe in any coordinated care, it will be just a beautiful slogan again, but it will not really help people.

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