– People are not allowed to be locked in four walls. The prohibition to leave home, go to the plot or enter the forest with your family was an absurdity that should never happen again. With prof. Ryszard Chazan from the Chair and Clinic of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, we talk about how we were maneuvered into “remote life”.
- – I do not understand on what legal basis unjustified fear deprives young people of education – says prof. Ryszard Chazan on the decision to close schools, which was taken by the Ministry of National Education in the first months of the pandemic. – After all, there were no serious illnesses among adolescents and children – rather elderly people with risk factors required isolation
- Krytycznie wypowiada się też na temat karania za brak maseczek. Jak tłumaczy prof. Chazan, nie ma żadnych naukowych dowodów, że noszenie maseczki zabezpiecza przed zakażeniem. — Pokazały to analizy porównawcze danych z Belgii i Holandii, gdzie w jednym kraju był obowiązek zasłaniania ust i twarzy, a w drugim nie — liczba zakażeń chorych i zgonów były porównywalne. Mimo to uważam, że powinno się zachęcać społeczeństwo do zasłaniania ust i twarzy, zwłaszcza w transporcie publicznym, w placówkach ochrony zdrowia
- — Przekierowanie służby zdrowia na zwalczanie koronawirusa kosztem innych chorób od początku wzbudzało mój największy sprzeciw — mówi i apeluje o jak najszybsze «odmrożenie» dostępu do lekarzy specjalistów
- For more up-to-date information on the coronavirus epidemic, visit the Onet homepage.
Zuzanna Opolska, MedTvoiLokony: Professor, for the last few weeks all of Poland has been debating one thing: returning the children to school, fortunately we followed the voice of reason, or rather in the words of the chief doctor of England, prof. Chris Whitty, who said that “opening schools is less dangerous than keeping children at home” – don’t you have the impression that we are participating in a “coronaparanoi”?
Prof. dr hab. n. med. Ryszarda Chazan: I have the impression that we have been participating in a tragic spectacle for several months now. I do not understand on what legal basis unjustified fear deprives young people of education. The idea of FIO and EDU-Klaster about creating the so-called School bubbles to limit teachers’ contact with children is absurd.
One teacher teaching all subjects is a return to the organization of schools in the middle ages. The announcements that the directors of the schools would make decisions about the possible closure of schools were equally absurd. On the one hand, like the entire society, intimidated by the media, on the other hand, they are held responsible for the health of children and employees.
After all, teachers in retirement age with chronic diseases, who are afraid for their health, are not forced to work. Unfortunately, hardly anyone thinks about young people and wonders about the consequences of closing schools …
Today we know that “homeschooling” has burned out the system … The mental condition of students and teachers is much worse than before the epidemic. Was it a good idea to close schools all over Poland for so long?
It is hard for me to believe how easily it was possible to stop the whole world with top-down decisions. At the beginning of the pandemic, little was known about the origin of the virus and its virulence. Citizens were informed that anyone with an elevated body temperature, cough or shortness of breath should report to the hospital immediately. As a result, medical facilities filled up so quickly that there was a shortage of beds.
Jeszcze wtedy można było uznać, że zawieszenie zajęć szkolnych było decyzja słuszną. Jednak już po kilku tygodniach o samym wirusie i jego skutkach wiedzieliśmy znacznie więcej. Było wiadomo, że chorobowość i liczba zgonów z powodu COVID-19 nie jest tak wysoka jak oceniano na początku, a większość hospitalizowanych to chorzy z chorobami przewlekłymi, część z nich z dodatnim testem na koronawirusa. Wtedy już nie rozumiałam, dlaczego podjęto decyzję o przedłużeniu zamknięcia szkól i uniwersytetów. Nie było przecież ciężkich zachorowań wśród młodzieży i dzieci — izolacji wymagały raczej osoby w wieku podeszłym z czynnikami ryzyka.
- Should face masks be compulsory in schools? We asked the doctors this question
Did any of the introduced restrictions raise doubts? For example: fines for not having masks?
Of course, many restrictions were inadequate to the situation and the current changing knowledge of the virus. The punishment for not having masks is a good example.
There is no scientific evidence that wearing a mask will prevent infection. This was shown by comparative analyzes of data from Belgium and the Netherlands, where in one country it was compulsory to cover the mouth and face, and in the other it was not – the number of infections and deaths was comparable.
Nevertheless, I believe that the public should be encouraged to cover their mouths and faces, especially in public transport, in health care facilities. Masks should be worn by sick, healthy people with a positive test, as well as by all people with symptoms of a cold. However, it is much more important to keep a certain distance, especially when we are in closed rooms, frequent ventilation and disinfection of the rooms. You should also be reminded constantly of washing your hands frequently and not attending large gatherings.
And the ban on leaving the house except in necessary situations?
People are not allowed to be confined within four walls. The ban on leaving the house, going to the plot, entering the forest park with the family was absurd and I hope it will never happen again. Fear must not be allowed to cause more damage than the virus. Doctors are already reporting an increase in the number of mental disorders and suicides. For me, in order to reduce the pandemic, more important than confining young people at home, performing tests for healthy people or sending healthy people to quarantine would be frequent testing of education workers, and above all health care workers. It is not children and adolescents, but people who directly care for the sick in hospitals and nursing homes that carry the virus, and often also spread the disease.
Zastanawiam się, jaką rolę w nakręcaniu paniki przed «koroną» odegrały media. Były kamerzystą, reżyserem, a może scenarzystą?
Biorąc pod uwagę, że od wybuchu pandemii stacje telewizyjne, radio czy portale internetowe prześcigały się w przekazywaniu katastrofalnych, niesprawdzonych, niespójnych wiadomości, bardzo dużą. To dezinformacja jest podstawową przyczyną lęku i strachu. Zresztą narracja «wojennego zagrożenia» zrobiła swoje… Dzisiaj ludzie boją się normalnie żyć i dobrowolnie godzą się na ograniczanie własnej wolności. Oczekiwałabym od dziennikarzy mniej własnych komentarzy, a więcej rzetelnych informacji. W Polsce od kilku lat każdego dnia umiera średnio około 1200 osób — wielu tym zgonom można zapobiec. Słyszała Pani o tym?
- Tysiące ludzi mogło chorować na COVID-19, zanim potwierdzono pierwsze przypadki
I certainly do not hear it every day … So what information in your opinion is missing?
Maybe we have known coronaviruses for over sixty years. Each year, they are the cause of several to several percent of upper respiratory tract infections, in the course of which complications such as bronchitis or pneumonia occur. Viruses also often mutate in order to survive, which is one of the reasons why epidemic outbreaks have a different course in each country. Today we know that several new genetically altered viruses of varying virulence are already involved in the present “pandemic”. The media coverage also lacked reliable data …
Recently, the Ministry of Health replied on the deaths of patients infected with coronavirus without comorbidities – 300 …
Maybe I will fill in during the “Polish pandemic”, by September 7, 2.751 people were tested for coronavirus, 419 were found to be positive, which is about 71126 percent. Only this does not mean the number of patients but the number of positive tests. During this time, 3 people who tested positive and most had comorbidities died. Without comorbidities, 2097 people died during this time, which is about 300 percent. This is what I call honest information, not showing off the number of deaths due to coronavirus infection several times a day over the course of months …
- Prof. Simon: they threaten me with death, they intimidate my family and they call me Dr. Mengele
Dlaczego w trakcie pandemii tak niewielu lekarzy zabierało głos?
Uważam, że zostali ubezwłasnowolnieni podobnie jak cale społeczeństwo.
Informacje od początku przekazywali politycy z Ministerstwa Zdrowia i Sanepidu, a ich decyzje były i są podobnie wiążące dla wszystkich obywateli. Nie słyszałam w tym czasie wypowiedzi konsultantów krajowych, kierowników Klinik Uniwersytetów Medycznych czy przedstawicieli Towarzystw Naukowych, którzy respektowali obowiązujący porządek prawny. Formalnie był nawet zakaz dla konsultantów wojewódzkim wypowiadania się sprzecznie z oficjalnymi komunikatami, co miało zapewniać spójny przekaz informacji.
Wiemy, że były minister zdrowia regenerował się na Teneryfie. Patrząc na obniżki płac, większość Polaków takiej szansy nie dostanie. Zresztą zamiast wakacji czeka ich kolejka do lekarza. Jaką Pani zdaniem zapłacimy cenę za «zamrożenie sektora ochrony zdrowia»?
The redirection of health care to fight the coronavirus at the expense of other diseases aroused my greatest opposition from the beginning. For many months, legal regulations restricted patients with other diseases from accessing family doctors, specialists and hospital care. Many procedures qualified as necessary to save health have been suspended. Only life-saving services were provided as recommended by the directors of institutions. Thousands of beds were unused for many months. A few months of delay in the performance of planned health services, as you described the “freezing of the health care sector”, will affect the health of the society in the coming months and years. And such long lines to specialists and planned treatments will only get longer. Delaying the diagnosis and early treatment of many diseases will drastically worsen their course and patients’ prognosis.
Prof. Bralczyk zauważył, że jednym z najmodniejszych słów ostatnich miesięcy jest kojarząca się z pilotem: «zdalność» – zdalna praca, zdalne nauczanie, zdalne leczenie. Dobrze wiemy, że teleporada nie wystarczy dla wielu pacjentów. Czy to dobry czas, żeby powiedzieć teleporadzie kres?
I believe that the health service must return to normal functioning as soon as possible. This is the last bell. It is impossible to practice medicine remotely – the basis of outpatient care must be contact with a doctor. Treatment must not be ordered without examining the patient based on a telephone interview. It’s against medical ethics. Of course, teleconsultations are acceptable and even desirable in the case of people with chronic diseases who require the extension of previously ordered medications, issuing referrals or certificates. Such a system of work is convenient for the patient, and at the same time increases the access to the doctor for other patients who require direct contact. However, teleports should not be more than 20 percent. all visits. The doctor cannot be afraid of the disease.
We know that changes are ahead – the new Minister of Health, Adam Niedzielski, has announced a change of strategy: from nationwide measures to flexible risk management. Does the “new” not come too late?
It is difficult to evaluate the work of the new minister of health after such a short time, but I am glad that he is an economist and has knowledge about the need for the scope of health services, resulting from his work in the National Health Fund. It is good that he has appointed a team of experts and talks to practitioners whose voice is included in his regulations. I know one swallow doesn’t make spring, but you have to start somewhere. Decisions to restore normal work in hospitals and introduce periodic restrictions based on the epidemic situation of individual provinces is a step in the right direction. Yes, the efforts to return to normal in the country are long overdue, but at least they are being taken …
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Prof. dr hab. n. med. Ryszarda Chazan – a graduate of the Medical Academy in Warsaw. From 1977, an employee of the Medical Academy (then the Medical University of Warsaw). Employee of the Department and Clinic of Internal Medicine, Pneumology and Allergology as a full professor. II degree specialist in the fields of: internal diseases, cardiology, lung diseases, allergology. Previously, she was also the head of the Department and Clinic of Internal Medicine, Pneumology and Allergology (2000-2014), Vice-Dean of the Faculty of Medicine and Consultant of the Mazowieckie Voivodeship in the field of lung disease (1990-2014). Member of many ministerial commissions and international societies.
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