Both experts and ordinary people are still wondering at what stage is the epidemic in Poland. Dr. Paweł Grzesiowski, an immunologist, believes that the number of cases of coronavirus infection in Poland is underestimated, and there are even 20-30 times more patients than official statistics.
- – The real number of cases is 20-30 times greater than it results from the tests – warns Dr. Paweł Grzesiowski
- Poland is still fighting the epidemic and it is difficult to predict what our disease curve will look like. What should we do? – You have to prepare for two or even three plans. One resulting from the observation of the current situation, the second in the event of a sudden deterioration of the situation and the third in the event of a total disaster – says the expert
- It should also be assumed that the virus will mutate and become more dangerous. – One of the mutants may prove to be particularly virulent and cause ten or twenty times higher mortality than before
Martyna Chmielewska, Medexpress: The coronavirus epidemic continues. At the moment, we already have over 33 thousand. infected. We know that in Poland from June 17, 2020, the number of infected began to decrease. Are the declines recorded in Poland in recent days, is it finally the longed-for and long-awaited collapse of the first wave?
Dr. Paweł Grzesiowski: It is very difficult to estimate the course of a pandemic on the basis of one or two days of observations. At the moment, weekly and even XNUMX-day averages are more stable. We have to wait a few more days for possible conclusions regarding the current phase of the epidemic in Poland.
It seems to me that we need to watch first and foremost those who are sick in terms of age and clinical structure. If young people are ill, then we will not see any symptomatic effects, and we will certainly not see the effects of hospitalization or deaths. On the other hand, when the disease reaches risk groups, and above all seniors aged 65+ with chronic diseases, we notice much more clinically active cases, and therefore symptomatic, with fever and dyspnoea, going to hospitals, and often requiring intensive care due to the threat to health. or life.
It is said that the data provided by the Ministry of Health on the number of infected are underestimated. All because too few tests are performed. How many do you think may be currently infected with the coronavirus?
Since the beginning of the pandemic, I have been trying to create a mathematical and clinical model that would allow to determine the degree of underestimation of test data. We have relatively few tests, approx. 38 thousand. per million people. The real number of cases is therefore twenty or thirty times greater than the test results show.
The reason for such a large variation between the number of true infections and the number of positive test results is that we do not test selectively. We test all the people who want it, the quarantined people. At the moment, we are massively testing all employees in Silesia. This shows that in a given exposed group, we have more detected cases. However, it does not reflect the national statistics. This is easy to illustrate with a specific example. In Silesia, the percentage of positive results in relation to all performed tests is four times, five times higher than in the rest of Poland. By targeted testing of groups in which we have a higher risk of spreading the virus, we detect many more patients. However, if we test random people, this percentage drops us below three percent of the detected cases in relation to the tests performed. It is certainly a huge underestimate.
Although there are still rules on, for example, covering the nose and mouth in public places, not all people follow them. Recently, the Ombudsman for Human Rights, Adam Bodnar, wrote a letter to the Minister of Health, in which he informs that “every second customer of commercial and service outlets applies to the obligation to wear masks in shops”. Poles also do not keep their distance, there is general relaxation. What could be the consequences?
I think there has been a social communication error somewhere. Firstly, it was signaled in the public space that we had overcome the epidemic. We have a feeling of winning with the virus. People will avoid additional painful procedures, such as wearing a mask that is uncomfortable in the heat.
The virus is still with us. The government has loosened the restrictions so the virus will have more opportunities to become infected. The health minister says more infections are to be expected. In my opinion, the message in the form of an interview or a comment is not enough. We must get clear procedures and follow them also through supervision. If masks are introduced in public places, closed rooms with a lot of people, it must be strictly observed.
After three months of a very strong lockdown, the society is tired of it and naturally avoids restrictions. The role of doctors, nurses, representatives of other fields is to remind people of this. Anyone involved in public activities should remind people of safety rules, such as: hand hygiene, avoiding face-to-face contact, keeping distance, wearing a mask (when we are in a closed room with a large number of people, where there is no good ventilation and distance).
I think the rules should have been promoted from the beginning of the pandemic. It would be easier to demand them from society. It is too late now. We need to act in a community of people who have relaxed and in many cases questioned the existence of a pandemic.
It is underestimated whether the virus causes any serious diseases at all. And the truth is, the virus has two faces. One is very mild in children and adolescents, young adults, and very dangerous in the elderly and sick. Many young people underestimate these dangers because they do not see seriously ill people around them. The media, doctors, and public health professionals should show that another person’s illness can be very serious and have serious consequences.
Also Read: Why Are Young People Dying From Coronavirus?
Do you think the restrictions should be strengthened? If so, which ones?
The most important element with us from the beginning of the pandemic is flexibility. We should prepare for two or even three plans. One resulting from the observation of the current situation, the second in the event of a sudden deterioration of the situation, and the third in the event of a total catastrophe.
The virus keeps mutating. One of the mutants may prove to be particularly virulent and cause ten or twenty times higher mortality than before. Such a scenario must also be placed somewhere and included in the preparations. I believe that any restrictions should be carefully distributed.
How to do it?
There are counties that often border with each other. In one of them we do not get sick at all, and in the other there are a lot of them. And it is not only about Silesia. We have the same situation in Mazowsze, Podlasie, Świętokrzyskie Province and Podkarpacie. There is no point in introducing a nationwide model of dealing with a pandemic. We must implement the recommendations locally, on the scale of communes or poviats, where there are local outbreaks.
- We recommend: Why is the virus reproduction rate the highest in the province. Łódź?
We know that the virus is not airborne in the sense of great distances. It is not transmitted by drinking, so it does not attack by food, which makes it much easier for us to fight it. Knowing that the virus spreads mainly through face-to-face contacts, it is enough to cover it, reduce interpersonal contacts and the effect is immediate.
Modeling of restrictions should be at the commune or poviat level (on the basis of a minimum five-day virus activity, because the shortest incubation period is equal to this), when we see the effects of infections that occur in the first strike in a given area. On this basis, we can identify and predict the next contacts of these people. And all because we know more or less the mobility of people, e.g. how they commute to work, whether they travel long or short distances.
Local authorities know it best. So that should be their domain right now. Of course, they should agree it with the central authorities dealing with security management, so that local decisions on lockdowns and exclusions can be implemented as soon as possible, if there is an unfavorable situation.
Should we wear a mask in summer?
The time of the year should not decide about wearing the mask, but the real threat. If we are in a crowded place, in a room with poor ventilation, close contact with people, then we wear masks.
We should wear it on the tram, bus, train, where a lot of people get on. It is so crowded and stuffy. We protect other people by wearing a mask. Remember that we can be asymptomatic and infect the environment. The mask is needed in a risky situation (when we breathe air exhaled by other people).
Interviewed by Martyna Chmielewska
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