it is Clear that today it is one of the busiest people in the state. And yet the novel Primula managed to carve out an hour for conversation with the correspondent “RG”.
Czech Republic surprisingly easy to cope with the pandemic. Here the indicators and the infected and dead is much better than in many other countries. How do you explain it? Timely taken measures? The introduction of the so-called “smart quarantine”? Or specific immunity of the local population?
Roman Primula: I can’t say that it was easy to get. We have watched closely how the situation developed in Italy and other countries, and on the basis of an analysis could take a number of precautionary measures, including isolating people and mandatory wearing of masks by all citizens without exception, as well as other measures that were adopted with the growth risks. As is now clear, all these actions were taken in time.
it is also true that the Czechs, especially in the first phase of the quarantine, showed very high discipline. And best of all it was evident from the way people began to sew the mask. Just then we had an acute shortage of means of protection, and many began to make them themselves.
Now the situation is much more complicated. Since the quarantine has been ongoing for more than six months, some of our citizens complain of hard measures, grumble about the masks and the communication with them is now much more difficult.
There is a version according to which the virus was less receptive inhabitants of the countries of Eastern Europe, and is supposedly due to the fact that all of them once (in socialist times) was vaccinated against tuberculosis.
Roman Primula: There are a number of theories about why in other countries, infections are much more. We also examined these hypotheses. In the Czech Republic, a vaccination rate of tuberculosis is very high. However, we did not find any significant difference in the incidence of vaccinated people and the unvaccinated. Besides, it turns out that Central and Eastern Europe, where were vaccinated against tuberculosis, is not so well-protected from virus. For example, a sharp rise in the incidence is observed in Romania and Poland.
with specific regard to the Czech Republic, the first wave began when the people returned from holidays spent in Italy and Austria.
How do you explain the fact of absence of the epidemic in Vietnam, where no one has died from a mysterious virus and the resulting inflammation, and the number of people infected, according to statistics, not more than three hundred people? Or is there just don’t test for this virus?
Roman Primula: just worked there part of the system of the so-called “smart quarantine.” Vietnamese authorities to be able to identify every one of the diseased, and those who are with them ��was kontaktirovat. They managed to isolate those people who brought the virus from abroad and those who stayed in contact, and thus in the Bud to suppress the possible spread of the disease.
Pandemic provoked a worldwide debate about the adequacy of taken measures against it. The world is divided into those who advocate tough action (isolation, quarantine, stop most sectors of the economy) and the supporters of the so-called “Swedish model” in which no special restrictions are not imposed. Is it true that the Swedes indicators of ill and dead are about the same?
Roman Primula: I Agree, this is a fundamental question because many countries now decide how to proceed – whether to continue to adhere to the policy of tough measures to either gradually start to let them go. Around it are being debated. We all understand that it is impossible for a long time to close the border to stop production, block economic ties. The vast majority of States have resorted to tough measures and the implementation of the key epidemiological events. There were some States, such as Britain, which waited to the last hoped that the trouble will pass them by, but a sharp rise in diseases and forced them to change strategy, to take unpopular actions.
If to speak about the “Swedish model”, which we of course followed, where the epidemic is also beginning to expand. Let’s compare the mortality rate associated with a coronavirus, in the Czech Republic and Sweden. Have died as at today, about two hundred thirty people and infected seven and a half thousand. In Sweden, about two and a half thousand dead and fifteen thousand infected. This despite the fact that the population is about the same. As far as I know right now about this there is a serious dissatisfaction among the population.
Since you are a virologist with epaulets, Colonel, we simply have to ask this question: can this Covid-19 to have an artificial origin? Recently on this version insist many influential politicians and physicians. For example, the Nobel laureate from Japan immunologist of Tasuku Honjo, who himself worked in the laboratory of Wuhan, offers to take his laureate title, unless someone can prove otherwise.
Roman Primula: this is also a lot of talk. But I have to pick up a Nobel prize this Japanese scientist. The situation is complicated, however, the origin of the virus was involved in a number of credible laboratories. It is impossible to prove the artificial origin of the virus. You have to be an incredible genius to do it. Moreover, he would have to cover his tracks, adding in his DNA such SEG��enty that it is very difficult to implement, although they have no special significance. In the structure of this virus there are the segments and the mechanisms which could arise only in the process of some natural mutations.
on the other hand, this virus is unbelievable. It creates huge problems. It is difficult to diagnose, we don’t know what the full clinical picture of the disease, how long the virus is excreted from the body, how long will the immunity from it, that is, from the point of view of epidemiology, this virus has a number of features, is extremely unfavorable to us.
Mysteries, indeed, too much. Right over the edge. For example, how to explain that some categories are clearly included in the risk group, for example, employees of supermarkets, do not hurt? And, by the way, are there statistics showing who carries the disease worse, and whom it spares?
Roman Primula: We already know that Covid-19 applies mainly respiratory droplets. And these drops are quite large. It’s not aerosol. It’s dangerous to be near infected people, especially if they cough or sneeze. In this sense, we introduced the mandatory wearing of masks, appears to have had a significant impact on the epidemic in the Czech Republic. We have, in fact, does not arise special problems in the stores.
Although your observation cannot be extended to the whole trade. For example, in one of the shops of zlín were identified forty-one people with coronavirus. Most of them are employees of the shop, but there are buyers, and members of their families.
the Virus spreads through the surface. University of Hradec Kralove carried out research in the hospital of Pardubice and found that the highest concentration on the doorknobs, and the filters of air conditioners and ventilation systems. The second obvious conclusion that follows from the observations: the virus feels comfortable in closed groups, for example, getting into the family, or the house where the elderly.
You headed in the Czech Republic the Central crisis headquarters. As it is now, from a distance of one and a half month, do you assess the effectiveness of the measures taken? Was there any of them redundant? And, conversely, what could the authorities do but did not?
Roman Primula: I Must say that from the very beginning, our activity was fast and efficient. The Prime Minister has listened carefully to our recommendations, all the measures taken are justified. Remember the same mask: first, many considered the use of them are useless, but then other countries began to act in a similar way, we managed to convince of the necessity of this measure, even the world health organization, which first their use was perceived negatively.
If we talk about current difficulties, the first thing I would say that the pressure from economic circles, which for us is to accelerate the exit from quarantine. Therefore, the current situation I would call ambiguous. After all, if you cancel in advance any restrictions, then it completely falls out of the range of measures that had been agreed previously. Break the chain.
Want to remind you that you haven April 6 spoke in favor of easing of the quarantine and to activate the natural immunity of the population. Your position since then has not changed?
Roman Primula: From the beginning, we considered different ways in order to cope with the pandemic. In particular, the possibility of controlled creation of herd immunity. However, it turned out that this is a very difficult way. We conducted research and found that we have a very low level of infiniroute of the population. As soon as our accumulated knowledge about Covid-19, we began to realize that one of the main questions to which no answer is this: “How long can I retain a natural immunity to the virus?” If this immunity lasts only a year or two, the path of collective immunization impossible. Imagine this: let’s say we allowed people under control to recover from this coronavirus, but the process would be delayed for a long time, and during that time the first had been ill again could get infected.
We conducted a mass screening of the population for antibodies, and a preliminary result is that only two or three people out of every thousand are immune. In new York, this figure is about twenty percent. Us to reach this level, it is necessary to have been ill more than half the population. But it has another side: the high mortality rate.
Now the government has announced a gradual easing of the quarantine. According to the schedule published, the country can return to normal life at the end of may. Question: do not break those plans for a possible second wave of the epidemic?
Roman Primula: these days we have a big discussion on the abolition of restrictions. I’ve already talked about the pressure that we have on different economic groups and industry, and agriculture, and tourism. They require a correction chart in the direction of acceleration. We are careful in this regard. No one knows what will happen tomorrow. If we cancel the limit very quickly, the virus will inevitably return, the number of cases start to rise again.
Our plan for the gradual five-step removal of restrictions, then it was simplified to three stages, each for fourteen days. And more to accelerate it won’t. At the end of each stage, we must carefully analyze the current situation, and if the number of cases suddenly grows and grows, the timing of the cancellation to the following restrictions must move.
How do you feel about the proposals (one of them was expressed by the President Milos Zeman), according to which the border should be kept closed for a year?
Roman Primula: First, our borders were closed pretty tightly, but more recently they are running: you can travel outside the Czech Republic for business or on vacation. Another thing is that to go essentially nowhere, because the closed borders of most other countries. The removal of restrictions on the movement of citizens was more a political decision.
Now at the level of Prime Ministers, negotiations with the governments of other European States about the Czechs could go on a summer holiday, say, Croatia, Slovakia, Austria and Greece.
the Best minds in medicine and the most leading pharmaceutical companies in the world are struggling with the vaccine Covid-19. This, as we understand, thrown enormous resources. Is there a light at the end of the tunnel? When such a vaccine will appear?
Roman Primula: Now in many laboratories of the research already known about eighty potential candidates to be tested in practice. But I repeat what I have said. It is unclear how long they remain natural immunity. If long, then this is bad news for pharmacologists. We are aware of these vaccines which are able to withstand the threat of viruses, for example, the vaccine against cancer of the virus hitting the cervix. I remain optimistic and hope and against the coronavirus vaccine is created, although it’s not one day.
Even if all goes at an accelerated pace and the vaccine will create, it will still produce in volumes sufficient for the whole world.
And still try to please us: when such a vaccine will appear?
Roman Primula: I think in the course of the year. Already there are drugs that are undergoing phase clinical trials.
Why such an insanely wide range of opinions from experts regarding the coronavirus, its origin, its dangers and ways of dealing with it? Does this mean that Virology as a science was shown to be ineffective?
Roman Primula: in Any case. Now in this regard there are a variety of people who are not specialists. Everything is done by virologists. All become healers. One of my colleagues says: “Many of the engineers were quacks, but doctors that do not build bridges and do not drive trains.” Everyone should mind his own business.
We faced with the disease and its source, which was not there before. Covid-19 behaves completely unpredictable. Even among experts, the range of opinions is very wide. Some argue that we are dealing with a species of microorganisms and fungi��ness of seasonal flu. Others emphasize the obvious danger of the new virus, pointing out the mortality rate in different groups. Where the mortality rate is very low, but somewhere it reaches fifteen percent. But is not the correct nor the first performance, nor the second. If you take the average data, the mortality rate of this virus is 0.6-0.7%, it is six to seven times higher than the loss from ordinary seasonal flu.
One can confidently assert: mankind is the virus will not ruin.
what do you think about being unprepared for a pandemic, which demonstrated the virologists?
Roman Primula: Virology and epidemiology is different science. We are all faced with a new, hitherto unknown pathogen. Maybe after three or four months horizons will open. Now we remind meteorologists.
do you Share the criticism of the American President (and only him) to the world health organization?
Roman Primula: speaking of who, I myself criticized this organization. This was two reasons. Apparently guided by economic and political considerations, it’s too late, who announced the pandemic. And then refused to admit the effectiveness of the use of masks. But then they have corrected their point of view. If to speak about the statements of trump, with some of them I like, disagree. For example, when he advises to inject the disinfectant. We had a case in the clinic, located in Hradec králové when the patient was mistakenly injected into the blood disinfection. It ended very badly for the patient.
would you Support the idea of creating a transnational epidemic prevention center, where it should be concentrated all the main resources and minds?
Roman Primula: to this center worked effectively, does not require the concentration of large funds and numerous personnel. Not necessary to fence something like that another who. This structure is a giant, ossified, she is caught in various bureaucratic procedures. Enough fifty talented and energetic scientists who would develop a different strategy.
of Course, it’s an interesting idea. We, along with other difficulties faced with the lack of synchronization of efforts of various governments and because of this inability to work together against a common enemy. Now actually put all the various experiments. However, we are in the same space face-to-face with an enemy, and if it’s a pandemic, you should search for the same path, because the goal is the same. We are open to such cooperation.
What lessons are there to learn medicine, and society in General from this sad story?
Roman Primula: Life after a pandemic will not be like it was before. Even if in the next two weeks lifted the restrictions, it is still the economy did not immediately recover, the restart will take quite a long time. We are not self-sufficient. For example, in the Czech Republic it will be all right, but economic ties are torn down, and suppliers from other countries are blocked.
If events will develop scenarios that are not too positive, but, unfortunately, very plausible, then this virus will remain here for a few years. And we will have to change your habits. We may not be able, as before, to communicate with so many people to limit the risk of infection. In the end, it will have global consequences. We can not exclude the fact that entire sectors of the economy can dramatically shrink, but others will begin to grow. This implies that the economy will have to adapt to the new conditions, she might have to share on any clusters to be flexible.
In this sense has to change and existing international institutions, for example, the same who. We should consider whether they are necessary in the new conditions, and if necessary, in what form.
As you can see, little virus greatly changes the whole landscape of our future life.
will Change the rules of a sanitary mode once a pandemic?
Roman Primula: the First thing I note, positive habit to wash hands thoroughly. That’s why many people have completely lost the habit. Also many have realized that social distance makes sense, they began to behave more carefully.
last question, humanitarian and political. Do not you think that now is the moment when all countries it is time to forget past grievances and to act together against the danger that threatens humanity?
Roman Primula: To this question the answer is not very simple. There is no common denominator. Where the result will need to achieve? Various associations exist today. For example, experts from eight countries summarize their experience so that they could use all the others. Will list these countries: Australia, New Zealand, Singapore, Israel, Norway, Denmark, Austria, Czech Republic.
Now we need to solve two problems. First: the lifting of the restrictions and steps to exit from the economic crisis. You should understand the extent to which it is reasonable to increase the test coverage. Second: the widespread introduction of “smart quarantine”, in which it is possible to quickly identify infected persons and those persons with whom they had contact.
In the Czech Republic “intelligent quarantine” has already been tested in all the administrative regions, the project has entered the implementation phase on 1 may. If we talk about the difficulties with its introduction, no problem with the survey and “map of memories”, that people go hunting��O. But there are problems with access to their personal data, phones, etc. it is giving the consent, approximately one tenth of the population.
***
After the interview, pan Primula agreed to a little photo shoot in his office and even for a moment at my request, took his mask off. Then the elbow of the right hand deftly pulled on the door handle to let us out. He told half an hour ago: the virus stored for a long time on metal. But better safe than sorry.
(the Author is grateful for assistance in arranging an interview with the newspaper “the Prague Telegraph”).
