Dr Elena Radeva: It is criminal to insinuate that Covid-19 is no different than the flu
After everything I've seen, I will keep washing my hands 20 times a day and wearing a mask during examinationsIvan Tropankev , Sofia
It does not take much to live with Covid, there is no room for panic. However, to live in a fictional reality that the coronavirus does not exist and that it is some kind of harmless flu is unreasonable. Do not wait for the danger to knock on your gate to make sure that it exists, says Dr Elena Radeva in an interview to Monitor News Agency.
Dr Radeva, let me ask you this from the outset - is the pandemic “a new form of slavery”, as some colleagues of yours in Bulgaria say?
The pandemic forced some new rules upon us, it hit hard and brought a tonne of unknowns with it. It caught countries and healthcare authorities unprepared, it flooded and overwhelmed infectious-disease units and ICUs, caused physical and mental harm to large swathes of the world's population. The world was confronted with an emergency because of a microscopic virus, which scientists and researchers still know too little about. At this point, there is no reliable therapeutic.
Inarguably, the pandemic changed everything. I think that after everything I've seen, I will keep washing my hands at least 20 times a day and wearing a mask during examinations for the rest of my life. In that sense, the pandemic is not a form of slavery, even though all of us, healthcare workers and regular people alike, might feel that our liberties have been diminished. I understand the protests of parents who see their children wearing masks and lament that their childhood has been taken away. I can assure you that we, health professionals, are suffering just as much, but all of this is in the name of public safety, something that cannot be played around with.
Your powerful message on social media about the “Covid-19 conspiracy” went viral as it was shared almost immediately over 3,000 times. Some of the reasons why you felt compelled to write it were the rising sentiment of mistrust and the undermining of the medical profession as a whole by some of your fellow doctors. But is this not just an emotional response to fighting a deadly virus that largely remains a mystery?
I shared my personal Covid-19 experience, moved to do so by close friends - intelligent, well-educated people who have been family friends of mine for 30 years. The topic of conversation was wearing masks at school. On the one hand, I see their point - masks are not required outdoors and kids spent the summer on family vacations and in parks. In that regard, the mask rule is restrictive, as my friends argued, especially in a situation where those in power are not setting a good example - if you ask your people to be careful and comply with the measures, you have to set the tone as a leader, and I do not see much of this in Bulgaria, unfortunately. Just look at the interviews of President Emmanuel Macron and PM Jean Castex in France, or other European leaders, they are all wearing masks, keeping socially distant and following mitigating measures, even if their last test came back negative. We all have this duty as a society. We should be able to hold each other accountable for not observing the measures, this is the true test of freedom and liberty, the rest is cynicism and stupidity.
The first wave in France came after a bunch of people contracted the virus at the same time and the healthcare system proved ill-prepared, but there was an epidemic too. The influx of new cases, some of which severe, put an enormous strain on hospitals. Fellow healthcare workers and hospital staff got sick, there was shortage of manpower. Every day I did rounds with different trained nurses who came to help for a day or two. The local population was called upon to help - seamstresses were sewing masks, municipalities then gave them out to people because there were not enough for everyone and yet life had to continue.
Why we did not see this in Bulgaria, I have no answer for you. But I believe that the lockdown imposed by the National Operational Staff had a role to play. In France, the measures were not so austere and things moved at a slower pace. I was particularly proud that my native country handled the situation so well, especially considering all those Bulgarians returning to the country and the necessitated home checks. That was the right way to do it - fines and control as deterrents because Covid-19 is not something to play with. The novel coronavirus is no flu, it is insidious, unpredictable and uncontrollable. There is no antiviral drug that reliably treats it 100%.
It would be nice if all my fellow interview-giving medical professionals could base their opinions on personal experience with combating novel coronavirus infections, but I have not heard them share as much. Unfortunately, some of them openly and irresponsibly state: take off your masks and be free, Covid-19 is mild, everything is fine. This claim is simply false, it is baseless and should not be perpetuated because it actively harms people. In a nutshell, it is criminal.
How do you view using the pandemic for political gain?
I am not a politician, I am a doctor. What I am most concerned about is that the guidelines are followed, that cases are limited and deaths are avoided. I have no desire to debate political considerations, I am just trying to do my job. I wrote my (social media) post spontaneously, moved by strong personal emotions. It is namely because the pandemic is being exploited for political purposes that I heard from a close friend the following: “I don't care that your colleagues have died, we're all going to die one day. You work in high-risk environment, fine, wear a mask, wear a burqa for all I care, but my child is not going to wear a mask.” Politicians around the world, not just Bulgaria, have enormous historical responsibility at this moment and they should not forget this for a second. Whether measures are followed or non-existent, one day they will all answer to their people or the court because this pandemic is far from over.
Does the French legislation provide for punishment for doctors who spread misinformation about the coronavirus, thus putting citizens' lives at risk?
The problem is addressed in detail in several articles of the Deontology Code in France. As you know, we are seeing such a case unfolding with Prof Didier Raoult, (director of the infectious disease department at the Marseille University Hospital - editor's note). We are not talking about penal legislation here, but a medical one enforced by Chambre disciplinaire nationale de l'Ordre des medecins. He is on trial before the medical court, which is pretty serious for a physician as it may result in him being banned from exercising the profession. I have no idea what measures will be taken, the matter is being discussed by the ethics commission. Recently, I read a piece by Dr Gilles Roche, a Montpellier virologist with experience and scientific background similar to those of Didier Raoult. In an open letter he slams all of his opponent's assertions - “Since January, all of your proclamations have turned out false. We were not to worry. This would be no more than a flu. Bike falls are more deadly. New infections would die down in August. It was supposedly unnecessary and unethical to do further comparative clinical trials.” He continued his case; “You trampled all over the need for clinical trials. You insulted the entire medical panel calling them incompetent and close-minded, you violated the most sacred duty of our brotherhood. You had no limits on spreading misinformation that confused the population at large and that seriously damaged public trust in medicine. Where is this delirium going to take us?” The use of the word “brotherhood” is very apt. For example, when asking for consultation, we begin our official letters to colleagues with “Cher confrere” (or “Dear brother”) and conclude with “Bien confraternellement,” which literally means “Fraternally yours”. That is the norm. Brotherhood is a sacred word in France and I understood its profound meaning during this Covid-19 pandemic, when fellow physicians would shed tears of exhaustion and nurses would collapse on hospital floors, saying: “I can't take it anymore.” In moments like this, you think to yourself: “I hope I can hold on a bit longer so that my fellow doctor does not have to suffer.” Perhaps we all reached some higher, unprecedented level of self-sacrifice and mutual assistance.
I suppose that everything cited until now from Dr Gilles Roche's open letter sounds somehow quite familiar and has different analogues. On the one hand, we have some alarmists, scaremongers, who stress people and cause them neuroses and psychoses, and on the other hand - some “rescuers” who calm people down, advise them that there is no point in wearing protective masks while they themselves are wearing them. The latter misinterpret scientific claims though they do not even have practical experience because they have not treated Covid patients. In the end, they say wisely that the Bulgarian Medical Union should know its place, because they themselves are omniscient and omnipresent.
It cannot be said that “a few dry twigs only will burn”! (Editor's note - i.e. mainly people with compromised health are at serious risk.) The question is about healthy people who, even if they are old, even having one or two pre-existing conditions, can live normally their lives with systemic maintenance treatment. Old age is not an official indication not to proceed with bypass surgery in cases of heart attacks. Adult patients have kidney transplants, even if they are 90 years old, provided, of course, that they do not have advanced dementia. My husband is an orthopaedist, he operates patients as old as 100 or 107 years, and this is the practice in the western countries. This is the future of medicine and we have to think this way. Moreover, it is not true that we “neglected” patients with cancer and other serious diseases because of Covid - neither in Bulgaria nor in the rest of the world. The type of colleagues who are claiming the above, generate themselves more plots and conspiracies and present them in a distorted way to ordinary people. None of us has neglected cancer or other serious diseases, no emergencies, no traumatism caused by the pandemic. Our emergency wards did not stop working with excessive effort, while the doctors, nurses and hospital attendants fell ill themselves because there were not enough masks and protective clothing provided for everyone. To say that we neglected a patient is impudent. Only scheduled surgeries were postponed - for example, knee joint replacement, implant placement, for the simple reason that being in a hospital environment, these patients would be at a much higher risk of becoming infected than if they had stayed at home and had waited comfortably.
You obviously approve the measures undertaken by the National Operational Staff for pandemic control. As a doctor who has been in the Covid wards for months, what would you recommend additionally for avoiding a severe crisis, of the magnitude that already happened in other countries? Or has medicine gained enough experience and - with each passing day - there are better opportunities to cope with this battle?
I strongly approve them. The decisions of the health authorities must be implemented unconditionally. There can be no interpretations. They are the result of consensus, taken with full responsibility. The authorities may overestimate the risks and the specific situation, but it is better than counting the dead tomorrow.
We have to think realistically, to check the fake news on the social networks, we have to get information from the original sources - from the doctors, nurses, from people with experience and qualifications. It does not take much to live with Covid, there is no room for panic. However, to live in a fictional reality that the coronavirus does not exist and that it is some kind of harmless flu is unreasonable. Do not wait for the danger to knock on your gate to make sure that it exists.
Why in Bulgaria there was no coronavirus pandemic or first wave like in Europe? I like to joke saying that in Bulgaria we wash our hands often and conscientiously enough and bathe more often than other nations, not because there was quarantine, when elsewhere there wasn't, but because there was a serious attitude by the doctors. Surely, the fact that there was a real first wave in more economically developed countries, with developed infrastructure and transport above all, has also an impact. In France, for example, it is common for people to work 40 or 100 kilometres away from their homes. We travel constantly in the subway, by car, by train or plane, even inside the country. Imagine an infected person how many people can infect in a big city with an intense way of life, especially when he is asymptomatic. Let there be no more infected people in Bulgaria, let it stay as it is now, I pray with all my heart for that. I have family, relatives, friends and my heart is with them. That is the reason I cannot remain indifferent exactly to the “contribution” of some colleagues who foster conspiracy theories that minimise the need of sanitary measures. And especially when it is done for some political purpose, gaining popularity in the media and proclaiming unhealthy ideas.
Medicine is above all political biases. Any doctor can be a member of any party they like, but when the health and life of people are in their hands, they must do their job well, because they have taken the Hippocratic Oath and their morality must be an example for the whole society.