DR PREDRAG KON: 'A 60 percent collective immunity likely after March' and when we will take off our facemasks

"I expect a collective immunity to the coronavirus, standing at around 60 percent of the population, to develop after March, provided that we vaccinate 20 percent of the population. Given that – basing this on a sample – the immunity stood at 20.7 percent in late August, and that the third wave is by far the largest, allowing us to assume that there are no fewer immune people, then vaccinating 20 percent of the population would create a significant barrier for the virus and slow it down considerably. We heard the prime minister announce that as early as January millions of vaccines would be available. If the first dose is administered in February, with three weeks before the second dose and a total of one month before immunity kicks in, it is realistic to expect to have the 60 percent of immune people after the first quarter, sometime after March," Dr Predrag Kon, chief physician and member of the Covid-19 Task Force, said in an interview with Kurir.

Provided that those who have had Covid do not get vaccinated?

"Precisely. They too can get vaccinated, but since it's perfectly possible that they are immune, they shouldn't register at a point when there aren't enough vaccines. They can do it later. A plan has been drawn up for the vaccination of 50 percent of the population."

Children aren't vaccinated either.

"No, because they aren't included in vaccine tests. It is a rule to only administer medications, including vaccines, to children once they have been administered to adults. Youngsters can be vaccinated when it is clear that there are no dangers for different groups of adults. In children, this disease is rarely severe and very rarely ends fatally. In those aged 10 or below, this outcome is practically non-existent."

But the UK variant is attacking children quite a lot now. Should we be afraid?

"There is certainly a natural fear, which causes concern and caution. However, we shouldn't panic. For the first time since the beginning, SARS-CoV-2 has developed a new variant and this mutation is linked to higher transmissibility. This news ought to be taken seriously. We have already seen what happened when the news from China were taken without sufficient caution."

The medical wing of the Task Force (TS) has requested that flights from the UK to Serbia be suspended. However, that seems unlikely.

"We didn't ask for flights to be suspended; we warned that some countries had done that and that it should be considered. The Veterinary Institute in Kraljevo and Milanko Šekler have identified the virus genome scientifically, which will allow us to see if the variant in question has arrived here as well. Each new strand can result in increased cases of the disease and, theoretically, in reinfections. That said, it cannot be the same disease as the first time around. But, it's all theory."

Do you mean to say that there have been cases of people who have had Covid-19 getting infected by the new strand?

"That's just me theorizing, it hasn't been proven anywhere yet, and I'm not sure if it's realistic. We keep getting new strands of the flu and, whenever a new one appears, it's possible for someone who has had the flu to get it."

You have taken the Pfizer jab. Do you think you have long-term protection, even from the UK variant?

"We'll see. I'll be sure to get an antibody test in about a month. I expect that I'll be protected. But we should know that the virus cannot be vanquished, only supressed. We'll be getting the jab now, and in five years new generations will be born and some people will die. The population keeps changing and vaccination is an ongoing process. And how the virus will behave remains a question."

How about half the Serbian population saying that you have been chipped by the vaccine?

"This requires a calm and composed answer – I have not been chipped. And I know that for a fact, as it is technically impossible. Such an idea cannot be put into practice at the present moment."

You are not on any coronavirus vaccination committee. Is that the price you are paying for what you had to go through after the swine flu vaccine scandal?

"I don't think so. I think this has to do with my age. And the scandal has been officially shown to be fake and it hasn't brought anything good. Nothing of the sort is happening now, and I hope it stays that way."

When will Serbia be able to go back to normal life, without facemasks?

"If we undergo a mass vaccination, taking off facemasks won't be a realistic option to consider before the second half of 2021. Unless the virus changes to such an extent that it starts a new round of disease. We also need to have 28 days without new infections to not need any protection. However, it needs to be said that there is always the possibility of the virus re-emerging from anywhere in the world. We'll see how the international community will react. Some will request that those entering their country and/or attending specific events are vaccinated."

France is introducing green vaccine passports.

"It's realistic to have something of the sort. And if there is one country that I expect this from, it's the US, which even now you cannot enter without a certificate confirming that you have taken almost all the jabs out there. However, in order to ask that of others, you need to vaccinate your own population."

What will Serbia do in this regard?

"For the time being, we have no vaccine requirements at all for entering the country, and this is why a coronavirus passport is not to be expected."

An easing of measures for everyone, with full sports stadiums, cafés, and night clubs – is that realistic in February or March?

"We can only discuss this seriously after the new infections curve goes clearly down and all Covid hospitals are empty."

What would the number of new daily infections be?

"When it's in two digits, then it's justified to consider a full easing of measures, but not before. If we fare as well over the New Year's and Christmas as we did over Saint Nicholas Day, or better, we have a chance for this to continue going down to two digits across the country. But, do you remember 5 June, when all measures were eased, and we had to pay the price? We had two digits then, and only 18 new infections at one point. And it seems to be disappearing completely."

From 5 June onwards many people have been saying that the medical wing of the TS doesn't have the authority or power, and that it has caved in to political pressure (back then over the upcoming election).

"Those are stories that the new developments have falsified."

But, for example, in early November, the requests of the TS medical doctors to tighten the measures weren't granted. This was done a month later, when we had nearly 8,000 infections.

"That is indeed what happened. Their arguments were rock solid – to the effect that both the health system and the other systems of this country would literally come to a standstill if we were to halt life. But if someone thinks that the medical wing of the TS isn't necessary or that it should operate outside the TS, then they are horribly mistaken in their belief that they could run the country. If someone thinks that all medical doctors' requests will be granted automatically on pain of resignation, they labour under a delusion that that's how the circumstances surrounding the pandemic can be handled. I can say this openly because I'm part of the defence efforts against what is already the third pandemic. I firmly believe that a pandemic cannot be managed without a state of emergency and without state involvement – precisely what is being done now."

Do you feel personally responsible for failing to convince them then?

"No, because what I did was close to the limits of my responsibility. Doing more isn't possible, as more means a different kind of responsibility, and that much should be clear. Those who wish to have no responsibility jump the TS ship."

In April, in the aftermath of the criticisms, you tendered your resignation, as you did in July.

"The medical wing of the TS had a collective resignation on its agenda in July, and we decided that we didn't have the right to abandon the ship in a storm. That was a unanimous decision."

How does the TS operate and how do you decide – in a 'one-person, one-vote' procedure or do you just talk, and the Government makes official decisions?

"The Government makes the decisions, there is no vote. The medical wing of the TS has organized itself – initially without the paediatrician, as he had a different view – in order to be unified. We have come up with this body, it doesn't exist officially. Prior to this, it was just a group of individuals, and everyone spoke their mind."

Until Professor Nestorović left?

"That's right, if you wish to be specific. But before as well, while Nestorović was still around, I personally organized the others. We have a meeting ahead of a TS session, where we coordinate our position, and we are always in touch. We have presented a unified front in the past two months."

When you say, we would like such and such measures, how do the others respond – the ministers, the prime minister?

"It is a very open and constructive environment even when our views are opposed. If the medical doctors were to demand absolute compliance, with everyone doing as we say, we would be left without a huge number of other jobs and various systems. I understand the balance between medical science and economy, but I have a duty, in line with the Hippocratic Oath, to be focused on preserving lives, and that aspect is always foremost in my mind. And that's why I have disagreements with the political and economic wing of the TS."

How do you feel now? Disappointed, helpless?

"The only thing that disappoints me is the attitude that some colleagues of mine have taken, who think that it is OK to have rifts among the medical professionals. Every medical doctor is literally like a brother to me. But there is more to the situation than being negative about it. A balance must be struck in everything, so that we could go through this as painlessly as possible, with as few deaths as possible, and ultimately keep the joy of living. And that takes a lot of energy, empathy, and love for one's own people."

Ten months on, when you look in the mirror, what do you say to yourself?

"I say that I have found myself in a situation that I really didn't expect. That initially I wanted to avoid it, primarily because of my age, and that then I realized that was impossible. I have understood something that many have not – this is not a question of ego, or proving a point; this is only about preserving lives. I know that I have given it my utmost, and that there have been no big mistakes. There have been historical errors in communicating with the public after 5 June, as a slew of messages were taken to mean that it was all over. But that cannot be pinned on either myself or the medical wing of the Task Force. I look at myself in the mirror with a clear heart and a clear conscience, and say, 'You've done well.' "

Jelena S. Spasić

On Nestorović

'We have had disagreements for decades.'

When you say that those who wish to have no responsibility abandon the TS, do you mean Professor Branimir Nestorović, who is implying in his photo montage as well that you and Professor Branislav Tiodorović are scaring the nation in order to make a profit from the vaccines?

"The two of us have had opposing views for decades. Professor Nestorović wants nature to take its course in everything, and that is his position on epidemics in general. He keeps saying that things look good, that it's all over, that we should let it all run its course, with some surviving and others dying. The position that the rest of us on the medical wing of the TS take is that human lives must be preserved at all times, and that you need to present accurate data. This data isn't a good match for the siren in that montage."

The antivaxxers

'They don't merit a serious conversation."

Should the antivaccine lobby be stopped somehow?

"Not everything that was official has had a good track record. They don't merit any kind of serious conversation. We have highly advanced institutional procedures for ascertaining vaccine safety and a regulator whose duty it is to provide a signature, certificate, and seal of approval – the Medicines and Medical Devices Agency of Serbia (MMDAS). No country has more than that. Do you honestly think that I would take the jab if there weren't a signature there?! The MMDAS is among the 50 agencies recognized by the WHO."

Nowhere to be seen

'The flu might appear in late January.'

Do you expect the flu to show its face from behind the facemasks soon?

"The flu really isn't there, it is being searched for intensively. SARS-CoV-2 has most probably supressed it. When the coronavirus activity diminishes, the flu, as well as other viruses – the rhinovirus, for example – can be expected to reappear."

Will the flu appear in late January or in February?

"It can be expected, but the fact that we are using all these protections will work against it. I don't expect any serious effects, but we should be mindful that for those who have had Covid, the flu can be a more severe illness than usual. This is why we insist so much on flu jabs."

Mortality

'My data is irrefutably true; we'll be better than the developed countries.'

Your investigation into the number of deaths from the coronavirus between March and June in Belgrade has spurred on those who claim that the data is doctored to present a smaller death toll.

"218 is the number provided in the City Institute for Public Health mortality statistics as indicating the number of deaths for which Covid-19 is reported as the main cause of death. My investigation differed by only 100. My data cannot be changed by anyone, it is absolutely true. And the story of doctoring has nothing to do with the truth. The data obtained directly, as the events unfold, is one thing, and that's the data that is available. Back then, 118 deaths were reported that were caused by the infectious disease Covid-19. The death report is a different thing – it's part of a separate form used to obtain a death certificate, and is used by civil registrars, the Statistical Office, and all other public institutes as a matter of legal obligation. In this case, a diagnosis provided under the Covid-19 code was used. This number can never be the same as the reports of deaths caused by infectious diseases, available only during the wave itself. I found more diagnoses that could be Covid-19 and estimated that the number was higher than 218. There were 29 cases of deaths caused by atypical viral pneumonia, which hadn't occurred before at all, and they could perhaps be added to the 218. Then you have 102 cases of unspecified pneumonia (it's unknown whether it is bacterial or viral) more than the average in recent years. And if that is assumed to be due to Covid and added, then you get the number that I mentioned."

Are you still looking into the data on the number of deaths?

"I have clearly shown that it is necessary to review everything, and that has been the decision of the government at any rate. So, I'm happy with that. This is very solid data that I will defend abroad as well, as there isn't a single criterion across different countries. Everyone should undertake a review if what we want is accurate data and a clear definition. The WHO provided a definition for death related to Covid as late as 20 April, when we were in the middle of a pandemic wave. If someone thought that that definition was going to be used straightaway, they were dead wrong. No one could find the time to have a look at it until mid-May, when the first wave was largely behind us. And the story of data doctoring is just outrageous, as time will tell. Lastly, if you draw the bottom line, as I have done – and which is irrefutable – very solid data will show that we will fare better than many developed nations in terms of mortality. It's already clear that this is probably due to mass hospitalizations, large numbers of people receiving oxygen therapy in intensive care, and large-scale testing."

Kurir.rs/Jelena S. Spasić