"Separating vaccinated students older than 12 years of age from those unvaccinated is the only logical solution that I can see for the start of the school year. Those who have had the jab should have in-person classes, and those that haven't can have online classes," Dr Predrag Kon, chief physician, epidemiologist, and member of the Covid-19 Task Force, said in an interview with Kurir.
Can this be done?
"Although it's recommended, vaccination of children older than 12 is practically non-existent. I say this as an epidemiologist – and I assure you it's true – creating workplace groups in which those vaccinated and unvaccinated freely mix essentially provides the virus with a mechanism to survive for as long as it wants. However, the decision must be made by the Ministry of Education. You cannot put those protected together with those who are not, primarily in the interest of those unprotected. This has been proven in Israel – when an epidemic breaks out, collective immunity can be reached only when there is a very high percentage of those vaccinated. At the outset of the epidemic, immunity is breached in those who have taken the jab as well, but the only thing that happens is what we're seeing now – the disease changes and becomes far milder. That's how the vaccine works, and eventually reduces the mortality rate, which is our primary goal. In a situation when the number of infections is on the rise, one of the important questions is how to tackle the issue of staff and student groups at schools."
What about those below 12 years of age?
"There should be a decision of the Ministry of Education for that too. Most likely years one to four will have in-person classes, and years five and six will alternate in-person and online classes daily. Wearing masks is mandatory."
'WE'VE SHOT PAST 500 INFECTIONS, WE'LL SOON REACH 1,000'
The corona numbers have reached 579 daily new cases, up by nearly 100 from a day earlier.
"That's bad, of course, and indicates that it's highly likely we'll be reaching a four-digit number soon. A four-digit number means that having things as they are now is out of the question, with respect to regulating gatherings."
Are we in the fourth wave already?
"If you take a look at the chart, it's still a mild increase. That said, we are certainly in a wave, and the question is just whether we should call it a wavelet or say that it is 'an increase at the present moment.' What matters is what we should do going forward. Since mid-July, Belgrade has registered over 20 infected people who have returned from vacations abroad. And there were seven on Wednesday alone."
And that is where the key to the problem lies – you can enter the country freely from six neighbouring states. On top of this, you can go to Albania and Montenegro freely, and it is mostly those who have not taken the jab that go there.
"All our citizens must register upon their return from abroad, excluding the countries in the so-called mini-Schengen – a political decision has been made there. Unfortunately, the seven abovementioned people have returned from one of these countries, where there are greater numbers of our tourists, but I won't name it. We have also had virus introduction via international travel passengers."
Do you mean Indian nationals, who might be carriers of the Delta strain?
"No, and that is interesting, because we monitor Indian nationals. They are mostly vaccinated, so there have been very few infected people there, and it's always individuals. They are treated at the hotel – residential treatment of sorts – and they are in quarantine."
The WHO calls for a moratorium on booster jabs until the end of September. Are we placing a moratorium too?
"I don't know the answer to that. As far as I know, it is only recommended for the US. But our position on the booster jabs is very clear – for the time being, it's used only with seriously immunocompromised people, i.e. those who have had organ transplants, are insulin-dependent or on dialysis, or are receiving an intensive cytostatic or radiation therapy. All such people are in serious risk if they become infected with Covid-19. Everything else is monitored. It's becoming clear, at least as far as Israel is concerned, that even those fully vaccinated get ill. We just need to take account of the fact that Israel tests around 100,000 people per day and records around 3,400 infections from among these. We, on the other hand, get a higher percentage of positive results than Israel because we test 10 times fewer people."
When will the third dose be administered to the general population in Serbia?
"This should be worked out in the next two months, but I don't believe that it will be administered to the general population. I don't want to jump to any conclusions, but it makes far more sense if it's administered to the elderly and people with specific diseases, because their immunity is compromised."
What changes with 1,000 infections a day?
"A four-digit number means that having things as they are now is out of the question, with respect to regulating gatherings."
Anything over 50 will be banned?
"I don't know. It's pointless now because people here really don't follow the measures."
'I GET MORE PRAISE THAN ATTACKS'
Do you worry that you might be attacked by an idiot in the street?
"Someone in a fancy car yelling 'Enough with the vaccines!' at me I don't see as a threat. The point is that this person believes that's been blown out of proportion, that it shouldn't be done, but quite the opposite is the case. When I post about this, I want to stress that this sort of belief is wrong, not for reasons of personal safety. I feel completely safe, in Belgrade as much as anywhere else. I get far more hellos and praise, people wishing me well. Unpleasant situations are actually rare."
It has all become pointless?
"The idea that vaccines shouldn't be used at the present moment is bordering on lunacy. You'll hear it said, especially by young people, that they have no intention of getting protected by the vaccine, and that they will simply have Covid and boost their immunity. But the truth is that it's far simpler and more painless to use the vaccine. I'm not saying that vaccination would stop the virus in its tracks, but that its circulation would be far more difficult and vastly smaller in scale. You cannot stop virus circulation in workplace groups that will form in September."
Which brings us to Covid passes.
"Covid passes have caused an unwarranted outrage. The City Institute for Public Health sent a notice on 6 April to the City Hall, The Belgrade Covid Task Force, and the Mayor, underscoring the need to ensure people are protected at public gatherings. We have said countless times already that you can have those who have taken the vaccine, those who have had the disease, or those with a negative test there. If someone isn't in any of these groups, then they must wear a face mask. And the logistics of it all has nothing to do with public health. Festival organizers have accepted this, but there is a huge number of events for which no one has requested permission. Then there are weddings and celebrations. We'll probably be forced to sort it out by means of public gathering measures again. Because all the other measures are in force – the indoor mask mandate, as well as the abundantly clear requirement to wear face masks on public transport buses. A lockdown – in the sense of a ban on movement and a curfew – will certainly not be enforced again.
"The Covid Task Force has never discussed Covid passes at its meetings, because the issue hasn't been resolved ethically. And it is unethical for healthcare workers not to be vaccinated because they can infect patients as well."
We have legal and constitutional grounds to make the vaccination mandatory, and still nothing.
"Mandatory vaccination of healthcare workers has been on the agenda of the Task Force meetings since March. It is discussed every time, and gets constantly dismissed."
What else is dismissed in the Task Force meetings?
"Establishing the criteria for when to do what is very difficult, and things are mostly assessed on an ad-hoc basis. We are already in a situation where we must give due attention to getting four-digit numbers of new cases. I have already said what I think, as has the medical wing of the Task Force. Nothing new can be said. And then you get a call about a game – how to get it organized and whether masks must be worn."
And then it gets as crowded as at the Rajko Mitić Stadium, or in the Busije area.
"Those are the situations when everything that has previously been agreed is violated."
What can you do about it? Are you helpless?
"Simply put, it's about accepting the fact that we are unable to enforce the measures."
So, do you feel like a placeholder, put there to legitimize what you do not approve of?
"I don't legitimize anything because I always speak against certain events and work to ensure the measures are enforced to the greatest extent possible. People need to understand that those of us in the medical wing of the Task Force don't run the country, we can only act in an advisory capacity. We do the same thing in the Task Force, which does not vote – decisions are made."
Are you pinning your hopes on lottery as a way to incentivize people – primarily young people – to get the jab?
"I have nothing against incentives, but for young people to change their minds, we need to talk to them. I get the impression that no one wants to do that, including teachers. The whole society is just standing on the sidelines, waiting to see what will happen, with the 'Hope it doesn't happen!' sort of strategy. But we don't have time for that, now we must firmly and actively insist on vaccination in forming workplace groups. Personally, I don't see any other solution. Whether you refer to it as mandatory, whether it's in line with the Constitution or human rights… Those kinds of ethical dilemmas have long since been resolved in many countries, as well as in all the states in the US."
The Constitution also prioritizes public health over the rights of the individual.
"That's how it should be, but you cannot see that at the moment. What we have is political decisions to which public health professionals have appended their dissenting opinions. I say 'public health professionals' deliberately, as it has a much broader scope than the Task Force. Not just the Task Force, every professional organization in the health system, both in Serbia and worldwide – and here I don't mean the trade union people – is in favour of mandatory vaccination and separating those vaccinated in the workplace. What can a handful of people do if the society doesn't want to accept scientific evidence?? The alternative is to test those who haven't had the vaccine every 48 to 72 hours – an idea which was brought up here, but was rejected, even if it were free."
GUČA STILL WITHOUT TASK FORCE PERMISSION
Will the Guča Trumpet Festival be held?
"The Guča Trumpet Festival hasn't been granted permission by the Task Force. The point here is that this is a high-risk gathering, given the number of daily new infections. They can obtain our approval only if they provide everything they said they would. The Guča Festival organizers and the Lučani Municipality have sent us a notice saying that anyone who hasn't been vaccinated or hasn't had a test in more than 48 hours prior won't be allowed in, and that they will provide testing sites. Further, they said that there would be four times fewer guests than it is estimated, but I won't mention the numbers, otherwise some may say I'm working against them all. No festival planned for the latter half of August has been granted permission by the Task Force yet, although Guča is planned for mid-August."
(Kurir.rs /Jelena S. Spasić)