Doctor Pēteris Apinis: Useless restrictions increase mistrust of the vaccine

Interview with Pēteris Apinis, doctor and former Minister of Health.

What happened with Ilze Viņķele?

Did something happen to her?

She was fired.

Oh, I was already getting worried that something serious has happened.

As a matter of urgency, the Ministry of Health has announced a competition for ten vacancies in the Vaccination Bureau, promising to pay up to 4,900 euros in salary. Is such an office necessary? Won't it become a feeding place for some people close to party Development/For! (Attīstībai/Par!)?

I have heard that more than 400 candidates have applied for a job there because these candidates do not need any special knowledge. I do not understand why such an office is needed. If the state did not meddle in medical matters, returned the vaccination process to private medical institutions, agreed on a payment of about 20 or 30 million euros, then in two months Latvians would have collective immunity, we would not need masks, curfews, children could return to school and we could go back to work. Vaccination passports for flights to warmer countries and ski resorts would have already been issued. This process can never be carried out by public hospitals with councils, boards, bureaucrats, and ministry opinions in the form of a mantra. Vaccination can be carried out quickly and accurately by a consortium of VC4, VCA, ARS, MFD, Baseina Hospital, Gulbja Laboratory, Central Laboratory, and perhaps other entities. They would even be able to borrow vaccines, for example from Finland, and start vaccinating the day after tomorrow. The ministry cannot do that, and the well-paid Vaccination Bureau is unlikely to do that. Private companies have at their disposal personnel, vehicles, and logistics (after all, every day drugs are delivered to all Latvian pharmacies), experience (laboratories, after all, knew how to provide and collect Covid-19 tests from all over Latvia).

The problem is not in medicine, the problem is in the government and the Ministry of Health, where there are no doctors and where the opinion of doctors is not listened to.

Why have three million people in Israel already been vaccinated, but the number is not even 10 thousand in Latvia yet?

If you count the doctors - graduates of the Riga Medical Institute and Riga Stradiņš University, then the biggest number works in Latvia, but in the second place is Israel. Our graduates currently hold leading positions in Israeli medicine, but some are directly involved in the organization of the vaccination process. For Israel, the education of RMI, including the knowledge provided by the Department of War, is good enough. In Latvia, the government does not listen to the opinion of doctors. It would not be a problem to call the medical general, the leading professor of anesthesiology, the leading epidemiologist in Israel and to ask in Russian (and sometimes even Latvian) - how did you do that? And they will be happy to share their knowledge and experience. I will cite the example of a friend of mine who works in a large Israeli hospital - one day 20 people came to the hospital and managed to vaccinate everyone - doctors, nurses, technical staff, patients (excluding those who had recently recovered from Covid-19).

And two main things that our Ministry of Health should definitely hear: vaccination against Covid-19 is not like a planned vaccination against diphtheria and tetanus in children. This vaccination is expensive, but it is justified. The Israeli ministry is paying ten times more for this vaccination than our ministry has planned. And the other is that not only vaccines and labor may be in short supply, but also one cubic centimeter syringes and all stocks of insulin syringes may be depleted very quickly.

In fact, even the Israeli Minister of Health, Yuli Edelstein, is a gentleman of my age from Chernivtsi with education from Moscow who could be phoned.

Shouldn't top government officials lead by example and get vaccinated? Otherwise, it might seem that the head of government, ministers, and deputies are afraid of vaccinations? Maybe they really are scared?

We could divide the population of Latvia into four groups. The first - ones who are not afraid of neither Covid-19 nor the vaccine. I belong to this group and will be happy to be vaccinated as soon as I am given the opportunity. The second group is afraid of the disease and not afraid of vaccination. It is thought to be the largest group of people, and we could call these people the pragmatists on whom the state is built. Most of my colleagues and acquaintances belong to this group, who do not want to get sick and experience complications, permanent side effects or go to the intensive care unit, so they are looking forward to the possibility of vaccination. The third group is not afraid of the disease but is afraid of vaccination. And there are a lot of such people, their opinion is respectable, but I think it is problematic. And there is a fourth group, a typical example of which is Krišjānis Kariņš, who is afraid of both the disease and the vaccine. He is ready to destroy the country just so that everyone would isolate from him, sitting in the Pļavnieki apartment, wearing ten masks and not allowing children to go to school. And at the same time, he has read horror stories of deaths from vaccination and will not let himself be vaccinated. By the way, at the beginning of the vaccination process in Israel, when the Prime Minister and the Minister of Health were vaccinated in front of the television cameras, they admitted that they would likely face one very serious complication or death per million vaccines. There is currently one more or less vaccination-related death in Israel (approaching three million people vaccinated), but without vaccination, the number of deaths per million population would be much higher.

Who knows how it will be in time, but for now it seems that quite a large part of society is not ready to be vaccinated. Some believe that they will be chipped, others are afraid of side effects. Even doctors are not quite keen on vaccination. But then should we get vaccinated or not? What do you recommend?

I really do read international reports and information every day, the same thing that is received by the leaders of medical associations around the world. And there is both conviction, a wait-and-see attitude, and doubts and worries in this information space. My attitude towards vaccines is that vaccination is currently the only way to stop this psychopandemic. Fear of Covid-19 is exaggerated, leading to panic and inequality in medical treatment, to depression, anxiety, which reduces immunity and the body's resilience, but currently, the only way out of this global psychosis is vaccination. Vaccines are not chips, vaccines are not dangerous, vaccines do not cause Covid-19.

I will get vaccinated as soon as possible, but I am not sure that the Latvian government will provide me with such an opportunity in the near future. If I have to answer the question honestly - how much do I believe in the current vaccine, I will answer - by 80%. And I believe that vaccine manufacturers and scientists are continuing work to make this vaccine better every month, with fewer possible side effects. I have, of course, read the discussions initiated by Norwegian doctors that very old people with many comorbidities should not be vaccinated at the moment, I have read the opinion of very professional researchers that this vaccine should not be given to children, pregnant women, and so on. So, I am absolutely convinced of the need for vaccination, but I am prepared to accept that people have conflicting views.

We hear about Pfizer, and Moderna has also come to Latvia. Johnson&Johnson has been discussed. And Sputnik too, which will not be available in Latvia. What is the difference?

It is not possible to ask a more complicated question. There are currently at least 80 ways in which the world is trying to create a unique, effective vaccine against Covid-19. The goal is one: to make the body produce the strongest, most effective, long-lasting antibodies to the Covid-19 virus possible. I will mention one way I read about yesterday. Medicago Inc. concept is based on the fact that plants can be used to produce recombinant, virus-like particles. These particles can be engineered to obtain the required influenza or coronavirus HA proteins, including SARS-CoV-2 proteins, that are identical to supercapsid receptors, such as the S receptor for SARS-CoV-2. So producing a protein as a vaccine against which the human body would make antibodies.

As a layman, I can only marvel at the way people think and the depth of their research. Behind each of these vaccines, both Pfizer/BioNTech and Sputnik, there are excellent scientists and researchers, but, of course, the safety and control criteria are different for the European Union and Russia.

Currently, some companies are approaching the development of vaccines against Covid-19, which will be a nasal spray or even a tablet, then people will no longer have to injected and fear getting chipped. In addition, these aerosol vaccines cause an increase in mucosal antibodies, which will significantly strengthen the immunity of the nasal mucosa and increase the protection of the entrance gate of infection. In any case, it is an endless reading list - how the scientists are currently driving the development of vaccines. And I think that, after a year, when the Covid-19 era will end, these scientific developments will serve as a basis for completing the development of a universal flu vaccine, and we will no longer have to vaccinate against another flu virus every year, but there will be a universal vaccine against all flu.

Can rapid Covid tests have a positive effect on limiting the spread of infection?

It would be better to ask this question to the former Minister of Health, now the doctor of the laboratory Didzis Gavars, who is constantly working on new, more accurate, and faster diagnostic methods. In this area too, new methods, new diagnostic possibilities are appearing all the time, and they are quickly becoming cheaper. I cannot answer the question about "rapid Covid tests", because again, in fact, the answer would be worthy of a whole lecture by comparing different methods. But the world will go for bigger, cheaper, and faster testing.

In the spring, when there was a "first wave" of Covid, there was no cure for the disease. But what about now? Has nothing been thought of? Shouldn't plasma from people who have recovered from Covid be used to treat patients?

We have known respiratory viruses for years. What is treated is not the specific virus, but bronchitis, pneumonia or acute respiratory distress syndrome. But I can tell you briefly - what would I do if I got Covid-19.

I would call my family doctor and she would laugh at me because she knows I do not believe this disease. I would air out the room several times a day, but the rest of the time I would lay a wet terry towel on the radiators for humidity. I would drink at least three liters of fluid a day and choose a slightly alkaline mineral water such as Borjomi. I would sleep on my stomach as much as possible. I would use a pulse oximeter, I would increase the dose of vitamin D to 8,000 IU a day, I would also take multivitamins with selenium and zinc. I would eat probiotics such as sour-milk products. I would rinse my throat and nose with saltwater. I would let professionals perform cupping on myself. I would light the room with the quartz lamp, but I will also use it on my back for a while. If my temperature is not too high, and the temperature outside is not too low, I would go for a walk in the forest or even in my garden. With the blessing of my family doctor, I would give analyzes - blood picture and biochemistry, and I would pay attention to leukocytes, C-reactive protein, liver function numbers.

If I were to get sick in a more severe form, I would rent an oxygen concentrator (at arbor.lv rent per month costs 42 euros and 90 eurocents) and use additional oxygen if my oxygen saturation decreases. I would probably prescribe myself a small dose of glucocorticoid and (I am probably currently loudly cursed by some of my colleagues) antibiotics. In case of high temperature - small doses of aspirin and ibuprofen.

At least three days after the onset of symptoms, I would be completely isolated, and I am absolutely convinced that by that time the symptoms will go away, but 10 days after the onset of symptoms, I would go into the world as a healthy person.

How do you assess the government's restrictions on which goods can and cannot be sold? What about the curfew? Are all these restrictions necessary? Maybe they need to be even tighter?

Latvia's current government is Latvia's biggest problem. Government restrictions are rising, but so are morbidity and mortality. It would be logical to stop and think - maybe we are doing something wrong, maybe there is another solution, maybe there are good examples from other countries (maybe even Estonia)?

The more pointless restrictions are created by Kariņš, the more diligently people think about circumventing the restrictions, the less they trust the government's promises that it will only be "for three weeks" or "this time we will need to be patient".

Why is this happening? In Latvia, no money is allocated for research that could reveal the wrong actions of the government. Therefore, we will have to do with the adaptation of world literature. There are currently a large number of publications on the social determinant and Covid-19 in the world, and convincing research shows that elderly people with co-morbid conditions, sedentary people, smokers, drug addicts, and alcohol users are most at risk of severe morbidity and mortality. On the other hand, from the point of view of social determinants, people with lower education, poor people, people of several generations living together, people living in apartment buildings, people living in a relatively closed information space are most exposed to severe morbidity and mortality.

Stupid and less stupid restrictions and ideas do not allow people to distinguish what is really important. I will repeat my example from an ancient Latvian story about a shepherd boy who cried wolf. He cried twice and all the people ran to him, but there was no wolf. The third time the wolf was really in the sheep enclosure, the people did not believe him and did not run to save the sheep.

So has our government and the media that indulge them - they have always scolded those who opposed restricting children's sports or endless distance learning, but now that everyone should focus on vaccination, when people should consolidate their faith in the vaccine, people do not take it seriously.

It seems that the head of government and his closest associates have never studied mathematics. For example, vaccination is a hundred times more important than masks, but Kariņš's government is investing all its efforts in fighting those who refuse to wear masks. The distance of two meters and handwashing remains valid. The worst thing is to be with others in poorly ventilated rooms closer than two meters, for more than 15 minutes. And at the same time, Kariņš's government is demanding warnings and calls to put masks on nature trails in the forests and swamps. You can't get a virus on a nature trail.

There is another bad side effect of using masks. People consider the mask to be an unpleasant restriction, but sufficient protection, so they stop following the restrictions on distance. All studies have been done with serious medical masks, but nowhere has anyone studied how a disposable mask protects if it is used repeatedly for months. The masks that were bought with the blessing of the government for a lot of money (someone has earned a lot) and are now distributed to nursing homes and students do not seem to meet any criteria. If the size of the virus is in nanometers, but the holes in the mask are in millimeters, then the comparison would be like a migration of a herd of sparrows between Doma and Pētera churches.

At school, the most important thing would not be a mask for children (which they anyway wear incorrectly), but ventilation of the premises or at least regular airing out and humidification. If 18 cubic meters of air per student per hour are not provided in the classroom, the virus will spread through the air with or without masks.

There is no hope that Kariņš and the company will listen to anything. Completely useless restrictions only increase people's mistrust of vaccination.