Issue link: https://maltatoday.uberflip.com/i/1302895
8 maltatoday | SUNDAY • 25 OCTOBER 2020 INTERVIEW PHOTO BY JAMES BIANCHI The Malta College of Patholo- gists has just issued a statement criticising the government's handling of the 'second wave'. But while the crisis has undeni- ably worsened considerably in recent weeks, other countries – including some that were far more cautious than us – are also experiencing dramatic re- surgences. So is the current sit- uation really the government's sole responsibility … or was it an inevitable consequence of re-opening after lockdown? It was 'inevitable', up to a point, in the sense that every- body knew there was going to be a second wave. For prac- tical reasons, the response to the first wave - lockdown - had to stop eventually; and this is something even the medi- cal community accepted. No health professional, or medical association, argued in favour of indefinite lockdown. We all agreed with re-opening the air- port, bars, restaurants, and so on. But it had to be done slow- ly, and properly. So the second wave was al- ways going to happen; but this doesn't mean that we shouldn't still try and limit it as much as possible. This is not just true of Malta: all other countries faced the same challenge; and their success, or failure, depended on how they chose to tackle it. Some fared as badly as we did; some better, some worse… but there were countries that coped reasonably well. As we can all now see, however, Malta was not one of them. And there's a rea- son for this. We chose the full- out approach: and re-opened everywhere, as quickly as possi- ble, without enough in the way of strict health measures. It was, in fact, a free-for-all: the government announced that the crisis was over; it opened the airport indiscrim- inately to all destinations, and invited tourists in on the basis that we were 'COVID-free'; there were mass parties, large gatherings… Paceville re- opened for business as usual… and that is where it all started. And the result, for a time, was that we had the highest death- rate, and the highest number of cases per capita, in Europe. So clearly, our approach failed… And yet, the Prime Minister has just addressed a press confer- ence, and reiterated that his government's approach was based on 'expert medical ad- vice'… The College has in fact just released a statement to rebut that claim. The reality is that, unfortunately, a lot of the med- ical advice that was given was simply not heeded. Two months ago – in mid-Au- gust – we sent a proposal to the Prime Minister, copied to Chris Fearne and Charmaine Gauci, with a five-point plan on how we felt the pandemic should be tackled. Obviously it's a bit dated now; but there were two very important points. The first was that the gov- ernment had to acknowledge that there was a problem. If you don't take that first step, you will never come up with an effective strategy. So that was point number one. The second major point was that there should be a commit- tee of experts from all the dif- ferent fields – public health, in- fection control, virology… even metal health, if necessary – to advise the minister on the way forward: without any political interference. The other points were about banning mass-gatherings; in- troducing stricter measures… and above all, enforcement. And this is the real problem; to date, there has been no real enforcement. Today – with the situation once again at crisis level – a proper enforcement regime, with proper fines and penalties, should be in place. Even now, however, I am not sure that that is the case. What I can safely say, how- ever, is that there is no way – absolutely no way – that any medical expert would have given the go-ahead for the gov- ernment's re-opening strategy. No medical expert would have recommended allowing mass events to take place: because we knew, from beforehand, that this was going to create chaos. None of this was on the advice of the public health offi- cials. It cannot be. If any med- ical professional gave that ad- vice, they should be struck off the medical register. So to go back to those famous last words – 'we won the war on COVID-19' – we, in the medical community, knew that wasn't the case. And, as pre- dicted, the numbers started to increase again... Speaking of numbers, we have also seen significant fluctua- tions recently. This week, new cases hit the 200 mark for the first time; then dropped to just over 100; then rose a bit, then dropped a little more… from a medical perspective, what is the significance of these fluctu- ations? Does, for instance, the recent drop suggest that the situation is improving? What you have to look at is not so much the fluctuations, but the overall trend. Because we are such a small population, the variation in daily figures is not all that important. Wheth- er it drops one day, or goes up the next… I won't say it's irrel- evant, but the really important statistic is that the average to- tal is consistently increasing. Not a second wave, but Raphael Vassallo rvassallo@mediatoday.com.mt Malta College of Pathologists president Dr JAMES DEGAETANO warns that the newly- introduced COVID-19 measures are not enough without proper enforcement; and that more drastic measures may be needed, to avert an public health catastrophe