Covid 19 – Doctors under pressure

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Susanne Berger
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Covid 19 - Doctors under pressure: How some governments are fighting dissent rather than disease

There is growing pressure on doctors worldwide to adapt or face serious consequences

By Susanne Berger (Washington D.C.)

DR. AI FEN (China)

„Now we remember the extraordinary joy we enjoyed in ordinary life. The feeling of holding the baby, going to play on a slide with him or watching a film with my husband, even things we didn’t do so often in the past, all seem a kind of happiness now, an unattainable happiness.“

Dr Ai Fen, Wuhan

In late December 2019, Dr Ai Fen, head of the emergency department at Wuhan Central Hospital, was the first to share information with her colleagues about the presence of severe COVID-19/SARS infections in several of her patients. She alerted her staff to the virulence of the virus and urged them to take extreme precautions, including wearing a double layer of face masks, gowns and gloves. Among those who received Ai’s warning was the young ophthalmologist Dr Li Wenliang. However, Li contracted the virus soon after operating on a sick patient. When Dr Ai posted her concerns on the popular Chinese messaging app WeChat , Dr Li spread her warnings further. He was subsequently detained and questioned by the Chinese security services. At least seven of his colleagues were later also arrested. Dr Li decided to continue speaking out and gave interviews from his hospital room, including to Western media. He died at the beginning of February, aged 34.

Dr Ai „the whistleblower“, as she is known in China has not been seen for almost a month. In early March, Ai reported on the efforts to silence her in an article published in the Chinese people’s magazine Renwu (People ). Although the Chinese authorities heavily censored the story, a full version of it soon went viral on social media. A few days later, a post appeared on Dr Ai’s Weibo (Chinese Twitter account): „Thank you for your care and love. Right now I’m fine and still working“. After an investigative Australian TV programme („60 Minutes“, Australia) aired a report on Dr Ai’s disappearance, another mysterious post showed a picture of a street in Wuhan along with the caption „A river. A bridge. A street. A clock strikes.“ And on 1 April, a post read „Happy April Fool’s Day „, showing Dr Ai in a lab coat and mask, supposedly at work. However, no one has yet been able to independently confirm her whereabouts. On 2 April, a Swedish journalist was able to participate in a video conference of several Chinese doctors from Wuhan and the surrounding area. Dr Ai Fen was one of the participants, although her exact whereabouts remained unclear. In the video, she appeared to be sitting in an unspecified room, without any identifying marks, and her comments were far less critical than before. Almost two weeks later, on April 14, Radio Free Asia (RFA) reporters were able to speak to Dr Ai, who said she was fine and continuing to work at the Wuhan hospital. She also told them that she was the author of the posts on her social media account. However, the reporters were unable to confirm Dr Ai’s presence at the Wuhan hospital.

In the earlier interview with Renwu , Dr Ai stressed that she had only one regret that she had not spoken out more forcefully after being reprimanded in a disciplinary review in early January.

„If I had known then what I know now, I wouldn’t have cared about the pressure (from my superior), and I would have spoken [expletives] everywhere, you know? (…) Nobody apologised to me at any point. I still think that these events are even clearer proof of why each person should stick to their own independent ideas, regardless, because if someone wants to stand up and speak the truth, there has to be that someone, and the world needs to hear a dissenting voice, right?“

Dr Ai’s anger and frustration at the Chinese authorities‘ haphazard response to the exploding health crisis in Wuhan is widely shared, but few people dare to speak out. Those who do, like property tycoon Ren Zhiang, are putting themselves at considerable risk. In a barely veiled reference, Ren recently attacked Chinese leader Xi Jinping in a biting essay, writing, „I don’t recognise an emperor standing there flaunting his ’new clothes‘, but a clown stripping naked and insisting on continuing to be emperor.“ Ren has also disappeared in the meantime.

Further reading

Science Integrity Digest, „Dr Ai Fen, 艾芬, the Wuhan Whistle“

The Guardian, Coronavirus: „Wuhan doctor speaks out against authorities“

The China Times, „ESSAY BY MISSING PROPERTY TYCOON REN ZHIQIANG“

Reporters Without Borders, Press freedom in the corona crisis

DR. ANASTASIA VASILYEVA (Russia)

„Access to information is a key aspect of the right to health. Everyone has the right to be informed about ongoing aid measures. Failure to guarantee this right undermines public health measures and jeopardises the health of all.“

Natalia Zviagina
Director for Russia at Amnesty International

On 3 April, the news portal Meduza reported that Dr Anastasia Vasilyeva, a well-known ophthalmologist and leader of the Russian doctors‘ union Allians Vrachy (@alyansvrachy), was arrested and beaten in the city of Okulovka (Novgorod region). Vasilyeva and her team were on a humanitarian mission to deliver 500 ventilators and personal protective equipment (PPE) to two local hospitals. The doctors‘ alliance is supported by Russian opposition leader Alexei Navalny (@navalny).

According to a report by the advocacy group OVD-Info, plainclothes police officers beat and choked Vasilyeva on 2 April, allegedly for violating recently introduced emergency regulations, in particular section 19.3 of the Code of Administrative Offences (disobeying lawful orders of police officers). Persons charged with this offence can be detained for up to 48 hours without trial. Vasilyeva’s team was apparently accused of violating quarantine regulations in the area.

Dinar Idrissov, a human rights activist who witnessed the attack, reported that Vasilyeva was hit in the chest and lost consciousness. An ambulance crew that was called was only able to attend to Vasilyeva briefly. The group was then taken to the police station. They were released at around 10.00 pm that evening. However, Dr Vasilyeva was immediately arrested again. She was finally allowed to leave 19 hours later, on 3 April. After two court hearings, she was sentenced to pay a fine of the equivalent of 20 dollars.

„It wasn’t about the money, it was about breaking me,“ Dr Vasilyeva said in a statement after her release. „But I am even more convinced that we are doing the right thing, and we will definitely continue to do so.“

In late March, Dr Vasilyeva was summoned before Russia’s powerful Investigative Committee after her union launched a public campaign to collect PPE for distribution to Russian hospitals. Dr Vasilyeva had been a vocal critic of the severe shortage of PPE and the Russian government’s decision to continue sending vital medical supplies abroad. Dr Vasilyeva also repeatedly warned that the Russian healthcare system was woefully unprepared to deal with the complex and widespread effects of coronavirus infections.

Natalia Zviagina, Russia Director of Amnesty International, strongly condemned Vasilyeva’s detention. „It is shocking that the Russian authorities seem to fear criticism more than the deadly COVID-19 pandemic. By imprisoning her, they are revealing their true motive they are willing to punish health professionals who dare to contradict the official Russian narrative and expose shortcomings in the public health system.“

Further reading

The Moscow Times, „meet-the-activist-doctor-who-has-become-the-kremlins-loudest-coronavirus-critic“

PROF. DR. ANTHONY FAUCI DR. ROBERT REDFIELD DR. RICK BRIGHT (USA)

„You don’t determine the course. The virus determines the course.“

Dr Anthony Fauci, Washington, D.C.

At 79, Dr Anthony Fauci, a leading immunologist and director of the National Institute of Allergy and Infectious Diseases, is one of the world’s most experienced public health experts. For more than forty years, he has led the United States through a series of global health crises, including the HIV/AIDS epidemic of the late 1980s and the recent Ebola and Zica virus outbreaks. As a current member of the US federal government’s coronavirus task force, he has once again become „America’s doctor“, as The New Yorker magazine put it in a recent portrait a steady, reassuring presence in daily briefings, delivering sober and often brutally honest facts.

For the White House press corps and the public watching at home, Fauci often explains, adds to and corrects „live“ the many misleading statements made by President Trump and other US government officials. This honesty could soon cost him his job. Behind the scenes, Fauci has reportedly clashed frequently with several key members of the Trump administration, most notably Peter Navarro, the Special Advisor for Trade and Manufacturing Policy. Fauci has made it clear that he strongly opposes the public promotion of questionable treatments and drugs in the fight against COVID-19, such as hydroxychloroquine, a drug used to treat lupus, malaria and similar diseases. Fauci and his colleagues have repeatedly warned that the drug’s effectiveness in treating COVID-19 is uncertain and requires additional testing. Dr Fauci’s concerns appear to have been justified: On 24 April, the US Food and Drug Administration (FDA) issued an urgent warning against the use of the drug due to potentially serious cardiac side effects.

In his public statements, Fauci was level-headed but unequivocal. When President Trump announced that he hoped to get the US economy back on track by Easter (12 April), Fauci pointed out that this was merely a „wishful date“ the President was standing just a few metres away. Faced with data forecasts that pointed to the possibility of hundreds of thousands of deaths if the rules of social distancing were suspended too quickly, Trump finally relented. But he obviously didn’t like it. Neither did Trump’s most ardent supporters, who verbally attacked and even physically threatened Fauci on Twitter and other social media for daring to disagree with the president. The situation became so serious that the FBI decided to give Fauci personal protection.

However, this did not stop Fauci from speaking out. When asked over the Easter weekend to comment on whether or not the US should have been better prepared for the current crisis, Fauci did not hold back: „I mean, of course, logically you could say that you could have saved lives if you had a continuous process and started containment earlier,“ Fauci said in an interview on CNN. This prompted President Trump to share a message from a member of the Republican Party calling for Fauci’s firing with his own 78 million Twitter followers: „Time to #FireFauci…“ (Time to fire Fauci…).

So far, Fauci seems unfazed. His focus is on creating a safe way to open up the US economy while ensuring that people’s lives are not further jeopardised. „We’re looking at this from a purely public health standpoint,“ Fauci explained. „We make our recommendation. Often that recommendation is accepted. Sometimes it’s not. But (…) it is what it is. We are where we are now. (…) It’s a consequence that you have to weigh up. Trying to save as many lives as you can.“

Several other American scientists and doctors have also come under pressure. When Robert Redfield , director of the American Center for Disease Control (CDC), warned in an interview with the Washington Post on 21 April that the next wave of coronavirus infections, expected in the autumn, could be even „more difficult“ than the current one, President Trump complained in a tweet the next morning that Redfield had been „totally misquoted“. Redfield, however, stood by his warning. At a later briefing at the White House, Redfield merely clarified his remarks in more detail, explaining that the additional problems of flu and influenza would make dealing with the coronavirus in autumn and winter „even more difficult“. At the same time, however, he also emphasised that he had been quoted correctly by the Washington Post reporter.

That same day, Dr Rick Bright , who held a key position in the Trump administration’s official pandemic response, claimed in an interview with the New York Times that he had been fired for refusing to endorse questionable coronavirus drugs and treatments that President Trump had previously touted. „Specifically, and contrary to misleading guidelines, I restricted the widespread use of chloroquine and hydroxychloroquine, which are being promoted by the government as panaceas but clearly lack scientific merit,“ Bright told the newspaper. Bright, the former director of the federal Department of Health and Human Services‘ Biomedical Advanced Research and Development Authority (Barda), has been reassigned to a position at the National Institute of Health (NIH). Bright announced that he will file an official whistleblower complaint. „I am speaking out because science not politics or cronyism must lead the way in fighting this deadly virus.“

Further reading

The New Yorker, „How Anthony Fauci became America’s Doctor“

Der Spiegel, „anthony-fauci-vs-donald-trump-the-corona-oracle“

SUCHARIT BHAKDI (Germany)

„As an emeritus professor at Johannes Gutenberg University in Mainz and long-standing head of the Institute of Medical Microbiology and Hygiene there, I feel obliged to critically scrutinise the far-reaching restrictions on public life that we are currently imposing in order to reduce the spread of the COVID-19 virus.“

Prof Dr Sucharit Bhakdi

In Germany, too, discussions are continuing on how to counter the spread of Covid-19 infections most effectively. However, the discussion has a slightly different focus. Scientists and legal experts are increasingly debating whether the drastic measures to combat the pandemic are really justified and justifiable from a medical, legal and social perspective. Critical and controversial voices such as those of Professor Sucharit Bhakdi, the former head of the Institute of Medical Microbiology and Hygiene at the University of Mainz, have so far only reached a limited audience. At the end of March, Bhakdi sent an open letter to German Chancellor Angela Merkel, asking her to respond to a number of specific questions about the official handling of the coronavirus outbreak. To date, the Chancellor’s office has not yet provided an official response to Professor Bhakdi’s enquiry. Bhakdi’s critics point out that his doubts about the threat posed by Covid-19 infections are partly based on the large gaps in reliable scientific data. The gaps do exist, but according to other experts, this does not in itself justify a relaxation of the current regulations.

Meanwhile, legal experts are sounding the alarm about the long-term effects of such serious government interference in the lives of private individuals. In a recent essay published in the journal Ossietzky , the prominent German lawyer and former president of the International League for Human Rights , Rolf Gössner, criticised the lack of transparency and limitation of the current scientific debate. He warns of the potentially serious and lasting consequences of the drastic restrictions on fundamental rights imposed by the German authorities at federal and local level in response to the current crisis. In addition, Gössner has repeatedly drawn attention to the catastrophic human rights situation in the refugee camps in Greece and called for their immediate closure.

Further reading

You Tube, Open letter from Professor Sucharit Bhakdi to the German Chancellor Angela Merkel

Open letter from Prof Dr Sucharit Bhakdi to German Chancellor Dr Angela Merkel (Text)

Computer and Net, „Fact check video“

Lawyer Rolf Gössner’s article in the magazine Ossietzky

Appeal by the Republican Lawyers‘ Association for the dissolution of the refugee camps