IAHN
Editor-in-Chief: Janusz Ostrowski
IAHN Bulletin is the official E-Newsletter of the International Association for the History of Nephrology
INTRODUCTION
TIME OF PANDEMIC
The
second
half
of
this
year
is,
perhaps
in
line
with
the
predicted
dark
scenario,
overshadowed
by
the
pandemic.
After
many
governments
relaxed
the
restrictions
during
the
holiday
season,
a
second
wave
of
the
pandemic
appeared
in
the
autumn, with double strength in some countries.
In
addition
to
the
negative
impact
on
the
economies
of
all
countries,
this
resulted
in
the
cancellation
of
all
cultural,
sports
and
scientific
events,
including
medical
ones,
especially
those
of
greatest
interest
to
us,
nephrology.
The
latter
were
and
still
are
carried
out
only
on-line.
May
this
not
become
the
rule
in
the
future!
Direct,
personal
contact
seems
essential
after
all.
The
organisers
of
the
12th
IAHN
Congress
in
Turkey
are
considering
postponing
the
next
year's
congress to 2022. An official announcement in the matter should be coming up soon.
The
first
optimistic
information
about
the
possibilities
of
fighting
the
virus
is
starting
to
surface,
though.
Of
those
concerning
a
larger
scale,
there
is
information
about
the
launch
of
vaccination
campaign
against
Covid-19
in
the
UK,
we
are
also
waiting
for
the
upcoming
vaccination
programme
in
other
European
countries
and
the
US.
A
long
process
as
it
might
be,
it
definitely
offers
hope
for
a
breakthrough
in
the
epidemic
situation
in
the
world,
fewer
complications
in the course of the disease, and fewer deaths.
A
few
weeks
ago,
an
issue
of
the
Archives
of
Hellenic
Medicine
was
released
with
full
coverage
of
the
lectures
presented
during
the
11th
IAHN
Congress
in
Larissa,
Greece.
An
exclusive
book
version
was
also
prepared
as
History
of
Nephrology
12.
The
material
was
prepared
in
an
extremely
professional
and
attractive
way
by
prof.
Athanasios
Diamandopoulos
and
prof.
Ioannis
Stefanidis
and
will
certainly
be
an
excellent
source
for
historians
of
nephrology
and
beyond.
Some
members
of
our
society,
as
well
as
its
supporters
remain
very
active
in
this
difficult
period.
It
is
certainly
very
much true of our dear Friend prof. Natale De Santo whose activities meet widespread admiration and respect.
Due
to
the
relatively
un
eventful
season,
I
turned
to
many
acclaimed
representatives
of
our
community
from
different
countries
to
prepare
a
publication
presenting
their
outlook
on
the
reactions
of
societies
in
their
respective
countries
to
the
course
of
the
pandemic.
I
personally
find
it
quite
an
interesting
topic
for
now
and
in
the
future.
My
request
met
with
a
positive
response
from
some.
The
materials
I
received
made
a
great
impression
on
me
and
confirmed
my
assumptions.
Anyway,
it
is
for
you
to
judge,
my
friends.
The
upcoming
Christmas
looks
like
a
great
opportunity
to
read
these
accounts.
The
works
were
prepared
by
prof.
Raymond
Ardaillou
from
France,
Ing.
Katarina
Derzsiova
from
Slovakia,
prof.
Athanasios
Diamandopoulos
from
Greece,
prof.
Michał
Kopczyński
from
Poland
and
prof.
Natale
De
Santo from Italy.
For
the
whole
Christmas
season
and
for
the
entire
New
Year
2021,
I
wish
you
all
a
lot
of
health,
rest
and
peace,
and
come
back
to
the
life
we
know
from
before
the
pandemic
as
soon
as
possible
so
that
we
can
meet
again
face
to
face
shortly.
Merry Christmas and Happy New Year
Janusz Ostrowski
The
Covid-19
pandemic
has
changed
the
life
of
our
country
as
well
as
that
of
many
others
with,
however,
specific
characteristics that I will try to identify.
The
majority
of
French
people
are
used
to
criticizing
the
decisions
of
public
authorities
and
of
scientific
experts,
and
are
rarely
unanimous
in
their
opinions.
Basically,
some
criticize
the
lack
of
preparation
for
the
appearance
of
a
new
emerging
disease,
late
decisions,
contradictory
assertions.
Some
French
people
have
even
gone
so
far
as
to
launch
legal
proceedings
against
successive
ministers
of
health
who
were
guilty,
according
to
them,
of
knowingly
endangering
the
lives
of
others
and
being
responsible
for
the
deaths
of
dependent
elderly
subjects
housed
in
establishments
intended
for
them.
Others,
on
the
other
hand,
criticize
the
public
authorities
for
giving
priority
to
the
fight
against
disease
by
imposing
a
2-month
period
of
almost
total
confinement,
which
has
destabilized
the
economy
and
prevented
schoolchildren
and
students
from
continuing
their
schooling,
especially
those
whose
parents
are
unable
to help them.
Bulletin
No. 5, December 2020
www.iahn.info
Janusz Ostrowski
Professor,
Centre of Postgraduate
Medical Education,
Warsaw, Poland
Board of the International Association for the History of Nephrology
Iwannis Stefanidis – President
Janusz Ostrowski – Past President
Ayse Balat – President Elect
Vincenzo Savica – Treasurer
Councillors:
The Covid-19 pandemic in the Slovak Republic
The course of the first wave
On
January
20,
the
Chinese
government
officially
announced
the
emergence
of
a
new
virus
with
human-to-human
transmission. In March 2020, WHO finally decided to declare a pandemic.
Despite
the
frightening
news
of
the
situation
in
China
and
even
after
the
outbreak
of
the
Covid-19
pandemic
in
Italy,
medical
authorities
in
Slovakia
behaved
as
if
it
had
had
nothing
do
with
us.
In
addition,
at
that
time
in
Slovakia,
elections
were
approaching
and
politicians
were
more
involved
in
the
political
campaign.
It
was
only
in
late
February
2020 during the pre-election moratorium that they started to pay attention and took action.
The
first
case
of
Covid-19
virus
infection
was
recorded
on
March
6,
2020
in
Bratislava
region.
With
the
situation
deteriorating,
Slovakia
officially
declared
a
state
of
emergency
on
March
15,
2020
when
strict
measures
were
taken.
Borders
with
the
neighbouring
countries
were
closed,
airline,
international
rail
and
bus
transportation
were
cancelled.
Based
on
a
measure
of
the
Public
Health
Office
of
the
Slovak
Republic,
due
to
the
threat
to
public
health,
all
retail
and
service
establishments,
except
those
providing
for
vital
needs,
were
closed.
Compulsory
wearing
of
masks
covering
the
mouth
and
nose
was
ordered,
and
2
meters
distance
from
each
other
became
a
rule.
The
movement
of
people
was
limited
to
going
to
work,
to
the
doctor
or
for
necessary
shopping.
All
mass
events
were
prohibited,
schools
of
all
levels,
as
well
as
universities
were
closed
and
distance
teaching
began.
Furthermore,
free
railway
service
for
pensioners
and
students
was
put
on
hold.
Visits
to
hospitals
and
social
service
facilities
were
prohibited.
The
Ministry
of
Foreign
Affairs
ensured
the
repatriation
of
our
citizens
from
abroad,
who
had
to
undergo
a
14-day
quarantine
in
state
facilities
to
prevent
the
spread
of
the
infection.
Although
the
outgoing
government
during
the
first
weeks
of
the
pandemic
really
took
responsibility
for
what
was
to
follow,
the
real
burden
remained
on
the
new
coalition
that
started
to govern on March 21, 2020.
The quest for equity
Michael
J
Sandel,
Professor
of
Political
Philosophy
at
the
University
of
Harvard,
asked,
in
April
2020,
to
remove
present
inequalities
in
America
where
the
best
colleges
of
the
country
still
give
access
to
the
richest
families,
so
they
just care for students originating in the top 1% of families in the country (New York Times, April 13, 2020).
The
quest
for
equity
is
also
very
strong
in
Europe.
By
the
end
of
2019
Aldo
Schiavone,
in
a
book
entitled
“Eguaglianza”
(equality),
stressed
that
the
concept
of
equality
was
born
in
Europe
where
it
is
considered
a
constitutive
character,
a
principle
of
the
world
that
has
been
lost
before
the
turn
of
the
21st
century.
In
Europe
there
is
a
minority
of
very
rich,
fortunate
persons
who
are
structured
in
a
pyramidal
fashion
and
embedded
in
a
mass
of
persons
who
have
difficulties to build a pension for age and cannot resist sudden needs due to disease or loss of work (1).
Economy is a consequence of the history of science
Thomas
Piketty,
in
a
recent
interview
(2),
explained
that
our
times
favour
l’économie
des
inégalités
and
that
“the
entire
world
shall
be
“rethinked”
in
a
more
equitable
and
sustainable
way
after
the
pandemic.
Every
society
shall
investigate
its
inequalities,
find
reasons
for
them;
otherwise
the
political
and
social
building
will
crush”
(Capital
and
Ideology
in
the Twenty-first Century, 2017).
However,
Sandel,
Schiavone
and
Piketty
may
be
wrong,
or
at
least
too
pessimistic.
In
fact,
Claude
Allègre,
Professor
of
Geology
at
the
University
of
Paris
and
Minister
of
Research
in
the
Government
of
Lionel
Jospin,
in
Dieu
face
à
la
science
(1997)
answered
the
question
“Did
science
progress
in
the
Western
world
since
capitalism
flourished
there?”
His
answer
was
“science
and
capitalism
developed
in
symbiosis
and
today
we
think
that
economy
is
relevant
for
the
progress
of
science.
However,
in
the
early
twenty
years
of
the
last
century,
in
the
world,
there
were
less
than
two
hundred
physicists.
Their
discoveries
did
not
depend
on
economy
but
by
their
imagination.
History
of
science
is
not
dependent
on
economy;
economy
has
been
a
consequence
of
the
history
of
scientific
progress
in
the
Western
world
since capitalism flourished.
Professor Raymond Ardaillou
Academy of Medicine,
Paris
History of the first containment to control the pandemic
The
first
alerts
in
February
2020
were
unexpected
clusters
in
Mulhouse
(Alsace)
and
Creil
(North
west
of
Paris).
Their
causes
were
rapidly
found,
a
religious
meeting
of
evangelists
and
the
return
of
military
from
Wuhan
(China)
without
any
quarantine
at
their
arrival,
respectively.
The
extension
of
the
epidemic
was
very
fast
in
these
two
regions
and
then
reached
Paris,
the
main
cities
of
the
eastern
part
of
the
country,
and
also
Lyon
and
its
surroundings.
Hospitals
were
overwhelmed,
particularly
intensive
care
units.
Deaths
of
elderly,
obese
and
chronically
ill
people
increased
and
long
stay
institutions
for
elderly
people
were
particularly
affected.
The
decision
of
the
government
was
a
quasi-total
containment
extended
to
the
entire
country
although
the
west
and
the
sparsely
populated
areas
of
the
centre
were
spared.
A
few
months
after
the
start
of
the
pandemic,
what
were
the
results
of
this
policy?
We
can
separate
the
good
from
the
bad.
Among
the
first,
the
French
hospital
system
coped
with
the
disease
and
no
patient
who
needed
to
enter
an
intensive
care
unit
was
excluded,
even
the
elderly.
The
staff
showed
dedication
and
overcame
fatigue
with
long
working
days
and
the
suppression
of
public
holidays.
Retired
doctors
and
students
were
also
active
to
help.
Patients
requiring
intensive
care
were
transferred,
when
necessary,
to
hospitals
in
spared
regions
and
even
abroad
(Germany,
Luxembourg
and
Switzerland).The
public
was
submitted
to
a
series
of
constraints:
physical
distancing,
outings
outside
the
home
for
a
limited
time
(1
hour)
and
a
short
distance
(1
Km)
with
a
signed
certificate
indicating
the
reason
of
the
exit
among
those
allowed,
closure
of
restaurants,
bars
and
all
businesses
considered
non-essential,
suppression
of
shows
and
religious
ceremonies.
Schools
and
universities
were
closed.
The
amounts
spent
on
supporting
the
economy
and
helping
unemployed
persons
or
businesses
without
activity
were
considerable,
the
highest
in
the
states
of
the
European
Union. Teleworking developed rapidly. The public observed the containment measures with discipline and application from March to May 2020.
The
bad
aspects
were
the
lack
of
masks
in
a
sufficient
amount,
the
psychological
distress
of
students
and
unemployed
staff,
the
isolation
of
elderly
people
living
in
long
stay
homes
who
were
deprived
of
visits
from
their
relatives.
It
was
also
difficult
to
find
some
private
medical
specialists
and
dentists
who
left
the
big
cities
to
get
to
their
country
houses.
This
escape
from
the
big
cities
just
before
the
start
of
the
confinement
was
often
badly
considered
by
country
dwellers
who
feared
being
infected.
Another
shortcoming
in
controlling
the
epidemic
by
detecting
and
isolating
virus
carriers
was
the
lack
of
machines
and
reagents
to
carry
out
nasopharyngeal
swab
and
RT-PCR
investigations,
the
first
tests
available
being
only
the
serological
tests
for
diagnostic
orientation
to
detect
the
antibodies
following
an
infection.
All
hospital,
private,
university
and
veterinary
school
laboratories
were
involved
in
the
detection
by
RT-PCR.
It
was
planned
that
subjects
who
tested
positive
were
to
be
isolated
for
2
weeks
and
questioned
about
their
contacts
both
retrospectively
(who
infected
them)
and
prospectively
(who
may
themselves
have
infected)
in
order
to
test
these
contacts
and,
if
necessary,
isolate
them.
The
laboratory
must
inform
the
health
insurance
which
was
in
charge
of
doing
so.
A
mobile
phone
software
was
disseminated
to
learn
more
about
the
contacts.
In
fact,
this
system
did
not
work
well
for
at
least
two
reasons:
there
were
no
coercive
but
only
incentives
measures
for
isolation,
and
the
department
responsible
for
notifying
contact
persons
was
quickly
overwhelmed
by
the
demands
of
the
health
insurance.
The
number
of
hospitalisations
for
covid-19
had
alarming
consequences
on
other
pathologies.
Many
surgical
operations
were
cancelled.
Patients
were
reluctant
to
go
to
hospital
for
fear
of
being
infected
and
many
children
missed
the
vaccination schedule.
The outing of containment
All
these
measures
led
to
a
gradual
reduction
in
the
number
of
positive
cases,
hospital
admissions
and
transfers
to
intensive
care
units.
Satisfied
with
this
improvement,
the
government
decided
to
end
the
confinement
after
2
months
(from
March
10
to
May
10)
and
to
restore
a
normal
economic
activity
and
the
freedom
of
transport.
The
wearing
of
masks,
now
in
sufficient
number,
outside
the
home
was
still
maintained
as
well
as
distancing
measures
in
restaurants,
bars,
churches
and
theatres.
The
committee
of
experts
advising
the
government
and
the
Academy
of
Medicine
expressed
reservations,
advocating
a
reduction,
and
not
the
virtual
elimination
of
confinement.
The
public
felt
liberated
and
festive
gatherings,
family
celebrations,
crowdy
exhibition
visits
or
walks
in
commercial
streets
or
parks
occurred
frequently.
Consequences
were
rapid.
As
soon
as
the
end
of
August,
warning
signs
were
noted:
the
presence
of
viral
RNA
in
the
waste
water,
and
with
the
greatest
ease
of
testing,
the
increase
in
positive
cases,
and
the
R°
factor
(number
of
people
infected
by
a
subject)
began to rise again and far exceeded the unit.
The second wave
Faced
with
this
upsurge,
the
government
decided
to
start
a
second
containment,
in
several
stages.
It
first
established
a
curfew
from
9pm
to
5am
to
avoid
festive
gatherings
at
home,
and
then
a
week
later,
again
the
closure
of
bars,
restaurants
and
shops
considered
non-essential
and
the
necessity
of
written
attestations
to
indicate
the
reason
for
an
exit
out
of
home.
It
also
made
an
update
of
the
StopCovid
application,
“Tous
anticovid”
allows
the
user
to
be
alerted
or
to
alert
others
in
the
event
of
exposure
to
Covid-19.
He/she
can
thus
act
directly
for
his/her
own
health
and
that
of
others
by
helping
to
break
the
chains
of
transmission
and
slow
the
spread
of
the
virus.
The
immediate
consequence
of
the
new
containment
was
a
relapse
in
economic
activity
and
the
loss
of
income
for
shopkeepers,
which
the
government
sought
to
mitigate
by
extending
the
financial
aid
measures.
In
spite
of
them,
the
result
was
an
impoverishment
of
the
population,
mainly
of
the
middle
classes
and
younger
people,
which
is
reflected
in
their
demand
for
food
aid,
formerly
reserved
for
the
poorest
classes.
The
distress
of
these
people,
who
are
often
isolated
and
without
family
help,
increases
the
number
of
suicides.
The
public
followed
these
constraints,
but
with
gloom
and
much
criticism
of
government
decisions
that
often
appeared
bureaucratic,
ineffective
in
countering
the
epidemic,
but
deplorable
for
small-scale
trade.
A
German
newspaper
“Die
Zeit”
proposed
to
rename
France
under
the
name
of
"Absurdistan".
However,
hospitals
were
better
prepared
to
fight
the
epidemic
with
a
sufficient
number
of
intensive
care
beds,
more
effective
treatments,
resulting
in
lower
mortality
and
shorter
hospital
stays.
At
the
end
of
November,
the
government
issued
flexible
measures
such
as
the
opening
of
small
shops
and
the
resumption
of
religious
services,
giving
hope
that
transport
would
be
back
for
Christmas
and
that
the
restaurants
would
open
in
January
2021.
The
new
regulation
retains
its
share
of
the
absurdity
inherent
in
the
country's
administrative
services:
only
30
people
will
be
allowed
to
gather
for
a
religious
service,
whether
in
a
small
chapel
or
a
huge
cathedral.
Go
and
understand!
This
is
where
we
are
at
present.
A
new
hope
has
appeared
with
the
arrival
of
vaccines
considered
effective
and
without
side
effects,
in
particular
the
2
American
mRNA
vaccines
from
Pfizer
and
Moderna.
In
France,
the
Pasteur
Institute
and
Sanofi
are
preparing
new
vaccines
either
of
inactivated
viruses
or
recombined
viral
proteins
but
still
in
phase
3.
The
European
Union
has
placed
orders
of
vaccine
doses
with
several
suppliers
which
should
be
distributed
according
to
the
population
of
the
member
states.
Phase
4
evaluation
of
these
vaccines
in
the
population
and
over
a
long
period
of
time
will
be
essential for the choice of the vaccine(s) selected.
The role of scientific experts
The
government
at
the
onset
of
the
epidemic
appointed
a
committee
of
experts
to
guide
the
measures
to
be
taken
to
contain
the
epidemic.
This
committee
proposed
measures
based
solely
on
epidemiological
data,
neglecting
socio-economic
and
psychological
aspects.
Moreover,
its
recommendations
were
made
known
to
the
government
alone,
which
drew
conclusions
from
them.
The
Academy
of
Medicine
filled
this
vacuum
by
publishing
from
March
2020
until
now
more
than
60
press
releases
aimed
at
doctors
and
the
public
and
often
quoted
by
the
press.
It
denounced
mistakes
made
by
health
officials
such
as
the
uselessness
of
wearing
masks
in
the
street
to
hide
the
lack
of
masks
at
the
beginning
of
the
epidemic.
It
insisted
on
the
necessary
reorganisation
of
hospitals,
the
purchase
of
equipment
and
reagents,
the
setting
up
of
additional
resuscitation
beds
and
the
obligation
to
train
and
recruit
specialised
nursing
staff
by
making their careers more attractive.
Conclusions
This
pandemic
will
profoundly
change
the
country.
France
had
poorly
anticipated
the
response
to
the
pandemic
because
the
successive
ministries
of
health
had
not
foreseen
any
predictive
scenario,
making
it
difficult
to
curb
the
disease.
This
pandemic
also
shows
us
that
Pasteur's
country
is
lagging
behind
others
in
the
development
of
vaccines.
French
researchers
are
behind
new
vaccines,
but
they
have
preferred
to
work
abroad
for
several
reasons,
the
reluctance
of
French
people
to
invest
in
venture
capital
and
the
meticulous
regulation
of
manufacturing
processes
and
authorisations.
We
have
excellent
researchers,
but
they
work
elsewhere.
Concerning
the
economic
crisis,
France
cannot
cope
with
the
mass
of
new
public
debts
without
the
help
of
the
European
Union,
itself
subject
to
the
dissensions
between
member
states.
Internally,
the
segmentation
of
society
by
the
multiplicity
of
identity,
community
and
sexual
groups
and
the
irruption
of
social
networks
often
spreading
false
news
and
hatred
of
others
makes
the
task
of
governing
increasingly
difficult.
Moreover,
a
gap
is
widening
between
the
regions
and
the
state
considered
dictatorial.
The
public
feels
the
burning
need
for
a
welfare
state,
but
their
often
disappointed
expectations
maintain
a
perpetual
contestation.
The
result
is
unkindness
in
social
relations.
Moreover,
France
is
the
target
of
Islamist
terrorists,
which
adds
to
its
problems
that
of
preventing
attacks.
Of
course,
French
society
is
complex
and
many
people
are
aware
of
their
individual
responsibility,
as
shown
by
the
dedication
of
the
carers
and
of
the
"indispensable"
people.
Merchants
have
shown
a
great
capacity
to
adapt
to
the
restrictions
imposed
on
them
and
the
digitisation
of
commerce
has
been
widely
developed.
The
same
was
true
of
medical
practice,
which
made
an
extensive
use
of
telemedicine.
At
the
same
time,
the
rapid
advances
in
science
demonstrated
by
the
rapid
development
of
vaccines
are
making
us
reconsider
our
future.
We
are
caught
up
in
the
need
to
prevent
the
current
world
from
falling
apart
and
to
reconcile
progress
with
the
observation
of
what
makes
us
human,
i.e.
the
freedom
to
think
and
to
confront
our positions with respect for others and also to help the most deprived of us.
France at the time of coronavirus
Katarina Derzsiova
Ing. Dipl., Former Head
of the Laboratory,
IV Internal Clinic,
University Hospital of. L. Pasteur,
Košice, Slovak Republic
Lessons from the pandemics
Natale G. De Santo, MD
Emeritus Professor,
University of Campania
Luigi Vanvitelli,
Naples, Italy
A world of foxes or hedgehogs?
We
do
not
yet
know
the
outcome.
In
Fragment
XXIV
of
Archilochus,
we
read
“The
fox
knows
many
things,
but
the
hedgehog
one
big
thing”,
meaning
that
the
fox
uses
many
tricks
to
escape
hunters
and
dogs,
while
the
hedgehog
only
one,
but
at
this
it
is
the
best
of
all.
Archilochus
had
many
followers,
among
them
Erasmsus
of
Rotterdam
(1470-1530)
who
translated
the
above
passage
in
Latin
“multa
novit
vulpes,
verum
echinus
unum
magnum”
in
Adagiorum
collectanea,
and
Isaiah
Berlin
(1909–1997)
who
in
the
tale
The
hedgehog
and
the
fox
(1953)
described
writers
and
thinkers
either
as
hedgehogs
(one
principle to explain everything), or foxes (utilising many possibilities) (3).
Watson
and
Crick
celebrated
reductionism
in
biology
in
1953
by
defining
the
structure
of
DNA.
The
peak
of
reductionism
was,
however,
achieved
with
the
demonstration of the Higgs mechanism and Higgs boson -hypothesised in 1964, when the “God particle“ was detected at CERN in 2012-2013 (3).
At
the
beginning
of
the
13th
century,
universities
in
Europe
were
based
on
the
trivium
(literally
the
place
where
three
roads
meet),
which
included
Grammar,
Rhetoric
and
Dialectic
and
on
quadrivium
(the
place
where
four
roads
meet),
which
included
Arithmetic,
Geometry,
Music
and
Astronomy,
as
described
in
the
seventh
book
of
Plato’s
Republic
and
represented
the
so-called
liberal
arts.
These
disciplines
represented
the
basic
curriculum
for
the
study
of
Theology,
Medicine
and
Philosophy
(4).
According
to
Nicholescu
and
Ertas
(),
there
was
a
“big
bang”
and
the
number
of
disciplines
rocketed
to
8,000
in
2012.
The
decision
for
fragmentation
is
wrong,
as
the
rapid
advance
of
communications
means
that
a
connected
world
is
driven
by
complexity.
“The
new
education
has
to
invent
new
methods
of
teaching,
founded
on
logics.
The
old
classical
binary
logic,
that
of
“yes”
and
“no”,
i.e.
the
logic
of
the
excluded
middle,
is
no
more
valid in the context of complexity” (4).5
A new role for university
Jean
Claude
Allègre
(born
1937),
highly
cited
scientist,
Emeritus
Professor
of
Geophysics
in
Paris,
and
former
Minister
for
Research
in
the
Government
of
Lionel
Jospin
in
Dieu
face
a
la
science.
Comment
peut-on
être
croyant
aujourd'hui
?
(
1997),
answered
a
seminal
question.
“Has
science
developed
in
the
West
due
to
the
fact
that
capitalism
took
roots
in
the
West”?
He
answered
“
Science
and
capitalism
developed
in
symbiosis
and
now
we
know
that
economy
is
important
for
the
development
of
science.
However,
we
have
to
bear
in
mind
that
in
the
twenties
of
the
last
century
there
were
less
than
200
physicists
in
the
world.
Their
discoveries
did
not
depend
on
the
availability
of
means
at
their
disposal,
but
on
their
imagination.
History
of
science
does
not
depend
on
economy,
but
economy
is
a
consequence
of
history
of
science.
Progress
of
science
and
capitalism
appear
linked
,
but
the
link
is
impalpable”.
He
prophesied.
“
In
Europe
of
diversity,
in
Europe
of
homelands,
federalism,
and
place
of
effervescent
exchanges,
universities
and
their
professors
will
have
a
role
of
primary
importance
since
they
drive
the
operational
platforms
where
new
knowledge
will
be
acquired
in
a
critical
atmosphere.
Nobody
minds
that
Galilei
was university professor as were Newton, Boyle Lyell. People trust University”.
Umberto
Eco
(1932-2016)
was
very
confident
of
the
role
and
creativity
of
the
university.
On
occasion
of
his
70th
birthday
he
explained
to
the
students
of
the
University
of
Bologna
that
”university
is
irreplaceable
since
it
is
the
origin
of
the
ideas
that
will
came
of
age
twenty
years
later.
All
things
that
are
in
the
media
nowadays
have
been
generated
in
the
university
20
years
ago,
and
all
topics
that
are
now
on
the
agenda
of
our
universities
will
have
a
place
in
the
media twenty years from now”.
Edgar
Morin
pointed
out
that
“
because
of
its
nature
university
saves,
memorizes,
integrates,
ritualizes
the
heredity
of
knowledge,
ideas,
values
and
regenerates
it
and
by
reviewing
it
makes
it
actual,
transfers
it
,
generates
new
knowledge,
ideas,
and
values
that
in
turn
re-enter
in
the
heredity.
Thus
university
is
conservative,
regenerative
and
generative.
Its
function
is
transnational,
and
this
main
characteristic
has
been
maintained
despite
the
nationalism of modern nations. Autonomy allows to achieve its goals (6).
Adopting complexity as a method
For
Edgar
Morin,
we
have
to
learn
how
to
learn,
that
is
learning
by
separation
while
linking
at
the
same
time,
through
a
process
of
contemporary
analysis
and
synthesis.
We
have
to
learn
to
overcome
linear
causality
(cause–effect)
by
learning
reciprocal,
relational,
circular
causality–the
latter
encompassing
feedback
and
recursion.
Furthermore,
we
should
be
aware
of
the
uncertainty
of
causality.
Causes
do
not
always
lead
to
identical
effects
since
the
reaction
of
systems
may
be
different.
Last
but
not
least,
different
causes
may
be
conducive
to
identical
effects.
Thus,
we
have
to
rise
to
the
challenge
of
complexity
arising
from
all
fields
of
knowledge
and
action.
To
meet
the
challenge
we
have
to
create
a
new
thought”
(Edgar
Morin,
Einsegner
a
vivre.
Manifeste
pour
changer l’education, 2017).
Building sand castles
Nicholas
A.
Christakis,
Professor
of
Social
and
Natural
Sciences
and
of
Medicine
at
Yale
has
explained
his
attraction
to
the
towers
made
of
minute
silica
crystals.
“Some
people
like
to
build
sand
castles,
and
some
like
to
tear
them
apart.
There
can
be
much
joy
in
the
latter.
But
it
is
the
former
that
interests
me.
You
can
take
a
bunch
of
minute
silica
crystals,
pounded
for
thousands
of
years
by
the
waves,
use
your
hands,
and
make
an
ornate
tower.
Tiny
physical
forces
govern
how
each
particle
interacts
with
its
neighbours,
keeping
the
castle
together;
at
least
until
the
force
majeure
of
a
foot
appears.
But
having
built
the
castle
this
is
part
that
I
like
the
most:
you
step
back
and
look
at
it.
Across
the
expanse
of
beach,
here
is
something
new,
something
not
present
before
among
the endless sand grains, something raised from the ground, something that reflects the scientific principle of holism”.
He
is
aware
that
“[T]he
properties
arise
because
of
the
connections
between
the
parts.
I
think
grasping
this
insight
is
crucial
for
a
proper
scientific
perspective
on
the
world.
You
could
know
everything
about
isolated
neurons
and
not
be
able
to
say
how
memory
works,
or
where
desire
originates.
It
is
also
the
case
that
the
whole
has
a
complexity
that
rises
faster
than
the
number
of
its
parts”
(Christakis,
force
majeure
of
a
foot
appears.
But,
having
built
the
castle, ).www.edge.org
“Universities
are
the
places
where
we
do
things
that
will
be
discussed
in
the
media
twenty
years
from
now”
stated
Umberto
Eco
to
the
students
of
the
University
of
Bologna
on
the
day
he
celebrated
his
70th
birthday.
We
have
to
be
aware
that
our
universities
have
the
talents
and
the
skills
to
maximise
the
effects
of
education.
However,
at
the
time
when
the
economy
of
knowledge
flourishes,
we
have
to
support
them
more
than
in
the
past.
In
“post-pandemic
university”
a
crucial
effort
is
required
to
achieve
a
diffuse
status
of
excellency,
not
just
for
few
and
not
just
in
a
few
places
and
not
just
in
a
few
disciplines.
In
addition,
students
should
be
empowered
to
give
solutions
for
the
present
but
receive
a
dual
education
for
the
short
and
long
period
of
time.
There
they
should
also
learn
how
to
achieve
another
peak
of
development
in
their
field
after
having
achieved
a
peak.
This
means
that
they
will
also
learn
how
to
walk
the valley between peaks that have downward and upward routes (7).
219 Italian physicians died because Covid-19
From
March
11
to
November
27
219
physicians
have
died
because
of
covid-19.
Such
a
huge
list
of
deaths
is
displayed
daily
and
commented
on
the
portal
of
the
Federation
of
Italian
Physicians
and
Dentists.
The
list
was
preceded
by
a
comment
of
our
President,
Filippo
Anelli.
“Dead
do
not
make
noise”,
wrote
the
poet
Ungaretti
-
however
the
names
of
our
friends
and
colleagues
make
a
deafening
noise.
We
cannot
tolerate
it
that
our
physicians
and
health
workers
have
been sent to fight with naked hands against the virus. An unequal struggle that hurts us, the citizens and the whole country
Curing non-Covid patients
As
written
by
Lis
Rosenbaum
in
N
Engl
J
med
on
June
11,
there
is
an
untold
toll
about
treatment
of
nonCovid-19
patients(
9).
All
resources
have
been
destined
to
Covid
patients.
The
other
patients
do
not
receive
enough
treatment
and
care.
The
number
of
myocardial
infaction
decreased
by
51%,
the
number
of
patients
who
received
cardiac
surgery
is
less
than
50%
,
the
number
of
undiagnosed
cancer
patients
is
increasing.
A
newspaper
calls
non-Covid
patients
a
lower
category.
There
is
a
need
to
“Cure
well,
cure
all”
as
discussed
at
a
congress
on
November
30,
2020
in
Naples.
It
was
a
congress
organised
by
the
Fraternity of Pilgrims, an association that has assissted migrants, pilgrims, patients, young people needing schooling for the past 442 years.
Southern
Italy
has
the
worst
healthcare
system
in
our
country
due
to
negligence
of
previous
governments.
They
imposed
commissars
who
balanced
the
budget
by
reducing
hospital
beds,
nurses
and
physicians
to
a
level
that
does
not
grant
function.
The
Campania
region
life
expectation
at
birth,
65
and
75
years is the lowest in Italy. A woman at 65 can expect to live for the next 20.5 years in Campania and 22.9 years in Trentino Alto Adige.
Who Can Put, Who Cannot Take
This
short
message,
just
six
words,
appeared
on
a
basket
suspended
from
a
balcony
in
an
alley
in
Naples,
during
the
pandemic
on
March
29,
2020.
In
Italian
the
words
are:
“Chi
può
metta,
chi
non
ha
prenda”.
More
fully
this
meant
that
those
who
have
(the
means)
may
add
to
the
basket
whilst
those
who
have
nothing
can
take
from
it.
It
was
a
strong
message
of
solidarity.
Passers-by,
inhabitants
in
the
neighbourhood,
in
anonymity,
could
take
or
add
safely-packed
food and other items such as soap, diapers, sanitary pads etc. Subsequently, special baskets were prepared containing cooked foods (Figure).
References
1. Schiavone A. Eguaglianza. Einaudi, Torino, 2019.
2. Ciccarelli R. Thomas Piketti: il socialismo partecipativo per la crisi che verrà. Il Manifesto, Rome, 2020 June 9.
3.
De
Santo
NG.
Nephrology
between
Reductionism
and
Complex
Systems:
the
Role
of
Philosophy
–
Review
of
Evidence
and
Opinion.
Eur
J
Mol
Clin
Med 2020; 7(1): 38-45
4. Martins PN. Descartes and the paradigm of Western medicine. An essay, Int J Rec Adv Sci Tech 2018; 5(3).
5.
Nicholescu,
B,
Ertas,
A.
The
Need
for
Transdisciplinarity
in
Higher
Education
in
a
Globalized
World.
Transdisciplinary
Journal
of
Engineering
&
Science
2012; 3: 118. DOI: 10.22545/2012/00031
6. Morin E. La testa ben fatta. Cortina, Milano, 2000.
7. Ceruti M. Il tempo della complessità, Cortina, Milano, 2018, p.144.
8.
Rosenbaum
L.
The
Untold
Toll
—
The
Pandemic’s
Effects
on
Patients
without
Covid-19”.
N
Engl
J
Med
2020;
382:2368-2371,
DOI:
10.1056/NEJMms2009984
Reaction of the population to the Covid-19 pandemic
When
the
Covid-19
pandemic
broke
out,
we
were
all
surprised
and
frightened
by
the
news
of
what
was
happening
in
Italy,
how
many
people
were
dying
there
every
day
and
that
the
healthcare
system
was
in
collapse.
At
that
time,
it
was
all
new
to
us,
unknown
and
we
had
a
lot
of
energy
and
perseverance
to
fight
the
infection
with
the
hope
to
defeat
it.
Thanks
to
compliance
with
restrictive
measures,
our
discipline
and
responsibility
towards
each
other
and
especially
towards
our
seniors,
we
managed
to
slow
down
the
growth
of
infection
cases
and
prevent
deaths.
Several
times
our
President
Zuzana
Čaputová
made
a
TV
appearance
to
address
the
nation
in
a
very
nicsupportivee
and
encouraging
way.
She
rganized
that
no
government
in
the
history
of
Slovakia
had
faced such a difficult situation as the present one, and, therefore, asked all the citizens for their support and compliance with regulations.
On
June
13,
2020
the
state
of
emergency
came
to
an
end,
preceded
by
4-tier
relaxing
measures.
The
total
number
of
infected
patients
with
Covid-19
from
March 6 to June 30, 2020, i.e. during the first wave of the pandemic was 1,687 and the total number of deaths was 28 (Table 1).
Impact of Covid-19 on the Slovak economy
In
all
European
countries,
including
Slovakia,
the
coronavirus
has
had
a
very
negative
impact
on
the
economy.
According
to
the
Statistical
Office
of
the
Slovak
Republic,
it
was
manifested
mainly
in
the
second
quarter
of
2020
with
a
decrease
in
the
average
salary
by
1.02%,
the
inflation
rate
up
to
3%,
an
increase
in
unemployment
to
7.7-8.0%
and
a
decrease
in
gross
domestic
product
(GDP)
by
7-8%.
The
soaring
figures
of
unemployment
were
mostly
fuelled
by
a
huge
decline
in
industrial
production.
Slovakia,
with
its
robust
automotive
industry,
is
dependent
on
the
economy
of
other
countries,
especially
Germany.
People
who
lost
their
jobs
or
had
their
businesses
temporarily
closed
or
worked
in
emergency
mode
needed
financial
assistance
from
the
state.
Although the state aid has helped save a lot of jobs, the poverty risk rate jumped from 11.9% to 12.55%.
Impact of Covid-19 on elderly people
Strict
measures,
in
particular
quarantine,
have
had
a
major
impact
on
the
quality
of
last
days
survival
of
the
country‘s
elderly
citizens.
Isolation,
minimal
contact
with
relatives
or
friends
have
had
a
negative
impact
on
the
mental
health
of
all
of
us,
but
especially
on
the
psyche
of
seniors.
Covid
-19
has
been
fearsome
for
the
elderly
living
alone
or
in
social
homes.
They
were
most
worried
that
they
would
never
see
their
loved
ones
again,
and
that
they
would
remain
bedridden
served
by
staff
wearing
masks.
As
it
is
around
the
world,
and
so
in
our
country,
adults,
old
and
very
old
patients
affected
by
Covid-19
have been dying in loneliness without the presence of their relatives, without tenderness, religious help and farewell.
Covid-19
pandemic
has
left
a
negative
mark
on
the
population
of
all
age
groups
and
in
all
sectors
of
our
economy
whether
it
is
education,
science,
health,
culture or industry.
After
the
strict
measures
were
relaxed
people
wanted
to
indulge
in
freedom.
Summer
came
and
many
of
us
went
on
holiday
abroad.
Borders
opened
up
and
people,
trusting
that
the
worst
was
already
behind
us,
ceased
being
disciplined
and
responsible.
However,
In
July
and
August
the
number
of
new
cases
of infected people began to increase.
The second wave of the pandemic
The
second
wave
of
the
pandemic
was
in
full
swing
in
September,
and
gradually,
the
whole
Slovakia
turned
red.
The
daily
number
of
new
cases,
the
number of hospitalized patients, as well as the number of deaths were rocketing (Table 1). On October 1, a state of emergency was declared again.
It
was
between
31
October
and
1
November
2020
that
the
government,
with
the
support
of
the
President
of
the
Slovak
Republic,
rganized
a
nationwide
testing (people aged 10 – 65+) of Covid-19, using Antigen tests. The testing covered 3,625,332 people (95% of those who should be tested), of which 38,359
(1.06%)
were
positive,
but
asymptomatic.
The
following
the
testing
was
repeated
in
the
most
critical
districts.
2,048,555
people
were
tested,
of
which
13,509 (0,66%) were positive. Both actions were declared very successful and Slovakia was the only European country to carry out such an undertaking.
From 9 November, mobile sampling points were set up for antigen testing. By November 20, 10,790 cases had been positive.
Table 1 shows only positive cases confirmed by a PCR test.
Table 1 Occurrence of Covid-19 in the Slovak population
Table 2 Occurrence of Covid-19 in nephrology patients
\% of recovered and death/total cases
% of total HD cases resp. Tx/total number of HD resp. Tx patients
Average age of patients dying: on HD 69.5 and Tx: 67.3
How do I perceive the pandemic?
Of
course,
I
have
been
disciplined,
I
have
followed
all
the
regulations.
What
I
have
been
missing
most
are
the
scientific
events
that
have
been
cancelled
due
to
the
prohibition
of
public
assembly.
Although
I
am
retired,
my
lifelong
interest
in
scientific
work
still
persists,
and
also
the
urge
to
participate
in
national
and international congresses.
Acknowledgements
I
am
thankful
to
the
medical
directors
of
dialysis
companies,
the
main
expert
for
transplantation
in
the
Slovak
Republic
as
well
as
the
heads
of
transplant
centres for the obtained patients‘ data.
COVID-19 in Greece
The
cov-19
pandemic
is
severe.
Globally,
as
of
9:54am
CET,
26
November
2020,
there
have
been
59,816,510
confirmed
cases
of
COVID-19,
including
1,410,378
deaths,
reported
by
WHO.
Even
if
we
allow
for
the
fact
that
the
number
of
cases
depends
on
the
number
of
tests
done
and
the
number
of
deaths
include
patients
who
would
anyway
have
died
soon
due
to
comorbidities,
the
burden
on
the
global
population
is
heavy.
But
it
is
lighter
than
that
of
the
great
epidemics
of
the
past
like
the
Athens’
Plague
reported
by
Thucydides,
the
Black
Death
or
the
“Spanish”
flu
which
killed
one
third
to
half
of
the
then
known
population.
Still
a
climate
of
panic
and
terror
is
felt
by
many
and
is
spread
by
the
media.
Why
does
this
happen?
In
my
opinion
it
is
the
shattering
of
the
established
certainties
of
the
Western
World.
The
pandemics
in
the
past
shattered
the
strong
beliefs
about
the
God’s
or
gods’
omnipotence
to
prevent
or
cure
any
disease.
Thus,
scenes
of
sacrilege
and
breakdown
of
the
social
order
followed.
Nowadays
the
strong
belief
of
a
modern
citizen
is
the
total
capacity
of
himself
to
control
his
life,
health,
finance,
desires
and
the
State’s
and
Science’s
omnipotence
to
provide
for
it.
Hence,
the
industrialized
world
was
taken
by
surprise
and
reacted
either
with
disobedience
and
uncontrolled
entertainment
like
the
period
before
Halley’s
Comet,
or
with
depression
and
acceptance
of
all
measures
imposed.
There
are
some
indications
of
this
assumed
failure
of
the
Western
World.
The
number
of
deaths
by
covid-19
in
Eastern
Europe
reached
almost
90.000
compared
with
350.000
in
Western
Europe
and
256.000
in
USA
both
having
roughly
equal
population.
Moreover,
the
ratio
of
positive
cases
to
deaths
is
4:
1
in
favor
for
the
East.
A
surprising
finding
comes
from
Africa.
Most
of
the
countries
there
have
a
very
low
number
of
covid
deaths.
Indicatively,
South
Africa
where
statistics
are
more
reliable
reports
765.00
positive
cases
and
21.000
deaths
having
a
population
of
57.000.000,
almost
half
the
incidence
than
in
the
USA.
There
is
wide
speculation
about
the
reasons
of
this
discrepancy.
The
compulsory
vaccination
with
the
BCG
vaccine
in
the
countries
of
the
Eastern
Block,
the
younger
population
in
Africa
(in
South
Africa
the
median
age
is
30
years)
thus
there
are
not
very
many
old
people
to
succumb
to
the
disease,
the
overcrowded
domestic
situations
which
lead
to
several
other
virus
infections
resulting
to
a
kind
of
natural
cross-resistance
to
cov-19
as
well
and
the
hectic
travelling
from
and
to
the
West
due
either
to
tourism,
commerce,
cultural
events
or
to
immigration
are
some
of
the
suggested
factors.
While
writing
this
article
everyday
revisions
were
made
as
new
data
became
available
continuously.
Thus
our
conclusions
may
soon
become obsolete.
Professor
Athanasios Diamandopoulos
Louros Foundation
for the History of Medicine
Athens, Greece
There
are
however
collateral
damages
by
this
obsessive
lamentation
on
the
pandemic.
That
is
the
hiding
of
other
real
catastrophic
situations
the
global
population
is
threatened
by.
The
most
severe
is
the
global
debt.
According
to
IIF
it
has
now
reached
227
trillion
dollars
corresponding
to
360%
of
the
global
gross
income,
the
pandemic
having
increased
it
only
by
45%.
The
sum
is
impossible
to
be
paid
back.
It
leads
to
bankruptcy
most
of
the
developing
countries,
Zambia
being
the
recent
victim.
As
this
article
is
not
a
Financial
Forum
we
would
not
elaborate
on
the
causes
of
the
phenomenon.
However,
the
result
causes
directly
and
indirectly
much
more
human
losses
than
the
pandemic.
A
second
damage
is
the
avoidance
of
contemplating
about
the
sharp
rise
of
the
death
of
old
people
in
Europe,
most
characteristically
in
Sweden.
The
Swedish
Public
Health
Agency
told
the
BBC
that
48.9%
of
deaths
were
care
home
residents
up
to
and
including
14
May.
The
reasons
there
were
the
great
number
of
senior
citizens
“stored”
in
private
or
public
institutions,
the
poor
measures
for
preventions,
the
guidelines
not
to
transfer
to
hospitals
or
even
giving
oxygen
by
the
nurses
to
the
aged
victims
of
the
disease.
"We
did
not
manage
to
protect
the
most
vulnerable
people,
the
most
elderly,
despite
our
best
intentions,"
Prime
Minister
Stefan
Löfven
admitted
last
week.
This
was
a
statement
rounding
corners.
The
“progressive”
line
of
thought
in
Northwestern
Europe
even
before
the
pandemic
was
that
the
aged
are
a
burden
to
the
societies,
they
should
understand
their
duty
to
die
and
thus
to
ask
for
euthanasia
and
even
to
install
special
booths
in
the
streets
where
those
people
could
enter,
enjoy
some
music and drink a tasty lethal cocktail. Hence, according to this line, covid-19 is making a favor to society.
Focusing
on
Greece
a
few
remarks
would
be
helpful.
The
country,
in
contrast
to
the
whole
of
Europe,
had
an
outstanding
low
incidence
of
the
pandemic
during
the
first
wave
in
March
-
April.
The
very
austere
measures
imposed
early
by
the
government
were
acclaimed
as
the
reason
for
it
and
public
opinion
overwhelmingly
supported
the
government.
With
the
second
wave
the
data
worsened.
We
have
roughly
98.000
positive
cases
and
2000
deaths
reaching
1.96%
of
them.
Still,
much
lower
than
in
the
West.
The
median
age
of
the
deceased
was
80
years
and
the
97%
of
them
had
an
underlying
disease.
It
is
evident
here
the
very
humane
approach
of
the
Health
System
towards
the
elderly.
However,
this
success
came
with
a
heavy
price
both
on
the
financial
and
the
cultural
level.
Greece,
alone
in
Europe,
emerged
in
2019
from
a
financial
catastrophe
after
ten
years
of
strict
supervision
of
its
economy
by
its
borrowers
via
complex
legal
agreements
nicknamed
“memoranda”.
The
rationale
was
to
lift
the
burden
of
a
non
–
sustainable
national
loan
equating
to
120%
of
GDP.
After
this
ten
years’
austerity
and
giving
away
a
good
part
of
the
state’s
property
the
percentage
increased
(!)
instead
of
falling,
to
180%.
In
spite
of
that
some
hopes
started
to
appear
that
we
could
escape
bankruptcy.
By
imposing
a
limitation
to
markets,
communications
and
travel
in
an
attempt
to
hold
the
virus
within
a
country
who’s
a
greater
part
of
income
was
tourism,
the
percentage
of
the
National
Loan
to
GNP
reached
210%!!
This
is
really
unstainable
and
a
catastrophe
is
pending.
Future
aid
by
the
European
Union
is
planned
but
for
the
present
it
does
not
affect
the
population.
On
the
cultural
level
the
measures
shattered
the
three
main
pillars
of
the
Greek
life.
Christian
faith,
invocation
for
unbound
democracy
and
outdoor
entertainment.
The
suppression
of
all
three
institutions
was
explained
by
the
need
of
avoiding
contamination
via
huge
gatherings
and
the
urgency
of
the
situation.
Although
this
was
partially
true,
in
reality
these
were
old
animosities
that
resurfaced.
Holy
Services
and
litanies
for
the
Easter,
the
Assumption
of
Mary
and
for
Christmas
were
banned
and
the
Holy
Communion
was
devaluated
as
a
simple
mixture
of
wine
and
bread
transferring
the
virus
to
the
faithful
without
any
Eucharistic
mystery.
Governmental
degrees
were
issued
without
parliamentary
enhancement
and
demonstrations
were
banned.
Sunbathing
with
company,
picnics,
café
shops,
taverns,
restaurants,
all
the
outlets
for
the
hardest
working
people
in
the
EU
according
to
Euro
statistics
were
prohibited.
Even
working
per
se
was
strictly
regulated.
The
damage
is
not
so
much
the
temporarily
loss
of
all
these
but
the
danger
for
the
people
to
become
used
to
this
loss
for
ever.
In
favor
of
the
government’s
handling
of
the
pandemic’s
second
wave
some
sound
arguments
should
be
stressed.
That
is
the
till
now
efficiency
of
the
National
Health
System,
a
bet
that
richer
states
lost,
the
heavy
direct
or
indirect
subsidy
of
the
private
sector,
the
great
upgrading
of
the
e-
teaching,
e-government,
e-business
and
the
keeping
of
public
order
up
to
a
point.
Against
these
successes
we
notice
a
rising
wave
of
disappointment
and
disobedience.
Recent
surveys
by
international
University
and
Media
agencies
report
on
a
higher
degree
of
anger
and
depression
than
in
many
other
European
countries
but
also
mention
a
very
high
degree
of
altruism.
The
reasons
for
the
first
two
negative
feelings
is
the
campaign
of
terror
issued
by
the
government
and
the
media
in
order
to
make
people
obedient,
the
discrepancies
between
the
pandemic’s
lethal
potency
and
the
small
number
of
deaths,
the
scorn
with
which
“specialists”
and
politicians
respond
to
any
reservations
about
the
measures
either
from
the
general
public
or
other
parts
of
the
scientific
community
and
the
blind
eye
the
police
turn
when
dealing
with
the
violation
of
the
measures
by
politically
strong
bodies.
All
these
are
alienating
the
population
but
acts
of
extreme
depression
like
suicides
are
not
reported.
The
altruism
is
enhanced by the strong family links, the charitable institutions and the feeling of the risk to the community.
Narrowing
further
our
survey,
we
focus
on
the
renal
patients.
Apart
of
the
death
of
18
patients
on
RRT
in
a
private
clinic
in
Athens
during
the
first
wave
there
were
not
any
other
accidents.
Strong
guidelines
were
issued
by
the
Ministry
of
Health,
the
Scientific
Societies
and
the
Patients
Associations
and
were
more
or
less
observed.
No
covid-19
renal
patient
was
refused
dialysis.
Naturally,
a
greater
degree
of
anxiety
and
depression
is
noted
in
this
group
of
patients
that
in
the
general
population.
These
feelings
are
limited
in
the
wards
where
there
is
a
great
degree
of
warm
patients/staff personal relations.
The
article
finishes
with
the
final
stage
of
the
covid-19
patients
in
Greece,
i.e.
their
last
hours
and
their
funerals.
These
issues
are
bound
to
any
pandemic
in
the
past
and
in
any
country
at
present.
Patients
hospitalized
in
covid-19
wards
are
absolutely
isolated
from
their
family
and
friends.
They
cannot
speak
or
even
see
them.
And
they
die
lonely
without
someone
to
hold
their
hand.
And
they
are
buried
enwrapped
in
many
layers
of
plastic,
without
friends
or
several
family
members
as
only
nine
persons
are
permitted
to
attend
any
funeral.
And
this
handful
of
close
relatives
cannot
kiss
the
corpse
as
it
is
the
custom
in
the
Orthodox
Churches.
It
is
a
very
Cold
Good
Bye.
Still
better
than
the
en
bloc
undignified
burials
in
Italy,
the
States
and
other
countries
with
hecatombs
of
victims.
There
are
hopes
that
the
rising
2021
will
bring
a
solution
to
the
problems.
Is
it
wishful thinking?
*The
opinions
expressed
in
this
article
reflect
the
author’s
thoughts
on
the
social
impact
of
the
covid-19
pandemic
mainly
in
Greece
and
the
renal
patients
and it is not a strictly scientific approach to the disease. Thus, citations are omitted but if any reader is interested he/she is welcomed to ask from the author
People and Epidemics Then and Now
Epidemics
that
had
been
haunting
mankind
in
the
past
can
be
traced
back
to
numerous
historical
sources.
Historians
of
medicine
have
dealt
mainly
with
medical
doctors
activities,
illness
symptom
descriptions,
demographic
outcomes
assessment.
A
historian
of
culture
is
rather
focused
on
the
types
of
behavior
showed
by
people
suffering
from
the
epidemics.
The
then
records
are
dominated
with
human
fear
of
a
sudden
death,
anonymous
burial,
lack
of
an
opportunity
to
account for one’s earthly life, and by the same token, eternal damnation.
Dread
deeply
infiltrated
culture
as
a
result
of
the
recurrent
cycles
of
epidemic.
It
was
scare
that
drove
the
flagellators
into
the
streets
and
made
them
birch
themselves
to
beg
the
grace
of
the
Almighty
for
the
whole
community.
It
was
scare
that
made
ever
growing
numbers
of
pilgrims
attempt
to
store
good
deeds
“in
advance”
to
secure
salvation
during
the
Final
Judgment.
Demand
for
the
“in
advance”
absolution
resulted
in
trade
with
indulgences.
As
a
response,
an
open-
minded
concept
emerged
that
the
path
to
salvation
leads
through
faith
itself,
and
not
through
penances.
This
brought
about
first
the
devotio
moderna,
and
next
the
Reformation
followed.
Dread,
however,
conditioned
more
mundane
behaviors.
The
fall
of
public
baths
in
the
late
Middle
Ages
was
one
of
the
symptoms
of
a
new
approach
to
the
body
hygiene.
The
trend
was
to
take
rare
and
sparse
baths,
so
as
not
to
risk
that
the
contaminated
air
penetrates
the
open
skin
pores.
Soap
was
replaced
with
a
frequently
changed
white
shirt
–
a
symbol
of
cleanliness.
A
discomforting
smell was neutralized by a scented handkerchief.
Professor Michał Kopczyński
Faculty of History
University of Warsaw, Poland
Nonetheless,
the
epidemics
had
caused
not
only
fear.
The
sources
mention
also
completely
opposite
types
of
behavior.
Medical
doctors
advised
a
stoical
attitude,
arguing
that
-
in
their
opinion
-
fear
might
disturb
the
balance
of
moods,
and
thus
make
one
an
easier
pray
for
disease.
Stoicism,
however,
was
an
elite
approach.
The
less
sophisticated
would
rather
pursue
risky
behaviors,
convinced
that
life
is
fragile
and
short
anyway,
so
one
should
make
the
best
of
it.
Against
the
background
of
fear,
liquor
was
flowing
freely,
and
promiscuity
followed
in
tow.
This
aspect
is
present
in
all
descriptions
of
the
epidemics,
including
the
“Decamerone”
by
Boccaccio.
Possibly
it
was
really
like
that,
though
Cezary
Kuklo
–
a
demographer
recording
births
and
deaths
in
the
18th
century
in
Warsaw
–
is
quite
skeptical.
As
his
calculations
show,
the
number
of
births
in
the
year
following
the
epidemic,
was
lower
than
in
the
years
with
no
epidemic.
Clearly,
the
external
threat
does
not
create
favorable
conditions
for
a
marital
intercourse.
I
remembered
the
conclusions
by
Kuklo,
when
in
the
spring
I
was
reading
a
blog
written
by
a
certain
frustrated
lady,
who
had
hoped
that
lockdown
would
bring
back
the
earlier
romantic
infatuation,
candlelit
dinners,
etc.
Meanwhile,
the
reality
turned
completely
different,
quite
mundane:
Netlix,
youtube,
home
office.
Psychologists
sound
a
warning
that
the
numbers of domestic abuse have been growing, though this might not be true.
The
attitudes
towards
epidemic,
recorded
in
historical
sources
not
so
long
ago,
seemed
to
be
a
merely
faded
evidence
of
the
former
era.
The
mankind
of
the
21st
century
was
convinced
that
with
the
help
of
science
and
technology
one
can
fully
control
nature.
The
year
2020
sobered
up
even
the
most
overconfident
of
human
power.
Poland
suffered
one
after
the
other:
Covid,
drought,
numerous
floods,
national
park
fire
and
a
series
of
violent
climatic
phenomena.
The
environment control proved to be an illusion.
The
old
attitudes
came
back,
though
assumed
a
new
form.
In
Poland,
fear
worked
from
March
to
June,
when
the
majority
obeyed
the
lockdown
rules,
while
the
then
Health
Minister
enjoyed
high
public
trust.
This
did
not
take
long.
Envious
politicians
and
their
media
henchmen
blackened
his
reputation
with
strong
charges,
putting
him
off
civil
service.
In
the
summer,
when
the
number
of
infections
visibly
dropped
down,
people
did
not
observe
restrictions
anymore.
Beaches
and
mountain
routes
got
crowded
too
much.
A
contemporary
human,
for
whom
to
live
means
to
consume,
is
not
ready
to
give
up
his
nice
holidays.
The
autumn
saw
a
second
wave
of
infections,
much
stronger
than
the
one
in
the
spring,
accompanied
by
a
crisis
of
confidence
in
all
types
of
authorities.
Protesters
of
various
types
hit
the
streets;
some
politically
motivated,
others
objecting
the
sanitary
regime.
Disregard
for
restrictions,
avoidance
of
Covid
tests
and
resultant
potential
home
quarantine,
reluctance
to
contact
a
doctor
in
case
of
mild
disease
symptoms;
all
these
were
less
spectacular,
nevertheless
clearly
visible.
In
November
family
doctors
were
alerting
to
this
dangerous
phenomenon
but
it
seems
that
it
was
of
no
avail.
Patients
lost
their
faith not only in the public authorities but also in the power of reason.
The
medicalization
of
social
problems,
or
in
other
words,
the
public
life
colonization
by
health
care
system
representatives
–
described
by
Michel
Foucault
in the “Naissance de la clinique” (1963) as an unavoidable outcome of the process of modernization – this time faced public resistance.
Fear
and
inclinations
towards
risky
types
of
behavior,
witnessed
today,
only
seemingly
bring
to
mind
the
responses
to
epidemics
from
the
old
times.
The
underlying
causes
of
their
manifestations
and
origins
are
rooted
elsewhere.
Fortunately,
fear
is
not
translated
into
the
quest
for
the
alleged
culprits,
witch-
hunting
or
persecution
of
aliens.
Defiance
of
the
sanitary
restrictions
is
more
than
simple
“playing
around”.
A
contemporary
human
is
completely
different
than
before,
though
not
necessarily
wiser.
As
pertinently
observed
in
the
“La
rebelión
de
las
masas”
(1929)
by
Jose
Ortega
de
Gasset,
a
modern
man,
in
politics,
in
art,
in
social
usages,
in
other
sciences,
will
adopt
the
attitude
of
primitive,
ignorant
man;
but
he
will
adpot
them
forcefully
and
with
self-
sufficiency
[…].
By
specializing
him,
civilization
has
made
him
hermetic
and
self-satisfied
within
his
limitations;
but
this
very
inner
feeling
of
dominance
and worth will induce him to wish to predominate outside his speciality.
Reason has been confronting anti-reason. It is hard to predict what their future struggle will be like.
*To
supplement
the
publication
by
prof.
Michał
Kopczyński,
I
give
you
a
handful
of
statistical
data
on
the
pandemic
in
Poland.
The
first
case
of
Covid-19
was recorded on March 4, 2020. Until now, there have been 1102096 cases. Covid19-related deaths stand at 21630, no. of recovered patients: 792119.(J. O.)
(data on December 10th, 2020)
1st w
ave
July - August
March - Nove
m
b
er 20
1st wave: March 6 - June 30, 2020