Structure Polish Academy of Sciences

“It is high time to stop thinking that we still do not know much about SARS-CoV-2 or vaccines. COVID-19 is one of the best-studied infectious diseases in the history of medicine, and the vaccine against this disease is the best-studied vaccine in the history of vaccination. However, what is apparently lacking is sufficient will on the part of those in power to combat the COVID-19 epidemic,” the scientists on the COVID-19 Advisory Team to the President of the Polish Academy of Sciences write in their Position Statement 28, and they remind us that people’s freedom to make irrational choices that contradict scientific opinions ends at the point when they start threatening the health and lives of their fellow citizens.

While the death toll of the fourth wave of the COVID-19 pandemic, caused primarily by the Delta variant, is still rising in Poland, a fifth wave associated with the emergence of the Omicron variant is just beginning. Studies show that statistically, the Omicron variant causes a slightly milder course of the disease. However, that difference may not be as significant for individual people, and infection with the Omicron variant will still be deadly for many. That is especially true for unvaccinated people. We also know that the risk of death for vaccinated and recovered people is many times lower, even if they are not fully protected from infection and the disease. This applies to people who received their last dose of vaccine no more than five months ago. Therefore, all those who missed this deadline should receive a booster dose. Unfortunately, there are still too few vaccinated people in our society. Those who have not yet been vaccinated should urgently join the vaccination program. Doing so can reduce the risk of dangerous complications after the COVID-19 virus is contracted. Many people have obtained vaccination certificates illegally without being vaccinated. They are now caught in a trap. Consideration needs to be given to how to help them get out of this situation. The country’s leaders should do everything in their power to increase the number of people who are adequately vaccinated. That is the only way to alleviate the tragedy caused by the excess deaths and the paralysis of health care services and the whole country.

The high infectivity of Omicron is causing a wave of disease of unprecedented magnitude. While the percentage of hospitalizations will be lower with Omicron than with the variants we have seen so far, this will be a percentage from a much higher number of infections. It is not “percentages” that occupy hospitals, but numbers of people, and these numbers will be unprecedentedly large. It takes about two weeks from a reported increase in infections to see an increase in hospitalizations. The maximum number of patients hospitalized due to COVID-19 is forecast for the second half of February and – in an optimistic forecast scenario – will be comparable to the peak in November 2020. The dramatic inefficiency of the health care system is likely to affect everyone, including people with conditions other than COVID-19, as the general health of the population in Poland is relatively poor, and the health care system is already profoundly inefficient. An indication of how weak the system is can be found in the very low number of nurses and doctors in Poland, as shown in the figure below, which presents the number of doctors and nurses per capita in individual European Union countries.

Figure 1.

Government inaction has led to tens of thousands more unnecessary deaths in the second half of 2021. Will this tragic statistic continue into 2022? What will the long-term consequences of government inaction be? What strain will there be on our society and health care in the years to come? The prolonged overcrowding of hospitals will result in more diseases diagnosed too late and a wave of deaths that could have been avoided. 

Not a lack of knowledge, but a lack of will

It is high time to stop thinking that we still do not know much about SARS-CoV-2 and vaccines. COVID-19 is one of the best understood infectious diseases in the history of medicine, and the vaccine against this disease is the best-studied vaccine in the history of vaccination. What is apparently lacking, however, is sufficient will on the part of those in power to combat the COVID-19 epidemic.

It is time to reject the notion that the doubts of a certain part of the population about restrictions and vaccinations are justified. It is time to fight against the dangerous activities of the well-organized group (though less numerous than it seems) of anti-vaxxers who are misleading a large part of the population. They must be resolutely opposed in politics, public institutions, and social life. All legal means must be used to defend society against the expansion of these groups. People’s freedom to make irrational choices that defy science ends at the point when they begin to jeopardize the health and lives of their fellow citizens.

The debates about the superiority of masks over social distancing, restrictions over testing, or vaccinations over treatment should be set aside. We need all of these things at once – and we need them immediately. Government ineptitude has already led to thousands of preventable deaths in Poland.

The measures proposed below do not require politically difficult changes to statutory laws – rather, lower-level acts such as ministerial regulations will suffice. For this, the only thing required is sufficient will on the part of those in power.

We appeal for immediate: 

1. strict enforcement of the MDDV rule (masks, distance, disinfection, ventilation) as well as the “when you are sick – stay home” rule, and a return, if possible, to remote working in the coming weeks, which applies to vaccinated individuals as well.
2. the establishment of facilities for the vaccinated and restrictions for the unvaccinated. To properly set expiration dates for certificates, follow guidelines on the protection provided by vaccines and the need for booster doses. Systemic measures should be taken, and difficult decisions and responsibilities should not fall to employers. Difficult decisions regarding future doses or inclusion of vaccines in the mandatory immunization schedule should be made rationally and taking the pandemic situation into consideration.
3. promoting universal testing for all (e.g., through free antigen testing available without a referral; for example, using the UK approach of providing free test kits for everyone in every pharmacy) and regular testing of children and staff in schools. 
4. urgent intensification of the information campaign on the COVID-19 pandemic. Implementing educational programs in schools on the pandemic and how to fight it, especially on such basic tools for fighting infectious diseases as vaccines.
5. decisive action to stigmatize views and attitudes that run counter to well-documented scientific facts and directly threaten the health and lives of Poles.

In Poland, we have paid a very high and unnecessary price for our inability to deal with the COVID-19 outbreak. The rapid actions proposed here will no longer stop a new wave, but they can stretch it out in time and thus diminish its devastating effect. We have the tools to do so. Failure to use them will be an unforgivable mistake.

About the team

The Interdisciplinary COVID-19 Advisory Team to the President of the Polish Academy of Sciences was set up on 30 June 2020. The team is chaired by Prof. Jerzy Duszyński, President of the PAS, with Prof. Krzysztof Pyrć (Jagiellonian University) as deputy chair and Dr. Anna Plater-Zyberk (Polish Academy of Sciences) as its secretary. Other members of the team are:

• Dr. Aneta Afelt (University of Warsaw)
• Prof. Małgorzata Kossowska (Jagiellonian University)
• Prof. Radosław Owczuk, MD (Medical University of Gdańsk)
• Dr. Anna Ochab-Marcinek (PAS Institute of Physical Chemistry)
• Dr. Wojciech Paczos (PAS Institute of Economics, Cardiff University)
• Dr. Magdalena Rosińska, MD (National Institute for Public Health – National Hygiene Institute, Warsaw)
• Prof. Andrzej Rychard (PAS Institute of Philosophy and Sociology),
• Dr. Tomasz Smiatacz, MD (Medical University of Gdańsk)