Scientific Council proposes thorough state audit of pandemic period

Toivo Maimets.
Toivo Maimets. Source: Stenbock house

Professor Toivo Maimets, head of the scientific advisory council, told ERR that Estonia needs a national audit to assess the pandemic times activities to be carried out by a dedicated government or parliamentary committee.

The Scientific Council met again on Monday. What are you talking about now, when Covid-19 topics are mostly forgotten?

The council continues to convene on a regular basis; we had a regular working meeting and the agenda is usually set up so that the first item to discuss is the current epidemiological situation.

And I disagree that the Covid-19 is forgotten. We dislike having to talk about it, but about 10 corona positive patients are admitted to hospital in Estonia every day. Half of them are hospitalized because of the coronavirus.

There are also patients on respiration machines who have Covid-19 as their primary diagnosis. The infection spreads quickly. The present viral strain and its substrains are extremely contagious.

We all know from our own social circles that someone has been unwell again. About 95 percent of Estonians have some form of immune response, so these medical conditions are usually light, but you are still off of work for a week.

In fact, one of our current duties is to generalize the lessons of the last three years and develop a reasonably concrete plan for what to do next time, so that we are better prepared.

There have been claims in the media that a new type of coronavirus is spreading rapidly in China. Do you have any information?

I heard about this yesterday. But I did not look into it because it was based on the mainstream press rather than scientific repots. However, the number of outbreaks in China is fluctuating and what is apparent is that if particular regions have been entirely closed, people have less immune protection when they reopen. And first contacts always in this case trigger large outbreaks.

I was sick with a virus over the weekend, and my symptoms were the same as usual: fever, cough and runny nose. Is it advisable to carry out a home quick test in this situation? What will it do for me other than satisfy my curiosity?

On the one hand, it is all about self-interest; for example, I am certainly curious about what is going on with me. However, it is clear that many people do not want to know much about their health.

But, more realistically, as I have said before, this infection is currently spreading at full speed in our country. Another significant issue is the so-called extended Covid-19 syndrome. At least 10 percent of persons who have Covid-19 will have long-term consequences. These symptoms are quite distinct. If you suddenly get any symptoms, tests will reveal that you have the infection. So I believe it is better to self-diagnose as well.

In Estonia, apparently 99 percent have contracted the disease...

It is difficult to say because there are so many asymptomatic patients. The present coronavirus, however, is causing immunity to deteriorate. People who experienced it three years ago by now have a lower immune response. For people over the age of 60, as well as those at risk, the advice is still to keep up to date with your vaccinations, as for flu or encephalitis. Knowing is always better than not knowing.

Is a thorough national assessment of what transpired in Estonia during the pandemic really necessary? It has been done in many countries, e.g., Sweden. The goal of this audit should not be to throw accusing fingers at anyone; for example, a judge ruled this week that it was unconstitutional to fire ambulance workers who refused immunization. Such things cannot be allowed to linger in the air, can they?

Indeed, as you said, many nations have established an audit committee, either at the government or legislative level. The committee's mission is to conduct an investigation of medical, social science, communication and legal issues.

An advisory council doing this in Estonia on the sidelines of its main work is a bit short of a thorough analysis. However, there have been some advancements, such as in the Health Board and a research group at Tallinn University of Technology focusing at crisis management. Something is currently being done, but I would prefer if the government or parliament understood that such an audit is necessary.

It was confirmed last spring that restrictions were necessary, particularly to prevent hospitals from collapsing. I have not heard of a thorough audit of hospitals, how they were managed and what may be done differently in the future. Viruses, after all, are not giving up and will always return; it is simply a matter of time.

However, I would add that the restrictions were imposed to prevent the virus from spreading, not to keep hospitals open. Overcrowding in hospitals, on the other hand, was a major issue. Many other health issues were left untreated.

The problem is that science always arrives after the storm has gone. However, there are now perfectly good meta-analyses showing the efficiency of various restrictions. For example, the efficiency and side effects of several vaccines, as well as the effectiveness of masks, are being studied. Many things, many mistakes, would not have happened if we had been as wise two years ago as we are now.

Give an example, what were the mistakes?

There is now conclusive evidence that masks aid to decrease infection without a doubt, albeit their efficiency is dependent on the materials used. Similarly, earlier this year, the Koch Group released a report on the efficacy of immunizations. It investigated 12 vaccinations, including Sputnik. A total of 500,000 persons were analyzed.

As a result, all of our immunizations were effective. They averted not just an increase in hospitalizations and fatalities, but also an increase in infections. Except, I believe, for a couple of vaccines where the numbers of side effects were so little that no statistical conclusion could be formed, the most of them had no greater side effects than the placebo or the zero group.

Throughout the crisis, Estonia was one of the most liberal countries. Our restrictions were incomparable to those of Latvia and Lithuania. Did we make the appropriate decision based on this new information, or did something go wrong?

I am just voicing my opinion. Estonia's restrictions were, for the most part, reasonable. Our economy, as has become clear in retrospect, could not take too much of a hit. Our mortality rate was substantial; we have more than 3,000 Covid-19 related deaths officially. We could have lowered it if we had done a better job with immunization. We continue to have one of the European Union's lowest immunization rates. But we are among those who are dealing in some way.

Many countries around the world, such as Russia and Bulgaria, have higher rates. There are also countries whose fatality rates declined during the pandemic, such as New Zealand, which closed all of its doors. As a result, other viruses, such as influenza, did not spread. However, these activities are only possible on remote islands.

Estonia's response was reasonable; additional vaccination could have decreased the number of unnecessary fatalities. The Scientific Council has drawn attention to our legal system as well.

You mentioned court trials. The fact that courts have made varied decisions in similar circumstances indicates that something is wrong. Tidying up the legal system is something that should have been urgently tackled three years ago.


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Editor: Mirjam Mäekivi, Kristina Kersa

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