The Epidemic of Secrets – part 1 (VIDEO)
THE CORONA VIRUS CHANGED THE WORLD. IT CHANGED SERBIA, AS WELL.
THE EPIDEMIC OF SECRETS - PART 1
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: It wasn’t only the doctors who were scared. The whole world was scared. We are still scared. No one knows anything about this epidemic. What is causing it or what is the clinical picture? It was horrible from the very beginning and it is still horrible.
TATJANA JOVANOVIC - Virologist, Vice-dean of the Faculty of Medicine, Crisis staff: Let me just tell you, I feel so sorry for our epidemiological team, to hear about them being criticized. There will be plenty of time for us to deal with politics and issues related to politics. This is the time when people's health comes first, and I think that's how we should organize ourselves as a society.
When the state finds itself at crisis - fear arises among the citizens, but trust in institutions and all those who decide about all of us grows. There is also a growing support for medical workers who, at that point, found themselves in the most difficult situation of all.
And so that’s how it all began. In March 2020.
The manner in which the state is governed in times of crisis - politically, health-wise and economically - leads to greater or lesser trust in institutions. It is without doubt that the goal of those responsible was to mitigate the effects of the virus in every way possible, using the resources available to the state at the time. However, the fact that they hid the important information in the process, or communicated them in the wrong and irresponsible manner, led to anger prevailing over fear for some, to trust being replaced by distrust.
In a short time, Serbia went from a funny little virus that exists only on Facebook to a warning that the Italian scenario awaits us, from the country that is best supplied with medical equipment to the country where - many procurements were secretly declared - from masks to respirators. At the moment, the officially announced number of deceased citizens differs from the number that was unofficially discovered.
With such a legacy, at a time when the whole world is in uncertainty due to the pandemic, Serbia is facing a new, as predicted, even stronger impact of the Corona virus. In order for citizens to know how to behave, how dangerous it is, what is forbidden and what is allowed, it is necessary for them to get all the information, and for those to be accurate.
DRAGAN MILIC, director of the cardiosurgical laboratory Nis: Here I am as a university professor and someone who has numerous specializations, and have been practicing medicine for many years, I have simply never seen this type of virus. If we figure out that secret, then we can solve a lot of other more easily, as well.
The virus, which was first registered in China at the end of December 2019 and has soon spread to all countries of the world, still remains a secret today. How it was created, what consequences it leaves, and whether we will get the cure soon - no one knows. The worldwide death toll has exceeded one million.
The World Health Organization has formed a team of experts to discover how the virus originated.
MARIJAN IVANUSA, World Health Organization: So, the work is in progress, we’ll see what the result will be in the end, but for now, it is valid that the virus that causes COVID-19 is of animal origin. That it is of animal origin and that it was transmitted or mutated. From animals to humans.
Corona viruses have already warned humanity in the 21st century that they can be very dangerous. Tanja Jovanović, virologist and member of the Crisis Staff, says that because of all this, the theory that Corona virus does not exist and that it was all made up is unacceptable. The Virus exists and it’s dangerous.
TATJANA JOVANOVIC, Virologist, Vice-dean of the Faculty of Medicine, Crisis staff: Each epidemic is very specific in its own way. As for some other coronaviruses, such as SARS and MERS, those that cause severe respiratory infections, they didn’t adapt to the host so well. Only a few hundred people died as a result of these infections. In contrast, this new coronavirus adapted to the host very well, and therefore managed to cause a pandemic of this proportions.
At what stage of the epidemic is Serbia in should be determined by the percentage of infected, cured and dead compared to the total population. In order for these data to be available at all, testing is necessary, and the whole story around tests and testing in Serbia was followed by several problems.
From the lack of tests, through changing the rules, to whether we even have good enough conditions to perform more testing on a larger scale. Unnecessary complications and inconsistent information eventually led to everything looking like another secret.
MARIJAN IVANUSA, World Health Organization: The state asked for tests in different ways. I remember one phone conversation, it was over the weekend, on Sunday morning, when the minister called me and we talked about how we could supply tests to Serbia, and one of the ways that Serbia received some of the tests was through WHO, and the additional ones were procured from the market by the state itself as much as possible
INSIDER: WERE THERE ENOUGH TESTS WORLDWIDE AT ALL?
MARIJAN IVANUSA, World Health Organization: When the new disease appeared, there were no tests at all at the beginning.
In the beginning, there were not enough tests in Serbia, but not enough laboratories either, and it often happened that you had to wait for the results for a few days. All this led to the fact that, according to the doctor's testimony, the cause of death was the Corona, but that wasn’t stated as the diagnosis since the results came in late.
DRAGAN MILIC, director of the cardiosurgical laboratory Nis: It can sometimes happen that a swab sample is taken from a patient, they have to wait 4-5 days for the results, it wasn’t done on the same day as it is done now, and the patient happens to die in the meantime, but since at the moment of death they haven’t yet been officially diagnosed with Coronavirus they don’t report it to be the cause of death. Three days after his death, the results came back positive, and what now? Well you obviously can't retroactively report his death on the 17th he died on 13th.
And the rules at beginning, who should be tested and who not, they were unclear to the doctors, but they kept saying that are not enough tests either way.
STEVA STANISIC, infectologist-anesthesiologist, Nis: There were tests only for those who were in a critical condition and had to be put on the mechanical ventilation. The test wasn’t even important to them, it was clear to them that they have a severe clinical picture and that it was a 99,9999% chance that it’s the COVID-19 infection, and more importantly, there were no tests for our colleagues in the Clinical Centre. We thought it was completely unacceptable, but no one asked us. Tell me, is that normal that colleague comes with a serious problem or a mild problem, and his saturation is good, he has a fever, well, you know what, just go home, we don’t have enough tests.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: We opened Pandora's box when it comes to this pandemic. Who is going to be tested, will that be people with symptoms, or those already infected, or maybe those who were in close contact with infected people, what does a clear definition of a case mean?
In the meantime, two types of tests have created, which has only added to the confusion. It was not clear to the people whether PCR or serological tests were more important, what does each of them show.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: There are people who don’t understand what is the sensitivity and specificity of the serological test, what does a serological test even mean. It’s a blood test. What are the IGG and IGM antibodies, and so on. So, you need to address people in a way that they can understand, that’s the first thing. Secondly, it has to be clear, precise and concise. I am resentful because I know that people did not understand what was said to them.
The Crisis Staff provided information on a daily basis about the number of tested and infected. It turned out that this number is not only the number of those relevant ones, but the total number of both together.
PCR involves taking a swab from the nose or throat, where the virus first enters the body, and is specific for the new coronavirus. Serological tests are blood tests.
MARIJAN IVANUSA, World Health Organization: PCR is certainly the test that represents the gold standard. Because it is very specific, it is specific for that virus in particular, it might not show accurate results if tested for another similar virus, and it’s currently the most sensitive of the tests we have.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: PCR is the gold standard.
INSIDER: WE UNDERSTAND THAT.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: It's a real virological test. This test determines the presence of the virus, or indirectly the viral genome, in the patient's sample. Other tests are serological tests. They are not really diagnostic tests in the true sense. They can be of use for some kind of orientation once the infection has already happened.
DARIJA KISIC TEPAVCEVIC, member of the Crisis Staff and Deputy Director of Batut, July 17th : No one is being diagnosed based on the results of a serological test. The tests that we report about are PCR tests.
Only 12 days later, the director of Batut, Verica Jovanović, practically contradicted her colleagues and stated that serological tests are included in the motal reported number of those tested.
VERICA JOVANOVIC, Director of the Institute for Public Health “Dr Milan Jovanović Batut” 29th July : "So, since the last report, 9653 have been tested. Yes, there are people who have been tested for control post-infection, people who have been tested for travel, as well as re-tested people because there were no negative results on the first test. There are also serological tests according to the indications set by doctors.”
It became completely clear then that the Crisis Staff announces every day the total number of those tested. Those who did the test because they have symptoms, those who overcame the coronavirus and did the control test, but also those who are tested for travel. This number includes, as it turned out, serological tests that are not considered reliable for making a diagnosis. It remains unknown how many PCR tests are performed daily, which are, for now, the only reliable ones.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: As for that database, believe me when I tell you that I don't have a password. Only those who work in laboratories and who enter the relevant data have access, so I have to tell you I didn't even see the database, so I can't tell you what percentage are serological tests are and what serological tests are entered into that database, but the number of infected is calculated according to the results of the PCR tests.
On April 20th, a new laboratory “Vatreno oko” was opened in Serbia, which was presented as a donation from China. Although there is little information on how it is equipped and what it is supplied with, the fact is that this laboratory has significantly increased the number of PCR tests that can be processed daily in Serbia. According to officials, it has a capacity of 2,000 tests a day.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: The laboratory that worked in that laboratory underwent a short training, because they work with a large number of analyses and because of the highly infectious material that they deal with, so they didn’t go home for 2 full months but were accommodated in a hotel. So it was a great sacrifice made by researchers, the greatest scientists in this country.
How much PCR tests can be done in Serbia in relevant laboratories per day has never been precisely announced. According to the statements of the officials, it was announced that once the construction of all laboratories has been finalized, the capacity of 10 thousand test per day would be reached. However, some of them are still not finished today.
That is why the information announced in July that as many as 11,000 citizens were tested in one day raised doubts about what the Crisis Staff is reporting.
ZORAN RADOVANOVIC, retired Professor of Epidemiology: Undoubtedly, the main motive was to show that the percentage of infected is less than 5%, but this was achieved by fabricating data, meaning that all the performed tests were taken into account, there were not only these PCR tests but also serological tests, control examinations, and then you fabricate this number to reach the percentage of infected that is relatively small, and there you go, the situation is not that bad.
The head of the DNA laboratory of the Institute of Forensic Medicine at the Faculty of Medicine in Belgrade, Oliver Stojkovic, was the first to publicly say that he doubts the fact that Serbia had the resources to test such a large number of people in one day. Another dilemma, according to him, is what the ratio between newly infected and total number of tested shows.
OLIVER STOJKOVIC, Professor of Genetics at the Medical Faculty in Belgrade: Those numbers, as well as most of the other information that I hear and that you hear at those press conferences mean nothing to anyone, I'm especially sure that they don't mean anything to the epidemiologists in the Crisis Staff who appointed to determine some epidemiological measures based on that data.
The percentages calculated by comparing the tested and infected are used as an important indicator that is supposed to tell us whether the epidemic is raging, peaking or calming.
ZORAN RADOVANOVIC, retired Professor of Epidemiology: I have given up making any assessments, but for the current epidemiological situation, to be able to make concrete decisions I need to know of course what the criteria are, it wouldn’t be such a problem if everyone was tested the same way, for example with PCR, but I have to have all the information to be able to assess what is the actual percentage of infected at the moment.
Wear masks, don't wear masks, schools are safe, schools are not safe, we have equipment - we lied about having equipment, everything is under control, the virus has weakened - nothing is under control, we did not expect the virus during the summer. These are just some of the contradictory statements made by the representatives of the Crisis Staff, the Ministry of Health and the Government of Serbia to the citizens at the beginning, during and at the end of the first wave - the second peak. Such statements have contributed to the loss of trust in a part of citizens, which is crucial in the fight against a virus - that is, in a situation when everyone is equally endangered - both the citizens and the government.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: It is completely clear to us that something doesn’t add up. About how many patients there were, how many have died, the numbers that we have and the numbers that are publicly announced do not add up, because as doctors we had one perspective of it all, and we listen to something on television that is simply not in line with what we personally face.
The Batut Institute of Public Health is in charge of data communicated to citizens. Thus, according to their data, every day in the period from May 23rd to June 26th, one or no citizens infected with the coronavirus died. In the period from June 13th to 26th, one died every day. Statistically, that’s almost impossible.
ZORAN RADOVANOVIC, retired Professor of Epidemiology: So, they came to the conclusion that the number is so unusual that such an epidemic would have to happen about 4 million times to be able to reach such unusual numbers once. It’s clear that it’s inaccurate.
According to the Serbian government, the Batut Institute was in charge of establishing and running a new information system designed for COVID-19. The decision to establish a new system was made by the Serbian government on March 28th so that it could monitor the epidemic as efficiently as possible. The conclusion clearly states that Batut Institute, with the technical support of the Office for Information Technology and Electronic Administration and the Republic Health Insurance Fund, will manage the new system.
This meant that all hospitals, institutes for public health and testing laboratories were obliged to update the data in the system up until 2 PM each date for the period of previous 24 hours. This refers to the data about the cured, the deceased from the consequences of COVID-19, data on all those who were tested, or who were ordered to stay in self-isolation.
Although the impression was that the IT Office of the Government of Serbia is responsible for the accuracy of the data contained in the database, the director of the office told Insajder that they do not even have access to the database.
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: The IT office simply doesn't have any insight into the COVID-19 database, we don't know what it looks like, we got a table with the most general data, we call it anonymized data of the number of infected people for the whole country and that's it. One should ask Batut who participated in the development of that database.
Director of Batut Institut Verica Jovanovic refused to talk to Insajder. Her former deputy Darija Kisic Tepavcevic also refused to talk.
DARIJA KISIC TEPAVCEVIC, member of the Crisis Staff and Deputy Director of Batut, October 4th: “For the first time, when it comes to this pandemic, we wanted to have transparent data. There wasn’t a single moment or a day that we published different data than what was in the database, including the latest updates at that moment”.
The Government's conclusion states that Batut Institute submits all data to the Ministry of Health on a daily basis, by 2 PM. The Minister of Health Zlatibor Loncar also refused to talk to Insajder.
Doubts about the exact number of Corona deaths arose in June when Balkan Investigative Reporting Network released official data showing that there were more deaths from the coronavirus than what was reported to citizens.
On June 22nd, BIRN published an article claiming that based on data seen in the state's COVID-19 information system for the epidemic, 1,080 people died in COVID hospitals from March 13th to June 1st. During that time, it was officially announced that 244 citizens of Serbia died from the new coronavirus.
MILORAD IVANOVIC , Editor in chief - BIRN: This difference was not the same on all days, we see that in the first weeks or the first days of the crisis, the numbers that were announced at the press conferences were approximately the same to the data that were in the database. Discrepancies started somewhere in late March and reached a peak somewhere between 12th and 14th April, and then mid-May they start to normalize and we again had a period where the data more or less corresponded to the data announced at the press conferences.
Ten days after BIRN published the data, a statement arrived from the Batut Institute for Public Health in which there are no answers to any of the relevant question that were being asked by public, it simply stated that the information is incorrect and that the Batut Institute data is verifiable, accurate and primarily based on medical records.
BATUT ANNOUNCEMENT: "It is very dangerous when individuals who are not medical experts interpret the classification of COVID-19 patients, based on inaccurate data. No one has ever, as today, so falsely attacked the Batut Institute, which is open to any professional cooperation and discussion. "
MILORAD IVANOVIC , Editor in chief - BIRN: When we got access to that database, we spent some time trying to authenticate the database, fearing that the database might’ve been set up to be inaccurate, that it was created as such or something like that, and actually doing everything we do in any other situation, we checked what sources hired experts who created the database, we checked certain data ourselves, and after some time came to the absolute conclusion that the database we have has not changed and that that is the original database, and that it is indeed a database used by the Batut Institute.
The biggest differences between the official data and those found by investigative journalists in the database appear on April 13, 2020.
MILORAD IVANOVIC , Editor in chief - BIRN: On that day, 16 patients died at the Nis Clinical Centre, which means that all the doctors who were in the COVID hospitals in Nis, nurses, lab technicians, they knew that the data announced at the press conference that day were not correct. The situation is the same in the Zemun hospital, on the same day 7 patients died in the Zemun hospital, while at the press conference it was said that 5 of them died in the whole country. So, the doctors in that hospital knew that the data were incorrect. I guess they all just wanted to be soldiers of that system, they didn't want to disrupt the hierarchy, and they were probably thinking that it’s better to be silent for a while until maybe one day the times comes for the truth to be told.
To date, none of the authorities has answered the question of who had access to the database, they do not rule out the possibility that differences in numbers may appear at the end of the day, but they claim that they communicated the true data that they had at that time. On the other hand, they ask journalists to reveal their sources.
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: I refer back to their procedure where at no time did they explain where that database came from, who granted them access to it, through which accounts did they access it and from which institutions.
INSIDER: AND DID THE STATE DETERMINE WHOSE DATABASE DID BIRN PUBLISH
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: And why would we do that?
INSIDER: BECAUSE IT IS THE RESPONSIBILITY OF THE STATE, BECAUSE TRUST IN THE INSTITUTIONS IS BEING QUESTIONED
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: How do we even know if this database works properly?
INSIDER: YOU’RE CLAMINIG THAT IT’S A FAULTY DATABASE?
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: No, first they have to tell us where did they get that information and from which institution, and with what accounts did they access the database.
INSIDER: WAS THERE ANY INVESTIGATION IN CONNECTION WITH WHETHER BIRN PUBLISHED SOMETHING THAT WAS COUNTERFEIT, BECAUSE THE MINISTER OF HEALTH SAID IT WAS FALSE DATA?
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: Why would we bother with that, I mean we have a lot…
INSIDER: WHY DO YOU MEAN WHY?
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: Because we have much more important and significant work to do when it comes to the fight against COVID-19.
INSIDER: AND DON'T YOU THINK IT'S IMPORTANT TO BE INFORMED ABOUT HOW MANY CITIZENS DIED FROM CORONAVIRUS BECAUSE IT'S PEOPLE IN QUESTION AND NOT THINGS?
MIHAILO JOVANOVIC, Director of the IT Office of the Government of Serbia: You’re completely right… The information communicated by the Crisis Staff are accurate, and citizens should trust that official information.
MILORAD IVANOVIC , Editor in chief - BIRN: We tried to reach Batut Institute several times before we published the first article, we called the director of Batut several times. Just before the article was published, she told us to come and talk to her, unfortunately she did not appear at that meeting and we published the article that day. Before publishing the database on our website, we called her again, the only thing she said was that the matter was very complicated, that it was very difficult to explain, and she insisted that the data announced at the press conference at three o'clock were correct, but she didn’t have an explanation about how it’s possible that we have their database which says that the real data is actually drastically reduced.
ANA BRNABIC, Prime Minister, Republic of Serbia, July 13th, 2020: When someone tries to publish some data, which I still don't know from which database you obtained it and who granted you access, and what did you even find, or what the report for the Government was... So, I don’t really know on what grounds to discuss this with you. You accused us, you didn’t talk to us, you didn’t ask us for an opinion, you didn’t ask us for an explanation before you published. They just published a super controversial article and said – trust is lost.
MILORAD IVANOVIC , Editor in chief - BIRN: We worked on that first article purposely avoiding it to become political, so we did find necessary to contact any political officials in relation to it, we did not call the Prime Minister, but we did call Svetlana Jovanovic, Prime Minister’s Chief Adviser, who we know was one of the most responsible people for functioning of this database. She did not respond. We called Dr. Kon, we called the Chief of Staff of the Minister of Health, so we did actually call all those we thought are relevant parties in this matter, but unfortunately, we received no answers.
It turned out that members of the Crisis Staff that were medical experts did not have access to the database either.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: There are very confidential information there. So, the name and surname of the patient, their personal identification number. There are even some details from their medical records there, and so on. These are data that we cannot have. By the way, for the first time in this country, a database for infectious diseases was built. Precisely because of that transparency, it would be really disastrous if everyone had access to that database. Not only because we would be able to see that confidential data, on the one hand, but also because we would be able to modify that data. So, I was completely shocked to learn that someone obtained the lists from that very database, because I, as a member of the Crisis Staff, did not have access to that database. That’s a very big offense for me. I'm now starting to doubt whether we have the right data in the database, whether someone may have accessed the database and modified some results.
The statements from the authorities about the data related to the coronavirus in the recent months have regularly been confusing, contradictory and illogical.
ALEKSANDAR VUCIC, The President of the Republic of Serbia: “I am proud of all the doctors, none of us lied a single word. I reached out to people from the Batut Institute, they said that they have fewer deaths."
ZLATIBOR LONCAR, Minister of health:
"I have nothing to add, except to tell you responsibly as the line minister that this information of yours, that three times more people have died, is not true.”
DARIJA KISIC TEPAVCEVIC, member of the Crisis Staff and Deputy Director of Batut, Hit tvit (TV show), 28.6.2020 : "I really don't know to which database the people who wrote such an article are referring to, but I am afraid that the aim of all this might have been the creation of mistrust in everything that is being done, well you know that we’ve been transparent right from the start about everything that is being done”.
Epidemiologist and a member of the Crisis Staff's expert body Predrag Kon made a number of different statements from June to October in relation to the database published by BIRN - from contradicting, through a personal investigation he conducted, to the confirmation of a larger number of deaths, and then again to denial.
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, June 25th - N1
"I am not the one who should be explaining it. That’s not something you should be asking either me or Professor Tiodorović, it’s well known who is the person that collects the documentation and he will certainly give it to you. As far as I heard, he did reply to BIRN, but someone obviously didn’t accept that answer. The one who did not accept that answer will have to explain why and what is written there.
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, June 28 "Utisak nedelje" (TV Show): "I am talking about what I know and what is true, and the truth is what 'Batut' published, these are official data and based on them, there were no particular reasons to alarm the public.”
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, July 11 - TV Nova S: WE HAVE WHAT BIRN SAID, WE HAVE WHAT THE STATE SAID. BOTH CAN BE TRUE.
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, September 12th : I launched my own investigation
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, September 30th: The death toll was three times higher.
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body:"What I'm saying is true, some like it, some don't. But it's the truth. So, it's true based on the mortality statistics that there were three times more deaths in Belgrade than reported, which means that doctors themselves did not report the is the deaths to be of COVID-19"
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body, October 2: I stated that the data were "based on mortality statistics, and that is obviously not clear to people."
Predrag Kon refused to talk to Insajder because of the series "Procurement of health", which was about the swine flu pandemic and broadcasted in 2010.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: I resent the fact that no one has taken responsibility for everything that has happened so far. I resent Dr. Kon for repeatedly presenting some facts, then withdrawing them, then elaborating them, then others tried to explained what he wanted to say in the first place, why did you even conduct any personal investigations if the data presented are accurate. Secondly, why did you have the need to deny that the mortality rate was higher. Thirdly, what mortality if those are COVID patients or patients that died from COVID, why the numbers do not match?
MARIJAN IVANUSA, World Health Organization: As a matter of fact, we don’t really check those numbers. As the World Health Organization, as I’ve said before, we are not an inspection, nor are we a global policeman. We can ask the state if the data provided to WHO is correct. That's what we can do from our end.
INSIDER: AND I GUESS THAT’S WHAT YOU DID
MARIJAN IVANUSA, World Health Organization: Yes.
INSIDER: SO, DID YOU GET AN ANSWER?
During that time, the answer was, actually the feedback was with data that were practically the same as the ones we received before.
Without an independent analysis of data from the COVID-19 information system, citizens can only decide for themselves whether or not to trust the official data. The Commissioner for Information of Public Importance says that his office found out how the database technically works, but what is the input data we can only hear from the person enters it.
MILAN MARINOVIC, Commissioner for Information of Public Importance and Personal Data Protection: I can honestly tell you, from the beginning when that system was established, I believed it because I had no other information, of course. Later, my trust was baffled a bit, but I still believe it, because I still don't have any other source of information.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: We were interested in getting accurate data and we expect to get absolutely accurate data, because we are not happy to hear through the media that something is wrong. We were promised at the Crisis Staff’s meeting that we would get that information and that we would see what it was about, whether there were really many more or much fewer infected people, and we would certainly inform the public when we get the results.
MILAN MARINOVIC, Commissioner for Information of Public Importance and Personal Data Protection: I do not see common sense in why someone would reduce or increase the numbers, regardless of the number of infected and the number of deaths. I really don’t see what the benefit of that is. I mean, you say honestly how it is and that's it. I'm not saying that it’s not being truthfully told, I just want to say that it should be so. Simply, the most important thing right now is to have trust among citizens. Either you have it from the beginning or you build it. You can build it by not creating any doubts anything. So, if you give more information, less will be asked.
More information on the cause of death can be shown by an autopsy, but it was not done because, as stated by Serbian experts and the Minister, it was banned on the recommendation of the WHO.
MARIJAN IVANUSA, World Health Organization: As far as I remember, they are not forbidden. Of course, all precautions should be taken to protect the autopsy team, and these are measures that are normally used with people who have potentially died from an infectious disease. Otherwise I don’t see any particular reason why autopsies should be done. But still some states… I mean there were autopsies being done on COVID patients, as well, but to a certain number of cases.
The head of the laboratory of the Institute of Forensic Medicine, Oliver Stojković, is not a part of any team that fights against the corona virus, because, as he says, his laboratory was not included in the decision of the state.
OLIVER STOJKOVIC, Professor of Genetics at the Medical Faculty in Belgrade: In order for us to establish that the deceased is not infectious at the moment of autopsy, it is necessary to take a sample from the body of the deceased from a deeper part of the nasal area of the pharynx. We could’ve examined these samples here technically, and we are equipped with personnel for that, we made that request to the faculty administration, which is at the same time a part of the Crisis Staff, and we were informed that it was not possible.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: Autopsies are not performed because autopsies are prohibited. This was prescribed by WHO. Therefore, autopsies cannot be done if you have a patient who is COVID-19 positive.
INSIDER: AND WHAT WOULD HAPPEN IF AN AUTOPSY WAS DONE AND THAT MAN HAD COVID-19 AND WE DIDN'T KNOW THAT HE HAD COVID-19?
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: You refuse to understand that the virus is highly infectious and that there is a high risk of contamination if you work with the virus. These are all just precautions that are being taken in order to prevent the infection from spreading further.
The infection spread from China, where the first outbreak took place, but the truth was kept a secret.
It all started on December 31st, when the whole world was preparing to officially welcome the year 2020. It was then learned that there were patients with atypical pneumonia in the Chinese city of Wuhan. Just a day earlier, Chinese doctor Li Wenliang sent a message to fellow doctors in the chat group warning them of the epidemic and advising them to wear protective clothing to avoid infection. He was accused of causing panic and warned that if he did not stop doing so, he would be prosecuted. It turned out that he did not spread panic with any false news, but that he warned of the possibility of an epidemic. He contracted the virus himself and died on February 6th.
DRAGAN MILIC, director of the cardiosurgical laboratory Nis: You know, if you get to that point where you know that something is going on, and you keep it a secret, in January you expel all journalists, with what ambition, for the news not to spread, you close off certain areas in China, but not ban air traffic. So, you can travel freely from there to wherever you want, but you can't travel between the cities, what’s that about, why? I don't want to accuse them either, but I want to say that they acted inappropriately. We referred to the World Health Organization, I read their recommendations regularly at the beginning, not anymore, because they changed opinions, as well. So how can we accuse our people for saying something in February, then something different in March, and then again in April, if they followed WHO’s recommendations, which was constantly changing its views on the situation.
On January 30th, 2020, the World Health Organization declared the global danger of an epidemic of a new coronavirus. The International Health Regulations are binding for both WHO and all the countries.
MARIJAN IVANUSA, World Health Organization: This means that states respect the rules. For example, cholera. Cholera appears in one city, in one port that is economically very important for the country. And the state does not want to say that cholera has appeared. Then we, as WHO, can officially demand from that country an explanation of what is happening on that territory.
INSIDER: DID WHO DO THAT THIS TIME WHEN CHINA WAS IN QUESTION?
MARIJAN IVANUSA, World Health Organization: There was no need because China itself informed that there was a number of patients with severe pneumonia and they did not know what was the cause, and it happened on December 31st. A few hours after that on January 1st WHO already had a team of experts that started reviewing the documentation delivered from China and other information, as well, and as early as January 5th, all members of WHO knew that something was going on in China. On January 10th, WHO sent the first set of recommendations on how to protect countries from respiratory infections that have appeared in China.
Chinese experts isolated the virus in January. While the epidemic was spreading through China and then Europe, the main topic in Serbia was the elections that were supposed to be held in the spring. Pictures from Italy and the world were also seen by the citizens of Serbia, who then took it to social media saying that they were worried because Serbia seems to behave very relaxed.
In order to show the public that everything is under control, a meeting was held after the president's meeting with representatives of all health and other institutions involved in the fight against the coronavirus. Messages sent from that conference turned out to be completely wrong.
Press conference on February 26th
PREDRAG KON, Epidemiologist and a member of the Crisis Staff's expert body: Our hospitals are ready. We may be affected by a small epidemic, there may be a few deaths, but it is far from dramatic and the need to change our daily routines.
BRANIMIR NESTOROVIC, Member of the Crisis Staff’s expert body: Women are free to go shopping in Italy. Women do not die from this virus, I heard that there will be discounts in Italy because no one wants to there at the moment.
MIJOMIR PELEMIS, Member of the Crisis Staff’s expert body: We cannot reduce the danger, but if this epidemic strikes us, we can only win if everyone does their job and if we are honest, all of us addressing this, because it is our duty. To tell the truth.
ALEKSANDAR VUCIC: There will be no postponement of the elections, we will not be delaying any events, not even sport matches.
The number of infected people in Italy grew, the first cases appeared in Croatia, Slovenia and then in BiH. In Serbia, a parallel reality is practically happening - elections have been called.
ALEKSANDAR VUCIC: I am announcing the elections on March 4th
Instead of preventing the spreading of the coronavirus, political parties and even the ruling party organized a mass collection of signatures. Citizens were all rushing at the same time to get their ballots signed so they could be collected and verified in record time, and it was all done indoors.
Two days later, the first case of coronavirus in Serbia was officially confirmed.
ZLATIBOR LONCAR, Minister of health, March 6th: What we expected to happen in a matter of hours, did in the end happen. The first case was registered in Serbia.
3 days later, Alexander Vucic visited the Krusik factory where a large number of citizens gathered in support of the president. There were no epidemiological measures, so many concluded that elections and campaigns are more important than health. On the same day, another case of coronavirus was confirmed in Serbia.
On March 10th, the Serbian government declared COVID-19 a contagious disease, which meant that the law on the protection of the population from infectious diseases could be applied. The law also envisions the introduction of a state of emergency and restrictive measures for citizens in order to preserve their health.
According to the same law, these measures are proposed to the Minister of Health by the Institute of Public Health and the Republic Expert Commission for the Protection of the Population.
ZORAN RADOVANOVIC, retired Professor of Epidemiology: If you follow the legal regulations, then it is necessary to assemble a republic commission of experts for infectious diseases, which according to that Law on the Protection of the Population from infectious diseases should be in charge of the situation.
However, on March 13th, the Serbian government established two Crisis Staffs - one for health and one for economy. Until today, the citizens of Serbia have not seen the decision according to which these Crisis Staffs were formed, their specific tasks or obligations that the members of these bodies have, and most importantly, there is no information on how they were assembled and how decisions are made at the sessions of those bodies. Only three and a half months later, the legal basis for the conclusion of the Crisis Staff and the list of members was published - it turned out that there were more politicians than doctors.
The Vice-dean of the Faculty of Medicine notes that, regardless of how everything looked like to the citizens, the preparations were taking place even before the first infected patient was officially registered in Serbia.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: We didn't know much about the virus then. We didn’t know what surprises awaited us with the virus and the infection. It two months for the coronavirus to come to the Republic of Serbia, so thanks to those preparations that were made earlier, we were able to recognize, diagnose the disease and treat patients right from the start.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: In April when my hospital entered the COVID system, on the first day our Chief Pulmonologist comes and says “listen guys, this is awful, a woman is sitting on the steps in her house, crying her eyes out, she says that she’s never seen anything like this, that this is horrible because it is completely unpredictable”, you don't know how a person will get sick, you don't know how to treat them, you don't know how the clinical picture will develop, you don't know who is more at risk, you don't know who is less at risk.
DR STEVO STANISIC, infectologist-anesthesiologist, Nis: At the same time there are that many or even three times as many patients on oxygen, or some kind of oxygen support, you see that they are constantly getting broken, you increase oxygen flow through the masks, but you see that the patient is not well. Of course, you try everything in your power, we did our best and had everything at disposal.
ANDJELA GAVRILOVIC - neurologist, COVID Zvezdara, United against COVID: We can only thank the enthusiasm, the courage, I do not know how to explain it, the superhuman efforts that doctors, nurses, technicians, non-medical staff, servers, cleaners, repairmen, all of them, invested in the health system, we were on the verge of a complete catastrophe that was barely avoided in the process, so to say. Solving all the problems with one altruism, that I think drives all of us who are doing this type of work. This does not mean that the danger has passed. It’s a process, we correct each other, we learn from each other, and I don’t know how to say it but of our strength, even our own lives, we put in the service of fighting that pandemic.
A state of emergency was imposed in Serbia on March 15th, 2020. Although well-criticized - strict measures have led to a decrease in the circulation of the virus. At the same time, economic measures were adopted - citizens were allowed to postpone the payment of loans, among the first measures an increase in salaries for medical workers was proposed, as well as one-time financial support to retirees. The economy was postponed from paying taxes and contributions, and employees in the private sector were paid a minimum salary of 3 months from the state budget. The whole package of measures was worth approximately 5 billion euros. Those who applied received 100 euros as a one-time financial assistance. Some ventures will be remembered as positive. In 14 days, the hospital on Karaburma was reconstructed and extended, and today it serves as a COVID hospital and the capacity is almost doubled from 80 to 140 beds. This, as it was announced, was a donation from the private company Termomont. There was almost no shortage in Serbia. Even the shortage of masks and gloves on the market has stabilized relatively quickly.
MARIJAN IVANUSA, World Health Organisation: Serbia very quickly started the procurement of materials that were much needed. No country had stocks ready for such a large epidemic, and at that moment, all countries found themselves at the point where they rushed for the supplies and protective equipment that they were able to procure from the international market, which was extremely limited, so there was a great shortage. Serbia did very well here and quickly acquired some essential things. Thirdly, Serbia quickly transitioned the healthcare system to COVID, so that the patients with COVID received the treatment they needed. The decision was quickly accepted that the costs of treatment of COVID-19 remain confidential from the state’s end, so that people do not have to pay themselves. So, a lot has been done.
What hasn’t been done and what has been done incorrectly become the main topics in the public in July, in the midst of the second wave of the coronavirus, when the state of emergency was already lifted. At that time, the question of the responsibility of members of the Crisis Staff was also raised.
ZORAN RADOVANOVIC, retired Professor of Epidemiology: The problem with that Crisis Staff was, firstly, is the fact that certain members were making statements that contradicted each other. And then whenever you ask a member of the Crisis Staff, how could you make that statement, it’s always “he said, she said”, we are not always for that, don’t take this for granted, and then the truth becomes relative, everything can be a truth, and the main problem is that the actual truth at that moment has been avoided for far too long. That’s what’s unacceptable in this whole situation and that’s what mainly caused the situation to turn into chaos later on.
Representatives of the Crisis Staff have repeatedly stated at press conferences that the Crisis Staff’s medical experts only propose the measures, but they also never complained when representatives of the Government or the state announced that "the experts have decided". This created the impression in the public that in fact the Crisis Staff is making decisions and not the government, and then by default it was the Crisis Staff that everyone started blaming for everything that went wrong.
DR TATJANA JOVANOVIC, Virologist and member of the Crisis Staff: I have to tell you that I belong to the medical part of the Crisis Staff. We do not make decisions, we make certain recommendations, certain instructions, but we do not make definite decisions.
MARIJAN IVANUSA, World Health Organisation: Trust is very important. In countries in transition, that level of trust is much lower, so people believe much less that something is needed if the representative of the government says so. That was one of the most difficult tasks during this epidemic.
OLIVER STOJKOVIC, Professor of Genetics at the Medical Faculty in Belgrade: It seems to me that the public is much more disturbed by the obvious concealment of true data and the obvious display of fabricated data than they would be disturbed by the public disclosure of true data, no matter how terrible that true data may be at some point.
The coronavirus epidemic continues, it has its peaks and waves, the number of infected is increasing and trust, by all accounts, is decreasing. In this fight, trust is necessary and the only way to regain it is to offer the full truth about everything ...
DR STEVO STANISIC, infectologist-anesthesiologist, Nis: I have no intention of defending anyone here. Medicine has one shrine called truth. The truth cannot be sacrificed. We have no right to hide the truth and not to tell the truth, primarily because of our patients and foremost because of our students. Because we will give them a very bad example of how not to work.
TO BE CONTINUED...
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