What has the emergency regime for the global health system shown?

“Since ancient times, people have known about many processes caused by microorganisms, but they did not know the true causes of these phenomena... Even Hippocrates (460-377 BC) suggested that infectious diseases are caused by invisible living beings. However, at that time it was impossible to verify the correctness of his ideas, and completely different hypotheses were spread.

Many scientists continued to reject the bacterial nature of infectious diseases even after the revolutionary discoveries of Pasteur and Koch. So, in 1892 Max Pettenkofer, confident that cholera is caused by miasma released by the environment and trying to prove his case, swallowed a culture of cholera vibrio in front of medical witnesses and did not get sick” (Wikipedia). Knowledge of history, even at such a primitive level, can be useful.

Let's go back to the present time. I will quote typical phrases that are actively being introduced into people's minds in connection with the current pandemic. "Certain chaos that reigned on the planet in the spring (2020) in almost all areas of life was not least caused precisely by the fact that scientists knew almost nothing about the new virus - and the authorities had to make many decisions at random." No comments. Or: "... scientists still know very little about the virus that causes the disease SARS-CoV-2."

The co-author of one of these works, the president of the American pharmaceutical company Nobilis Therapeutics Vlad Bogin talks about the unsolved mysteries of COVID-19:

"It is precisely for this reason that there has never been such a super-powerful imperative in the history of modern medicine and epidemiology to study the virus that is terrorising humanity, to understand its strong and weak sides in order to have protection from its first side and hit the second one with drugs and vaccines."

And now a little bit of our history. In 1933, the Council of People's Commissars, headed by N. Semashko, developed such a system of measures to combat tuberculosis, which to this day is not only admired for its effectiveness, but also the main links of which are still being used in this fight. And what did they know about Koch's bacillus? Compared to today's knowledge, almost nothing. In our time, the genome of Mycobacterium tuberculosis has been deciphered, we have more than ten anti-tuberculosis drugs in service. And what are the results?

"In 2019, a total of 1.4 million people died from tuberculosis. Worldwide, tuberculosis is one of the 10 leading causes of death and the main cause of death due to any unique causative agent of infection (ahead of HIV/AIDS). In 2019, a total of 206,030 people with multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) were identified and registered, which is 10% more than in 2018 (186,883 people). Currently, success in treatment is achieved only in 57% of patients with MDR-TB." (See WHO, Tuberculosis Report of October 14, 2020).

Let me remind you that in 1933 there was not a single anti-tuberculosis drug in the world. And our great-grandfathers managed to somehow treat this disease without panicking. Therefore, clinicians, that is, practicing doctors, are engaged in treatment. There is another question.

And how did we cope with pandemics of viral infections before, without deciphering the full genetic code of the virus? For example, the flu pandemic known to specialists in 1957, when, according to official data, about 4 million people died from influenza in the world (it is clear that the mortality rate is underestimated due to the lack of basic medical care in a number of countries).

Two words about "new technologies" in medicine. It's in this way that correspondence counselling, designated by the advanced term "remote", is presented to us. Did you know that in the USSR, correspondence consultation was prohibited by a special order of the Ministry of Health? Of course, the doctor will continue to examine the rich and chosen ones in the old grandfather's way.

The most important thing in a doctor's examination is to determine the root of the problem. During a remote consultation, should the patients determine themselves

the algorithm of their examination? There is just a need to ask the right questions.  However, with the same success, Google can consult them for free.

A few years ago, French media discussed a case when a woman went to the ambulance with complaints of vomiting and diarrhoea. Doctors regarded the symptoms as simple food poisoning, the team did not go to the patient. A few hours later, the woman died, because the diagnosis made remotely was erroneous.

And now a few words about another thesis that is so deeply embedded in the minds of most people today that even leading political figures take it for an axiom.

"The COVID-19 pandemic has demonstrated the vulnerability and fragility of our world. As a result, the way of life of societies has turned upside down, the population of the planet found itself in serious danger, and deep inequality has clearly manifested itself.

This shock, which simultaneously affected both the health and social sectors as well economic life, is the most severe crisis remaining in the memory of mankind and a catastrophe in every sense.

Experts have repeatedly warned about the impending threat of new pandemic diseases and called for radical changes in the ways of protecting against them, but the necessary changes have not yet ensued... This cycle must be interrupted. Changes are needed to prevent the next pandemic.

In this regard, the Commission recommends that deep transformations be carried out to ensure the highest level of commitment to a new system that is characterised by coordination, coherence, dynamism, accountability, justice and equality, that is, a system of fully-fledged pandemic preparedness and response that can reliably ensure the safety and health of citizens."

Co-Chair of the Commission, The Honourable Helen Clark, Co-Chair of the Commission, Ellen Johnson Sirleaf Mauricio Cardenas, Aya Chebbi, Mark Dyble, Michelle Kazatchkine, Joanne Liu, Precious Matsoso, David Miliband, Thoraya Obaid, Preeti Sudan, Ernesto Zedillo, Zhong Nanshan (211294_main_report_ppr-ru).

So, while we doctors are busy rethinking the details of the genetic features of the coronavirus and conflicting treatment recommendations, a certain group of people is preparing the ground to take control of all the health systems in the world. This means control over the reorganisation of medical personnel, hospitals, polyclinics. People will come who will think that instead of a maternity hospital in your city, it is necessary to open infection boxes. And so that they do not stand idle, patients with cholera and Zika fever will be brought to you from Africa. You think it's unlikely?

First, the Germans also did not expect that millions of Arabs and Syrians would live in their country on their benefits, and up to 80% of these so-called refugees are men, not women and children. Secondly, 2 years ago, I would never have believed that healthy and honest people around the world could be locked up under house arrest for an indefinite period.

So, what will follow the thesis that "the situation with the coronavirus has shown the unpreparedness of national health systems around the world to work in an emergency"? Are we already ready to accept control over our healthcare from an outside structure? Let's leave the analysis of emergency preparedness to experts in this field. Maybe, we should try to keep the remnants of our national health system under our control?