Mr. Rahul Gandhi interacted with Prof. Johan Giesecke, Former Chief Scientist, European Centre for Disease Prevention and Control
About Prof. Johan Giesecke: Prof. Giesecke was born in Stockholm. In 1979, he defended his thesis, On The Molecular Structure Of Dopaminergic Substances, at the Karolinska Institute. He trained as an infectious disease clinician and worked with AIDS patients during the 1980’s. Giesecke received an MSc in epidemiology from the London School of Hygiene and Tropical Medicine in 1992, after which he worked as a Senior Lecturer at the school. From 1995 to 2005, Giesecke served as state epidemiologist of Sweden. During a one-year sabbatical 1999-2000, he led a group at the World Health Organization working on the revision of the International Health Regulations. After this, he was Chief Scientist at the European Centre for Disease Prevention and Control from 2005 to 2014. As of 2020, Giesecke is a member of the Strategic and Technical Advisory Group for Infectious Hazards of the World Health Organization, and also works as an advisor to the Public Health Agency of Sweden during the COVID-19 pandemic in Sweden.
RAHUL GANDHI : Good Afternoon Prof.
PROF. JOHAN GIESECKE : Good Afternoon.
RAHUL GANDHI : Thank you very much for agreeing to
talk to me. I know you are extremely busy. PROF. JOHAN GIESECKE : No problem. I have time.
RAHUL GANDHI : I saw an interview of yours where you were suggesting some different ideas and that sort of aroused my curiosity.
RAHUL GANDHI : You’ve been an infectious disease expert. How are you seeing this from Sweden and Europe?
PROF. JOHAN GIESECKE : This is a disease that is spreading across the globe like a wildfire and almost everyone in the world will be infected. But it is a very mild disease. 99% of the people infected will have very little symptoms or no symptoms at all.
PROF. JOHAN GIESECKE : So what we are seeing now is 1% of the epidemic. The real epidemic is going on. We don’t know this is really.
RAHUL GANDHI : But ofcourse that is not the perception of the disease. The perception of the disease even in India is that it is a very dangerous disease. Why this discrepancy in perception? What has created this discrepancy?
PROF. JOHAN GIESECKE : Because people are dying, and quite a lot of people are dying… and it is a quick process. But in the end you will see that it is a very small proportion of old or all who have symptoms of the disease. Most people will be completely symptomless.
RAHUL GANDHI : How would you view the strategy from an Indian perspective? Massive country, over a billion people, large migration, population with specifically diabetes, heart disease, lung disease. How would you think of the disease from an Indian standpoint?
RAHUL GANDHI : And now that we are in a lockdown, how do you transition out of the lockdown? What is the best strategy to come out of a lockdown? Because now it is a psychological reality, the lockdown and an actual reality. So, how do you come out of that? What is the gentlest way, the smartest way from a healthcare perspective to come out of that?
PROF. JOHAN GIESECKE : That is a very good question. I’ve been asking myself, all the countries in Europe that instituted a lockdown one or two months ago, did they ever think about the exit strategy at that time? I don’t think any single country said we’ll do this lockdown, we’ll close this school, we’ll close this border, we’ll close the restaurants. I don’t think at that point they thought about how to get out of it. Now everyone is asking the same question, how do we get out of this.
PROF. JOHAN GIESECKE : It has to be step wise I think. You take all the restrictions you have in India, you take one away, you soften one restriction. You wait 2-3 weeks and see what happens. Do we have more spread of the disease? Yes we have more spread. Ok then we take one step back and try another restriction. So I think it will take months to really ease out the lockdown. But you must do one restriction at a time and see what happens.
RAHUL GANDHI : What is the role of testing in all this? How should one think about and use testing.
PROF. JOHAN GIESECKE : One is clinical. In the hospital you want to know if a patient has the infection or not. But then you can follow the epidemic a bit more across the country. See whether there are special geography or special people that have it. So that’s for planning a little.
PROF. JOHAN GIESECKE : Then we have the new tests that you are aware of. We have the old test-the PCR test, which shows that you are infected right now, that you have the disease right now. And then there is the new serology test that shows if you had the disease. That will also be useful to see who had the disease, and who is now immune.
RAHUL GANDHI : And ofcourse the real impact and the balance here is between economic damage and the healthcare damage. How do you think about those two aspects of this?
PROF. JOHAN GIESECKE : That is a difficult balance there. I think the way we have done it in Sweden is that the main thing is to protect the old and the frail. They should be protected from the disease. Everything else comes second. So what we have done is that we have not completely shut down the country. Many workplaces are still open. Many people are working from home if they can. We don’t have restrictions. You can go outside and meet other people outside. Better than in your home. But at some point, I think for India, and I don’t know India, I’ve been in Delhi once to your Communicable Disease Centre in Delhi but that’s many years ago. I think you will soon create more harm than good with a severe lockdown.
RAHUL GANDHI : That is from an economic perspective?
PROF. JOHAN GIESECKE : Economic and Humanitarian perspective.
RAHUL GANDHI : Of course there is a connection between the economic side and the healthcare side because while you are doing this lockdown, you have got your hospitals under COVID wards so to speak. In India they have sort of decided that they are going to maintain some space in those hospitals just for COVID, so a lot of patients who have other diseases can’t actually access those hospitals.
PROF. JOHAN GIESECKE : I think for India you will ruin your economy very quickly if you had a severe lockdown. I think it’s better, skip the lockdown, take care of the old and the frail and let the other people have the infection. Most people will not even be sick. They will not even notice they have it. It’s a mild disease.
RAHUL GANDHI : Do you have any questions about India on this front?
PROF. JOHAN GIESECKE : How are you talking about this balance between disease and economy?
RAHUL GANDHI : Well we got a full lockdown and I’m skeptical of a full lockdown myself. I do think that one has to move to a partial lockdown. I think the full lockdown is damaging and the damage increases exponentially. The sooner you get out of the lockdown, the better it is.
PROF. JOHAN GIESECKE : You may even create more deaths by a severe lockdown than the disease will do.
RAHUL GANDHI : Exactly. The issue in India is that we have a Central Government and a large number of State Governments, and there is a tension between these two. The Central Government has one view, the State Governments have another view. That sort of slows down the discussion. The big issue in India has so far been the migrant labour. The fact that we have a large number of people living in slums who happen to be migrant labourers, so when they have done the shut down, they can’t go back to their homes in rural areas. That has created a lot of concern. Food is going to become a serious problem because we have a lot of manual laborers who depend on daily wages and they are already in trouble because they simply aren’t getting those wages. Provision of food for them, at scale, is a challenge that the Indian government and State Governments are facing.
PROF. JOHAN GIESECKE : Now I think for you, the situation that India is in, with the federal States and everything, I think you should have a very soft lockdown. As soft as possible.
RAHUL GANDHI : I don’t want to keep you.
PROF. JOHAN GIESECKE : Can I take a picture of you in my computer.
RAHUL GANDHI : Ofcourse you can take a picture of me on your computer.
RAHUL GANDHI : Very nice talking to you.
RAHUL GANDHI : Thank you very much.