EANS President's message May 2020
Wednesday 6 May 2020
Dear Friends & Colleagues,
This year is a year like no other. Instead of meeting each other, we are confined in so many different countries and cities and we are obliged to communicate through various digital channels. Despite being affected by this situation in different ways, we keep the good spirit. Life goes on. There will be a post-Corona life. And, we are continuing to work as an organisation of European neurosurgeons. Thus, Excom and Board are video conferencing with each other on an almost weekly basis. EANS business and neuropolitics go on – no matter what virus-induced lockdown is hitting the world.
It is my privilege to inform you about ongoing business, and my personal view. So, here come the…
…News from the Board:
Importantly, EANS and the office team could avoid penalty payments for cancelled courses and meetings, with the exception of a total €400 - so far. But, of course, given the current insecurities concerning travel bans stretching beyond the summer of 2020, grounded airlines, and country-wide differing laws for gatherings of people, we must be prudent so as not to take financial risks for i.e. our big annual congress in Belgrade in October 2020, nor for other courses and meetings in the autumn and winter of 2020/2021. Through our PCO - AIM - we are gathering information on how other organisations are handling this crisis, be it by shifting their events to the next year, or be it by offering full digital meeting options, or hybrid digital-physical solutions. Of course, we will keep you updated on these developments, which may affect your own travel plans. Until the end of May we shall know better, what’s going to happen in this direction, and which way we will propose to go. When I look out of the window, however, I am happy that we can’t do the course in Evian this week. It is likely, the weather will be even better in November.
Other tasks have not been abandoned: Peter Hutchinson, together with a specialised lawyer, is working on the creation of our new EANS Research Foundation.
Our external consultant is gathering offers from various publishers, so as to possibly go for our own EANS-owned journal in the future. In that same context, I assisted several telephone - and video- conferences with the Excom and the Board of Eurospine. These meetings happened to be extremely friendly and based on mutual trust and transparency. The creation of a joint journal for science and surgery related to the spine with 50/50 responsibility seems entirely possible. But, it’s a long way to go still, and we need a full SWOT analysis prior to taking on such an endeavor.
The ongoing crisis has led to enormous activity and cross-fertilisation among some of our sections and committees: The Young Neurosurgeons, together with the IM team, the Skull Base section, the International Relations Committee, and many others are working hard to bring our social media presence and our website content, including Webinars to another level. It is delightful to see how information is now flowing across all boundaries of sections and committees. Thanks a lot, and keep going, please!
We are trying to organise a real Board Meeting for early July 2020 in Geneva. That shall serve as a preparation for our annual general assembly during the Congress in October, and we will keep you informed about the details. That shall allow you to prepare yourself or your delegates for the ensuing discussions during the assembly.
Those, who don’t want to read anything anymore (and, especially not from me) on the Corona crisis, may stop reading here, I greet them, and I wish them good health and a lot of energy when it comes to reboot their local system. Hope to see you soon!
The remainers may continue here:
The longer that misery is going on, the more difficult it will be and the longer it will take to find a coordinate way back to normality. While the various countries are discussing as to how much they may release the lockdown, which has been keeping us low for so many weeks by now, there are many uncertainties still, which don’t shed the best light on the political and the scientific community – nor on society as a whole.
While I don’t doubt that virus to be a particularly nasty one (i.e. we have to create a special post-Covid neuro-unit, because many survivors present a whole portfolio of neurological signs and symptoms), I believe that the pendulum has swung way too far in one direction. Collateral damage is mounting not on the economical side alone, but on the medical side as well. In the last two weeks alone in my direct perimeter of action, one child had died, because his parents wouldn’t allow him to be brought to a Corona-ridden hospital. Another boy was almost strangulated to death with a wire by his mother, who was convinced she would have to die of Covid and then could not leave him behind alone. Domestic violence is up >30%, and suicide rates are surging. Thousands of hospital beds are empty currently in many countries, and we are still preparing for the first Tsunami of Covid-patients to arrive, or, for the second wave, and – more recently evoked – for the kids, suffering from associated inflammatory disease. At the same time, it turns out that governments hadn’t ramped up enough Corona-tests, PPE, face masks etc., despite having been warned to do so years ago already for the latter.
That crisis brought up enormous differences between countries and health care systems. What might be the right way to go for one society may not be the right way for another. I.e. maybe Scandinavians (Sweden’s R-value of today: 0.8) are respecting an inter-personal distance a priori already, and they don’t sit nor walk as closely together as Southern Europeans. So what? That’s how we are: different! But, we see that health care systems, which were deprived of money and personnel, where health care was squeezed to the last drop, are doing worse than others, where there is enough and reasonably paid medical staff and access to hospital beds and appropriate equipment. It is possible to treat 80year-old Covid-patients properly, and to take care of other patients at the same time, if there are enough resources, and if the whole system, or a regional hospital system doesn’t break down because of a first wave of sick people is arriving. Interestingly, this deprivation of health care applies for very socialist systems (such as the NHS in England) and for very social Darwinist systems as well (i.e. situation in New York City). And a very dark side is showing its ugly face, when we see what has been happening in countless retirement homes and homes for the demented, which were simply abandoned by their frightened staff, leaving helpless people behind and dying. Then, the images of dysfunctional freezer trucks in front of such retirement homes and hospitals. As always, this is also a period of images, which will remain stuck in our minds: The photos from the ICU in Bergamo, from NYC hospitals, empty inner cities, and many others. A man-made dystopia.
A society has to be ready to pay the price for being as protected and safe as possible. And, it has the leaders it has chosen. In that context, I am questioning the role of those politician-whisperers, who are at least in part responsible for so many unclarities and uncertainties and back- and forth-tumbles. The impact of virologists and epidemiologists on our lives has become ever-important. That may be considered surprising by us, who were used to receiving high appreciation from patients and peers frequently. But, even if we may count some true divas amongst us - those with the aura of masters, monolithic opinions and high-flying lives: Nobody cares about that, however, except themselves, and maybe some patients and some close members of their teams. The opinion of those scientists and doctors, however, who have become influencers on the political side recently are exerting a huge impact on us all, on whole societies and economies.
To use an analogy, it is, as if being asked about the best possible treatment for dural AV-fistula, our vascular section would come up with totally divergent opinions - with one proposing endovascular therapy, another one proposing surgical resection, and the third one to nuke it with Gamma Knife. But, wrap one of these contradictory solutions over a whole society: Imagine, what happens then?!
And, far from being a conspiration theorist, I believe that in that very same context it is only legitimate to question the safety of biohazard laboratories. If there is no unequivocal common sense among the specialists’ community as to how a virus, such as the SARS CoviD might have been fabricated in a high-security lab or not, how should the public know? Given the gravity of the current situation, the public, not only the scientific community should claim their rights to get to know what’s happening behind the walls of i.e. S4 labs all over the world, including those, which are run by the military. One article, published in Nature Medicine in 2015 clearly refers to the fabrication of a chimeric virus in the Wuhan lab (2): „ Therefore, to examine the emergence potential (that is, the potential to infect humans) of circulating bat CoVs, we built a chimeric virus encoding a novel, zoonotic CoV spike protein—from the RsSHC014-CoV sequence that was isolated from Chinese horseshoe bats1—in the context of the SARS-CoV mouse-adapted backbone. The hybrid virus allowed us to evaluate the ability of the novel spike protein to cause disease independently of other necessary adaptive mutations in its natural backbone.“ The authors of that article were Chinese, American, and Swiss, respectively, with additional funding through the US-NIH. Even, if more recently the theory of an artificially generated virus has been abandoned by other groups, and, probably, the current Corona strain represents a mere zoonosis, one may ask, what the involved research groups have done from 2015 to 2020 in order to prevent such a situation of potential virus escape to occur (2). If in 2020 in our high-tech neurosurgical departments wrong-side or wrong-level surgeries may happen, despite the strict application of time-out protocols – why shouldn’t it be possible that virus-contaminated material, generated in some S4 lab anywhere in the world may end up in the public sphere - due to human failure, or even by purpose? If we don’t want to be kept hostage by conspiration theorists in the future, we need to have clarity on that, and that information must be delivered by those running such institutions and their respective governmental/military body, controlled by independent institutions.
When you look at the reactions of people in general, and at those of some so-called role models, or idols, that makes you nauseate as well: I.e. my friends in the German-speaking world would be shouted at by other pedestrians to maintain more physical distance. Or, i.e. anonymous reporting to the police of neighbors, who were or were not respecting the Corona rules, went up significantly in Germany. Looting (of e.g. liquor stores!) commenced in South Africa. And, i.e., one of the richest English couples, the Beckham’s, have almost immediately laid off their workers and thus submitted them to public welfare. That saved them app. £ 75.000.- per month – very shortly after they had publicly shown off their new $ 20.000.000.- Miami penthouse. Had they continued to pay their workers for a few more months only, it wouldn’t have done serious harm to the Beckham industries. At the same time, that would have shown empathy for their employees – and respect for the public system, which is keeping a country together. Of course, it is everyone’s private business what they are doing with their money. But some people are exposing themselves more than others. They are being rewarded by that publicity, which in addition pays well. And they should accept that there is a responsibility, which comes with it, especially during difficult times for so many. It is up to the young generation herself what idols they are following – in social media and/or in their real life. Maybe, the current painful situation, which is submitting so many people to precarious conditions, will trigger some reflections on who one wants to be, apart from being seduced into false glittery and glamourous virtual media space, lacking essential traits of humanity. Of course, I don’t know, who he was in his past: But I liked in particular the British 100year-old WW2-veteran Captain (meanwhile: Colonel) Tom, who, with his stamina of invincibility and the charisma of true and sympathetic determination, raised more than £ 30 Millions by relentlessly walking around his lawn for the sake of those in need. Chapeau!
Enough now! We will go back to normality as soon as possible. We have to. I am getting adverse skin reaction and nausea when only receiving an invitation for yet another digital Zoom- or GotoMeeting-Meeting.
Let me conclude: In this ongoing mess, I find solace in talking to neurosurgeons. That is reassuring! I find the current situation so messy, and the so-called expert and political opinions so disturbingly divergent and confusing, that I enjoy more than ever talking to my neurosurgeon friends. We are far more pragmatic and straight people than most everybody else. And, we possess a lot of good judgement. There is a German saying, which I am trying to translate into English in the most elegant way (if at all possible): “The Popo belongs into the pants”.
That said, I wish you an excellent spring in strange times. And, us all, let’s try our best to go back to normality as soon as possible, and to meet again later this year - and healthy!
1. Liu S-L, Saif LJ, Weiss SR, Su L: No credible evidence supporting claims of the laboratory engineering of SARS-CoV-2. Emerg Microbes Infect 9:1, 505-507, 2020
2. Menachery V, Yount Jr BL, Debbink K, Sudhakar A, Gralinski LE, Plante JA, Graham RJ, Scobey T, Ge X-Y, Donaldson EF, Randell SH, Lanzavecchia A, Marasco WA, Shi Z-L, Baric RS: A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence. Nat Med 21(12):1508-1513, 2015