“I have been vain, I am not proud of it and I try to get as far away from vanity as I can”

BarcelonaThe infectologist Oriol Mitjà (Arenys de Munt, 1980) publishes today The world that awaits usa book about the future challenges of public health and also an exercise in introspection on his life between Catalonia, where he has lived the last two years for covid, and his hut in Papua New Guinea, where tries to eradicate yaws, an infectious tropical disease.

The world that awaits us is a book of reflections that have arisen to him when returning to Papua.

– I wrote it to have a quiet moment and to reflect calmly, which is what we lacked the most during the crisis, as we had to solve urgent problems every day: the arrival of the vaccine, restrictions … In Papua I found moments of stillness and I was able to have a discussion with colleagues and friends that helped me a lot to understand what had happened and especially where we are going, where we need to make the changes to return to a normality that must necessarily be different from what we had. We cannot pass up the opportunity to improve as a society.

He calls these two years a “devastating time.” In what sense?

– We are facing a global health crisis for the first time. It has been devastating for society and specifically for health care workers, both physically and emotionally. Many decisions have been made on how to respond to what was immediate, but we have not yet done anything to transform ourselves into a more resilient and prepared society. Or do we plan to turn the page and forget about it as we did with the volcano of La Palma and now with Ukraine?

He says that returning to old normalcy is not desirable.

– The pandemic has shown that the old normality created inequalities, that it left out the elderly, that people with fewer resources became more easily infected and that vaccines did not reach poor countries, and therefore the virus continues to mutate there. new variants appear. That normalcy failed because he forgot about the most vulnerable. It was the law of the jungle: whoever was individualistic, arrogant triumphed, and forgot too much to recognize the other, to dignify him, to help him, and to accompany him.

Does that mean that if we go back to normal, will we have a pandemic again or will it be easier to have one?

– That too. This scientifically selfish attitude also brings us closer to increasing the risk of pandemics, which are totally linked to climate crises, which have two manifestations: extreme weather events and pandemics, because mosquitoes grow better, human settlements are closer of the jungle and animals, especially bats and rodents, easily infect us. If we continue like this, for the next 50 years there is a high risk of finding a second covid or a more dangerous disease.

The spice jump, right?

– This is critical. Humans have always lived with infections and have been able to adapt to them. The problem comes when he gets infected with a virus he had never been infected with, which was from an animal, and jumps on it. This causes a zoonotic disease, we have no immunity and can cause great lethality. With the climate crisis, interspecies jumps have multiplied: before there were four each year and now there are 20. And the next few years are expected to be 40 a year.

Doctor Middle, make me a spoiler: is the world waiting for us good or bad?

– It will depend on what we do. The world that awaits us is good, it has progressed for 500 years, and it has improved longevity and decreased infant mortality and death by birth. Humans will live more and more comfortably, but adjustments need to be made.

What must we do to make the world a better place?

– Many of the mismatches are related to pandemic preparedness, which involves knowing how to find and stop infections before they reach us. This is done primarily by veterinarians, and they should be given resources to identify which pathogen is most dangerous, where it may appear, and what can be done to prevent the jump. The next jumps are known to be in Africa or Asia, in wooded areas of central Africa or the Indochina Peninsula, and the animals most likely to transmit will be bats, rodents or birds. The second phase is to create epidemiological intelligence structures. All this requires an investment and at the moment we have not seen that anyone is interested in preparing. In fact, there is a lot of interest in forgetting about covid, as if it never existed.

Here we have started to take out the positive isolation and any day they will take off our mask. What do you think?

– I put my hands on my head to see that the isolations are stopped because they are the alphabet of infection control. A pandemic will not go away overnight, we will continue to live with the virus and difficulties will appear, new variants resistant to vaccines and treatments. We also know that maintaining the interest of the administrations when the transmission is low is very difficult. We all want to close our eyes but in the medium and short term the covid will continue to be transmitted, a new variant will end up appearing that will catch us when the immunity has diminished and there will be a new wave. This is the most likely scenario and we all want to deny it.

Will we have a seventh wave?

– I don’t have the glass ball, but it can start in the next four or six months.

When the cold comes back.

– Rather, because there will be more unprotected people, he has passed the omicron or received a vaccine two months ago and will no longer have as much protection. The variants take about two months to arrive and therefore the temporality would be 4, 6 or 8 months.

Will covid end up being a flu but will we have it all year round?

– Yes, we could get to that point. There are four ways to end a pandemic. The first is that the human species is extinct, as has happened with other animal species because the virus was very deadly. The second is that we manage to eradicate the virus. The third is that there is immunity from the herd and that the transmission is very low. The fourth is to live with the virus and pay a toll, which are the dead. Scientifically the same threshold has been set as for the flu, which we are still a long way from reaching. In 2020 there were 1,500 deaths per 1,000 inhabitants and in 2021 there were 1,000. With the flu, there are 100 a year.

He dedicates the book to nonconformists who believe they can change the world. Nobel laureate José Saramago said that he was pessimistic because of his ethical imperative, because the optimist did not think he had to change the world. Are you a nonconformist or a pessimist?

– I want to think that I am a non-conformist because to be so is not just to have critical thinking but to have the energy for transformative action. I think we should all be like this: think critically and have the ability to transform.

Do you think we will get better out of the pandemic?

– It’s early to learn a lesson. I don’t think we’re any better yet, but we should be. With cholera came urban hygiene, and with World War II, human rights declarations. Big crises always make us jump ahead. This crisis should make a leap in the protection of the elderly and the poor.

Were you vain and eager for prestige when you got into the pandemic debates?

– I was clear that my north was fighting the diseases of poverty. But it is true that on this journey there are siren songs that manifest in unexpected ways and can come as longing for prestige, power or economic security. They make offers to you on TV and you have to be very clear about where you are going. And yes, in this case I had vanity, but I have already taken the first step: I said “I have been vain and I am not proud of it», and I try to get as far away as I can. Some may think I didn’t make it.

In the book he says: “What I had were professional disputes, not personal ones.”

– I’m very clear about that. I have a specialty, a discipline and an expertise in the control of infectious diseases, which is very scarce in our country because we had never faced epidemics. In the last 15 years I had faced epidemics of cholera, chikungunya, dengue, malaria, filariasis …

Therefore, he felt empowered.

– I thought I could add value because, in addition to my expertise, I had an epidemiological intelligence team. I speak the language of science, I know how to ask them the right questions. What I wanted to say to them is: “Listen, we are working in this way, we can do something very positive for Catalonia”. But I did not succeed because the information alone is not enough, it must be preceded by the confidence that you must have gained and demonstrated before. And I didn’t have that.

For many people it was.

– From my earlier days, the piano, but I had lived in Papua for many years. He was disconnected from the institutions. And in the end what matters is being able to give information and let the person make the decision to change their behavior more responsibly.

He accuses journalists of being “novolatres”. That is, to always chase the last hour and the most outrageous thing. If a million people have been vaccinated and it has gone very well, but one has had a lump, let’s just talk about the lump.

– When you are interested in what is urgent and what is new, you lose perspective to reflect on important things.

He also says that he tries to stand out so that others do not think that he is useless, that he tolerates uncertainty badly, and that he has stopped to orient himself but has not discovered anything that you did not know. Is your mood at the moment a dead end?

– I discover the purpose that gives meaning to my life. These years I have lost a lot of energy, I have gone through a mental health problem. And, yes, I realize I’m the billionth person to make that joke. to look for a normality in which I am more comfortable and that allows me to have a calm mind.

It would seem that Papua New Guinea is an ideal place to find this.

– There the rhythm suddenly declines. There are not whatsapps practically no wifi. I am much calmer because I move away from external pressures, from everything that is media or also financiers, and from my own internal pressures, from self-demand, perfectionism, the need for the approval of the other, to think that if I am wrong or give a data that is incorrect it will be serious. That is, I allow myself to accept some fragility, that I can be wrong and nothing happens.

Does your level of self-esteem, for example, make you ready for this interview?

– Yes. It’s a level of obsession that keeps you from enjoying things and I want to enjoy the book because it’s been healing to write it and the reader can enjoy it, but that doesn’t stop me from having the need to always be in control. And that is very limiting. It is a disease. Just as heart failure keeps you from climbing a mountain, anxiety or depression keeps you from spending a weekend with friends because your brain doesn’t allow you to enjoy many moments. It robs you of happiness and energy.

It did not seem to me that this was the book of a hopeless person.

– True, I’m not always hopeless. I have made an introspection: I know my feelings of suffering and I try to find moments of calm and fullness.

Does he stay all month until St. George’s Day?

– Yes, I will promote the book and then return to Papua.

Where he will take distance again and try to continue healing his wounds.

– Mine and the others. Papua gives me energy in a way, and it is rare to find the engine in the tragedy of the other, but there are so many needs that being able to be useful and help brings energy and a will to transformation.

Source: Ara.cat – Portada by www.ara.cat.

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