Dr. Ler for NAP: We must train epidemiologists systematically in the future, we have reasons to be afraid

SARAJEVO, (Patria) - Epidemiologist Dr. Željko Ler, formerly the director of the Public Health Institute of the BiH entity of the Federation of BiH, has selflessly made himself available to the General Hospital "Prim. Dr. Abdulah Nakaš", all in order to fight the coronavirus pandemic as effectively as possible and to ease the healthcare system with his knowledge and experience.

In an interview for the Patria News Agency, he talks about the invisible enemy of humanity and the greatest challenge in recent human history.

As an epidemiologist and a professional, how would you assess the behavior of the Crisis Headquarters so far?

Ler: Every crisis situation catches the government of any country more or less unprepared to face a new and, until then, unprecedented challenge. And the coronavirus pandemic is a challenge without precedent in recent human history! It also took some time in our country for the Crisis Headquarters to consolidate and focus on the main goal and task: prompt planning and implementation of anti-epidemic measures.

There were certainly mistakes and confusion at the beginning. Now, the Crisis Headquarters, both of the Federation and the cantons, have a defined role and mechanisms of action. However, I believe that the Crisis Headquarters of the Federation should have been composed primarily of a professional team of experienced healthcare professionals (field epidemiologists, virologists, infectologists, anesthesiologists, pulmonologists, internists). Other members should have been representatives of services and institutions who, according to their departments, enable the implementation of measures proposed by the professional team (economists, lawyers, police officers, etc.), with representatives of the FUCZ as moderators of the entire work process.

Do we have reason to fear, and how do you assess the increase in the number of infected people compared to other countries, did we react in time?

Ler: We have reasons to fear, because we are facing a new virus, of unpredictable behavior, with multiple possible transmission routes and, apparently, resistant to external conditions. On the other hand, the proposed anti-epidemic measures have 'cracks' caused by their incomplete and insufficient implementation.

I believe that we reacted in a timely manner and that we still have a tolerable number of infected people. We have managed, for now, to avoid a sudden jump in the number of infected people and to achieve a somewhat stretched course of the epidemic in certain hotspots, which is very significant from the perspective of the healthcare system's capacity. Whether this trend will continue depends on the duration of strict isolation measures, bans on gatherings, and social distancing. If we lift them prematurely and relax measures for the public, we will have a second wave of the epidemic, 2 to 3 months after the first, with an increased number of infected people requiring hospital treatment.

There are very few epidemiologists in BiH, it seems no one believed something like this could happen, what is your advice?

Ler: Epidemiology, like other public health disciplines (Social Medicine with organization and economics of healthcare, Hygiene and Environmental Health) are not attractive specializations for young colleagues, who prefer to opt for 'major' ones like surgery, internal medicine, etc. Such crisis situations show how much we really need them, and in the future, we must train them systematically.

In the current situation, I propose activating all the aforementioned public health capacities, and rapid training of general practitioners to perform basic epidemiological tasks, primarily organizing and monitoring anti-epidemic measures.

Some claim that coronavirus is a stronger flu, can you explain the difference professionally?

Ler: It is true that the disease caused by the current coronavirus is very similar to the flu. The main difference is that we know very little about coronavirus, while we know almost everything about flu pathogens, and we can control it every new season, thanks to vaccination, in addition to other anti-epidemic measures.