Be very careful how you live, not unwise but wise, making the most of every opportunity, because the days are evil.

(Ephesians)

There might be, and, you know, most doctors or some doctors say that it will happen, and it’ll be a flame and we’re going to put the flame out.

(President Trump)

There is no Greece without philosophy and Greece must be united and free; upright, direct, straightforward and prosperous; enlightened, glorious and a light donor; respected, recognized and just, this according to Paris Katsivelos.

Covid-19 is a disruptive event on a scale the modern world has not seen before. Lives are being destroyed, the world’s economy is being damaged and international cooperation has been compromised. It has already caused an increase in global poverty and a sharpening of global and national inequalities while a second round of the virus is now envisaged. Some prefer the term spiking.

Who could have envisaged the geopolitical fallout of Covid’s first round and who can predict what will emerge in the second round from its Pandora’s Box. In the aftermath of the still ongoing first round of Covid with pulmonary and multi-system damage and so much misery and human sacrifice the hope must remain that a force for unity will emerge to provide an impetus for the creation of a new culture of public health and philosophy in Greece and elsewhere as a counterforce to environmental madness and humanity’s slide into oblivion.

The creative force of applied classical philosophy can restore diminished autonomy to its institutions, act as a vehicle of humanism and an antidote to despair. It will result in more lives lived with meaning. In modern and ancient parlance nothing is possible without man, nothing is achievable without institutions and prevention is only possible with democracy. The concept of a well fulfilled life implies wisdom, reason, morality, responsibility and obligation encapsulated in classical philosophy. Dementia depleted consciousness is a dangerous threat to democratic society and to human existence.

Statements of concern made in Athens (2016, 2019) but ignored completely by politics include one by representatives of European public health from more than 100 institutions expressing their concern with “rising population vulnerability from austerity in Greece, the consequences of large refuge trails threading the Balkan Peninsula and the threat of emerging epidemics such as Ebola and West Nile Virus” and the second a statement by the World Philosophical Forum: “our world and peoples, habitats and cultures face imminent threat; threat to life, to humanity and to the planet, which can erase man’s trace and collective memory”. The first, paradoxically, provided a useful platform for the Ministry of Health although plans were underway to scuttle one of public health’s most prestigious international institutions, the second was directed towards the incoming prime minister. Neither were read!

Missing from most Greek perspectives or political narratives is an appreciation of the remarkable contribution of public health from antiquity until today, which helped improve the physical conditions of life, eradicate malaria, produce a twenty-year increase in the lifespan of the average Greek (1930-70) and moved Greece into international modernity. Let us not forget that in 2019 overnight a historic institution of public health, part of Greek cultural heritage was abolished without reaction from the intellectual elite. Let us not forget the moment of pure political mockery in 1994 when that institution was simply renamed by a parliamentary law never to be implemented. Even so, in the first round battle with Covid-19 colleagues in public health once again were at the front. To their courageous acts I dedicated an Ode.

Although the management of the Greek government has been good and effective so far, Greek society does not yet support public health as it should, which is the case in several other democracies. Greece, and just one short step away from its most important emblematic National celebration; 200 years since the Revolution of 1821 has not yet conceptualized a road map to its future. At the time of the revolution whose logo was freedom or death, cholera was overrunning Europe and the health conditions in Greece were deplorable (typhus, plague, cholera, chickenpox, malaria, tuberculosis). One century later (1921) the health conditions were not much better. In 1907, one high profile professor in the Athens Medical School hoped that public health - hygiene would be welcomed and receive its due after the Renaissance (Revolution) as a science supporting the most precious human commodity, health, but it was not to be.

Professors in touch with the world circa 1900 saw a desperate need for a school of public health. It took 30 more years to materialize while from its birth in 1929 it had to fight a losing battle with bureaucracy, academia and vested interests until its executioners crashed its gates in 2019. 200 years after the Revolution of 1821, public health should already have had a central role in the coming emblematic National Anniversary (2021) and in remembrance of the dreadful conditions of health then and to celebrate its significant contribution to the reconstruction of the nation and its elevation in the international arena. 100 years later the revolution for health was short lived but it still helped to promote national development and over the next four decades it contributed 20 some years to life expectancy. Those gains are in danger of being lost, today.

Responding to the miserable health conditions of those two specific times, John Capodistria (19th C) and Eleftherios Venizelos (20th C) strengthened public health, improved the background of poor scientific knowledge and developed short-lived and reluctant cooperation with the international community. Between 1929 and 1934 Greece orchestrated a revolution in public health, which followed on from the Spanish flu, the Asia Minor Disaster 700,000 dead, 300,000 lost in the martyrdom marches without returning to the depths of Turkey and 1.5 million refugees! The breaking point came with a pandemic of dengue fever or terrible break back fever which paralyzed Athens and panicked European capitals. Dengue in its most virulent form jumped borders and temperature zones to knock Greece off the European continent for months. In 1928 it added 3000 deaths to the annual toll of malaria’s 6000 mainly refugees.

Circa 1930, Greece saw health as a means to an end and central to the nation’s development. The Athens School (1929-2019) was described as “a post-World War I, imposed necessity based on the conviction that first among all things, Greeks must live and develop under healthy conditions”. The driving force was the Athens School of Public Health (1929-2019) the first postgraduate, free school in Greece and one of the first in Europe. It was created as a beacon of public health and an island of excellence in the Greek reality, offering an interdisciplinary approach with work of social and national dimensions. It has been described as “a pioneering School with huge national achievements and of "informal" postgraduate studies and, as a great weapon for development and implementation of the NHS (1983)”, has been “closely connected with culture and having an important, pioneering role in community service for the good of all and a great contributor to the health of the Greek people”. Melina Mercouri noted its important work, not only in health but also in culture and Anna Benaki-Psarouda, current President of the Academy of Athens emphasized its role in cultural development and promotion of Greece. On another level and from the same conditions that made applied public health a necessity, Rembetica music, banned by the authorities, emerged. Sometimes public health statistics is without the tears while the culture implicit in Rembetica clings to the tears and passion. In 1992, Mimi Plessa played for public health and discussed his history of Greek music. In 2019, the School was abandoned but we can still listen to music.

In our time of ongoing austerity, the refugee-immigration crisis and Covid, strengthening and adaptation of the Health System and revitalization of interdisciplinary public health to the new conditions are major priorities in all countries. In our times the small School characterized by low cost-high benefit has submitted many useful proposals to the competent Greek authorities concerning the prevention and treatment of health effects from natural, social and humanitarian crises and disasters. They included the creation of postgraduate studies based on public health, human security and health diplomacy; and the establishment of a High Level Advisory Committee to promote societal awareness, scientific preparedness, and relevant education and to facilitate disaster monitoring. In the current crisis [socio-cultural, political-economic], the clock is ticking as health in Greece is harmed and is gradually transformed from a healthy to a less healthy nation at a creeping pace. Where are the spiritual, philosophical and academic elite today?

The intellectual elite never protested the shutting down of Greece’s small unique historic School of Public health, just ahead of Covid. It followed on from imposed austerity that I designated a creeping disaster, new regimens of dose-installments of monthly payments including for water; the flooding of Mandra with Attica aflame with utter destruction of the settlement of Mati; unless they are already forgotten together with earthquakes, forest fires, oil spills, and other floods? One disagreeable outcome is that the newly born will live fewer years than their parents and have a lower quality of life. Life expectancy and child mortality are issues of concern, issues to worry about and so are early and avoidable deaths. Now we have Covid and a question of overwhelming importance: will Greece grasp the opportunity to come out of this set of horrendous disasters with new priorities and plans of action to reinvent and reshape itself?

The global madness, that is universal social dementia that we see today, was slowly being prepared until late yesterday. The result is that the world can at any time be demolished with nuclear weapons. All it will take and heaven forbid is a button pressed. Setting aside arms control agreements is making the world a more dangerous place. It can gradually disintegrate as a result of climate change. As it does more diseases relating to mental health and the autoimmune system will emerge.

Now under the weight of Covid the world is demonstrating collapse, socially and economically but some countries are more resilient. However, nuclear war remains the greatest threat to humanity and is exacerbated by developments in artificial intelligence and the confusion observed worldwide emanating from the response to Coronavirus (Covid). Flattery for dictators, especially coming from the leader of the most powerful state in the world, does not make them reasonable. Authoritarian leaders are known and feared for their violence and dictatorial characters.

The coronavirus Covid-19 has already brought a health crisis, completely unknown to the scientific community. In its first wave it has seriously affected almost all countries and regions of the world causing great poverty and by exacerbating population inequalities. A second wave is predicted. Of course there are other opinions such as there is no second wave of Coronavirus and it is what it is from the Vice President and the President of America. In October 2019, a global study found the United States to be the best-prepared nation in the world for “high-consequence and globally catastrophic biological events.”

If after so much misery and human sacrifice from the pandemic humanity returns to the same old mental habits and unsustainable patterns of life then in the possible second wave it may experience greater tragic dimensions, different and more dangerous populations. The numbers in the first wave continue to increase and shifting to include a wider spread of earlier ages. In America, north and south, Africa and India, the first wave of Covid is galloping wildly. Like a forest fire Covid can suddenly shift course, take a new direction.

In a better world, the Covid-19 pandemic should unite people against the evil that befell them, as happened in other disasters e.g. WWII against fascism. Unfortunately, that is not happening! Instead, an even more divided humanity is emergent with growing inequalities that undermine global stability. The factors of evil are greed, corruption and a lust for power.

We went through the first wave of Covid-19 with unprepared governments. We know, on the one hand, that effective treatment is multifaceted and at the same time difficult, and on the other hand, we do not know how the general state of the world or the course of Covid will evolve. In terms of crisis prevention and management, Greece remains weak in terms of public health. The way and the approach to deal with Covid and other crises depends on governance and trust, which resides in the choice of science-based policy. Here several aspects of the subject will be clarified:

  • We live and work in the context of dysfunctional relationships between humanity and nature, where misinformation, disinformation with reduced autonomy of science pose serious threats to democracy and public health. While climate change is denied politics supports the overwhelming use of fossil fuels. A virus that has killed so many is also being denied, or explained as a conspiracy.
  • Today authoritarian regimes face serious disadvantages from sociopathic narcissistic leaders who are unable to understand the consequences of infectious diseases or their impact on the health of their population. Examples include President Trump and Mr. Erdogan. The former doesn’t know why he has fewer warheads than his predecessors while the latter cultivates nuclear ambitions while both spout crazy divisive rhetoric. Such men are far removed from the ethics of public health, dangerous and contribute to social dementia.
  • After the recent explosion in the Lebanon a high level politician offered "I discovered that corruption is greater than the state and that the state cannot solve it".
  • Let us remember that the relative success of Greece in the first wave was based on the vigilance of the authorities, the temporary and appropriate emergency measures imposed, the dedication of the expert group set up at the Ministry of Health and the work of the health staff in the country. This has made us more experienced while having more tools for the ongoing new epidemic wave. The positive response of the society was exemplary and was an important parameter in the successful treatment of coronavirus in our country. They made us proud. Certainly Greece is at a pivotal point in its history and we wish a quick way out of the crisis with the first light of a new Hellenistic spring.

While the Covid virus is everywhere, there is no proper international plan to curb it, nor is there any reason to conclude that the situation will soon improve. But what we can hope is that the infectivity or toxicity of the virus, or its ability to cause harm, will decrease. Also the experience of Medicine and the Health System in the first wave will prove very useful in the developments that are ahead of us. As far as the citizens are concerned, they have learned to strictly observe the measures during the first wave, but they should continue to pay attention to their contacts and wear masks. Additional needs include civility and mutual respect, putting country and its population first, listening to and learning from experts and from one another with neither the pretense of having all answers nor demonizing those with whom we differ.

How to end? It is always difficult! On the one hand we need a sense of optimism: It is not over until it is over, knowing that we cannot know now that what we will know but with a sense of alarming speculation as we tell it as it is. Greece supports the retention and potential use of nuclear weapons on its behalf having voted against a UN General Assembly resolution in 2019 that welcomed the adoption of a specific treaty for their banning. Humanity will experience catastrophes with increasing frequency as more people find themselves in harm's way. To turn back the clock, return to normalcy necessitates the strengthening of public health and its mindset.

Suddenly, Covid entered our lives as did the terrible eruption in Beirut with a size of 2% of the atomic bomb dropped on Japan 75 years ago. Effective disaster management requires valid and comparable data, appropriate standardized methods and definitions, mitigation measures, scientific preparation and political commitment combined with social preparedness. 90 symbolic seconds before midnight disaster management more than ever must be based on interdisciplinary public health.

Poetic postscript (written in lockdown)

Suggestion to Greece

So once again, to Greece I say, do not unlock stay put, Lay low, protect the loved ones that you know, While in the words of a Nobel, noble poet, just a little more and we shall see almond trees in blossom, marbles shining in the sun. Don’t frit away again the glory there, coronavirus is not fair.

Stick to Science

Wear Covid out Quarantine, keep devils at bay, Wear Covid down Lockdown, contagion give way, Test, test for Covid, test til’ we know, where the pest comes from, where do he go.

Covid Waves 1 and 2

Endings, turnings-yearnings and new starts, Beware of Cupid’s art, avoid sharp Covid’s darts, art you’ll survive! The other? Mean, agonizing, can bring demise.