"After a year of the COVID-19 epidemic, threats are starting to arise not only against health officials, but also against doctors. It is probably necessary to think about why people act like this in similar situations," says Ján Mikas (second from left), the Chief Medical Officer of the Slovak Republic. Photo: Stanislav Pecháček

The public health sector will lack professional staff. We need to motivate them more, warns Ján Mikas, Chief Medical Officer of the Slovak Republic

The coronavirus pandemic has tested everyone’s capacities. No country was prepared for the long period of its duration. For Ján Mikas, the Chief Medical Officer of the Slovak Republic, it was, in his words, „the hardest ordeal in his life,“ during which he „aged more than two years.“ He stated the aforementioned at the 2nd Annual International Panel of the Permanent Conference on Healthcare in Prague. He admitted that the period of the pandemic fully tested his office. Moreover, in the near future, the office will face a generational change of professional staff for which there is not yet adequate replacement.

The Public Health Authority of the Slovak Republic (ÚVZSR), which is headed by Slovakia’s Chief Medical Officer, faced similar problems during the pandemic as health authorities or institutions in other countries. However, Ján Mikas pointed out at the conference that his office does not only focus on epidemiology, hygiene, preventive medicine, or microbiology. Its activities also include legislation, good management, information technology, and communication.

„During the pandemic, we issued around 250 decrees with an economic impact on all Slovakia. We are now facing various legal actions, which is not a simple matter. At that time, we were also under time stress and pressure from politicians, the media, and the public to issue a decree as soon as possible. And when it was issued, everyone searched for flaws in it,“ recalls the Chief Medical Officer of the legislation created during the pandemic.

PhDr. RNDr. MUDr. Ján Mikas, PhD., MPH, Chief Medical Officer of the Slovak Republic at the 2nd Annual International Panel of the Permanent Conference on Healthcare. Photo: Radek Čepelák

The problems during this period were also caused by the number of ÚVZSR employees, which according to the Chief Medical Officer, is around two thousand throughout Slovakia. „This equals a medium-sized hospital, which is terribly small. We have had to change the way individual disciplines operate, not just epidemiology. We were working with the capacity we had,“ he said, adding that in the future some activities would be specialized due to the limited number of staff.

Complications for the Medical Authority include the turnover of professional staff. „There is a generational change. Many older and experienced professionals are retiring and we have no adequate replacements. Because you rarely entice a doctor to go work in the public health system. He would rather work for a foreign hospital. We will have to look for motivating factors to strengthen our activities,“ said the Chief Medical Officer of the Slovak Republic.

The session entitled „The Role of an Interdisciplinary Approach in Public Health Policymaking (Key Actors, Awareness-Raising, Public Opinion)“, from left: Piotr Jablonski, National Anti-Drug Coordinator, Poland, Jindřich Vobořil, National Anti-Drug Coordinator, Czech Republic, Ján Mikas, Chief Medical Officer of the Slovak Republic, Tomáš Cikrt, Editor-in-Chief of Zdravotnický deník, Richard Raši, Member of the National Council of the Slovak Republic, former Deputy Prime Minister and Minister of Health of the Slovak Republic, and Ivan Duškov, Deputy Director of the General Health Insurance Company. Photo: Stanislav Pecháček

Communication is the most important

Mikas said from the start of the pandemic that one of the most important things was communication. The public expected relevant information, which was only partial at the beginning of the pandemic. At that time, the Public Health Authority received about 150 queries from the media daily, press releases were issued, and press conferences were held. „We also hold meetings with journalists where we try to explain the issues and our procedure to them,“ Mikas explained.

Professor Roman Prymula, former Minister of Health and now Chairman of the Board of Directors of AGEL Říčany Hospital, also attended the Zdravotnický deník conference – he is pictured on the right, with Zdravotnický deník publisher Ivo Hartmann sitting beside him. Photo: Stanislav Pecháček

Moreover, public opinion in Slovakia has been very volatile. At the beginning of the campaign, the evening applause of the people on the balconies was a global gesture of solidarity with doctors and public health officers. Later, however, the unity in society gradually disappeared. „After a year, threats started being issued not only against public health officers, but also against the doctors. It is probably necessary to think about why people behave this way in similar situations,“ the Chief Medical Officer said. „Trust and verified information are the basis,“ he added.

However, finances also played an important role. During the pandemic, the Office of the Chief Medical Officer had to set up PCR diagnostics for the coronavirus, the sequencing of samples, and testing of wastewater for the virus. „We can consider it one positive aspect of the pandemic that we received funding for these tools during that period,“ says Mikas. He adds that it generated substantial health data that needs to be applied. His office also wants to modernize this area.

A view of the conference auditorium during the second session, which dealt with an interdisciplinary approach. Photo: Stanislav Pecháček

The pandemic is not over yet

The Chief Medical Officer also warned that the pandemic is still ongoing. It has been declared and also revoked by the World Health Organization. Slovakia is still in a state of emergency, the declaration of which was initiated by Ján Mikas just after the outbreak of the pandemic. „We do not know what lies ahead. I hope a new variant does not appear because people are tired of it. Even ordinances can be perfectly written, but people no longer follow them,“ he warned. The Public Health Authority still faces various challenges. According to the Chief Medical Officer, the public healthcare system should be strengthened and made more efficient. „We are currently working on a project to make our activities more transparent. People will work differently and some processes and data should be digitized,“ he said. He also said that the pandemic demonstrated that his office should be granted more powers.

Miroslav Homola

Photo: Radek Čepelák