The topic of "He alth security as an element of the national security system" is more relevant than ever, especially against the background of the latest and frightening coronavirus epidemic. We are talking to Prof. Dr. Krasimir Koev - specialist in eye diseases and doctor of sciences in national security.
In 2018, Assoc. Prof. Koev obtained a scientific degree of Doctor of National Security after defending his thesis "He alth of the population as a factor for sustainable development of the national security system" at UNIBIT-Sofia, where he is a part-time lecturer in national security security.
In his monograph "He alth Security and National Security", which is the first of its kind in Bulgaria, Assoc.Koev presents he alth security as part of general security and of great importance to our nation. And in his dissertation work for obtaining the scientific degree Doctor of Sciences in National Security, Prof. Koev presents the National He alth Security of the USA.
See the most important thing about the topic in the interview with Prof. Dr. Krasimir Koev.
Prof. Koev, our readers know you from a number of useful materials concerning eye diseases. Today we will be speaking with you in your capacity as a National Security Doctor with an emphasis on he alth security. Why is he alth security now a mandatory element of national security?
- In the last decade of the 20th century and the beginning of the 21st century, he alth security became one of the main priorities for both national governments, the European Union and the United States. T
has been on the agenda for the EU since its creation, and with the Maastricht Treaty, a strengthened construction of a coordinated European approach to dealing with threats to he alth security begins.As he alth is a key aspect of community resilience, the national he alth security strategy focuses on community he alth resilience.
And it is the ability of that same community to use its capabilities to strengthen he alth systems and improve the physical, behavioral and social he alth of the community, adapt and recover from disasters and accidents. The viability of the nation is defined as the opportunity for its sustainable development.
How do you define he alth security as an element of national security?
- The he alth security of the society is a system of norms, institutions, activities and relations aimed at the maximum possible equality of citizens to guarantee their he alth, respectively their access to high quality he alth services. This is why he alth security is a decisive factor for the quality of life in a given society.
I mean that nowadays security as such is defined in much broader terms than it was in the late 20th century. In modern conditions, this security has not only military but also humanitarian aspects.
The he alth of a community and in turn the sustainable development of the community is defined as a combination of physical, social and environmental factors. And also from the actions necessary to achieve stable development of the community.
The he alth system includes all parts of the he alth care delivery system (eg, primary hospital care, disaster medicine, and behavioral he alth care) and the public he alth system.
The emergency services system includes the police, fire, military, emergency medical services and emergency management. After all, the viability of the nation is defined as the opportunity for its sustainable development.
The top priority of he alth security is for the nation to withstand and recover in both the short and long term from disasters, accidents or terrorist attacks.
Any large-scale incident, such as a natural disaster or emergency, such as an infectious pandemic, that affects human he alth and compromises society's ability to provide food, water, he alth care, and, more broadly, economic productivity, threatens national security and the stability of society.
As of today, the whole world is trembling in anticipation of how it will develop and when the coronavirus epidemic will finally start to subside and pass. It is in this environment that we should probably see and feel the role of he alth security as an element of national security
- In the last decade, our country, the EU and all countries within the UN have been united in their efforts to deal with large-scale incidents that threaten human he alth.
We have already mentioned them - these are not only natural disasters and terrorism, including the use of weapons of mass destruction. These are the outbreaks of diseases reaching pandemics. And yes, the coronavirus is a typical representative of this kind of incidents.
Assoc. Dr. Krasimir Koev
But before we discuss the situation of this almost sudden outbreak, which is largely localized to the China region for now, I want to remind your readers of other similar large-scale incidents that threaten human he alth and life.And of course they undermine national security.
• The spread of HIV (human immunodeficiency virus) overseas (mostly in Africa) among the military and the wider active-duty workforce in the 1990s seriously undermined the national security of affected countries. In 2000, HIV became the first he alth issue to draw attention to he alth security at the UN.
• Years after the AIDS pandemic, Ebola, Hantavirus, SARS (Severe Acute Respiratory Syndrome), Anthrax, and Avian Flu appeared in our world. Jared Diamond (biologist, physiologist, and biogeographer, author of the bestsellers Guns, Viruses, and Steel, The Collapse, and Cataclysm) explicitly links infectious diseases to he alth and national security. Many politicians and academics have called for a redefinition of national security to include threats to he alth and infectious diseases. Many proponents of the he alth security paradigm support their claims about the importance of infectious diseases in system change.
• Thucydides (Ancient Greek historian) recalls how the mysterious plague struck the Athenians, which had a decisive role for the army in the outcome of the Peloponnesian War.
• The plague, which killed about a third of Europe's population, played a crucial role in ending the feudal system and promoting reformation.
• Many people also know how the American settlers kindly gave smallpox-infected blankets to the Native American Indians, causing them to become infected and easing the process of acquiring territory.
Could you comment on the coronavirus situation?
- The new coronavirus is a respiratory disease caused by a new virus. Coronaviruses, which are a large family of viruses, cause illnesses that can range from the common cold to severe illness.
The interesting thing is that so far this particular coronavirus has not been detected in humans, it happened in December 2019 in the Chinese city of Wuhan.
Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) are also caused but by different types of coronaviruses. Much has been written and spoken about the symptoms of COVID-19, but the main ones are fever in 90% of cases, fatigue and dry cough in 80% of cases, worsening breathing in 20%, and in 15% of cases they include respiratory distress.
X-rays show signs of involvement in both lungs. During admission to the medical facility, the condition of patients in most cases is stable. Blood tests show low white blood cell levels.
More serious cases develop severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock, which can lead to death. People with existing chronic diseases are more prone to a severe course.
Many of the initial reports of the virus in Wuhan were of infected people working or visiting the seafood and animal market. This market was only closed on January 1st, which was a rather late measure.
Since then, several countries outside of China, including the US, have reported cases of human-to-human transmission of the virus. For now, the World He alth Organization believes that the incubation period of the disease is between 2 and 14 days. The virus is most likely spread via:
- close contact with an infected person
- contact with droplets from an infected person's cough or sneeze
- touching objects or surfaces (such as handles or tables) on which droplets from an infected person coughed or sneezed and then touching your mouth or face.
Surgical masks are not recommended for he althy people as they do not protect against the virus. Good hygiene is required, which includes: frequent hand washing with soap and water; covering the mouth with a tissue (some tissue) when coughing or sneezing; avoiding close contact with other people such as touching etc.n.
- Prof. Koev, is Europe prepared for COVID-19 and is what the EU and Bulgaria are doing enough?
- The European Center for Disease Prevention and Control (ECDC) is in constant contact with the European Commission, the public he alth authorities in China and the World He alth Organization to assess the situation.
In order to keep the EC and public he alth authorities in the Member States informed of the development of the situation, the ECDC publishes daily summaries and continuously assesses the risk to the citizens of the European Union. ECDC and WHO have developed technical guidance to support EU Member States in their response. The EC ensures the coordination of risk management activities at EU level.
The coronavirus outbreak is similar to the 2002 and 2003 acute respiratory syndrome that also started in China and killed 774 people.
Now with the new coronavirus, the data is changing every day, the cases are increasing, but a few days ago it was reported for the first time that there was some decline in the incidence.In Europe, there are proven cases of coronavirus in France, Germany, Spain, Italy, England, Sweden, Finland. So far, 30 countries have been affected. The coronavirus is also advancing towards the Balkans, there is already a case in Croatia.
Despite the fact that China has allocated 10 billion dollars for the prevention and control of the spread of the coronavirus, the measures taken by the government there have been late.
The attempt to hide the epidemic at the beginning of December in Wuhan and not take adequate measures was disastrous, which led to the rapid spread of the epidemic and its exit outside China. The number of deaths in China reached 2,000 people, and the number of infected - 75,000.
Illustrative of this is the case of the Chinese ophthalmologist in Wuhan, who understood the seriousness of the epidemic and informed his colleagues, as the cases were initially covered up by the local he alth authorities.
As a result, the doctor died doing his duty, being declared dead twice by the authorities in China. So far, 7 doctors, including the director of Wuhan Hospital, have given their lives fighting the epidemic.
In Bulgaria, adequate measures were taken by the government and the Ministry of He alth with few exceptions, and it was found that there are no cameras everywhere at the airports to measure the temperature of the arrivals. Subsequently, cameras were installed at all Bulgarian airports, reagents for proving the coronavirus were also delivered. All suspicious people were quarantined and isolated.
On February 11, the Ministry of He alth opened a hotline where any citizen can ask questions over the phone regarding the coronavirus.
Can we talk about treatment and prevention to deal with this disease?
- There is currently no effective treatment or vaccine available for the COVID-19 coronavirus, although attempts are being made to develop one. Although there is no specific treatment for the human coronavirus, the US Centers for Disease Control and Prevention recommends that those infected take cold medicine, drink fluids and rest to ease symptoms.
Some countries require their citizens to report flu-like symptoms to their GP, especially if they have visited China.
The US National Institutes of He alth hopes that the first human tests to create a vaccine can be conducted in April 2020. China's Centers for Disease Control and Prevention has begun developing vaccines against the novel coronavirus and is conducting tests of the effectiveness of already existing drugs against pneumonia.
The Commission on Epidemic Preparedness and Innovation is funding three vaccine projects and hopes to be able to conduct tests in June with the intention of approving it within a year. The University of Queensland in Australia receives $10.6 million to create a vaccine platform against the coronavirus. Companies are developing an RNA vaccine.
It is being developed so that it can be tested on animals first. A vaccine is also being developed at the Pasteur Institute in France. San Francisco-based Vir Biotechnology is evaluating whether previously identified monoclonal antibodies are effective against the virus.
Where are we?
The Global He alth Security Index measures a country's ability to deal with an epidemic, such as the coronavirus that spread from China. It is a comparative assessment of the he alth security of 195 countries in the world that comply with the standards of the International He alth Regulations. According to this assessment, Bulgaria is placed in 61st place, being overtaken, however, by almost all Balkan countries. The USA, France, England, Canada, Australia turned out to be the most prepared for this epidemic. Another important indicator of he alth security is the he alth prevention coefficient, which in the USA is 76.65%, and in Bulgaria it is half - 37.6%. They have several he alth security centers in the US