You have been in office for over half a year, so the defense period is over. Can you give a little evaluation of the regional hygiene situation?
I want to start by saying that this is a big challenge for me, because my predecessor, Doctor Valentawas a big personality in our field (he also worked as the chief hygienist of the Czech Republic for four years – note ed.). I would like to continue his work so that regional hygiene remains an important organization within the region and within the entire republic. The current system is set up well and I have no ambitions to make any major changes. Now the main thing is that people who are really tired after two years and many of them have reached the bottom of their mental and physical strength, stabilize and return to their normal activities. Of course, covid is not over, we must continue to focus on it.
You joined at the height of the omicron wave. A number of people were already fed up with the measures, and the negative wave turned towards health workers and hygienists, who faced, for example, vulgar insults. How did you perceive it after you started?
Of course, I also carried out epidemiological investigations, so it did not escape me. The reactions were really diverse, people were tired, some did not believe, they were not well. This was a new angle of work for us hygienists, we had to apply a psychological approach, motivate patients, deal with individuality on the other end of the phone. It was all about communication, about balancing. Even now, from the position of director, I encounter two poles of approach, one group thinks that the situation does not require anti-epidemic measures, the other that we should be more vigorous. It is necessary to realize that we are in a new situation, in the age of social networks, in the age of misinformation that must be explained. And I think that is something completely new. It is a pandemic that takes place in new conditions, in conditions where information spreads very quickly, and it is up to us, the experts, to explain it in such a way that the public has confidence in us. Build an argument on evidence.
Did anything in the misinformation surprise you? What you said to yourself is probably no longer possible…
Of course, I came across opinions that covid does not exist and the like. But even if you communicate with someone who believes this, you still need to convince him to take measures to stay in isolation so as not to endanger his loved ones.
What is the situation now regarding covid? Medical facilities have again introduced the obligation to wear respirators, the numbers are quietly rising…
The advantage of the omikron variant is that it does not have such a severe impact on the patient’s clinical condition. Many people have mild or no symptoms at all. Therefore, society does not perceive it so acutely and many do not go to get tested. As a result, the number of positive people is much higher than officially reported, and the omikron variant is more contagious than the delta variant.
It’s contagious, but the intensive care units are empty. So is covid still dangerous?
The number of infected people is still growing and more variants may come. I think that at this moment, following basic principles such as social distancing, hand hygiene, not going to the collective with a cough or wearing a respirator in small closed spaces, for example in public transport, should not be a problem. It’s about personal responsibility.
But it’s not tracking at the moment?
At the moment, we continue to focus on risk groups, which are mainly social care services and medical facilities. But, of course, we are intensively monitoring the development of the situation, in terms of testing, increasing cases, sequencing continues, variants are identified and so on.
Covid certainly kept the hygienists busy, how is the return to their normal activities going?
At the time when the covid waves were culminating, almost all employees of the regional station were involved in dealing with the pandemic. However, in the background, the handling of the so-called preventive hygiene supervision was still going on, that means, for example, project documentation for various constructions and the like. Where we saw a health risk that needed to be caught, there were various state inspections. For example, the swimming season last year was exactly the same as usual. We also focused on risky areas, such as ice cream sampling, snack checks, children’s recreation checks, drinking water checks… But this year is really the first period when we are checking comprehensively in the original width.
Have you managed to fully return to your own work yet?
Of course we try and we succeed. But we have found that covid has affected a number of other areas as well. For example, operators of catering services or boarding houses have changed, especially in Semila. New, inexperienced people joined and we tried to help them if needed, at least until they set up the system to minimize health risks. We see in the field that after these changes of operators, problems occur again, which can lead, among other things, to alimentary diseases (disease caused by food poisoning – note ed.). We try to explain the risks to them, remind them of the rules. In addition, when establishments began to reopen, we also had to be helpful to existing operators and alert them to potential problems. Because closed businesses, such as boarding houses, service establishments or swimming pools, have their own risks, which are hidden, for example, in warm water, where microorganisms can multiply and subsequently cause illness. We have also seen an increase in the area of the working environment for occupational diseases. Covid has just affected absolutely everything and absolutely everyone, and it will take a lot more effort on both sides before we get back to normal.
Regarding occupational diseases, could you be more specific?
Here, we have seen large numbers of occupational diseases, not only with covid-19, but also with regard to unilateral long-term excessive workload. We solve this, for example, by co-organizing seminars for employers in the field of employee health care. But it is certain that no stone was left unturned in healthcare and other areas either. Covid has been reflected in absolutely all areas and healthcare fields. Some were affected less, some more. For example, it was less pronounced in oncology, but it had a negative effect, for example, in the field of healthy aging, which concerns the most at-risk group.
It’s probably hard to find something positive about covid, but I’ll try anyway…
…we have not had any confirmed cases of flu, measles, VHA (viral hepatitis A – note ed.). It can therefore be said that the set measures led to an overall reduction of other diseases as well.
I would go over to you now. You have been at the Regional Hygiene Station in Liberec for more than twenty years. Why hygiene? I don’t find this field very attractive for a young girl…
I originally studied environmental issues, already during my studies I was dedicated to waste management, landscape ecology and the non-profit sector. And I had several options where to board. I applied here as well, I was attracted by the issue of environmental health. I had an interview with the director and he convinced me that hygiene will be what will fulfill me all my life. And I have to say he was right. This work is still a mission for me and I am still interested.
What is so appealing about hygiene? People imagine that it is mainly controls and regulations.
It is an extremely varied job. I headed the department of communal and general hygiene and was involved in the assessment of health risks. This means that we try to calculate the actual impact of some effects on human health regardless of the given limits. The limit is always a social consensus, but it may not correspond to the actual effect on health. For example, we have the air here, even if the pollutants are below limit values, they still affect you in some way. Or, for example, noise that has no threshold. When a person comes in and complains that they can’t sleep because of the noise, even if it’s below the limit, we know that it can have an impact on their health. I also devoted myself to the method of evaluating the effects on health, which can highlight the positive effects in the prepared development documents, not just point out the negative ones. It is important to realize that it is also necessary to evaluate non-medical concepts, policies, and strategies in this way, because they have a great impact on people’s health, I would say greater than medical ones.
That sounds very official. Could you be more specific?
An example can be a current issue, and that is climate change. These will have a big impact on our health. So even you in Liberec can influence global warming policy in some way. How? For example, we are seeing new species of disease-carrying mosquitoes, ticks will colonize areas where they were not before. However, it can also be manifested by the formation of heat islands in urban buildings, which have a noticeably higher temperature than the surrounding area. This can be influenced by thinking about greenery or water features in urban planning, which are very important to reduce the temperature. The point is to combine all this information and present it to politicians as a basis for decision-making.
Do you yourself see changes during your career?
Yes, sure. I have noticed this in two areas, namely in the area of bathing waters, where our ecosystems are changing in large reservoirs. New cyanobacteria started to appear, which were not there before, so we have to deal with a different quality of water for bathing. Torrential rains occur much more often, which is also a consequence of these changes. There are also changes in the area of drinking water, we are in close contact with operators of water pipes and public wells. In the dry season they face a lack of water, in warm seasons it is often more difficult to maintain the quality of drinking water. I perceive the weather to be more extreme.
Food poisoning, noise, air, weather… If I understand it correctly, the work of hygienists includes everything that affects our lives?
Yes, and that’s what makes the profession what it is. (laughter)