David Brunat 04/25/2020 05:00 –
Oriol Mitjà receiving the ‘Catalan of the Year’ award from Quim Torra. Below, excerpts from the emails chain
On Saturday, April 18 at 8:23 pm, Quim Torra’s head advisor for the coronavirus crisis, Oriol Mitjà, sent an email to the heads of the main departments of Public Health and infectious diseases in Catalonia. He asked them to review a document with the strategies to develop the ‘Plan of De-confinement’, the new bible of the Catala Government to try to take the political initiative in this crisis. Mitjà gave them 37 hours, until Monday at 10:00, to return it with the appropriate considerations.
What Mitjà did not imagine is that the document and the petition itself would unleash a very critical email chain, which served as an outlet for several of these high-level professionals, who have been trampled for more than a month by the political audacities of the Catalan Government and by that ‘parallel team’ headed by Mitjà who acts as a scientific anchor to the theses of the Catalan executive and, by extension, of the pro-independence movement.
Click on the link to see the PDF of the De-confinement Plan.
The emails, which are a cascade of flat refusals to participate, reveal that some of the greatest professionals in Health and epidemiology in Catalonia are upset, if not shocked, by the gimmicky and sensationalist manner in which this parallel team is managing the crisis. , always one step ahead of the work of experts in the field in Catalonia with the alleged purpose of amending the plan to the Spanish Ministry of Health and showing that Catalan Government is leading the strategy in the fight against the coronavirus.
This is an account of a weekend of high tension in the upper echelons on account of the ‘Plan of De-confinement”. Proper names have been omitted so as not to expose the protagonists.
“What a real nerve you have got”
“Oriol, was the document not confidential? The ‘president’ just explained it with hair and signs. What a fuss you have and what a lack of respect for all of us. Your time in our Service did not help you learn the slightest notions of ethics or professional dignity. I am sorry and I am happy with your distance from us. The people of our Service would never act in this way”, they blurt out the star adviser to the Govern from the Vall d’Hebron university hospital, of which Mitjà was Resident in his first years, after verifying that Torra has just released the document in the midday news on Sunday. “What goes around, comes around. Good luck,” they warn him.
“I received your email yesterday with amazement at 8:24 pm”, they react mid-afternoon on Sunday from the Observatory of Bioethics and Law – Unesco Chair at the University of Barcelona. “It is impossible that the ethical and legal analysis on a matter of importance can be done with rigor in 37h and 36mins of a weekend. (…) On the other hand, after a quick look that does not enter in the content of the report, it is to be highlighted a very surprising circumstance: there are no jurists, no bioethics experts in the working group, nor – what is even more unusual – public health experts or epidemiologists. (…) It strikes me that it is already circulating profusely in the media a communication of the proposal information as something closed and decided, taking into account that it has not yet been analyzed by the reviewers nor does it have any normative basis”.
The outrage, which had been mounting ever since morning, forced Mitjà to try to calm things down at 4:19 p.m. “The reason [for the urgency to review the document] is that I have to deliver it to the Govern in the afternoon” on Monday, Torra’s advisor excuses himself. This indicates that the Govern was in a hurry to have a post-confinement document in hand to deliver to the Government and thus win back the game of public discourse.
“It is a document of a strategic type, with global recommendations, which draws on documents from the ASPCat [Public Health Agency of Catalonia] and the Department of Health. Your names and affiliations do not need to appear in the final document unless you want”, says the advisor.
“Remove my name from the document“
Of the few experts who finally lend themselves to enriching the ‘Plan of De-confinement’, none wants to be named. There is even a final episode of anger from several professionals when they see their names in the document delivered to the Govern without having given their authorization.
“Without going into the debate on the use of this document for certain political strategies, (…) just asking you how my name has been collected in that final document, because I think I made it clear in my previous email that I did not share it in its initial draft” , a professor denounces him already on Tuesday, the 21st at 11.28, shortly before the document is delivered to Quim Torra. “I reiterate that I do not want my name to appear in this document”, another doctor reminds him. And another goes further: “Thank you for the trust, but I am not comfortable with the document and even less with political interference. Please remove my name from the document”
Mitjà is forced to delete names, but maintains the Barcelona Public Health Agency and the General Sub-Directorate General for Public Health Surveillance and Emergency Response in the section ‘External review process’. And these are forced to give a second touch to Torra’s adviser for having included them when they never agreed to be named. “Despite the fact that we sent you our comments, we do not agree with the final document. Therefore, we prefer not to go out”, one of the two organizations demands.
However, their names remained in the final document, as shown in the extract below these lines, until there was no other choice but to withdraw them. It is striking that institutions that should be working side by side do not want to be cited even as external reviewers.
In spite of everything, this Friday Mitjà was showing pride on twitter at a document that proposes “viable solutions for de-confidenement, of proven efficacy” and “immediate” application and thanked those who have contributed.
Used by “small politics”
The extensive chain of emails that this newspaper has accessed is a trickle of polite evasions, veiled criticism and also some direct accusation. Like the one that arrived on Sunday morning (12:54 pm) from the Hospital del Mar Institute for Medical Research in Barcelona (IMIM). They criticize him for the fact that this parallel team headed by Mitjà “tries to do without” the Public Health agencies of Catalonia, both at regional and provincial level, the prestigious ISGlobal and many others who are also working, and they demand “democratic respect for the institutional fabric and the law”. Besides, from the IMIM they point out “incomprehensible weaknesses” in the document at the ethical and legal level and in the use of technology, and end by regretting the attempt to “subject science to small politics”.
Six minutes later (13.00h) one of the leaders in epidemiology at Bellvitge Hospital also declines the request with an argument that can be seen as a slap in the face. He argues that he is dedicated to caring for the covid-19 patients in his hospital and that he cannot spend time on this. “My ignorance in such a complex and new topic of epidemiology means that from discretion, humility and common sense, I prefer not to comment”, writes the doctor, who nevertheless has the same authority as Mitjà to pronounce on this crisis.
Rejection of the immunity passport
It will not be the only one. Another leading epidemiologist at the Hospital del Mar will also tell Torra’s adviser that he declines the offer on the basis of humility and because it seems to him a “hasty” document. However, it does leave him a message by pointing out deficiencies in the proposal to carry out massive tests on the population, since “they have so far shown little sensitivity and specificity”. He also shows his concern about the insistence of Mitjà (that is, of the Govern) to introduce an ‘immunity passport’ “whose supposed effectiveness is based on an opinion piece, not a scientific reference”, says the expert. “It could generate dangerous social dynamics, such as seeking rapid contagion to be ‘green’ and be able to access certain places that others cannot”.
In the last hours, Mitjà is explaining in the media this idea of the traffic light, inspired by Asian countries, according to which people in “green” who have passed the disease or are not related to those infected can access spaces that the population in “red” cannot. And the email chain indicates that the health experts in Catalonia are not clear about it.
“The proposal is presented in a vague and indefinite way and with unfortunate language (people tracking; traffic lights, immunity passport), disproportionately affects the privacy of people and the other fundamental rights that must be guaranteed, perhaps more than never, in times of pandemic “, they tell him from the Observatory of Bioethics and Law, that like the majority refuses to review the report.
Another expert, professor at Pompeu Fabra University, also underlines the dangers of implanting the ‘immunity passport’ due to the “high risk for our individual liberties”. And he leaves a message for Mitjà: he asks him to base his strategy on empirical results and not on assumptions of mathematical models “whose predictions are modified (…) as you yourself have been able to verify”. Mitjà has become a media and political star in Catalonia, particularly in the ranks of independence, thanks to his mathematical models, especially his apocalyptic model that projected the collapse of the UCI in late March.
Only a handful of Health professionals come out in support of Mitjà in this storm. The first, the virologist Bonaventura Clotet, Mitjà’s mentor and member of the Junts per Catalunya family, who on Sunday morning encourages those mentioned to make their contributions when no one has yet responded. Another is the general director of a section of the Catalan Department of Health, and then another small number of professionals (seven in total) who nevertheless ask that his name not appear in the star plan of the Generalidad for lack of confidence.
Finally, on Wednesday the 22nd, the spokesperson for Junts per Catalunya in Congress, Laura Borràs, delivers the controversial document to President Pedro Sánchez as the roadmap for Catalonia to get out of this crisis.