President of the Council of Portuguese Medical Schools and Director of the Faculty of Medicine of the University of Lisbon, Fausto J. Pinto has been an active protagonist, never ceasing to send warning messages until he felt we had received them.
Clockwise: Joana Sousa, Isabel Varela, Catarina Monteiro, Sofia Tavares and Cristina Bastos.
Concerned as a doctor and leader of several teams and work groups, as well as being largely responsible for his own students, Fausto J. Pinto never gave up the role of doctor and remains at the side of his hospital team. It was from there that some of the best videos of recent times came out, offering encouragement, calling for awareness, but above all with a constant message, "we are all together and doing the best".
Interviewing him was our aspiration. We wanted to listen to one of the major drivers of the most proactive movements at a time when the government did not want to hear about the interruption in the Schools and even less about a national emergency. This is the man who strongly believed that his mission was to alert, over and over again.
The Communication Office team got together and each explained what they would like to ask if they were in front of him. And so it was, even from a distance, we got even closer.
How and when did the Professor realize that what we were facing was something new and serious given the seriousness of the problem?
Fausto Pinto: When news from China and Macao started to arrive and mainly after talking to my Chinese and Macao colleagues, I started to get worried. This was dramatically accentuated when the virus arrived in Europe and when I began to realize that if reactive rather than proactive measures were taken, the result here would be a catastrophe like in Italy. Given my vast international connections, I started to receive very alarming news and the opinion of my colleagues about the ineffective way in which the authorities, for example in Italy, were facing the problem. It was then that I started to try to influence and alert to the need to learn from the mistakes of others and not to commit them. It is yet another example of the human condition, as Andre Malraux described it, where we see all types of behaviour and attitudes. It also shows the importance of having the right leaders in the right places when it is necessary to face crises with the severity we are experiencing. Governing in easy times, anyone does, it is in these moments that true leaders come to the fore. The virus has exposed the vulnerability of the system, especially the inability of politicians to deal with a situation that escapes them entirely, always denoting fear. I believe that they are more afraid of themselves than of the situation. It also showed that, unfortunately, we still have a kind of oligarchy in Portugal that, like an octopus, permeates our system, which means that they are almost always the same ones to take care of situations, based more on party politics, or on members of organizations or friendships, rather than competence. This was the reason that made the CEMP go public, when we found that whoever was advising the government, namely the obscure Public Health Council, had no idea of what was going on, in such a way that they were overruled by the Prime Minister himself, after great pressure from us, to prevent an even greater catastrophe. Here the Prime Minister did well, albeit late in his decision. What is amazing is how that group of gentlemen and few ladies, continue to show their faces in public. I would have resigned on the spot. They could have been responsible for a catastrophe of even greater dimensions than what we are seeing in Italy, since our health system is not as robust as the Italian (which is collapsing !!!).
In this war, a designation you have used from an early stage to describe the pandemic we face today, who are the greatest allies?
Fausto Pinto: From the beginning, my colleagues from the Council of the Portuguese Medical Schools realized the gigantic dimension of this problem, as well as our Rector, which resulted in the suspension of face-to-face classes at all Medical Schools, and some Universities, like ours, which gave rise to some criticism. But the great allies, who realized what we were facing were, from the beginning, our students, our teachers and our employees, who from the first hour, have shown great responsibility. It goes without saying that internally I had unconditional support, from the very start, both from my board and from the presidents of the various bodies, as well as from their members, and from the AEFML. Finally, the stance of the President of the Republic has, until now, albeit belated, been one of great responsibility for knowing how to listen and deciding the state of emergency, which, while not being a vaccine, nor solving the problem, will certainly mitigate it.
How do you assess our students' willingness to help their most experienced doctors in fighting Covid-19?
Fausto Pinto: I have an indescribable pride in our students. In a first phase, when many people still thought that this was a “joke”, we had total adhesion on the part of our students, not only supporting what we were deciding, but also by spontaneously making themselves available to help in all forms, including being in contact with patients, which is of remarkable generosity. Also, their massive support regarding the virtual classes programme set up at our Faculty made me very happy, as it was a sign of our students' maturity and sense of responsibility
What advice would you give to young doctors who are facing a crisis of this dimension, for the first time, and have little clinical experience?
Fausto Pinto: It is for these types of situations that we doctors are trained for and it is in these moments that we have to show why it is essential to have a system in which doctors are properly valued and supported. We are the soldiers in the trenches fighting the enemy that does not give up. We have to defeat it. And this is also where our oath and ethics are a reference for the entire society. We never turn away from the fight, even if it puts our lives and those of our family members at risk. But this is what a doctor is made of. Our only goal is to alleviate suffering, fight disease and give hope to those who need us so much right now, without discriminating anyone. For younger people it is a shock treatment, it is true, but it is also a kind of catalyst for what it means to be a doctor.
How are social networks changing the experience sharing paradigm? Be it among health professionals or the general population? Large sharing and solidarity networks have been generated from these nets. In your opinion, what has been the importance of these new means of communication at this moment?
Fausto Pinto: The most effective way to reach any part in the world today, a second later, is through social networks and that is why I have tried to pass on so many messages. On Twitter, where the academic and medical community is very active and where we exchange several scientific articles that underlie our deepest convictions, but also on Facebook where there is a very large community more accustomed to this platform.
It is in sharing articles, many of them reports from friends and colleagues of mine from other countries, that we are able to show what is happening. Take the case of Italy.
It is this catastrophe we want to avoid in Portugal and that is why we have been fighting, against some initial laid back attitude of the authorities, which took time to react appropriately and always with some suspicion. Even now, despite the State of Emergency, many people are more concerned about their personal situation than with preventing an announced catastrophe, if nothing was done.
As a doctor and professor, every day you face a new challenge. So far, and in the special situation we are experiencing, which has been the most challenging?
Fausto Pinto: I would say that the most challenging thing is to continue to convince and explain that the main fight is prevention, which can only be achieved, at this moment and as I have already mentioned several times, if mandatory quarantine is decreed. It has to be long and for everyone, not just for those considered to be at greatest riskl. Whereas the problem is not completely solved, at least we will be able to reduce it.
DN recently published an article, where it referred to you in a headline that read, “you need access to the data from covid-19 to help fight the epidemic”. Don’t you have access to real data?
Fausto Pinto: It is essential to have access to data on how many infected people we have to help us better understand the situation in Portugal and to be able to confront and complement what is happening in the rest of the world. This must be coordinated by credible entities and not by the usual gentlemen, usually appointed, who accordingly, pay restrictive obedience. The CEMP (Council of Portuguese Medical Schools), which includes all Portuguese Medical Schools, which includes the largest number of real and independent experts from Portugal, in addition to their respective international networks, offered its services to the authorities, as an independent structure to ensure that the data analysis, which is complex, is done according to rules well defined by the scientific world and not curtailed by political fears. Unfortunately, the authorities’ response was, once again, tentative, and we deeply fear that yet another committee will be created, possibly coordinated by one of the usual gentlemen or ladies, who will follow political and not scientific criteria. It is time, once again, to raise the voice of independence and academic authority that a structure like CEMP has, to demand that strict criteria be followed in the assignment of a mission of vital interest for the future. We will monitor the following steps carefully and the country will continue to have a responsible and totally independent entity in CEMP that will strive solely and exclusively for what it believes to be most appropriate for the country. We will never be inhibited from exercising what we consider to be an intervention civic duty. This is what many of us have been proposing and what, in part, we have managed to convince politicians. But we need to be more aggressive in the quarantine, I insist, in the effective protection of health professionals, a massive reinforcement of the National Health Service is needed, the use of masks must be mandatory. And, I repeat, it is necessary to test, test and test. Then we have to insist that people have to stay at home, because there is no Plan B.
What improvements can the NHS implement to be better prepared in the event of a recurrence of this crisis?
Fausto Pinto: This is a golden opportunity for a substantial strengthening of the national health system. As I said publicly, in this war that we are fighting, the Ministry of Health should concentrate all the war effort and be a kind of Ministry of War. As in any war, the whole effort must be channelled into that same war, which has not yet been won. Therefore, it is essential to have a very substantial reinforcement of the Ministry of Health's budget, including reducing the bureaucracy of processes, namely in the hiring of human resources, services, materials, and many other examples. Obviously, this reorganization requires a well-prepared chain of command that is capable of applying the decisions that have to be made, not looking at interests other than the people and the country.
To those who may be accusing you of being too alarmist about the public messages you are passing on, what do you say to them?
Fausto Pinto: You know that I am flabbergasted at the still unbelieving, or at least little convinced way in which some political leaders still look at this situation. Some have even tried to politicize the situation and others have engaged in futile intellectual exercises, which only lead to distractions from the problem, so unnecessary and dangerous at this time. And I am even more amazed when I see the same faces, who were not able to interpret the various signs that were being shown to them, and may have led the country to the same or worse situation than the Italian, to continue to be called and consulted, not even having the humility to realize the nonsense that they were saying, and disappear from the scene. I am referring to the infamous and obscure Public Health Council, completely discredited in public and in the medical and scientific community, which only for very obscure reasons that escapes us all, who are at the forefront, still remains and apparently is to be consulted again!!! What for? What credibility can a structure that has already shown that it is not even up to the current situation have? But we will not forget and accounts will have to be rendered one day. As I wrote a few days ago, there are leaders who, when making courageous decisions at the right moment, will have the country be forever grateful to them; but if they make them too late, the country will never forgive them. Now, however, it is time to unite and help, all together, our country to get out of this situation, which will take a long time (Bill Gates predicts 2-3 months and he rarely fails).
You often say that that for you “the bottle is always half full instead of half empty”. Which is the half full bottle in the face of all the adversity the world is going through?
Fausto Pinto: It is in adversity that what people are made of is revealed. And it showed up. I cannot thank enough my clinical team for everything they give to others. I am grateful for the effort that everyone has made to maintain the activity in our Faculty, students, staff and lecturers. In less than 24 hours, we were very strong in implementing a system of classes by videoconference. It has been a remarkable effort that shows that even in difficult times we know how to overcome and respond to the demands. I am proud of my Faculty and all its members, without exception. I am proud of the teams that surround me and my peers from other medical schools. And of my country.
We see you actively present at Santa Maria Hospital, far from your family and at the epicenter of danger. Aren't you afraid of the collateral damage you can suffer from this?
Fausto Pinto: On Father's Day I recorded a video precisely to encourage those health professionals who, like me, are fulfilling their mission. And it is because we are not able to be with our families at this moment as much as we would like, but this is now our time for acting. We all have full hearts and the certainty that we are making these sacrifices for a collective good and where our own families fit in. My Cardiology team also published a video of cheer and hope, always focusing on the general public. The idea is that we will be fine if the population is well. This is the material we need to overcome obstacles that sometimes seem insurmountable. These are the ones who fight in the trenches, sometimes in very difficult conditions and exposing themselves to all risks, so that our citizens feel that we have not and never will abandon them. I have unlimited pride in my team. And you can always count on us. We did not run away or come up with excuses.