Arriving at Ports in Europe and Further Afield

“Travel is fatal to prejudice, bigotry, and narrow-mindedness.” Mark Twain

Many patients, families and colleagues prefer to travel by boat, ship or cruise ship. Most report “the fresh air, the ocean – it is an escape, good for health”, GP, mother of 5.

Colleagues report that;

A – “face masks do not have to worn on cruises, on busy beaches or pools, in busy restaurants or shops, but in the port during embarkation and disembarkation, it makes no sense, this is the reason so many avoid cruises, ferries or boats now”,

B – however at these ports “they never ask you if you have recently tested positive, if you have symptoms, and many are sick, if you have been in contact with anyone who tested positive or who is sick, or check your temperature … and this all was necessary and clinical indicated a year or two ago, but not now, but tell me why they continue to force masks on us, when no clinical evidence ever supported masks, but the things supported by good clinical evidence, such as temperature or positive contact, are not asked about … so they do what is cheap and fast, rather than follow good evidence”, medical specialist.

We have arrived in ports in Europe in the past few months and we were surprised that masks were mandated during embarkation and disembarkation, as above, but that no authorities asked about vaccines, symptoms, positive contact or positive tests or tested core temperature. “No medical doctor in the world will understand or support an approach where this is consistently neglected, but face masks are forced”, medical director.

“Many islands, ferries, cruise ships, boats, people who rely on tourists, now suffer, unnecessarily, and not based on clinical evidence. Doctors cancel their charity work, because they refuse to wear face masks.” Medical specialist

“In the same country I don’t have to wear a mask in the airport or on an airplane, but I do have to wear one on a ferry, what is going on there?” Medical director

“I was told cruises can decide to follow Spain’s or Portugal’s rules, even if they don’t even ever stop by Spain, and that they can make their own rules with face masks and change the rules after you have boarded, all not based on good clinical evidence, that is why so many avoid cruises”, medical director.

We have liaised with many cruise lines who have been more than helpful and who have kept their word during cruises for their passengers; it does however seem that 1:10 will cause passengers or patients severe distress by decisions not based on good clinical evidence. “Unfortunately one bad apple does spoil the bunch, because even with 1:10 bad experience, many people avoid it (cruises) as a rule now”, medical director.

“Based on statistics and current clinical evidence, the only appropriate clinical decision is now to drop all mandates and to declare that there is no longer a state of emergency in most if not all countries”, medical director.

We trust that policies and mandates will soon change to follow good clinical evidence.

We have been asked to provide more information on where face masks are not mandatory; we have agreed to spend a day and liaise with colleagues to identify information.

Please know that information may change from day to day. Please see government website for up to date and detailed information.

Countries where face masks are not currently mandated in the public, indoors and outdoors, and in airports, on airplanes and ferries:

We will not include the UK and numerous EU countries we have mentioned earlier. It is our understanding, from observation and from ongoing liaison with colleagues that the UK, most countries in the EU, such as France, Italy, Greece, Sweden and Norway, and most states in the USA do not mandate face masks with good outcomes (many for a significant period of time).

We have also been asked to mention specific countries with details, even if face masks still mandated or if borders closed.

1. South Africa (very recent change – many colleagues report that they are planning a trip – ideal time for safari now to avoid, to some degree, mosquitoes and cool enough for animals to linger in the sun)

2. Canada – Vancouver (most report that face masks are still mandated in airports and on airplanes)

3. Alaska (perfect time to visit now) – Colleagues report “we visited Alaska in June (2022) and it was the best trip we have ever taken, we did not have to wear face masks”, ITU consultant.

4. Hawaii (as above – Hawaii’s weather is ideal this time of year)

5. Tahiti (ideal weather considering storm seasons to visit now)

6. New Caledonia (ideal weather, as above) – We understand that Air Vanuatu reports that no face masks are required for flights to New Zealand and Fiji, but are required for flights to New Caledonia and Australia.

7. Vanuatu (as above)

8. Solomon islands (no masks are mandated in the general public, but the borders remain closed)

9. Samoa (no mask mandate indoors or outdoors in the general public, however, masks and nasopharyngeal swabs still mandated on arrival and antigen tests are still mandated), American Samoa (quarantine still relevant, no mask mandate, but masks mandatory on flights) and Tonga (it appears as if masks are still mandated on arrival)

10. Fiji (except planes and airports masks still have to be worn – no information were identified for ferries at this stage)

11. Cook islands (masks are still mandated on public transport) and Rarotonga (masks not mandated on public transport)

12. Australia – masks continue to be mandated – we were provided with this website by colleagues with details of the “unique set of mask rules”: https://www.finder.com.au/mask-rules-every-state-territory

13. Indonesia – “In Indonesia, mask-wearing will still apply when travelling on public transport or visiting crowded indoor areas..” We were provided with this website by colleagues https://www.ttrweekly.com/site/2022/05/indonesia-ditches-mask-wearing/

14. Philippines – face masks are still mandated in many contexts, as far as we understand.

15. Hong Kong – face masks are still mandated in many contexts, as far as we understand.

We are interested to find that medical colleagues report that in informal settlements, where individuals live up to 20 in one small room, without wearing face masks, that individuals are not presenting with symptoms or testing positive. We have also observed this pattern.

16. Japan – face masks are still mandated in many contexts, as far as we understand.

17. Reunion – no mask mandates (part of France – masks are not mandated in France in the general public)

18. Mauritius – face masks mandates in place

19. Seychelles – face mask mandates in place

20. Maldives – no mask mandates (we strongly recommend Maldives – check the weather at this time of year)

21. Mexico – no mask mandates due to “endemic” status

“Many countries, on paper or in the media, they say face masks are mandated, but you visit and you see that it is not”, medical specialist.

“Statistics, if you look at different countries and patterns with rules about face masks, certainly do not support face mask mandates or any restrictions or testing at this stage, or even asking about vaccines, most now agree that the annual flu is more dangerous, even with this or that variant, it is time to stop if we want to protect people”, medical director, 25 years of clinical experience.

“If you want people to have a healthy immune system, stop asking them to wear masks, this can hamper the immune system in so many different ways”, medical specialist.

We recently liaised with colleagues in Asia, Australia, New Zealand and the East; most report that “we followed the trends of the UK and Europe or America, so we all started to make face masks compulsory, but in the beginning, when the pressure was not big, we did not make face masks compulsory, because there is not good evidence, and it worked well, but of course now after many has had a taste of the power that the fear and the masks bring, and many like to hide in life and feel more confident with it, it is now a snowball that is difficult to stop, led by anxiety in two powerful ways, but the first world is to blame in starting the face mask obsession – an interesting person who hears ‘viral respiratory infection’ and responds ‘face mask’, not a trained or educated person most would say, but we respect the decisions that people make, but we won’t believe it is due to health or protection”, GP.

Colleagues in these areas report “it will take at least 10 years before people start letting go of the face masks, not because Health or Medicine or evidence mandates it, because no acceptable degree of evidence ever supported masks, so it will take years before travel, economy or health is prioritised it seems”, medical specialist.

Colleagues agree that it is “very difficult to find information on most countries in terms of face mask mandates”, GP.

Please feel free to inform us of changes or if we have misunderstood the situation in a country. Most colleagues value accurate information.

We plan to visit Fiji and the pacific islands as soon as mandatory mask mandates discontinue. Please feel free to contact us as admin@mentalhealthbus.co.uk to arrange a meeting to discuss pro bono service development or service provision. We currently aim to be available in April 2023. Please know that we have worked with interpreters in high risk context for nearly 20 years.

Most medical colleagues report “my main way to maintain or boost my health is to travel, but (mandatory) masks will change a protective activity into a risky activity for me and most of my colleagues, so we don’t travel anywhere if we have to wear masks to get there or once there, not in any setting outside surgery or the medical circumstances that actually warrant mask wearing”, medical director.

For up to date travel and health information please see the UK website http://www.travelhealthpro.org.uk

We thank colleagues for providing us with information, and we thank countries who follow good clinical evidence to protect the general public, rather than mandating face masks.

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” Marcel Proust

#Travel #Tourism #SouthAfrica #pacific

Travelling Southern Europe – Are Face Masks Mandated?

We thank colleagues for providing us with this up to date summary on where face masks are currently mandated.

Patients, families and colleagues ask us almost daily for information regarding “where can we go without a face mask”?

Please know that information often varies from day to day. “This is the reason so many suffer with health and mental health problems, we now live in constant fear and uncertainty about face masks, the focus is not on a viral or respiratory infection, it is on face masks, no one can tolerate it, and it is not based on good evidence”, medical director.

“It makes no sense that face masks are mandatory in ferries, but not on airplanes or in airports, this is not a medical or clinical decision, clearly”, medical specialist, 20 years clinical experience.

We thank countries such as France and the UK for their current consistent and evidence-based approach; face masks are not mandated in general public settings including ferries, flights or airports. The government website has further details.

“I wonder why the travel agents and magazines are mute about face masks, which is the news of the last few years, the one topic that directs travel for many or most people, they pretend it does not exist”, medical director.

Medical colleagues agree that;

A – Many countries or states have never introduced mandatory face mask initiatives or have discontinued face mask mandates, some for longer than 6 months now; medical doctors we liaise with report that “it made no difference to statistics in terms of serious presentations, hospitalisations or deaths … there is very good evidence that face masks do not help or work or protect anyone, but it is not summarised or published, why not, and furthermore, statistics in terms of mental health, social harms and other health problems improve often (when face mask mandates discontinued), such as doctors return to work, sick leave is 3x higher with face mask mandates it seems”, medical director and responsible officer.

Please know, as mentioned, Singapore was the first country to recommend to the general public to not wear face masks; their good outcomes supported this clinical approach. We observed this approach in person at the beginning of 2020. We are most grateful to Singapore.

B – “75-90% of doctors I speak to speak only or mostly of how face masks harm their patients (or their friends and family); they refer to drinking more alcohol, starting to use drugs or using more drugs, more medication (over the counter and prescribed medication), more violence, more divorces, more child abuse, more general health problems requiring medication, such as allergies or stress related symptoms, more mental health problems (3-10x higher), more suicidal and homicidal ideation in the general public as well as within the medical community. Most doctors report that 9/10 patients report these problems, with 50% being ‘high risk’, and that they keep notes”. Medical director

Please know that we routinely ask patients, families and colleagues regarding their own experiences in the context of face masks, and this pattern is congruent with our own findings.

C – We were asked to liaise with organisations to ask two questions:

1) “why do the WHO, CDC and ECDC (or Public Health England) not make it clear that that no good clinical evidence supports face masks in public settings (… most doctors with appropriate clinical training and experience will know that no good clinical evidence will ever support face masks) and that taking possible benefits and risks into account, face masks should never be mandated or compulsory”?

“People who recommend face masks only make it clear that they themselves have no good medical training, clinical experience and thirdly, that they don’t understand infectious diseases or related research, how to critically review clinical evidence, … although no doctor with good training or extensive clinical experience will ever believe ‘good evidence’ for face masks even if it existed, but it does not – face masks cause harm to many, this most medical doctors know, look at risks of violence, drug use, alcohol use, all increased, and people say they want to end their lives due to it, that their general and mental health is poor due to lack of freedom and this constant fear that masks will be mandated again”, medical director. 

2) “why don’t the WHO, CDC, ECDC and PHE make it clear that statistics currently indicate that the state of emergency has not been appropriate for months now, and that countries who drop all restrictions have no more problems than countries who don’t, and that the numbers for many things like child abuse or suicidal ideation are actually better in those countries”?

“Many medical colleagues are liaising with legal colleagues and the International Criminal and Human Rights Courts, because this is criminal, to force something that causes risk and harm is not acceptable in any country or context, or did I miss something, is deprivation of liberty now legal?”, medical director. 

“Service development and service provision have been negatively affected, delayed and stopped in numerous countries due to this state of emergency that continues when it should have been stopped a year or more ago, so many suffer unnecessarily, because people are invested to keep us afraid and masked when this was never necessary, any person who keeps quiet shares in the blame”, medical doctor, director (legal training). 

“Half of my medical colleague group said they are retiring because the system is broken, they will not wear face masks in hospitals when no evidence supports this for going on 3 years, as a blanket rule, and because they cannot believe that masks are mandated in the public, despite no good evidence, and evidence that it hurts people, the medical community has lost faith in their leaders, because they force bad evidence on people”, medical director.

“If we don’t stand together, all the nations, face masks will be a thing and a risk for 10 years, is what my New Zealand colleagues say, this will affect travel and the economy and also health and mental health and social harms for decades, we can’t say it is not our problem, because we don’t have to wear face masks, nations copy each other, what happens with our neighbours, will affect us, we need to work together to protect children who now suffer with development, health and mental health, and adults”, medical doctor, 20 years clinical experience.

Please know that we have been contacted by many leaders in Health or Government, and many share these concerns. Generalising will not help anyone; good clinical evidence will ensure protection and a consistent, collaborative and congruent approach.

Risk assessments need to be systemic (consider all relevant bio-psycho-social risk and protective factors) to be effective. We thank our colleagues who engage in systemic risk assessments before finalising recommendations. Safeguarding the general public is not complicated in this regard, as most medical colleagues would agree, “if you follow good clinical evidence and make decisions based on good medical training and clinical experience”, medical director.

“Many say ‘I don’t mandate it, but I recommend it, or I don’t recommend it but I say it’ – from a legal point of view, if you are a medical doctor, leader or leading organisation, it makes no difference, and if you say, recommend or mandate it – you have to take responsibility for it – so make sure it is based good clinical evidence”, legal colleague.

We have shared concerns with relevant individuals and organisations. We thank colleagues who have responded to us since March/April 2020. We have only received negative responses from 3 individuals. We have been informed by tech colleagues that some responses have included efforts to sabotage our work and sharing of information. We thank our clinical, legal and tech colleagues for their support in ensuring that no harm is caused to any party in any way by our involvement.

Our aim is to ensure that the general public is safeguarded by following good clinical evidence from a bio-psycho-social point of view. Risk and protective factors have to be considered. Important protective factors include, for example, education and supporting the immune system. We thank those with similar goals.

#travel #EU #Mediterranean #Flights #Travelagents #Travelmagazines #Ferries #Airports #France

Good Clinical Evidence for Good Clinical Outcomes

Medical recommendations invalidated by non-medical personnel:

We were asked to liaise with government and private organisations in various countries regarding whether a medical letter exempting a patient from wearing a face mask will be accepted in their domain. We subsequently reviewed government documents and liaised with government departments, CEOs, company presidents, directors and board members.

Many medical doctors who provide ‘face mask exempt’ recommendations have patients (often children) presenting with genetic problems causing serious medical problems, or presenting with mental health problems such as depression, or with learning disabilities, hearing, developmental or neurodevelopmental difficulties such as ADHD (Attention Deficit Hyperactivity Disorder) or ASD (Autism Spectrum Disorder). Some patients present with a history of anaphylaxis or serious allergies or asthma, or serious medical and mental health concerns relating to head injuries or dementia (many relating to head injuries have a military history). Comorbidities are not uncommon. Most of these clinical presentations are associated with significant risk.

Mask wearing for most children and adults, but especially individuals in these contexts, often cause severe distress and perpetuate or increase functional impairment, often markedly increasing bio-psycho-social risk and harm.

Many other contexts in terms of development, medical or mental health are relevant here and can cause significantly increased risk and harm, as most medical colleagues agree.

Ongoing indiscriminate mandatory initiatives, such as testing, self-isolation or quarantine, without clear patient specific clinical indications, weighing possible risks and benefits, can cause similar increased risk and harm. We have previously shared examples.

Most of our referrals in the last year are of children of medical doctors, academics and legal colleagues; referrals have increased markedly of children where parents are professionals engaged in the pandemic. At least 90% report “it was fine before the first lockdown, but since then all spiralled, and face masks continue to drive the distress and trauma, a constant cause of chaos and fear”, GP.

Many patients (some colleagues report 50-80% of their patients), adults and children, have been started on regular or long term medication such as antihistamines or Prednisolone by GPs or medical doctors to “assist children or patients to cope with mask wearing or avoid serious allergic reactions relating to or exacerbated by mask wearing”, GP, which can have a “detrimental affect” on the immune system, immune response and can lead to serious medical complications.

“This needs to go to the International Human Rights Court or Criminal Court, because no good clinical evidence has ever supported face mask wearing in any public context, and it causes harm to many, but people are forced to do it – this goes against anything we’ve learnt in Medicine as doctors, and it is going on for more than 2 years for many.” Medical director, 20 years clinical experience. It is our understanding that many medical colleagues have referred this matter relating to deprivation of liberty not based on good clinical evidence to legal colleagues and courts.

Many doctors report that they have started patients on regular benzodiazepines to “cope with mask wearing”, which not many responsible psychiatrists will support in the community as part of a regular treatment protocol weighing potential risks and benefits, considering concerns relating to addiction (often within days); there is usually no long term benefit, only risk, with these treatment options. We have informed medical doctors of our concerns. Replies include “what must I do … no one cares enough to stop these face mask rules and follow good evidence instead, they care about power and fear …”, GP and Emergency Department doctor. These concerns are relevant in the NHS, prison populations, private and pro bono sector, and will likely lead to markedly increased harm.

Face mask wearing in the general public is not associated with or supported by good clinical evidence, as most medical doctors and relevant professionals, as well as the WHO, will agree, and now, with this indiscriminate mandatory initiative continuing for more than 2 years after the onset of the outbreak, despite lack of good evidence, and with good evidence of increased risk and harm associated with face mask mandates, medical doctors are starting or maintaining children and adults on medication associated with serious risks, side-effects and additional harm; no argument can be made relating to clinical appropriateness, medico-legal soundness or ethical consideration in this domain.

“This is relevant in the world of liability if you force people to wear masks when there is no good evidence behind this, and when it harms many people, and then they have to be started on medication to cope with this harm, but this medication too can cause and causes even more harm in other ways, such as addiction or low immune responses” GP, legal background.

We were asked to liaise with various organisations in various countries regarding whether a medical letter that exempts a patient from wearing a face mask, which is accepted in the UK, and many other countries, will be accepted in the host country or various businesses, airports, airplanes, cruises or ferries. We were also asked to visit businesses or areas to observe and gather information, which we have done.

Most businesses accept letters from doctors exempting patients from face mask wearing. Most CEOs agree that “face masks cause more problems, especially anger, fear and aggression”.

We thank the CEOs and directors who have responded to us; only 5-10% did not respond, however, clear information was provided on websites within a short period of time in many instances. It is our opinion that most share concerns and the agenda to protect the general public as the first priority.

Further to liaison with academic, clinical and legal colleagues, non-medical personnel invalidating medical recommendations by an appropriately qualified, registered and licensed medical doctor for their patient(s) is found to be clinically inappropriate or negligent and unacceptable from a medico-legal, legal and ethical point of view, and individuals who invalidate medical recommendations will be liable in court for any adverse outcomes. It is our understanding that a ‘state of emergency’ will not alter this fact. Most medical doctors now agree “a state of emergency is now not clinically appropriate in most nations, and has not been in 6-9 months”, medical specialist.

“Medical doctors are taught to provide recommendations based on their current impression of the current clinical presentation, formulation and complications or risks for the patient. If someone decides not to follow the recommendations, be it the patient, GP, social worker, teacher, CEO, government official, and there are any adverse outcomes due to this decision not to follow your recommendations, they are responsible or liable, irrespective of (context). … Everyone does however have the responsibility to think for themselves and to gather more information or opinions if they are not comfortable and do not agree with the doctor or if they have concerns. … They have to use their brains, resources, gather information. People also need to remember that things change often and fast, so review often. Risk assessment is not a one time thing or easy, it is constant, and it includes extensive assessments, liaison and observation, so it is best, in my opinion, to follow the advice doctors give for their patients if you have any degree of uncertainty. …” Medical doctor, legal training, 20 years experience in court work

It is our understanding, further to liaison with legal colleagues in various countries and domains, that no emergency legislation or ‘state of emergency’ can invalidate the above including medical opinions, recommendations, reports or letters for their patients in any context.

We recommend speaking to your GP or medical doctor or team and getting legal advice for every question and context.

“We are so happy that good clinical evidence is followed by many countries such as Sweden, France, the UK, Belgium, Portugal, Spain, Greece and Italy, so many others in Europe and the USA and now South Africa have dropped restrictions – some have dropped all restrictions, which now makes sense, despite all the threats that will continue to pop up, but with any pop up threat, face masks will never make sense, because no good evidence supports face masks, it is a dark age type thinking in my opinion and most medical doctors agree I think”, medical specialist.

We are offering pro bono input in the EU this year, along with the UK. Colleagues agree that “it is best to avoid areas where you need to wear masks to get there or to work there, because we also need to protect our own health and trying to manage risk and harm in a context that supports risk and harm makes no sense”, medical specialist.

“I am so glad we can travel again, this sustains health for so many – freedom. I have so far gone to 5 EU countries, all where I never have to wear a mask, we haven’t worn masks in 6 months and we can live again and we are starting to believe there is hope. No one goes to the islands by ferries of my friends and colleagues, because oddly you have to wear a mask on a ferry, but often not on the plane, like in Greece. We love Greece, but we will wait for things to change. So many countries have suffered because many avoid travel if they have to wear masks, and masks hurt so many people. How simple is it to follow good medical evidence in a medical scenario?”, medical specialist.

“The countries who stopped all mandates and mask wearing have better numbers or equal numbers to others, and look at Florida where no one wears masks nearly, and most are over 75 or 65, well many are, they have good numbers – why? Because they follow good clinical evidence, and fear does not rule.” Medical director and specialist

Many individuals in every domain such as government, business, law or social care have consistently made significant efforts to follow good clinical evidence, medical recommendations and to liaise with various medical agencies or professionals to gather relevant information to educate their teams regarding possible protective factors as well as risk and harm to inform the weighing and decision making process, which resulted in subsequent informed and responsible decisions for clients, staff and the general public. We thank you. You lead by example.

We would also like to take this opportunity to thank CEOs and presidents of companies or organisations who have gone to great lengths to contact us ahead of policy changes to discuss concerns and to prioritise the health and safety, based on good evidence, for their customers or guests. These decisions will have a global impact to protect the general public.

Lastly we would like to thank colleagues in local health ministries, Public Health England, the WHO, the ECDC and the CDC for their commitment to following good clinical evidence.

“Following good clinical evidence is one of the simplest things in this situation, and it certainly does not include face masks or mandating face masks in any setting outside of hospital settings for immune compromised and surgical settings; if we don’t follow good clinical evidence we should not hope for good clinical outcomes.” CEO, medical doctor

If you would like to know more about our work in the EU and UK this year, please contact us at admin@mentalhealthbus.co.uk – we currently have more or less 25 medical and non-medical volunteers (mostly GPs, psychiatrists and paediatricians), but we always need more hands or feet to play Football.

We are also waiting for confirmation from South Africa to proceed in a local township. We will aim to be available for this project as a priority this year and also, if possible, next year. We usually aim to remain available for all projects and visit on a regular basis offering consultation or clinical input if required to ensure sustainability. If you are interested in joining us, please contact us via the email address as mentioned.

#Travel #Health #MentalHealth #Children #Evidence #Volunteer #Football #EU #UK

There is no such thing as part freedom – Mandela

“Freedom is never dear at any price. It is the breath of life.” M Gandhi.

This photo was taken in Mumbai.

Numerous human beings on every continent have spoken of the importance of freedom; the effects on social risk, mental health, general health, and on communities in general. Liberty is the most important protective factor to maintain bio-psycho-social risk; most considered expert in the field of deprivation of liberty, would agree.

“It is interesting that deprivation of liberty can occur and be maintained (since 2020 in many countries and without good clinical evidence supporting this), without one doctor, one lawyer saying ‘stop’, but tomorrow we will sell liberty to our children to defend us in war”, medical director.

“We need to think of our neighbours, we are not free, if they are not, because what happens next to us, will affect us, what happens on the other side of the world, will affect us. We should focus on education, providing people with tools to achieve their goals, not money, which evidence shows will only lead to more debt, and give people freedom and choice, autonomy, to prioritise protective factors in their lives and manage risk factors”, medical director.

“Money won’t create success, the freedom to make it will”, Mandela.

“Give us the tools and we will finish the job”, Churchill

“Matters or poverty (or risk) are seldom complicated, we make it complicated, so that we can arrange several boards and have several meetings about it, and talk about it for years, it is the same with social risk and mental health, if the agenda is to manage the risk and provide solutions, the answer is seldom complicated”, child psychiatrist.

“For to be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others”, Mandela.

It is important to respect others, to not force anything for those with capacity to make decisions for themselves, or ridicule or humiliate – we teach our children by doing. “We teach kids not to tease the kid who eats different or wear glasses or talks different, why do we as adults believe we can do what we want”, GP and mother of 2.

In Medicine or Health, liberty can only be deprived in certain circumstances, and there are several policies, protocols and procedures in place to ensure, for every person, where liberty is deprived, that reviews and safeguards are in place, so that liberty is not deprived, for one moment, without clinical grounds. Most medical doctors agree that liberty has been deprived during the pandemic without clinical grounds. “A man who takes away another man’s freedom is a prisoner of hatred…”, Mandela.

“I was not born with a hunger to be free, I was born free.” “Freedom can never be taken for granted… Use this precious right to ensure that the darkness of the past never returns.” Mandela

We need to stand up, speak up, for those without a voice, but we need to do this in a respectful and curious manner, always willing to learn. “Whenever you have truth, it must be given with love, or the message and the messenger will be rejected”, M Gandhi.

“Intervention only works when the people concerned seem to be keen for peace”, Mandela.

“In matters of conscience, the law of the majority has no place”, M Gandhi, 1947.

“The best way to find yourself, is to lose yourself, in the service of others. M Gandhi.

We would like to thank every one who has contributed to comments. Your input is valued by many. We receive most comments from medical doctors and academics, however we have received some of the most profound comments and quotations from public servants, veterans, retired police officers, retired teachers and social workers or solicitors. Please feel free to contact us at admin@mentalhealthbus.co.uk to share thoughts or experiences. Please know that we cannot reply to everyone, but that your thoughts will be appreciated.

#Freedom #Liberty #Health #peace #poverty #children #Mentalhealth

Swimming Upstream – European Islands

European Islands

“European islands are swimming upstream, because travellers or tourists can’t get to the islands without face masks, which ferries seem to demand, despite flights saying masks are not mandatory, but people want to island hop and see the islands, so they don’t visit now”, medical specialist.

Medical colleagues with 20-30 years experience report that:

A – they will not travel to a location where face masks are required on route or at the location, “or any risk of masks”,

B – “face masks have never been associated with good clinical evidence to protect anyone”,

C – “there isn’t even good evidence to use face masks in hospitals, yes in certain areas like in surgery they are commonly used, but most people who are high risk or immune compromised go into a different area of the hospital, they are not allowed to be on main wards, the rule for decades, and even there, a face mask was never part of the outfit, doctors mostly base their decisions on good clinical evidence, not masking people, which is not based on good evidence, and the face mask in hospital rule keeps people from attending hospital or follow up appointments, so in a way for some people, it works, because the workload is less, that is what my colleagues say”,

D – “forcing any person to engage in a medical or paramedical intervention has never been legal, certain grounds are required, such as the person has to have no capacity to make that decision, or the person must be an imminent risk to himself or others”, “you can’t even force someone to get a blood transfusion to save his or her life, but now we want to force people to wear masks for 2 years”,

E – “if people want to wear masks, because some do and for many reasons, like lack of confidence, let them, but don’t force something on people, it is not legal, and it actually hurts a lot of people”, “look at child abuse, domestic violence, divorce, alcohol and drug abuse statistics, or general violence, everyone says they feel trapped, they don’t have freedom any more, it is predictable”,

F – “even before vaccines, this viral agent was only a serious risk to about 5% of the population, and masking everyone helped no one, if you look at evidence, it deprived people of liberty and increased other medical and mental health problems and violence and abuse”,

G – “for at least 6 months professionals have agreed that this viral risk is now less harmful than the seasonal flu, but deprivation of liberty has never been based on evidence here”, medical specialist 30 years experience.

Consistency and good clinical evidence go hand in hand – if doctors or leaders followed good clinical evidence – there would be consistency across countries and transport methods.

We have written about evidence-based protective factors for general and mental health, such as liberty, education and autonomy, along with a positive and calm mental state. These factors have to be considered in any bio-psycho-social risk assessment and management strategy, for patients and national policy.

Europe has now returned liberty to many countries and areas. However, most of the islands, can only be reached with face masks, and medical colleagues and tourists report that they will not visit islands until face masks are not compulsory on ferries (in most cases now not compulsory on planes or in airports). Medical experts report “it makes no sense, face masks make no sense, but how they decide about face masks, it is not based on clinical thinking or evidence”.

Many medical colleagues and patients now report phobias: “My fear is I get on a cruise and after day one it all changes, we have to wear face masks, because 2% tested positive, it is makes no clinical sense, but they do what they want isn’t it” (“many of my patients say that they were told that face masks are not mandatory on cruises, but after they embarked, the rules changed suddenly”). “I can’t breathe on a plane and go anywhere, because I fear the face mask rules will change.”

Psychology colleagues report that “face masks and this type of reinforcement in terms of fear is perfect to cause serious mental health problems and to control groups and large groups at that, because it is never certain, one moment you think it is fine, then you know it is not, then it repeats, then it stops, and repeats, this will break people, it has to stop, and not ‘stop for now’, but ‘stop permanently’ and it has to stop now if the priority is mental health and even general health it seems”.

Legal colleagues report “it makes a mockery of laws about liberty, capacity, competence, confidentiality, but no one says anything, people are scared, as was the intention.” “Things stopped in America when the lawyers became involved it seems.”

Medical colleagues report “based on current clinical evidence, ‘no restrictions indefinitely’, is the only recommendations that makes sense, and that the public and patients should ask their doctors if any specific recommendations would apply to them, as has been the case for decades – that advice should be patient specific, not based on public policy, considering that this viral risk is no longer more extensive than the seasonal flu”, and

“we hoped the world would pay attention to good clinical evidence, and stop all of this, but it seems initially Singapore and other countries in Asia such as India, Malaysia and Sri Lanka followed good clinical evidence (Singapore advised against face masks beginning 2020), then Sweden’s approach similar to Singapore, then France prioritising liberty, and also Florida, and the UK – (and then much of Europe, starting with Scandinavia followed) if you look at countries or areas where liberty was prioritised, which will also mean education is often prioritised, their numbers are not worse, in fact, they are usually better, … and take into account how many colleagues in Florida are 75 or 80 years old, and they are not getting sick. Face masks are about control and fear unfortunately, not clinical evidence, most doctors will say this in the courts” and

“so many people in informal settlements, living on top of each other, and without face masks, they are not getting sick and going to hospital, their lives have not changed, they still have the same freedoms and calm as they had in 2019, so many doctors and nurses say this every day, but it doesn’t fit the story we need to tell it seems” and

“‘if so many test positive, then we will’ is not based on good clinical evidence – it should not matter any more, because as we all know this viral agent has evolved so that it is very infectious, but not even the risk of a seasonal flu, so it is time to stop, it was time 6 months ago, but who will keep those responsible who keep the public deprived of liberty, there was no grounds for deprivation of liberty in 2020, perhaps you can argue a week or two, or a month at most, but now, to continue like this, more than 2 years later, where are the courts in this global deprivation of liberty scenario where people are living in fear and chronic and serious harm is being done to the health of many” and

“it is funny that even the travel magazines do not comment on where one can travel without masks, it is as if everyone is afraid to mention the word ‘masks’, what an unfortunate outcome in a pandemic, that the focus is on masks, fear of masks, compulsory masks, not on anything with good evidence, such as maintaining a positive mental state” and

“look at the thousands in the pools together, or in the sea, now tell me it makes sense to mask them in airplanes or ferries or indoors, this is not medical or clinical thinking, this type of thinking is not based on clinical training or experience, or any knowledge about respiratory infections, the community deserves more, be honest and follow good evidence, lead with the truth, not agendas” , medical director.

A systemic approach is required in medical risk assessment and management, which means that all bio-psycho-social factors have to be considered. “We cannot consider an airport in isolation, or a ferry, one has to look at the big picture, where they people come from, where they go, where and how they eat, it all has to make sense, or it is deprivation of liberty not based on clinical grounds, and that is illegal. “Where are the people with responsibility, To those who are given much, much is expected.”

“Greek islands, Sardinia, Spanish islands, Azores – they are all excluded by many travellers, because people don’t want to wear masks when they island hop, and these islands often depend on tourism to an extent, it makes no sense at all”, medical specialist.

Colleagues report the following current information regarding Travel in Europe and European Islands:

Greece:

– Cruise-ships: Mask mandate is suspended and is implemented again if a rate of over 2% of the passengers or over 4% of the crew gets infected within one week. Also for the case when over 1% of the total passengers and crew onboard get infected.

– Ferries/Ships: Mask mandate is suspended in the outdoors areas of the vessels, but remains valid for passengers and crew in indoors areas. (Measure will be re-evaluated end of June.)

– Daily-Ships*: Mask mandate is suspended.

The Committee has also recommended that taxi drivers and their customers will continue to be obliged to wear a mask.

The mask mandate remains also for personnel and customers in pharmacies.

Masks are not mandated in airplanes.

(Medical colleagues report that they find it makes no clinical sense that face masks continue to be mandated in contexts such as ships, ferries or pharmacies, when no good clinical evidence supports this.)

– Taxi : Mandatory mask for drivers and passengers.

– Cruise ships : The mandatory use of the mask is suspended and returns when more than 2% of the guests or more than 4% of the crew fall ill within a week or if more than 1% of the total population on board falls ill within 48 hours.

– Passenger ships : The obligatory use of a mask outside the ship is suspended, the obligatory use of the interior inside remains for all, crew and passengers (review at the end of June).

– Pharmacies : The mandatory use of a mask for staff and customers remains. 

Corsica:

https://www.corsica-ferries.co.uk/flashinfo.html?_gl=1*1dx6pm5*_gcl_aw*R0NMLjE2NTQ0NDQ4NzguRUFJYUlRb2JDaE1JM2FIazFOYVctQUlWRXVSM0NoMGJXd25pRUFBWUFTQUJFZ0preGZEX0J3RQ..*_gcl_dc*R0NMLjE2NTQ0NDQ4NzguRUFJYUlRb2JDaE1JM2FIazFOYVctQUlWRXVSM0NoMGJXd25pRUFBWUFTQUJFZ0preGZEX0J3RQ..&_ga=2.264561423.1426047491.1654444879-1029189006.1654444878&_gac=1.141215366.1654444879.EAIaIQobChMI3aHk1NaW-AIVEuR3Ch0bWwniEAAYASABEgJkxfD_BwE

All passengers 12 years old and older coming from a green zone country (with a low Covid circulation rate) must provide the following documents when boarding:

– for vaccinated passengers, a vaccination certificate;

– for passengers who have not been vaccinated, a negative PCR (taken within the previous 72 hours) or antigenic test (taken within the previous 48 hours).

– for passengers who have not been vaccinated, a proof of recovery from COVID-19 (less than 6 months)

– Should the passenger not be able to present the above papers, boarding will be refused.

Passengers coming from orange zones are invited to consult for details of further measures and restrictions.

Sardinia:

On Corsica Ferries for Italy:

– Starting from 1 June 2022, travellers are no longer required to present the Covid-19 Certificate (green pass) to enter Italy.

– Wearing the ffp2 mask is obligatory on board.

Please know that no masks are required on Corsica Ferries for ferries to Corsica and to France.

(Medical colleagues report that they find it makes no clinical sense that face masks continue to be mandated in contexts such as ships, ferries or pharmacies, when no good clinical evidence supports this.)

Italy:

Still required on public transport, indoor public venues including theatres, concert halls, cinemas, live music clubs and indoor sporting events, healthcare settings.

NOT Outdoors

Face masks are still required on planes until at least 15 June.

(Medical colleagues report that they find it makes no clinical sense that face masks continue to be mandated in contexts such as planes, ships, ferries or pharmacies, when no good clinical evidence supports this.)

Please know that face masks are now not compulsory on most EU flights and on flights in many countries such as the USA.

Spain:

Face masks are no longer needed in public buildings like shops, restaurants, museums, cinemas, or theatres. However, you still need to wear a face mask inside airports, at train stations, on public transport, in hospitals, and in doctor’s surgeries. The type of mask to be worn is not specified.

The use of face coverings is mandatory for anyone over the age of 6 years if you are in the following situations:

– on any form of public transport in Spain

– visiting a hospital or medical centre (including other healthcare settings such as dentists, opticians, pharmacies etc.)

– visiting a care or nursing home

Therefore, in our regulations, it is not compulsory to wear a mask either on platforms or at airports, but it is on public transport and also on flights,” Darias stressed.

(Medical colleagues report that they find it makes no clinical sense that face masks continue to be mandated in contexts such as airports, ships, ferries or pharmacies, when no good clinical evidence supports this.)

Portugal:

Mandatory mask:
– in public transports, taxis and similar passenger transports;
– access and visits to care and nursing homes and health facilities.

(Medical colleagues report that they find it makes no clinical sense that face masks continue to be mandated in contexts such as ships, ferries or pharmacies, when no good clinical evidence supports this.)

Colleagues report that “we are perturbed that masks are compulsory in airports, but not on planes, but on ships, but not daily ships, it all makes no clinical sense; but this is congruent with the fact that face masks were made mandatory in 2020, but were never supported by good clinical evidence for any of the places where face masks were mandated, not even on the general wards of hospitals or pharmacies … and face masks caused a lot of people a lot of harm, and they still do … one can’t make it up as you please in Medicine … this does not protect people”. Medical director, 20 years clinical experience

“The ECDC, WHO and CDC have a principle role in protecting the health of the public in nations; I feel they have dropped the ball by not making it very clear that no good clinical evidence supports face masks, not in 2020, not now, and that their lack of clarity regarding this very important fact, has meant that a lot of people have seen their liberty deprived, illegally (not based on clinical evidence or medical thinking), and are suffering with serious health and mental health problems, often chronic problems, now, and a lot of other problems like child abuse and drug use are up 10x or more, this is unacceptable in every way.” Medical director, 25 years clinical experience

We thank colleagues in the WHO, ECDC, PHE and CDC for their continued involvement to ensure that only good clinical evidence is followed, because this will protect communities and patients in hospitals or medical clinics from a bio-psycho-social point of view, not only now, but in years to come.

We are presenting our findings, based on work, travels and continued liaison with medical professionals during the pandemic, since Jan 2020, in Cambridge in November 2022. Please contact us at admin@mentalhealthbus.co.uk if you require further information.

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