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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