The Four Musketeers at Frontline of Georgia’s Fight against Pandemic
Exceptional circumstances have brought three men and a woman, physicians by training, to the forefront of Georgia’s fight against the pandemic. Known previously to only few, all four have now become household names. With 296 people infected and death toll standing at 3 so far, many observers credit Georgia’s professional doctors for relative success in taming the outbreak. Civil.ge decided to introduce you to Georgia’s docs-turned-musketeers, who are shaping the government’s response to the public health crisis.
Amiran Gamkrelidze took the helm of the National Center for Disease Control and Public Health (NCDC) in 2013 and has been on the job since. He also served as the Deputy Minister of Health from 1997 to 2001 and went on to serve as the Minister until 2004. Gamkrelidze credits himself for playing a part in establishing the now-acclaimed Lugar Research Center situated near Tbilisi Airport, an ultra-modern biological laboratory that made its name for delivering prompt diagnosis in the early days of the outbreak.
From the very onset of coronavirus spread in Georgia, the chief public health official has become the calm public face of government’s response to the pandemic. While leading near-daily media briefings, he took on responsibility for dispensing facts about gloomy global statistics, and for boosting people’s confidence in Georgia’s ability to handle the crisis.
Gamkrelidze was lauded for his level-headedness and remarkable equanimity – for at least by the Georgian yardstick – when dealing with a gaggle of journalists. But beyond the manners, he has had one principal task to accomplish – always provide the public with clear, unvarnished information and advise the government on policies based on the best science. In this respect, critics say, Gamkrelidze has not always been up to the task.
Gamkrelidze’s critics point to his reticence to recognize the importance of rapid testing in gauging the extent of community spread. Gamkrelidze chose to focus on using much-vaunted PCR methodology, for its reliability. Some say, in doing so head of NCDC shielded the government from admitting its failure to stock up on rapid test kits on time. The Ministry of Health procured such kits from China, but has scrapped the contract after some other countries found them faulty.
Another criticism is that Gamkrelidze, who regularly pleads and cajoles Georgians to follow physical distancing rules, has skirted directly appealing to the churchgoers – and to the Georgian Orthodox Church itself – to suspend service and especially to refrain from dispensing Holy Communion with a shared spoon.
After being grilled about the hot-button issue of test availability on March 28, Gamkrelidze withdrew from the media spotlight, having spent days holding the line. Many regret his self-imposed isolation, since he cut a trustworthy figure. Although the pressure from dealing with both professional and media constraints might have become too hard to bear.
For Gamkrelidze, there was a personal side to the public health crisis: his own son (who is the CEO of country’s largest healthcare service provider) was one of the first to be diagnosed with COVID-19 in Georgia. Fortunately, he made a full recovery and many others are on the mend now.
Paata Imnadze, Gamkrelidze’s deputy, is in charge of running the U.S.-funded Lugar lab, and is employing country’s best scientific minds for the benefit of public health in Georgia. Unusually for a mid-ranking official he has become a high-profile media personality, as NCDC’s role has taken on more urgency.
A fixture at the Inter-Agency Coordination Council, a government task force to handle COVID-19, Imnadze gained prominence for blunt, but justified criticism of laxity towards the pandemic, and of public’s reluctance to observe health recommendations. He was also outspoken in condemning xenophobia against Chinese nationals at the outset of the epidemic, and in warning against stigmatizing those who caught the virus.
Yet, in the eyes of many, Imnadze paid lip service to his public duty faced with religion and politics, two touchy topics in Georgia. Imnadze lost his temper while interviewed on the air by an opposition-minded TV-channel and threatened to spill the beans about his critics’ efforts to persecute him in the past – most likely referring to former ruling party politicians.
When asked about Church’s defiance of state of emergency regulations, Imnadze raised eyebrows by saying he feared “that a campaign of persecution against the faithful” was starting in the country. Much like his boss, Imnadze decided to keep a distance from the media hereafter, only appearing to update public at now-regular coronavirus task force briefings.
Tengiz Tsertsvadze, Director of Tbilisi Hospital of Infectious Diseases, Georgia’s main medical facility treating COVID-19 patients, has spent over five decades researching and treating most dangerous maladies. Stern-faced septuagenarian has long forged his reputation as country’s top infectious disease expert. In Soviet times, Tsertsvadze embarked on a career devoted to fend off HIV and AIDS expansion in Georgia – where he performed admirably, especially given scarce resources. Along with Gamkrelidze and Imnadze, he has been instrumental in launching world’s first hepatitis C elimination program in 2015 in Georgia, co-financed by Gilead Sciences, a U.S.-based biotech firm.
By no means a political appointee, Tsertsvadze was soon tapped by the government to lead a group of medical experts tasked with devising COVID-19 detection and treatment guidelines. It was his personal decision, to omit high fever as a necessary pre-condition for screening the potential patients. Although this was against the WHO-endorsed testing criteria of the time, many claim that it enabled Georgia to detect mild COVID-19 cases early, and winning crucial time at the outset of the outbreak in Georgia.
The critics note however, that Tsertsvadze stood firmly against expanding the testing guidelines passed in the wake of the epidemic: doctors were then testing only people who recently traveled to the particularly affected countries, and those who had been in close contact with already diagnosed patients. After the first cases of internal COVID-19 transmission in Georgia, these guidelines should have encompassed wider layers of potential risk-groups, the critics argue.
“My life goal has always been to face the risk and combat infectious diseases [like coronavirus],” remarked Tsertsvadze in a brief interview that has shortly gone viral. Many Georgians reckon that he has indeed risen to the challenge.
With her mild manners and ready warm smile, when she comes to deliver good news of patient recovery, Marine Ezugbaia has become a near-daily presence. As the Medical Director of Tbilisi Hospital of Infectious Diseases, Ezugbaia directly supervises treatment of the gravest cases of the novel disease in Georgia, which, for the most part, include senior patients with underlying medical conditions. She shepherded thousands of Georgians into knowing the medical jargon and keeps them abreast of sprawling clusters of newly admitted cases. Georgians have gotten used to her medical lingo by now and are eagerly listening to signals – how many have recovered, how many linger in “critical, but stable” medical condition…
As the virus begins to affect mental health of the population, often triggering distress, Ezugbaia bears the responsibility to convey scientifically sound information and provide trusted medical advice. When asked whether she was going to attend Easter Vigil, Ezugbaia replied, controversially, “whatever be the [Georgian Orthodox] Patriarch’s benediction, I shall observe it as a devoted Orthodox Christian”.
Would her faith let her compromise her medical judgement? Georgians can only hope, it won’t.
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