Is fighting against COVID-19 enough?

Tools of empirical epidemiology have been and are indispensable to focus political power on blocking the spreading of coronavirus disease 2019 (COVID-19) by stopping transmission. The present paper is a comment on E. Gibney's article 'Whose coronavirus strategy worked best?' (Nature 2020;581:15-6). The strategy for phase 2 should be more complex and interdisciplinary than described in the paper in Nature, especially in the period before a vaccine and specific treatments are available. The focus on reducing the mortality of COVID-19 will have side effects, including excess mortality from other causes. A part of this excess mortality will be based on the reduction of health-care offers as a consequence of the pandemic, and on structural limitations of the health-care system. A special challenge is to understand the relationship between death from and death with COVID-19, and therefore the relevance of severe acute respiratory syndrome coronavirus 2 infection in people with pre-existing burdens, for example coronary heart disease, cancer or older age. There is a need to extend the recently used tools to all available instruments, including physiological principles of prevention and promotion. The way to integrate global solidarity into the strategies of the different countries is critical not only for global health but also for the peace and long-term success for each individual country. The consequences of efforts against COVID-19 and the impact on reduced air pollution and climate change are also important to analyse from a global health perspective.

I.M. Sechenov (1829 - 1905) and the scientific self-understanding for medical sciences.

There is no discussion about the historic relevance of I. Sechenov for physiology and neurosciences as the "father of Russian modern physiology". But he is relevant for modern natural science too because of his basic epistemological and ontological work. He did not accept the up to now basic paradigm of "Ignorabimus" which can be seen as the reason to exclude even the generalizable aspects of individuality, creativity and spontaneity from natural science. He developed techniques for empirical based science to deal with materialistic and idealistic aspects of the comprehensive person the "ignoramus" according to the actual stay of knowledge and the acceptable ontologies. He demonstrated that ontologies ("paradigms") can be used as tools according to the given problem which should be solved. So Sechenov can be seen as a precursor of the so efficient philosophical positions of Einstein and Th. Kuhn. The stay of the art in physiology and neurosciences changed since the time of Sechenov dramatically. Therefore the philosophical positions of the 19th century should be discussed. Maybe this is indispensable for the needed linkage between materialistic and idealistic aspects of a person. For this the proposals of Sechenov are helpful up to now but nearly unknown. There is no discussion about the historic relevance of I. Sechenov as the "father of Russian physiology." But he is relevant for modern natural science too because of his epistemological and ontological work. He did not accept the up to now basic paradigm of "Ignorabimus" that can be seen as the reason to exclude even the generalizable aspects of individuality, creativity, and spontaneity from natural science. He demonstrated that ontologies ("paradigms") and epistemology can be used as tools according to the given problem. So Sechenov can be seen as a precursor of the so efficient philosophical positions of Einstein and Th. Kuhn. The state of the art changed dramatically. Therefore, the philosophical positions of the nineteenth century should be questioned. Maybe this is indispensable for the needed link between materialistic and idealistic aspects of a person as a whole. In this respect the proposals of Sechenov are helpful for medical science in the twenty-first century too but nearly unknown.