Fernando Alcoforado*
This article aims to point out the conditions required for people to resume their normal activities after the Coronavirus crisis. Brazilian researchers consider it impossible to estimate when the worst will have passed in Brazil, but they say that the resumption of normal activities will require overcoming the peak of those infected with the new Coronavirus and conducting comprehensive immunity tests. According to biologist Fernando Reinach, a retired professor at the Faculty of Biochemistry at the University of São Paulo, for people to get out of quarantine it is necessary that all people or 80% of the population is immunized. Like all pandemics, they only end when the virus has no one else to infect. The virus will stop infecting people in two ways: 1) with immunization by the vaccine, which should take time to happen; and, 2) immunization with the infection of the entire population by the disease.
It is known that the strategy of total social isolation of the population does not aim, just to prevent people from contracting the Coronavirus, but also to avoid that there is not a large contingent of the contaminated population at the same time that overburden the health system. Much is said about overcoming the peak of the infection curve as a borderline from which one could start thinking about relaxing the restrictions imposed by social isolation. In Brazil, for example, as the infection curve is on the rise, with the number of cases increasing every day, there could only be flexibility in social isolation when, after the peak, the number of infected people started to fall progressively. However, no one is able to say at what point in the fall of infected people it would be safe to suspend quarantine. So far, the only country that has actually gone up and down the contaminated curve was China, where the quarantine relief only came after two or three weeks with no new cases and with about 70% of the population immune. In addition to being gradual, the release should not be national, and the time ahead may be longer than desired.
Despite decreeing the end of the period of isolation in most parts of the country, the Chinese government maintains strict control over citizens, and the release is gradual. The population continues to wear a facemask, undergoing constant temperature measurements, in addition to being controlled using a municipal health QR code (Quick Response code) that functions as an immunity passport. In several Chinese cities, there is a QR for each inhabitant, informing their health condition based on both their own statements and data available to the government. Thus, citizens receive codes marked in green, yellow or red. Only residents with a green code can move freely around the city. Yellow and red code holders must keep quarantine and register daily on an internet platform to provide information, until they obtain the green code.
For Domingos Alves, professor and researcher at the Laboratory of Health Intelligence (LIS) at the Ribeirão Preto Medical School (USP), who works with projections in the group of researchers Covid-19 Brazil, the first step in thinking about getting out of quarantine is to have reliable data on infected people, which is not the case today in Brazil. As long as data is not as complete as possible, it is necessary to maintain total social distance to avoid having a large contingent of the contaminated population while overburdening the health system. The uncertainties are great, starting with the fact that it is not yet clear how the immunity of people who have already had the disease and recovered will be. The only way to better calibrate the measures to be adopted will be to obtain more knowledge, starting with data on the behavior of the virus in tropical regions such as Brazil.
One of the important indications is that radical social detachment, if carried out only once and for a relatively short period, with people resuming their normal activities, may bring worse results later, because it would cause a large population of people susceptible to the virus to be infected, with no chance that some of them will develop defenses. Thus, when contact with the virus returns, the peak of cases may be more abrupt according to several experts in medical science. Intermittent social distancing strategies can be employed until 2022 if there are no antibiotics to cure patients and vaccines for immunizing the population to prevent the new Coronavirus from continuing to put health systems at risk around the world, indicates a study signed by researchers from Harvard University in the United States.
Intermittent strategies require knowing how immunity to the new Coronavirus (Sars-CoV-2) really works and understanding the impact of measures such as drugs and vaccines that, now, are unreliable despite many tests. It will be crucial to test more and more people to determine the presence of antibodies against the virus and to know how to calibrate the “open and close” of social distance based on the proportion of new cases and hospital and ICU beds in the population of each country, they highlight several infectologists. One fact that needs to be considered is that there is a tendency for the new Coronavirus, Sars-CoV-2, to circulate every year, or every biennium, like other coronaviruses that today cause various forms of cold worldwide, in general, with mild or moderate symptoms.
From the above, the Brazilian population will have to wait a long time in order for the social isolation to become more flexible with the adoption of the measures described above. It will be very risky to make social isolation more flexible without the Brazilian population being massively tested to obtain data on their infection status, antibiotics available to cure infected people and vaccines to immunize people from the disease. Until the emergence of antibiotics and vaccines, the relaxation of social isolation should only occur, intermittently, when the infected and non-infected people will be identified, freeing the latter to resume their activities and keeping the former isolated.
REFERENCE
UOL. Caminho do Brasil até fim da quarentena promete ser árduo. Available on the website <https://noticias.uol.com.br/ultimas-noticias/deutschewelle/2020/04/10/caminho-do-brasil-ate-fim-da-quarentena-promete-ser-arduo.htm>.
FOLHA DE S. PAULO. Distanciamento social intermitente pode ser necessário até 2022 se não houver vacina, diz estudo na Science. Available on the website <https://www1.folha.uol.com.br/equilibrioesaude/2020/04/distanciamento-social-intermitente-pode-ser-necessario-ate-2022-diz-estudo-na-science.shtml>.
* Fernando Alcoforado, 80, awarded the medal of Engineering Merit of the CONFEA / CREA System, member of the Bahia Academy of Education, engineer and doctor in Territorial Planning and Regional Development by the University of Barcelona, university professor and consultant in the areas of strategic planning, business planning, regional planning and planning of energy systems, is author of the books Globalização (Editora Nobel, São Paulo, 1997), De Collor a FHC- O Brasil e a Nova (Des)ordem Mundial (Editora Nobel, São Paulo, 1998), Um Projeto para o Brasil (Editora Nobel, São Paulo, 2000), Os condicionantes do desenvolvimento do Estado da Bahia (Tese de doutorado. Universidade de Barcelona,http://www.tesisenred.net/handle/10803/1944, 2003), Globalização e Desenvolvimento (Editora Nobel, São Paulo, 2006), Bahia- Desenvolvimento do Século XVI ao Século XX e Objetivos Estratégicos na Era Contemporânea (EGBA, Salvador, 2008), The Necessary Conditions of the Economic and Social Development- The Case of the State of Bahia (VDM Verlag Dr. Müller Aktiengesellschaft & Co. KG, Saarbrücken, Germany, 2010), Aquecimento Global e Catástrofe Planetária (Viena- Editora e Gráfica, Santa Cruz do Rio Pardo, São Paulo, 2010), Amazônia Sustentável- Para o progresso do Brasil e combate ao aquecimento global (Viena- Editora e Gráfica, Santa Cruz do Rio Pardo, São Paulo, 2011), Os Fatores Condicionantes do Desenvolvimento Econômico e Social (Editora CRV, Curitiba, 2012), Energia no Mundo e no Brasil- Energia e Mudança Climática Catastrófica no Século XXI (Editora CRV, Curitiba, 2015), As Grandes Revoluções Científicas, Econômicas e Sociais que Mudaram o Mundo (Editora CRV, Curitiba, 2016), A Invenção de um novo Brasil (Editora CRV, Curitiba, 2017), Esquerda x Direita e a sua convergência (Associação Baiana de Imprensa, Salvador, 2018, em co-autoria) and Como inventar o futuro para mudar o mundo (Editora CRV, Curitiba, 2019).
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