Fernando Alcoforado*
This article aims to present what and how to do to reduce and halt the advance of the new Coronavirus in Brazil, which accounted for 10,627 deaths with 155,939 confirmed cases until 05/10/2020 and 730 deaths in the last 24 hours. It is demonstrated by these figures that the policies adopted so far by the federal, state and municipal governments of Brazil are insufficient to contain the progress of the new Coronavirus and that more effective measures urgently need to be put in place to reduce the number of contaminated and killed by the viruses without which more than 1 million deaths from the new Coronavirus in Brazil may occur.
Imperial College London report about the new New Coronavirus in Brazil, prepared by Thomas A Mellan, Henrique H Hoeltgebaum, Swapnil Mishra et al., Is entitled “Report 21: Estimating covid-19 cases and reproduction number in Brazil”. In this report, there is information that Brazil is an epicenter of the covid-19 in Latin America where the most affected states correspond to São Paulo, Rio de Janeiro, Ceará, Pernambuco and Amazonas, which account for 81% of the deaths reported until now. In Brazil, the number of infections continues to grow with the record of almost twice as many deaths by covid-19 as in China and more than 100,000 confirmed cases.
This report predicts that, in the worst case scenario, if no one is quarantined and the tests are not multiplied, there would be up to 188 million people infected (the equivalent of 88% of the entire Brazilian population) and 1.1 million people killed. More than 6.2 million people would pass through hospitals in the country because of the coronavirus collapsing the health system. In a quarantine scenario only for the elderly, the number of deaths would vary between 322 thousand and 530 thousand, depending on the transmission rate and public health measures. In the best scenario calculated with 75% of the entire population in quarantine, with tests for all suspected patients, the number of deaths from covid-19 in the country would not exceed 44,300. In these conditions, at the peak of the pandemic, there would be a demand for 72 thousand beds at the same time. Therefore, with the best quarantine scenario for 75% of the entire population, it can save up to 1 million people in Brazil, calculates Imperial College.
In this report from Imperial College there is information that the interventions employed in Brazil to combat covid-19 so far are insufficient because they fall short of the generalized and mandatory blockages implemented in parts of Asia and Europe that have proven to be highly effective in containing the spread of the virus. It also informs that the results of the study on Brazil show that until now the changes in mobility adopted have not been rigorous enough. The epidemic is expected to continue to grow throughout Brazil and to increase the associated number of cases and deaths, unless other more vigorous actions are taken. There is a suggestion of the need to break the chain of transmission of the virus as essential to control it and prevent its exponential growth. The study concludes that “the rapid adoption of proven public health measures, including testing, case isolation and greater social distancing” are essential to contain the impact of the pandemic. This is what would “flatten” the contaminated curve, which would reduce the burden on hospitals and consequently reduce the proportion of deaths per week – one of the variables calculated by Imperial College.
After breaking the record for the daily increase in deaths (610 new deaths) and cases of the new Coronavirus (9,888 cases of the disease) this week, Brazil has 9,146 deaths and 135,106 infected by covid-19. Faced with this situation, lockdown, that is, confinement or total closure as the most radical method imposed by governments for people to fulfill the period of social distancing, begins to spread throughout the country, reaching 18 cities in five states. First state in the Southeast to enact the strictest isolation regime, Rio de Janeiro announced yesterday the measure in Niterói and Bangu. Salvador decreed the lockdown in some neighborhoods of the city. Most states that have already decreed lockdown are on the list of 12 federal units that exceed 100 deaths from the disease. The group includes São Paulo (3,206), Rio de Janeiro (1,394), Ceará (903), Pernambuco (845), Amazonas (806), Pará (410), Maranhão (305), Bahia (165), Espírito Santo ( 155), Minas Gerais (106), Paraná (104) and Paraíba (101). Together, these states account for 8,500 deaths, that is, 92% of deaths in Brazil.
Considering the reports from Imperial College, which states that the actions taken to date in Brazil were not rigorous enough to contain the spread of the new New Coronavirus, there is no other solution to prevent the spread of the virus that could catastrophically affect the entire population with its deadly effects with over 1 million deaths except by breaking its transmission chain. This disruption of the virus transmission chain would have to be radical like the one adopted by China, which, by adopting the lockdown with the isolation of Wuhan (epicenter of the virus) from the rest of the country, was successful in controlling the spread of the new Coronavirus by the rest of the country. In Brazil, there is no other way but to adopt the lockdown of the cities and regions most affected for an indefinite period. In each city and region most affected by the new Coronavirus and isolated from the rest of the state and country, mass tests should be adopted along the same lines as those adopted in China to identify who should be quarantined and who should be released for social coexistence. There should be strict control on the movement of people at the entrance and exit of cities and regions in lockdown, with tests to verify whether or not they are contaminated by the new Coronavirus. This would be one of the measures to prevent the collapse of economic activities by eliminating the conflict between the need to prevent the spread of the virus with the collapse of the health system and the resumption of economic activity.
Lockdown cities and regions should only be released gradually in the same way as in China with the population wearing a facemask, being subjected to constant temperature measurements, in addition to being controlled by means of a QR code (Quick Response code) of health that works 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.
In addition to these measures that must be adopted by states and municipalities, income should be distributed by the federal government to the populations, especially the vulnerable ones, to avoid that, due to the need for survival, they are forced to leave their homes to work in offices or in streets. In other words, the federal government should pay people not to take to the streets to avoid contaminating or being contaminated by the virus. Measures should also be adopted by the federal government to help companies, especially micro, small and medium-sized companies, to survive at this time of falling revenues, as well as states and municipalities to avoid their insolvency due to the drop in tax collection. Only the federal government has the capacity to implement these measures.
For these measures to be successful and result in the successful fight against the new Coronavirus in Brazil, coordinating action by the federal government is urgent. The indispensable condition for Brazil to win the war against the new Coronavirus is the government at all levels and the population being united against the common enemy. Unfortunately, in Brazil, this situation does not exist because the President of the Republic Jair Bolsonaro is against the social isolation of the population, systematically disrespecting all restrictive measures to the gathering of people under the pretext that it is also necessary to save the Brazilian economy from debacle. In his compromising action in the fight against the new Coronavirus, Bolsonaro says that people should go back to work. The fact that Bolsonaro takes this attitude is encouraging a large number of people to leave the isolation in which they find themselves and return to the street as is already happening in several cities in Brazil, contributing to the increase in the number of contaminated and killed by the new Coronavirus. The end of the social isolation of many people is also related to the fact that they need to work to survive, given that the Bolsonaro government does not offer people and companies the conditions necessary for their survival.
In addition to acting to destroy the effort of governors and mayors to fight the new Coronavirus, the Bolsonaro government does not act with the necessary urgency in the economic plan with the release of the financial resources it has approved by the National Congress to help vulnerable populations to fight hunger, companies in general to avoid bankruptcy and states and municipal governments to avoid their insolvency. This is one more reason why Jair Bolsonaro’s removal from the Presidency of the Republic is necessary with his replacement by Vice President Hamilton Mourão who, in addition to being more qualified to play the role of general commander in the fight against the new Coronavirus for being general Army, would be better able to unite the nation against the common enemy. The political leaders of all parties need to act as soon as possible to remove Bolsonaro from power to avoid the catastrophe that is envisaged with the dizzying advance of the number of contaminated and killed by the new Coronavirus in Brazil.
In the article “How and when will this pandemic end?, Published on the website <https://www.weforum.org/agenda/2020/04/how-and-when-will-this-pandemic-end-we-asked-a-virologist/>, Belgian virologist Guido Vanham, former head of virology at the Antwerp Institute of Tropical Medicine in Belgium, replied that it will probably never end, in the sense that this virus is clearly here to stay, unless we eradicate it . In addition, the only way to eradicate this virus would be with a very effective vaccine that be delivered to every human being. We did this with smallpox, but that is the only example – and it took many years. Therefore, it will probably stay. It belongs to a family of viruses that we know – the coronaviruses – and one of the questions now is whether it will behave like other viruses.
Therefore, the vaccine is the only weapon we have to use to eradicate the new Coranavirus. Throughout history, vaccines have helped to significantly reduce the incidence of flu, chicken pox or chickenpox, mumps, dengue, yellow fever, hepatitis, rubella, measles, smallpox, herpes simplex, rabies, polio, measles and tetanus. Today, vaccines are considered the most cost-effective treatment in public health. The reality now is that the world needs a vaccine against the new Coronavirus that causes covid-19. It will probably not be ready in the next few months. Maybe this will only happen in 12 or 18 months. More than 90 vaccines are being developed against covid-19 by research teams at companies and universities around the world. The researchers are testing different technologies, some of which have never been used in a licensed vaccine before. At least six groups have already started to inject formulations into volunteers in safety tests; others started testing on animals.
It is through the vaccine that what is called “herd immunity” is rationally obtained, ie the immunization of the virus of the entire population. The other way to obtain “herd immunity” is to allow the entire population to be infected by the virus. This was the idea developed by Donald Trump, President of the United States, and Boris Johnson, British Prime Minister, who considered only crossing their arms while the population of their respective countries was infected with the new Coronavirus. This idea, put into practice initially and abandoned later, was based on the premise that only the most vulnerable should be protected. This was the proposal defended by Bolsonaro to be applied in Brazil.
The idea was to create what they understood to be “herd immunity”, that is, the greater the number of infected with covid-19, the more people would become resistant to the virus due to the acquired immune memory. Thus, there would come a time when the pathogen would stop spreading due to the lack of susceptible hosts. The problem with this reasoning is that the new Coronavirus is a new infectious agent and it is not known how many people it is able to infect and kill if no action is taken. If too many people are allowed to become infected in a short period, health systems will not be able to handle the cases that will get worse. In addition, herd immunity is only performed in a rational manner, obtaining excellent results when it is done in a controlled manner, using vaccines.
From the above, it can be said that without the total isolation or lockdown of cities and regions affected by the new Coronavirus, without the effective help of the federal government to populations, especially the most vulnerable, to companies, especially micro, small and medium companies, and to states and municipalities and without the coordinating action of the federal government to combat the common enemy, there will be no success in the war against the virus. Without the adoption of these measures, Brazil will be subjected to the greatest humanitarian disaster in its history. In addition, these measures are essential because in the absence of a vaccine that will immunize the population against the new Coronavirus, the humanitarian disaster that is envisaged will turn into the collective murder of the Brazilian population whose biggest responsibility will be the Bolsonaro government if nothing is done to avoid it. To avoid the foreseeable humanitarian disaster that is envisaged in Brazil, it is necessary to remove Jair Bolsonaro from the Presidency of the Republic with his replacement by Vice President Hamilton Mourão who, in addition to being more qualified to play the role of general commander in the fight against new Coronavirus because he is an army general, he would be better able to unite the nation against the common enemy.
REFERENCE
CANN, A. J. Principles of Molecular Virology. 4. ed. Massachusetts: Elsevier Academic Press, 2005.
CARTER, J.; SAUNDERS, V. Virology: Principles and Applications. Chichester: Wiley, 2007.
MAHY, B. W. J. Dictionary of Virology. 3. ed. London: Academic Press, 2001.
IMPERIAL COLLEGE. Report 21: Estimating COVID-19 cases and reproduction number in Brazil. Disponível no website <https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-05-08-COVID19-Report-21.pdf>.
PASTERNAK, Natalia e ALMEIDA, Luiz Gustavo de.Coronavírus: quase todo mundo tem que pegar para a pandemia passar? Disponível no website <https://saude.abril.com.br/blog/cientistas-explicam/coronavirus-quase-todo-mundo-tem-que-pegar-para-a-pandemia-passar/>.
PIFFERO, Luiza. Em busca da “imunização de rebanho”: o contra-ataque da ciência diante do coronavírus. Disponível no website < https://gauchazh.clicrbs.com.br/saude/noticia/2020/04/em-busca-da-imunizacao-de-rebanho-o-contra-ataque-da-ciencia-diante-do-coronavirus-ck8u9z90e01pv01qw6vod7kx9.html>.
RIBEIRO, Krukemberghe Divino Kirk da Fonseca. Vírus. Brasil Escola. Disponível no website <https://brasilescola.uol.com.br/biologia/virus.htm>.
* 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).
Site Title 