By PAULO CAPEL NARVAI*
Missive on the current (hybrid) vaccine war
Dear Dr. oswaldo,
Initially, I apologize for disturbing you in your eternal rest by disturbing the heavenly peace with matters of war. But I am sure that, as this is a good and urgent reason, you will understand. Ah, yes, I wanted to chat in real time using my Chinese cell phone, but the Angel at the gate of heaven said “no, no way, who-do-you-think-you-are?” and such and, I have to admit, that intimidated me and I gave up on the dialogue that would have been a great honor for me, of course.
I know, however, that you liked letters(1), so I hope you don't get bored with this one.
But, Dr. Oswaldo, the thing is, things have been really bad around here and, there's no way around it, we really need your advice.
A real vaccine war is underway... No, no, Dr. Oswaldo, it is not a “vaccine revolt”, it is a vaccine war [it is very interesting that the addressee can interrupt the letter writer in the heavenly epistles, and clarify doubts as they arise. I found that out now, in this paragraph]. No, Dr. Oswaldo, is not “another” vaccine revolt, although some admit it is(2), but it really is a political war. Such a post-modern war, without cannons, without barricades, without firearms. It is a little political war between the President of the Republic and governors and mayors of large cities. Today they call it “hybrid warfare”. War-what? Hybrid, Dr. Oswaldo, hybrid. Several tactics and means of aggression and defense, including 'lawfare' and actions on the internet to influence people, without a scenario of operations with well-defined contours. Barricade? No, no… In this case, no. But you can, yes, Dr. Oswaldo, because this “hybrid war” is a kind of military free-for-all.
doctor Oswaldo, I understand your interest in this type of war, but we are not going to disperse, as Tancredo Neves would say. Ah, did you speak with Tancredo the other day? Good guy, good guy... As for his grandson, Aécio, I won't even tell you.
But, Dr. Oswaldo, let's go back to what made me write this letter. Yes, I'm glad you're enjoying the conversation, but I don't want to take up any more of your precious time. Do you have all the time of eternity? True, Dr. Oswaldo, I was forgetting this detail. But, let's get back to the pandemic.
Internet? For me to talk more about war on the internet? Good, Dr. Oswaldo, this is very complicated. Shall we leave it for another letter?
Who is the president? No, he is not related to Rodrigues Alves, no. The Director of Public Health? Good, Dr. Oswaldo, today is the Minister of Health. Did you hear? Yes, it is true that at the height of the COVID-19 pandemic, Brazil did not have a director of public health for four months… that is, without a minister of health. If I can explain this? That four months is a long time? I can't, Dr. Oswaldo, it doesn't work quickly. I would have to tell about many things.
Imagine, Dr. Oswaldo, that the current president is against vaccines! Yeah, more than... I know, I know... Yes, it's more than 100 years after the "vaccine revolt". It's just that Jair Messias is not easy, Dr. Oswaldo, he threatens democratic institutions every day and considers himself a defender of freedom. Behold the lord... Defender of liberty! It would be good if he could hear some advice from President Rodrigues Alves. Mainly about science, scientists, about doing things based on scientific knowledge and leaving faith for faith. I know, I know, they are people of faith… Yes, I respect Dr. Oswaldo, I respect him, yes, but he believes that the pandemic can be faced with prayers and fasting... And he thinks that, because he is President of the Republic, he has to prescribe medication for the population. And people dying, dying; by the thousands. Is he doing something? The other day he was asked about the dead and he replied: “So what? I'm not a gravedigger." It hurt, see Dr. Oswaldo, it hurt to see a President of the Republic not having a word of consolation for friends and family of the dead and shrugging when asked what he could do.
Yes, there are thousands, Dr. Oswaldo. No more than 30 deaths like in 1904. There are more than 5 million cases and more than 160 deaths. You are right, we still know little about COVID-19. It is true that there are more doubts about how to deal with it than you had with smallpox. It's true, Brazil today has 212 million inhabitants. It's not even possible to compare. They are very different diseases and epidemics. Look, Dr. Oswaldo, with about 3% of the world's population, Brazil records approximately 15% of cases and 14% of deaths from COVID -19 worldwide. COVID-19… Sorry, Dr. Oswaldo, I didn't know that you were attentive, following everything, in the world and here in Brazil. Well, anyway, there are things that I still need to tell you, because I know that you are being informed by the media and, you know, these people are very similar to those angels that São Pedro leaves there at the door of heaven. They are very “white plate”, aren't they? They love sucking up to the powerful and don't tell everything they know.
That's right, Dr. Oswaldo, I am referring to the military who are in charge of the SUS, without having prepared themselves for the exercise of their duties. Ah yes, the SUS, Dr. Oswaldo is a syst… Do I need to explain? That's right, Dr. Oswaldo? Wow, it's good to know that you've been talking a lot there in heaven with Sérgio Arouca, Davi Capistrano, Eleutério Rodriguez and those health reform people. And with the girls too? Well, I thought so… I wasn't really going to hang around with just the boys, was I? Did you speak the other day with Cecília Donnangelo and Regina Marsiglia? doctor Oswaldo, you are really privileged. Imagine that, around here, there were people who celebrated when they saw Mandetta with the SUS vest. Don't remember who Mandetta is? It is that former Minister of Health who was against 'More Doctors', who said that there was no lack of resources for the SUS, that it was enough to improve management. Yes, that, the one who voted in favor of removing Dilma from the presidency. That, himself! Many say he is a "scam". By the way, Dr. Oswaldo, there are a lot of people around here who directly participated in that attack on democracy, or who supported it, that today you can't even hear the word “coupist”. Prefer to talk aboutimpeachment”, as they do not like to be seen in the shoes of scammers. They feel Democrats. Don't laugh, Dr. Oswaldo.
Yes, yes, let's get down to business. Sorry about that, Dr. Oswaldo, is that this dialogue with his insightful interventions makes me feel almost like an Asclepius in prose with Apollo, for some privileged access to Mount Olympus.
The case, Dr. Oswaldo, is that after recommending prayers, chloroquine, hydroxycloquine, ivermectin, anal application of ozone, nitazoxanide, people are doubting the effectiveness of anti-COVID-19 vaccines. Others then don't even care if vaccines work or not, they just don't care about any vaccine. Not just this possible anti-COVID-19 vaccine, but any vaccine. I tell you that in recent decades Brazil has consolidated our National Immunization Program (PNI) and the degree of vaccination coverage in general has improved a lot, surpassing that of the United States and many countries in western Europe. That, Dr. Oswaldo, SUS offers all vaccines recommended by the World Health Organization (WHO). Every year, more than 300 million doses of vaccines are applied, immunizing against more than two dozen diseases, in different age groups. The PNI is a national source of pride and is among the best in the world. As? Well, this is a long story, which has to do with the history of the SUS and the way in which our country developed primary care. But nothing has been easy lately. Yes, the NBP is in trouble. There has been a lack of vaccine in the Basic Health Units, people go, are not seen and have to come back a few days later, but they end up not coming back. Coverage against the main childhood diseases is decreasing a lot, Dr. Oswaldo. Everyone in the SUS and in the specialist entities is very concerned about this(3). But the President of the Republic says that “no one is obliged to be vaccinated”. He refers to anti-COVID-19, but people think that if it doesn't work for one thing, it doesn't work for another, right?
It's like that old liberal Dr. Rui Barbosa, you know?
Calm down, Dr. Oswaldo, calm down. Remember that you have a good heart, but your kidneys were never that good. I know that just hearing the name of Rui Barbosa makes your heart race even though you don't need him anymore, but I say that I am mentioning Dr. Rui because this letter will be published on the website the earth is round… As? That: the earth is round. Don't laugh, Dr. Oswaldo. Yes, there are many people, and not only in Brazil, who firmly believe that the earth is not round… What a good laugh, Dr. Oswald! Good to know that in heaven you can also keep a good mood. Well, Dr. Oswaldo, we had to create a website called the earth is round, imagine!… A website is a space… Oops, sorry again. It's just that from 1917 to 2020 is a long time and I'm tempted to explain these terms. It's… it's good. When you want, ask. Combined.
Well, I was talking about Dr. Rui Barbosa, and recalled that he assured that “the mandatory vaccine law is a dead law. Just as the law prohibits human power from invading our conscience, so it prohibits it from penetrating our epidermis”. He said – recalls Dr. Oswaldo? – that “has no name, in the category of crimes of power, the temerity, the violence, the tyranny to which he ventures, exposing himself, voluntarily, obstinately, to poison me, by introducing a virus into my blood whose influence there are the most well-founded fears that it is the conductor of illness and death.”(4)
You say he was wrong, but was he a cultured man, a patriotic Brazilian? Yes, Dr. Oswaldo, but I tell you that I remembered him because the current president is a fool, a guy who thinks he is a patriot, but who is handing over all of the Brazilians' assets to foreign companies. Did you already know that? Ah, Monteiro Lobato already told Petrobras about oil? Did Getúlio and João Goulart say that Eletrobrás was privatized? Yeah, what a difference isn't Dr. Oswaldo, what a difference! Well that Dr. Rui Barbosa could give a few lessons here to the Esplanada people, at one of those ministerial meetings. No-way-would he be up for it? Well, it makes sense. It is understandable that he was horrified by that video in which a minister said that he had put a grenade in the pocket of the enemy – which in this case were public servants – while the other said that he would use the fear caused by the pandemic to change protection rules environment and authorize deforestation, paving the way for logging and mining companies in preservation areas. He's right not to mix with those types. Another good guy is Rui Barbosa.
Of course, of course, Dr. Oswaldo, let's get down to business. Sorry for my digressions.
Well, I write asking for your advice because we have the possibility of having an anti-COVID-19 vaccine(5), but the president doesn't want her, because she's Chinese. “Communist”, as he has been saying. He doesn't like and doesn't want anything created, planned, organized, produced by communists. What to do Dr. Oswaldo?
I understand. I see… Yes, I understand. It's okay, Dr. Oswaldo. So, I'm going to say this here to the people. Yes, you can, Dr. Oswaldo, I'll be careful. Yes, I will say that, therefore, coherently, the president should immediately leave the Alvorada Palace and any other place in Brasilia. I will say that since Brasília was created by a communist (Oscar Niemeyer) and a humanist (Lúcio Costa), the city is, like the Chinese “communist” vaccine, incompatible with the current president. Okay, I will say that he may not know (he probably doesn't know, Dr. Oswaldo, the guy is pretty pissed off), but he's living in a house – a palace, in this case, the Alvorada – that was created by Niemeyer, a notorious communist, the very red ones. Let him, therefore, leave as soon as possible. I'll say, leave it.
I send my cordial regards, Dr. Oswaldo, wishing you well out there and promising that, around here, we will continue to fight for vaccines, for the right to health and for SUS.
*Paulo Capel Narvai is senior professor of Public Health at USP.
PS: Gosh, Dr. Oswaldo, I almost forgot to tell. The 'Instituto Soroterápico Federal', which you created in 1900, was renamed Instituto Oswaldo Cruz in 1918, a year after your departure. In 1970 it was transformed into a Foundation and in 1974 it was renamed Fundação Oswaldo Cruz (Fiocruz). Today Fiocruz is another national source of pride, Dr. Oswaldo, with 21 units in Brazil (11 in Rio de Janeiro and 10 in other states, in all Brazilian regions) and a unit in Maputo, Mozambique, is among the world's leading public health research institutions.
References
- Letters reveal Oswaldo Cruz's intimacy on display at the Post Office. By Ferreira R. O Globo. Apr 9, 2019. Available at: https://tinyurl.com/y2ssljrb
- Kotscho R. Against Doria and China, does Bolsonaro want to re-enact the “Vaccine Revolt”? UOL. 20 Oct 2020. Available at: https://tinyurl.com/y4lxfznn
- For the first time in the century, Brazil does not reach the target for any of the main childhood vaccines. By Natalia Cancian. Folha de S.Paulo. 7 Sep 2020. Available at: https://tinyurl.com/y27hb2zf
- Sevcenko N. The Vaccine Revolt: Insane minds in rebellious bodies. Sao Paulo: Scipione; 1993.
- Vaccines against Covid-19: Positioning of Abrasco. 20 Oct 2020. Available at: https://tinyurl.com/y32t6kvd