Dialectic of construction and ruin



The season is open for the most promising answers regarding the solutions for our… new construction, new ruin, trans and post-pandemic…or will we have to face the abyss: “better than taking anxiolytics, is reading Nietzsche”

“Here everything seems
that was still under construction
And it's already ruined
(Out of order, Caetano Veloso)

From Oswaldo to Pazuello

The study of the Brazilian saga, dealing with some of its epidemics, helps to understand a little of our singularities and historical dilemmas. From them, one can also see our sociopolitical displacements, or our Nietzschean fascination to confront the abyss – the construction and ruin of our projects for society.

As an approximation to cinematographic language, with flashbacks in our timeline, we will use temporal cuts that move forward and backward. We begin with an anecdote, as a pretext for historical context. It composes the first scenario (C1), more exactly in the history block between 1900-1905.

(C1) The anecdote summarizes some of the health scourges in Brazil at the dawn of the XNUMXth century. pari passu, major economic losses were recorded, affecting foreign trade – since then and always based on the agro-export sector –, but also the nascent industry(1):

“The three great evils, smallpox, bubonic plague and yellow fever, exchange impressions on the campaigns that Oswaldo Cruz moves against them:
YELLOW – But… Oswaldo is a talent. He discovered that the mosquito is my servant and does nothing but kill mosquitoes – he is a bailiff!
BUBONIC – Which; does something better: catches mice with the trumpet and box. It's a cat!
SMALLPOX – Because with my appearance, not wanting to blame flies and cockroaches, he started to kill the poor children with poisoned irons, that obligatory vaccine. It's a peacock!"

Since we want to develop a second scenario (C2), which will deal with the 1918 flu, we will do that later on. For now, a third scenario (C3) immediately imposes itself, which takes us directly to the 2020st century and, more specifically, to the 115 situation. under XNUMX years old: Oswaldo Cruz and Eduardo Pazuello.

(C3) Let's now visualize the picture of Brazil in 2020, in full force of the Covid-19 pandemic (C3). What would the anecdote be? And here, certainly, anecdote does not acquire the common connotation of meaning a joke, as there is nothing that stimulates laughter, quite the contrary. Perhaps, someday it will take some form like this:

COVID-19 – And the Minister of Health, huh? What a sledgehammer! But who is it? Mandetta, Teich, Pazuello..., Health in Brazil seems to have become a place with a European surname, but no man's land! I don't care, I'm only looking for a single species: the human! And Minister for me also became a bailiff, I mean, an official of (in) justice carrying out crazy orders without adherence to the principles of the SUS or identity with the Brazilian people!

Of the great health scourges of the early XNUMXth century, Brazil eradicated smallpox – being the last country in the Americas (2). The last 19 cases took place in Rio de Janeiro, in Vila Cruzeiro, Penha neighborhood, in April 1971. As for the bubonic plague, the last record in Brazil is from 2005, when there was a single case in the municipality of Pedra Branca, in the region mountain range of Ceará. Unfortunately, yellow fever in the 2017/2018 period re-emerged in one of the most tragic events in Brazilian health history. The spread of the virus reached the east coast of Brazil, in the region of the Atlantic Forest biome, which is home to a wide diversity of non-human primates, potential wild vectors and where the virus had not been recorded for decades.(3).

As if our health, epidemiological and humanitarian challenges were not enough, carried as a tragic legacy from the past and from our history of mistakes and repetitions of mistakes, we are now once again challenged in a very complex context. The Platonic polyhedron of complexities includes faces, vertices and edges of a socio-environmental, political, economic and cultural reality, of extreme volatility and pregnant with mutable configurations, threats, but also convergences(4):

“[…] judicial activism, biopolitics, post-pandemic scenarios, corruption and patrimonialism, criminalization of politics, democracy, human rights, EaD and attacks on education, incarceration and repressive system, fascism and neo-fascism, home office, necrocapitalism, neoliberalism, population LGBTI, right-wing populism, precariousness of work and social rights, racism, solidarity networks, relations between powers, political use of the pandemic on the global stage and gender violence…”.

Having said the above, just to stay in a discreet circumscription, the question that assails everyone remains: “which country will be left after the crisis?”

(C1) In 1897, having graduated in medicine five years earlier, in Rio de Janeiro, Oswaldo Cruz traveled to Paris, where he stayed for two years studying microbiology, serum therapy and immunology at the Pasteur Institute, and legal medicine at the Institute of Toxicology(5). Back in Rio, in 1902-1903, he took over the direction of the Instituto Soroterápico Federal and the General Directorate of Public Health (DGSP). He undertook a health campaign to combat the main diseases in the federal capital, adopting methods such as isolating patients, compulsory notification of positive cases, capturing vectors – mosquitoes and rats –, and disinfecting homes in outbreak areas. He launched sanitation campaigns, and within a few months the incidence of bubonic plague had declined. While fighting yellow fever he faced several problems. A large part of doctors and the population believed that the disease was transmitted through contact with the clothes, sweat, blood and secretions of patients, while he proposed a new theory: the transmitter of yellow fever was a mosquito. His actions provoked a violent public reaction.

(C2) Our history with epidemics suggests a strong governmental and popular passion in favor of controversy, the exalted emotion, because we like discussion – especially, when it comes to discussion about other people's lives. For example, about the 1918 flu in Brazil, it already arrives under the accusation of being guilty “… of German enemies for the creation of the disease, spread throughout the world through their submarines”, as recorded in a humor article, but which reflected society's reactions to the new disease(6). There would be another controversy, this one international, since the flu was not in fact “Spanish” but of American origin, from Kansas, in the USA.

Yet another controversy: the thesis raised by Ruy Castro that Rodrigues Alves (1848-1919), elected president, could not assume the presidency for the second time, in 1918 – for other reasons, but not for having died as a result of the so-called flu. . Records of Afonso Arinos (father) contest Ruy's vision: “The death certificate was signed by Professor Raul Leitão da Cunha, giving leukemia as causa mortis (acute asystole in the course of pernicious anemia). In fact, the death came from the flu.” Arinos, being a discerning biographer, was also married to the president's granddaughter. This confirms the family's conviction that his death came from the flu, for someone who already had poor health.(7).

Journalist Alex Solnik, like Daniel Defoe (in “A Diary of the Year of the Plague”, about the bubonic plague epidemic in London in 1665) did an exquisite job of rescuing the journalistic narrative of the 1918 flu, consulting the diary "The Night"(8). This one, it seems, offered extensive coverage of that pandemic, which was called by the press the “Spanish flu”, “Peste de Dakar” or “Mal de Seidl” (referring to Carlos Pinto Seidl who – lo and behold!? – in amid the pandemic, initially caused controversy by minimizing the crisis and then resigned from the General Directorate of Public Health, a position equivalent to that of Minister, there being no Ministry of Health at that time).

It is curious to note that the first cases of the flu in Brazil hit the military in full. On October 8, 1918, the main report is called “The epidemic in Vila Militar”: “There are 249 sick people”; “[…] a hundred and so many people with the flu at the Army Hospital”.

The next day, “Almost all corps in the 3rd region are under attack. There are people with the flu in all the bodies of the Army's third division. 392 are in the hospital.” However, the strange conclusion makes us suspect that then and now, the news can be manufactured: “The epidemic has a benign character” [sic].

And then, on the 13th of October: “Student of the Colégio Militar, Mauro Soares, dies at the age of 13”. And, just two days later, the headline that transforms the “benign character epidemic” suddenly converted into: “Evil”. “[…] The appearance of the city is desolate. Closing establishments. Schools, theaters, cinemas, factories. The streets have much less movement. The number of 'Spanish people' is always increasing”. “The fatal cases are also increasing and some of them are going fast…”.

On the 18rd of October “[…] what you see is a passer-by sucking his little bottle of salt…”. Good thing it still isn't a little bottle with "tonic water - drink it because it contains quinine!" (referring to videos from the fake news blogosphere), or self-medication with (hydroxy) chloroquine!

And on the 21st of October, “[…] it is waited with a 'Fakirian' passivity that the fever, when it has no one else to attack or kill, will spontaneously withdraw”. The “livestock language” of herd immunity had not yet been adopted, as it is ostensibly or covertly adopted now, in presidential exhortations for the population to leave isolation and return to “normal” activities… with their indifferent naturalization: “some will to die! ”

There, in 1918, the flu was also designated as a generational disease, a disease of the “young people”, because “[…] Rodrigues Alves and Rui Barbosa recovered quickly. It is a disease that attacks and kills people under 40 years of age”.

Well, with the following news, on October 22 and at the height of morbidity and mortality, we are closing the scene that interests us in the temporal/pandemic analogies that are being drawn: “The population only trusts in the goodness of Divine Providence”. Yes, religious people at that time also put their faith in divine providence, but there is no news of a pastor selling anointed wine, an invisible mask or a miracle bean... Chagas assumes Public Health).

(C1) Newspapers, Congress and a League against compulsory vaccination, sparked violent reactions that emerged in November 1904, with a popular rebellion added, on the 14th of that month, by the uprising of the Military School of Praia Vermelha, under the conspiratorial leadership of Florianist militaries, positivists. Ah, the military that made the first Republic, the Old Republic… How many Republics will we still have, with what plots?

Therefore, between November 10 and 16, 1904, opposition to Oswaldo Cruz reached its peak. With the resurgence of smallpox outbreaks, sanitarians tried to promote mass vaccination of the population. The vaccine revolt breaks out. A balance of 30 dead. From smallpox? No. Of riot? Of insurrection against repression? Opinion manipulation?

(C2) On January 16, 1919, the fateful news for the time: “The end of a great existence”. Rodrigues Alves dies at the age of 70. From the flu?

(C3) Thousands die in 2020. From Covid-19 (underreported)? From “other causes”?

– Create your own narrative. Today there are groups defending that everything is allowed, including historical revisionism! If you want and have talent, you can also write a book, as Boccaccio did. At the Decameron, the Italian author tells the story of ten people who amuse themselves with stories while isolating themselves from the plague (Black Death), describing how the epidemic attacked the city of Florence in 1348, and how people reacted (rich people taking refuge in rural properties and poor dying in the city). For revisionists, it is good to remember that the outbreak would completely alter the European social structure, as well as the belief systems of many of those who survived.(9). It is also good to remember that no one is immune (not even revisionists/denialists), as even the Italian national poet Giacomo Leopardi died during the cholera epidemic of 1837, and his remains were not interred in a mass grave (as the strict regulations of hygiene of the time required), through the intervention of a dear friend, who recovered his body from a cart of dead people, so that today a national monument can be erected.

(C1) The Government defeated the rebellion. In 1908, in a new smallpox epidemic, the population itself sought vaccination posts. Oswaldo Cruz does History!

(C3) And here we are, again, with great social turmoil in a nation that has already been polarized in recent years, and now with the evident politicization of the virus, Covid-19 and its controversial (possible) treatments. We are, in the midst of the pandemic crisis, certainly the only country in the world that has chained a succession of three ministers of health, in the short span of one month. We came out, way back, from an honorable tradition of a sanitarian like Oswaldo Cruz – patron of our “house of health”, the Oswaldo Cruz Foundation, which celebrated 120 years of dignified history, but so attacked by science “denialists” that proliferate in our country. means – for the confirmation of the military interim Eduardo Pazuello in the Ministry of Health. Today, the Ministry is very similar to a Logistics Battalion. Will make story?

I can not breath…

The population of Minneapolis, Minnesota, triggered yet another protest, among so many over the decades: now, against the murder of George Floyd, a black man asphyxiated by a white policeman. Demonstrations spread across major US cities, from coast to coast.

The phrase, almost a breathless breath in the throes of death, is already iconic: "I can not breath! ”

Millions know this phrase around the world, and have been using it for a long time for different reasons. It's good to remember, as does Castiel(10), who

“[…] before COVID-19, neoliberalism was already constituted with its own epidemic caused by the virus of precariousness. A social evil that admitted, long before the declaration of a state of alarm, its own emergency regime for certain groups considered socially surplus or marginalized. Unprotected groups made up of the poor, unemployed, migrants, domestic workers, single-country families, refugees, undocumented people…”

One of the most constant reasons for the serious dyspneic crisis, which shortens the already quite toxic air for the democratic field, is to verify the inexorable advance (but that can be contained in time, I hope!) of a new thought of the extreme right, resentful, revisionist, vindictive, petulant.

In another "Diary of the Plague Year" (not Defoe's), Dunker teaches us(11):

“We know three basic reactions to the violation of expectations: denial, cognitive dissonance and projection. By denial we move away from reality, reducing the conflict between it and our opinions. By adjusting cognitive dissonance we alter our desires, our thoughts, and the value of our perceptions to deflate conflict, for example: “It's not that the grapes are out of reach, it's that they're sour. Deep down, I didn't even want to eat them." The third strategy consists of believing that the cause of the contradiction is neither in reality nor in what we think about it, but in the manipulation that the other continues to practice to deceive us, which is why we need to continue acting to prevent and eradicate the cause of evil, regardless of reasons and facts, which are just part of the counter-advertisement.”

We have seen, in the dystopian Brazil of 2020, the three reactions profusely: denial, cognitive dissonance and projection. In all of this, of course, there is much of the “reactive”, but also much of the “deliberative”(12). As Giuliano da Empoli observes “[…] behind the extreme appearances of the populist Carnival, hides the fierce work of dozens of spin doctors”, ideologues and, increasingly, scientists specializing in big data, algorithms, machine learning, without which the leaders of far-right neo-populism would never have come to power. Empoli adds:

“The Chaos Engineers' algorithm forces them to hold no matter what position, reasonable or absurd, realistic or intergalactic, as long as it intercepts the aspirations and fears—mostly the fears—of voters [...] new wave of post-ideological techno-populism, founded not on ideas but on algorithms made available by the engineers of chaos”.

And it is urgently necessary to understand and delimit the borders of this new “terra incognita” in which our democracies have begun to sink. In the Brazilian case, our democracy emerges and submerges with the same voracity, from the Old Republic of Oswaldo Cruz to the post-New Republic of General Pazuello.

We finish with Eliane Brum, with her book whose title is similar to our sketch(13):

“Brazil, eternal country of the future, at the end of the first decade of the 21st century believed that it had finally arrived at the present. And then he found himself mired in the past. At that moment, however, I didn't know how much of the past was involved. Now you begin to understand. What does the country of the future do when it realizes that the future is a huge past? ”

The season is open for the most promising answers regarding the solutions for our… new construction, new ruin, trans and post-pandemic…or will we have to confront the abyss: “better than taking anxiolytics, is reading Nietzsche”.

*Samuel Jorge Moyses is professor of epidemiology and public health at PUC-PR and UFPR.

*Marco Akerman is a full professor at the Faculty of Public Health at USP.


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  2. Muniz ES. Memoirs of smallpox eradication. Science & Collective Health. 2011;16(2):699-701.
  3. Ministry of Health. Yellow fever: symptoms, treatment, diagnosis and prevention. Journal [serial on the Internet]. 2020. Date of access: May 30, 2020. Available at: https://saude.gov.br/saude-de-az/febre-amarela-sintomas-transmissao-e-prevencao.
  4. Augusto CB, Santos RD, editors. Pandemics and pandemonium in Brazil (e-book). São Paulo: Tirant lo Blanch; 2020.
  5. Cross FO. The trajectory of the physician dedicated to science. Journal [serial on the Internet]. (Text adapted from issue nº 37 of Revista de Manguinhos, 2017). Access date: May 31, 2020. Available at: https://portal.fiocruz.br/trajetoria-do-medico-dedicado-ciencia.
  6. Cariello R. Enigma of pandemics. Piauí Magazine. 2020 may 2020.
  7. America Journals Group. Still the death of Rodrigues Alves. Journal [serial on the Internet]. 2020. Access date: May 29, 2020. Available at: http://gda.com/detalle-de-la-noticia/?article=4125826.
  8. Solnik A. Rodrigues Alves did not die of the Spanish flu. Journal [serial on the Internet]. 2020. Access date: May 30, 2020. Available at: https://www.brasil247.com/blog/rodrigues-alves-nao-morreu-de-gripe-espanhola-fb8cn5ku.
  9. Mark JJ. Boccaccio on the Black Death: Text & Commentary. Journal [serial on the Internet]. 2020. Access date: May 30, 2020. Available at: https://www.ancient.eu/article/1537/boccaccio-on-the-black-death-text–commentary/.
  10. Castiel L.D. Essay on Pandemic. Rio de Janeiro: Fiocruz; 2020. p. 75.
  11. Dunker CIL. Diary of the plague year. Journal [serial on the Internet]. 2020. Access date: May 30, 2020. Available at: https://diplomatique.org.br/diario-do-ano-da-peste/.
  12. Empoli G. The Chaos Engineers: How fake news, conspiracy theories and algorithms are being used to spread hate, fear and influence elections. São Paulo: Vestigio; 2019.
  13. Brum E. Brazil, builder of ruins: A look at the country, from Lula to Bolsonaro. Porto Alegre: Editorial Archipelago (Kindle Edition); 2019.


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