By RUBEN BAUER NAVEIRA*

This text is based on surveys about covid and the possibilities for dealing with the disease, and it contains therapeutic indications that people can adopt and practice themselves, and that their communities can embrace on behalf of their members.

“The reason for a country to exist is to provide well-being to its inhabitants”.

It makes me ashamed to see myself compelled to start this text stating such a truism. However, if in the past Brazil could even have been a place that deserved to be called a “country”, today its ruling class doesn't even bother to pretend that anymore. If there is something prophylactic that can result from this Covid-19 pandemic (which we will simply call “covid”), it is to see any pretense to maintain those appearances liquidated:

– In Brazil, the ICU beds in public hospitals are fewer than those in the private network, but the State is exempt and omits to activate the mechanisms (which exist) to request vacant private beds, turning its back on thousands of deaths due to mere lack of medical care;

– Brazil accounts for 38% of the total deaths of health professionals from covid worldwide (the vast majority are nursing assistants, the most precarious category among them), a tragedy that screams the terrible working conditions of these professionals, in particular in the public network;

– In Brazil, emergency aid to the most needy people is refused to 37 million applicants, which forces these people to risk contagion in the queues outside Caixa branches; mothers registered in the Bolsa Família program have this benefit suspended, even though the emergency aid has not been approved for them; the MP's Federal Public Prosecutor's Office for Citizens' Rights reports that there are at least 40 cases of aid arbitrarily denied for the simple fact that the person has a family member in prison; and the President of the Republic vetoes the extension of aid to categories such as recyclable waste pickers.

It is in this non-country that the covid epidemic hits its inhabitants.

It is already known that when a person reaches the point of feeling “short of breath”, it is because he has already had pneumonia for days – “shortness of breath” is a symptom of the worsening of this pneumonia.

It is also known that covid pneumonia, even when the person ends up cured without ever needing to be admitted to the hospital, leaves some sequel in terms of reduced lung capacity; only in the future will it be known whether these consequences are reversed over time, or whether they are permanent.

It is in this context that the recommendations to the population boil down to these five:

1.) Stay home;

2.) If you need to go out, wear a mask;

3.) Wash your hands frequently (when you can't, use gel alcohol);

4.) If you have a fever, use paracetamol;

5.) Only look for a hospital or health center if you start to feel “shortness of breath”.

The first three, if the person contracts covid, will only help him not to spread the disease, but not for him to be treated; the fourth one won't work either, because it only mitigates a symptom (and even suppressing the body's response to the disease, something that is at least debatable).

The fifth recommendation, late because pneumonia – which leaves sequelae – is already beginning to reach an advanced stage, with each passing day it becomes innocuous for the population of more and more cities, whose hospitals no longer have the capacity to provide care. .

If the person, on the way to a hospital feeling short of breath, finds a bed for admission; if she, in case it complicates, find ICU; if she, if it gets worse in the ICU, find a ventilator; if, even so, she dies, well, that's life, it's acceptable that she died of covid as long as she received the possible care.

Unacceptable is when the person does NOT die from covid - they die from lack of beds for hospitalization; she dies from lack of ICU; she dies from lack of ventilator.

It is unacceptable that all you can do is limit yourself to isolating yourself, washing your hands, wearing a mask, taking paracetamol and praying that the disease does not reach the point of shortness of breath. If there really isn't going to be a hospital, then an alternative treatment must be possible outside the hospital.

This text is based on surveys about covid and the possibilities for dealing with the disease, and it contains therapeutic indications that people can adopt and practice themselves, and that their communities can embrace on behalf of their members. Treatments that should be used both by those who have contracted covid and by those who have not contracted it but are trying to take precautions.

If Brazilians can no longer count on Brazil (quite the contrary, they have to defend themselves against it), then Brazilians can only count on each other.

This text is therefore intended especially for people imbued with a collectivist spirit, who generously assume the task of organizing themselves in the community, in order to make these possibilities for coping with the disease reach all people in their communities.

In this sense, there are ten recommendations:

- Don't freak out;
– Rinse the nostrils and throat;
- Drink more water; - Lie on your stomach;
– Measure your saturation (blood oxygenation);
– Boost your fabric mask;
– Prevent microthromboses;
– Prevent cytokine storm;
– If you are diabetic, be careful with control; It is
– Sovereignty over one's own life and health is not delegated.

1. Don't freak out:

It is not true that eighty percent of covid cases are mild cases, and that the other twenty percent are complicated. This is not true because there are also asymptomatic cases, in which the person is not even aware that they have covid. Precisely because they are asymptomatic, they do not enter the statistics, and thus the percentage of cases that cause complications is certainly less than twenty percent (and not all of them will require hospitalization, and even fewer will require intubation).

Of course, knowing this doesn't guarantee anyone, because some will even complicate things. But, always keep in mind these chances of a favorable outcome in order to maintain your inner peace, for a very simple reason: stress raises the blood levels of a substance called cortisol, which is a corticoid. If you get covid, the main factor that will make the difference between you having only mild symptoms or complicating it will be the general state of your immune system. And corticosteroids weaken the immune system.

Parentheses: patients hospitalized with covid may receive corticosteroids, but this will be because the inflammation in the lungs has already reached such a point – precisely due to the uncontrolled reaction of a malfunctioning immune system – that there is no other way but to fight the inflammation even at the expense compromising what remains of the immune response to the disease. Close parentheses.

It has long been common for doctors to prescribe placebos to their patients without telling them about it, and the patients still recover. This occurs because medicine has understood that, in many diseases, psychosomatic factors are preponderant, and thus autosuggestion has an effect. In the case of covid, in which the outcome of complications or not will depend on the immune system, not letting yourself be dominated by anguish and anxiety after starting to experience the first symptoms can make a difference.

In addition to avoiding stress, the other factors that favor the immune system are: practice physical activity; have a good quality of sleep; stay hydrated (we'll cover it later); have a healthy diet; and avoid alcohol consumption.

Community action: educational campaigns can be carried out regarding the importance of self-care for the immune system. As isolation itself tends to be stressful, the community can develop forms of support to alleviate these tribulations. For those who caught covid and are unable to maintain self-control, a friendly word (taking care to avoid contagion) can help a lot.

2. Rinse the nostrils and throat:

We claim here that rinsing the nostrils and throat with saline water prevents covid. But what does “prevent” mean? Among the dictionary meanings are: “Putting things in order to avoid harm, damage: 'prevention is better than cure'; to take precautions, to take precautions, to prepare: 'prepared to face the winter' ”. So, “washing your nose and throat to prevent covid” does not mean that it guarantees that you will not contract covid. It means that you are taking good care (such as isolating yourself, washing your hands, wearing a mask, etc.) to avoid contracting it.

Gargling with warm water, salt and vinegar to prevent covid has already been disqualified as fake news, due to the lack of unequivocal scientific proof (forget about the vinegar, please). But there are many doctors who prescribe salt water sprays for flu or sinusitis – because this rinse removes the layer of mucus that covers the mucous membranes of the nostrils, while the gargle removes it in the throat (in the nostrils the layer of mucus still retains dust). Of course, salt water will not kill the virus, but the mucus layer makes it easier for the virus to adhere to the mucous membranes, and thus its removal will “make life difficult” for the virus.

The Doctor. Albert Sabin, creator of the polio vaccine, advocated cleaning the upper airways as a factor in preventing viral respiratory illnesses; in this regard, it is worth watching the video with the testimony of a Brazilian doctor who lived with Dr. Sabin: https://www.youtube.com/watch?v=vRInuPdjiV8.

In studies on viruses (virology) there is a parameter called “infectious dose”, which is an estimate of the minimum volume (quantity) of a given virus from which, in contact with the organism, that infection will be established. The infectious dose varies greatly from virus to virus, from the unit/ten range (in the case of the influenza virus, which causes influenza, for example) to the thousand/ten thousand range (in the case of the HIV virus, for example).

What is the infectious dose of the new coronavirus, so that the covid infection is established? Nobody knows yet. Thus, it is very worthwhile to invest in a procedure that is simple and practical to make the environment of the nose and throat “less friendly” to the coronavirus. In the healthy person, this will increase the amount of virus from which the disease will set in; in the person already with the initial symptoms, this will help the immune system to fight the disease and prevent it from complicating.

The procedure is simple: boil drinking water for at least three minutes and let it cool. When it is slightly lukewarm, to 300 ml of water (a very full glass) add a coffee spoon of salt and half a coffee spoon of sodium bicarbonate, mixing well (adjust these amounts for your comfort). Tilt your head to one side so that your nostrils are vertical, and inject the saline water into the upper nostril, so that it drains, by gravity, through the lower nostril (you can use a syringe to inject). Tilt your head to the other side, and repeat the procedure. With what's left of the water, gargle to wash your throat. You can do this wash once a day, before bed, and, if you get covid, three to four times a day.

One caveat: if you have a home-use nebulizer, don't use it on the assumption that you must "clean" your lungs with saline water (or saline, which is weakly saline water) as you would your nose and throat. Nebulization should not be used in Covid, for two reasons: nebulization is the inhalation of a mist of microdroplets, and, as the virus travels in droplets, you may be facilitating its migration from your nose and throat into your lungs. ; in addition, when exhaling, the sick person projects a mist of droplets into the environment, spreading the contamination.

Community action: awareness campaigns can be carried out on the importance and technique of nasal washing. Syringes (without needles) can be distributed along with sodium bicarbonate, warning that each syringe must be identified so that it is not used by more than one member of the family.

3. Drink more water:

In the same way that doctors recommend that their patients with the flu or sinusitis spray saline water in their nostrils and gargle, they also recommend that they stay hydrated. Hydration has a direct effect on the mucous membranes of the upper airways, and it is known that if the person continues to feel dry in the mouth, nose and throat, the symptoms of the flu or sinusitis are worse.

There is no reason to be different with covid. Disrupt the life of the virus, keeping your mucous membranes hydrated instead of dry, as well as helping your immune system to fight it, drinking at least two liters of water a day (note: it's not because Coca-Cola is liquid and is produced with water that it hydrates the body, quite the contrary; hydration is to be done with water). The immune system only operates optimally with daily intake of this minimum amount of water.

Community action: enlightenment campaigns, and taking drinking water to those who don't have it.

4. Lie facedown:

Search the web for "covid prone" or "covid prone" (from "prone position," which is the medical term), and you'll see that hospitalized patients are placed facedown most of the time, especially if they're intubated. Compared to patients who are kept lying on their backs, the improvement is remarkable.

The explanation for this is that, in normal breathing, the air only occupies the front and top parts of the lungs (those that are “first”), little reaching the parts that are lower and behind (the “back” part). ” of the lungs, so to speak). The prone position, by compressing the “front” part of the lungs, makes the air better distributed throughout all lung regions, reaching the “back” part. For more information see for example the website: https://multisaude.com.br/articles/ventilation-in-prone position/.

Covid pneumonia settles silently (there are cases where the person doesn't even have a fever); when you feel short of breath it's because the pneumonia has already worsened. If, before that, the person sleeps and rests on his stomach, he will be preserving his lung function, and reducing the risk (or severity) of an eventual complication.

When realizing that he has caught covid, the person should try to sleep as long as possible on his stomach, as well as lie on his stomach every time he goes to rest. If she only has mild symptoms (the vast majority of cases) lying on her stomach won't have made any difference, but if she ends up complicating things, her lungs will have suffered less damage.

Community action: clarification and information campaigns.

5. Measure your saturation (blood oxygenation):

There is a way to detect the initial – and silent – ​​phase of covid pneumonia at an early stage, which is the measurement of oxygen saturation in the blood, carried out by a device called a pulse oximeter (in yet another hasty translation from English, it should be called “pulse oximeter”), because covid pneumonia immediately begins to reduce these levels – although the person will only start to feel the “shortness of breath” when these levels are already very low (to find out more, look on the web by “covid saturation” or “covid oximeter”).

The oximeter is like a “clamp” that is placed on the person's finger, and a few seconds later it already displays the result on the display.

Normal saturation values ​​are between 94% and 100%. Between 89% and 93%, the levels are already low, but still acceptable. As these devices can have a margin of error of up to two percent plus or minus, a value of 87% would still be within the range – in short, with a saturation of 86% or less there is a high possibility that you already have pneumonia has started to develop, and so you should seek medical attention immediately.

Every health center, as well as every local Family Health team, should be equipped with such an oximeter, so it won't be difficult for you and your family members to get examined. If you have around 200 reais, you can buy the device online. And most of the most modern cell phones have an oximeter function (attention: it is necessary to calibrate), so owners of the latest type of cell phones already have an oximeter, they just don't know it.

For the test, the person must have a clean, uninjured finger and the hand resting on a surface. Nail polish can distort the result, and fake nails prevent the test from being effective.

Community action: An oximeter test takes a few seconds, so a single device can be used to monitor an entire community – with due attention to hygiene, which should only be done with isopropyl alcohol, as common alcohol can damage electronic devices such as the oximeter; in fact, the purchase of isopropyl alcohol by the community should also be used to clean people's cell phones, tablets, notebooks, keyboards and mice, because cleaning with 70% alcohol or gel alcohol can damage these devices.

6. Boost your fabric mask:

Make your homemade cloth mask filter (and protect) equivalent to a standard N-95 hospital mask (the best of all) with this simple step: place a coffee filter sheet under inside the mask.

The filtering power of the coffee filter is very high, as can be seen in this comparison chart on the website: http://www.comunica.ufu.br/noticia/2020/05/fisicos-da-ufu-avaliam-quais-mascaras-sao-mais-eficientes-contra-coronavirus.

 

The fabric mask presents a problem: after some time, it starts to retain the moisture of the breath, thus becoming an environment conducive to the virus – ideally, the mask should remain dry all the time. The coffee filter, in addition to its greater filtration, also retains moisture, keeping the cloth mask dry.

A coffee filter is a sheet folded in half and glued along the edges. Detach the two “half-sheets” of the filter, and accommodate one of them inside the mask, covering the nose and mouth. The filter sheet must be changed every two hours, so as not to accumulate moisture.

Also watch this explanatory video, produced at USP: https://youtu.be/oRzwKQxE-lk.

Community action: distribution of coffee filters, with guidance on how to use them.

7. Prevent microthromboses:

In addition to the lungs, covid also attacks the blood, causing microthromboses in the capillaries, which are the thinnest blood vessels that irrigate the periphery of our body's tissues. Thrombosis is the formation of a clot (or “thrombus”) that blocks the free passage of blood. For this reason, covid also causes heart attacks, strokes, kidney dysfunction and other problems (search the web for “covid thrombosis”).

Inside our lungs, the capillaries that reach the alveoli are extremely thin (the thickness is less than a strand of hair), to allow the so-called gas exchange: CO₂ brought in by the blood is released and will leave the body by expiration, while oxygen inhaled by inspiration binds to the blood. The microscopic caliber of these capillaries favors the occurrence of microthromboses which, when accumulated by the thousands, will prevent gas exchange even if the lung is still managing to fill with air.

For this reason, hospitals already apply anticoagulants to covid patients. However, self-medication with anticoagulants purchased in pharmacies can be very dangerous, and therefore you should under no circumstances take anticoagulant medications without proper medical supervision.

There is, however, a natural anticoagulant, without major contraindications: parsley. Yes, that seasoning. Parsley has a peculiar anticoagulant effect, liquefying the blood (making it “thinner”, so to speak). As the anticoagulant properties of parsley are still not well understood, it was only possible to find this video: https://globoplay.globo.com/v/973841/.

To prevent microthromboses, in the event of a complication from covid (recalling that, throughout this text, “prevent” does not mean “prevent” but “reduce the risk of”), you should start eating parsley every day days (preferably raw).

You should however be aware that if bleeding occurs (eg a cut or wound) it will take longer for the bleeding to stop. Parsley needs to be seen as a medicine, even if it is an in natura herbal medicine instead of an industrialized drug – its anticoagulant potential should not be underestimated. Thus, the daily consumption of parsley implies risks that must be considered for groups such as pregnant women, women with excessive menstrual bleeding, hemophiliacs, people with gastric ulcers, who are about to undergo surgeries or who practice activities with risk of accidents. In case of hospitalization due to covid, the medical team must be informed of the preventive consumption of parsley for anticoagulant purposes, and you must insist that your coagulation parameters be tested before other anticoagulants are administered.

As there is still very little known about the anticoagulant action of parsley, when doing a search on the internet you will find claims that it has coagulant properties – when it is just the opposite. This is because parsley is a dark leafy green, and the established notion that dark leafy greens (kale, spinach, etc.) are rich in vitamin K, which has a clotting action. The fact is that, in addition to some vitamin K, parsley contains some other active ingredient that is effectively anticoagulant.

Community action: clarification regarding the benefits of parsley; the community can also provide a daily supply of bundles of parsley in the amount needed to supply everyone.

8. Prevent Cytokine Storm:

The so-called “cytokine storm” in covid is an uncontrolled inflammatory reaction in the lungs, caused by the immune system itself, which ends up breaking down when trying to neutralize the coronavirus. The lungs fill with liquid, suffocating the person.

The accumulation of fluid in the pulmonary alveoli caused by the cytokine storm, together with the microthromboses in the capillary mesh lining the alveoli that prevent oxygen from adhering to the blood, are the factors that lead to the respiratory collapse that is the main cause of death in covid.

When a person contracts covid, the main factor that will define a favorable or unfavorable evolution of the disease is the general state of the immune system. People with a healthy immune system will tend to remain asymptomatic (and won't even know they've had Covid) or may only have mild symptoms (cough, fever, sore throat and fatigue) that disappear in just over a week. People with a poor immune system can develop pneumonia, characterized by a progressive drop in the oxygen saturation index in the blood, they can have this pneumonia aggravated to the point where they begin to feel “shortness of breath”, and they can suffer from the storm of cytokines caused by the imbalanced immune system itself.

Substances that act in the regulation of the immune system are called immunomodulators. One of the main ones, if not the main one among all, is cholecalciferol, better known by the name by which it was baptized almost a hundred years ago: vitamin D.

Vitamin D is generated by the body itself (so it is actually a hormone and not a vitamin), in the skin when exposed to the sun. This formation is more effective when the person is exposed to the most intense sun (between 11:00 am and 14:00 pm). After reaching the “optimal daily dose” of formed vitamin D, the skin “turns off” the formation mechanism, even if the person remains under the sun. This optimal daily dose, which is why it is called the “physiological dose”, would be around 10.000 IU (international units), and the exposure time necessary for the formation of the physiological dose, with the person lying horizontally, with at least 80% of the body uncovered and without sunscreen, under intense sunlight, varies from about fifteen minutes for people with lighter skin to about one hour for people with darker skin. This exposure needs to be daily to maintain adequate levels of vitamin D in the body.

Aside from people who live in the countryside (and who still tend to work wearing a hat and a shirt, to avoid exposure to the sun), no one else gets the sun like this. In urban centers, it is estimated that more than 90% of the population has vitamin D deficiency. Optimal levels of vitamin D in the bloodstream would be between 60 and 80 ng/mL (nanograms per milliliter of blood), and below 25 ng/mL the deficiency is already severe; alarmingly, the estimate is that the average for the urban population is around 15 ng/mL. The result is disease, because the immune system cannot function well without minimally adequate levels of one of its main regulators.

Research on the correlation between levels of vitamin D in the body and the evolution of covid is still in progress, but a clear direction can already be discerned: first, it appears that deaths from covid occur in people with deficiency of vitamin D; later, it was found that the cytokine storm also occurs in patients with vitamin D deficiency.

Several doctors in Brazil already advocate the replacement of vitamin D as a way to prevent and treat covid, including Dr. Cícero Coimbra, from the Federal University of São Paulo; there are countless videos of him on YouTube, like this one, in which the role of vitamin D replacement in coping with covid is already discussed: https://m.youtube.com/watch?v=QROeQXPPwvU.

Even if the covid pandemic was not taking place, replacing vitamin D, one of the most critical regulators for the immune system, in a population where it is known that the vast majority of people are deficient in this vitamin, should already be a public health issue. However, many other physicians object to replacement techniques with the argument that very high levels of vitamin D may carry a risk of renal dysfunction (it is estimated that from 100 ng/mL onwards this risk would increase).

Thus, since the physiological dose (natural daily dose) would be around 10.000 IU, a replacement with daily doses of this value would be safe, and it would take about three months for a person with vitamin D deficiency to reach adequate levels. . Other techniques advocate doses greater than 50.000 IU at intervals that are also greater than once a week, also taking around three months.

The explanation for this delay is that vitamin D tends to be deposited in the body's fatty tissues, with only the "leftovers" of this absorption process by fat ending up in the bloodstream. Thus, obese individuals will take longer to reach adequate levels than lean individuals.

A person with complicated covid (pneumonia), even at the onset of this complication (drop in oxygen saturation levels) cannot wait two or three months for replacement. Argues Dr. Coimbra that in these cases 600.000 IU should be applied in a single dose. According to him, this high dose quickly “soaks” the body's fatty tissues with vitamin D, causing the level in the bloodstream to reach, also very quickly, an adequate level. For excessively thin people, and for children, the dose should be lower.

Community action: some presentations of vitamin D require a prescription for sale, while others are labeled as supplements and sold over the counter (including on department store websites); the community can plan and arrange for high doses (of 600.000 IU, or adjusted) to be given to people who get into trouble, especially those who cannot be admitted to the hospital due to lack of beds; with regard to replacement, lower costs can be negotiated with clinical analysis laboratories so that a larger volume of vitamin D levels tests are collected in the community itself, and thus dose especially people belonging to risk groups, in order to accelerate safely replenishment for them; the community can also seek discounts from drugstore chains or even manufacturers, or even donations, for replacement doses.

9. If you are diabetic, take care of control:

One of the biggest problems with diabetes is that it is only in the future that the disease will take its toll on today's high blood glucose levels. Thus, diabetics are able to adapt to living with their altered glucose levels without having to make greater sacrifices in terms of food restrictions, especially thanks to fast-acting drugs whose dose ends up being adjusted at each meal, depending on whether they abuse less or more inadequate nutrition.

This condition generates a dichotomy between “current” diabetes (measured by glycemia) and “accumulated” diabetes (measured by glycosylated, or glycated, hemoglobin, the result of which expresses a kind of “average” of the glycemic levels over the last three months. to four months).

It has not yet been rigorously proven, but there are already certain indications that covid complicates especially in the elderly, cardiac, hypertensive, diabetic and obese people due to all these groups presenting vulnerabilities in their peripheral vascular circulation (capillary). Specifically with regard to diabetics, however, it may not be just that: a survey in Italy (also still unproven) points out that there is some relationship between complications of covid and hemoglobin, as well as that, in relation to diabetics, the higher the levels of hemoglobin glycosylated (ie, the more precarious the control over time), the greater the propensity for these complications.

For a diabetic with sloppy control, improving that control will only be reflected in their glycosylated hemoglobin level within three months; there are projections, however, that the covid pandemic could extend until the year 2022, especially if an effective vaccine is not developed (so far, there is no guarantee that it will be). So, it's really worth investing in better control right now.

Community action: guidance and clarification campaigns; the community can facilitate the arrival of adequate food (vegetables) to those diabetics most in need.

10. Sovereignty over one's own life and health is not delegated:

We have already dealt here with anticoagulant drugs (the active principle, still little known, present in parsley) and immunomodulators (vitamin D).

However, in terms of antiviral drugs (that is, those that directly fight the virus), there is nothing to recommend. Because there are hundreds of drugs being tested (including given to patients in hospitals), but there is still none that can be minimally (that is, even before due scientific proof) pointed out as effective.

In an extreme situation, in which the patient agonizes in despair, it is understandable that he (or the family) is willing to take the risks of experimentation. In an even more extreme situation, in which the person agonizes outside the hospital because there is no available bed, it is even more understandable. So be it.

But, recommending experimentation for people with only the first symptoms (of whom around eighty percent will be cured by themselves, anyway), with drugs that have already gone through tests but without verification of efficacy, and which, on top of that, carry serious side effects, is complete nonsense.

We are talking, of course, about chloroquine and hydroxychloroquine. According to the current stage of research, neither is effective against covid. And both can cause cardiac arrhythmia, which can lead to sudden death from cardiac arrest (several cases have happened).

If such a recommendation is already absurd, the conduct of some groups to distribute chloroquine and hydroxychloroquine pills in needy communities, as a preventive (!) for covid, is nothing short of criminal. Unfortunately, this has been happening all over Brazil.

If people like that appear distributing these pills in your community, assume that they are disposing, in an invasive and abusive way, of your health, your life, and the health and life of your family members. Assume, then, that this makes it legitimate for you to employ whatever means you see fit to drive them out of your community. The community action here will be to exercise this self-defense collectively.

***

It was necessary for Nature to impose a virus on us so that something that we could sense, but did not see, became evident: one of the spheres of life in society (or of institutions, in the sense of what is instituted, formalized), public health , it may even exist for a lot of other purposes, but in practice it does not exist to fulfill its reason for being: to provide health to people.

Public health is not just buying respirators in a hurry (who knows at what price). Public health, in fact, is also having, to properly operate each respirator, a team of trained, qualified, equipped, recognized, valued and respected health professionals. Where does this occur?

Public health is not about promoting “do-it-yourself” social distancing, with maids considered “essential services” and shops and churches reopening on the basis of who can afford it the most. Public health, in fact, is having the attitude of imposing a lockdown, bitter but necessary – the more bitter, for the shorter time necessary –, with fines and even imprisonment for violators. Where has this been done, or even attempted?

Nowhere in the world, except here, public health means people turned away from public hospitals and sent away to die at home (preferably due to “respiratory failure” and not due to covid so as not to fatten up the statistics – that’s not right, dear mayors and governors ?), while there are vacant beds in private hospitals.

What has not yet become evident, but it will only be a matter of time before it becomes clear, is that all other spheres of “life in society”, that is, institutions, are metastasizing, and will also crumble. So, in the outskirts, villages, slums, settlements and villages of this place we still call country, people will increasingly need to rely on each other, and make it real that the collectives in which they live together deserve to be called communities.

So, the community self-organization focused on health care that is being proposed here does not end in itself. May it be a sowing that will bear fruit in many other dimensions of the organization of community life. That, in addition to helping to deal with the covid pandemic, it will also strengthen ties, establish solidarities, build collective identities.

May this “Self-Care Bacurau” be the foreshadowing of the Bacurau itself, that of self-defense – because it will be necessary, sooner or later.

*Ruben Bauer Naveira is retired, activist and author of the book “A New Utopia for Brazil: Three guides to get out of chaos (http://www.brasilutopia.com.br)

In memory of my dear father, José Bacchi Naveira (1925-2018), a doctor who devoted his life to caring for the underserved, and who never failed to provide care to a needy person who sought him out.

Originally published on the website Other words.