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A bitter medicine, but essential to save lives.

Nobody likes to close everything, stop the movement of people and the economy (it's the workers who produce and make the economy circulate, see what an interesting discovery, bosses?). Nobody thinks that suspending classes, commerce, services, culture, entertainment is a simple measure, without side effects and damage: NOBODY! Also, no one defends that this measure be adopted without basic income measures and refinancing and support for small and medium-sized companies 9so that they do not close and can keep paying salaries), in addition to the self-employed and other vulnerable segments.

But do you know when an oncologist recommends chemotherapy or an orthopedist or angiologist recommends amputation? They don't do it because it's fun, because it's the first option, because it's a simple option or because they don't know the harms and side effects, they do it because all the other measures they tried didn't work and this was the only one left. Fukushima City had to be evacuated after an earthquake and tsunami that also resulted in a nuclear power plant accident that spilled radioactivity. Can you imagine someone saying they don't want to leave because "it's going to have losses". Of course there will be losses, but it is necessary to save the life and then see how to equate the damage.

Ah, but there was nothing we could do to avoid getting here…

There was. And it was explained by specialist scientists in the field: virologists, immunologists, epidemiologists, public health specialists, among others.

The measures were: social distancing; control and monitoring of cases and contacts; massive use of masks (we now know that they need to be certified masks); hand hygiene; control of borders and circulation in airports, highways and railways of those coming from areas of contamination; strengthening of the health system: with an increase in beds, reinforcement of stocks of health supplies and protective equipment; economic and social measures that would allow people to respect social distancing and possible stoppages of economic activities and clear information in official pronouncements and guidance and clarification campaigns.

All these measures needed to be taken in a coordinated and organized manner by a central government guided by scientific committees, in articulation with regional or local powers and other powers (legislative and judiciary) and civil society organizations, including trade unions, neighborhood associations, NGOs, press etc. Countries such as Vietnam, New Zealand, China and Norway have adopted these protocols. All these countries are in control of the pandemic even without the use of the vaccine, they have very low numbers of deaths and cases. Vietnam is probably the country that achieved the best equation, having in the entire period – even though it is very close to China where the first cases were reported – 35 deaths, being a country of around 100 million inhabitants.

We would never be advocating the stoppage of all non-essential activities (the real and immediate essentials are food, supply, energy, technological services and, obviously, health and transport services for all those involved mentioned above) and the rigid closure of borders, airports and highways if there was another option for the current situation. And unfortunately these measures have to be imposed and supervised in an exemplary and rigorous way. To give you an example, in France during the period of the most restrictive measures, if you were walking down the street and your purchases were not enough for a week, the fine was €143, the equivalent of around R$940.

Yes, there are many side effects as serious or more serious than an amputation, but Brazil as a nation, from business entities and the Bolsonaro government and with the consent of (almost) all other powers and spheres of government and a considerable part of so-called civil society chose to let it happen. Giving the virus freedom to make its own way and leave the population to its own devices. Some cities and states have adopted social distancing measures to varying degrees, but they have never been taken adequately and sufficiently. We know that it was impossible to be sufficient without centralized and national guidance. But we also know that most of the representatives of state governments and city halls did much less than they could, with exceptions like Edinho (PT, mayor of Araraquara) or Alexandre Kalil (PSD, mayor of BH), among not many others and others. It must be said that the big companies represented by their federations, including bankers, industry, retail and others who are the masterminds of the genocide at the national level, implemented, via their regional headquarters, pressure of all kinds against all the managers who adopted the measures as scientific committees initially, and the vast majority give in to pressure and choose the profit side of the big explorers. Thus we paved a consistent path to the disaster we now face.

We are in the worst possible scenario: the disjointed and precarious attempts at control (the only consistent one was the suspension of face-to-face classes) were efficient until May 2020, since then the easing of the rules before a consistent decrease in the circulation of the virus has generated deaths and fueled a collective sense of a normality that did not exist. The implementation of emergency aid without planning and in a disorganized manner, with its reduction and subsequent unacceptable interruption, the increase in unemployment and the deepening of an economic crisis that we had already been fueling in a context of state disinvestment and privatizations, recession and lack of confidence and as icing on the cake, the end of any effective social distance with the holding of the elections and the resumption of face-to-face classes at the worst moment generated destruction compatible with a war scenario: unemployment, recession, inflation, shortages (including health supplies such as oxygen and essential drugs for sedation), vaccination at a snail's pace, collapse of the health system, collapse of the funeral system, lack of health professionals and funeral directors, hunger, massive closure of companies, partial stoppage of fundamental sectors such as culture and of course the worst of all: hundreds of thousands of dead still exponentially growing. We are not yet at the peak of the crisis, we will only know that we have passed it after we have had two weeks of consistent decline in the number of cases (corresponding to a transmissibility rate of less than 1), followed by two weeks of consistent and numerically significant decline in the number of hospitalizations and deaths.

An important aspect of understanding this pandemic is that we are always looking to the past when we look at the numbers. The number of cases notified today is the result of what was done ten or fifteen days ago, the number of hospitalizations of 20 days and the number of deaths of 1 month before or more. And as growth is exponential, any measure takes a long time to generate results beyond a certain point of lack of control and time alone is not enough, action is needed.

The collapse of health that we are experiencing is like the breaking of a dam, it cannot be solved by trying to go back, it is not possible to go back. But it is necessary to act immediately. And there are few measures that can be efficient to minimize the duration of the collapse and consequently the number of deaths that we can still avoid.

It is necessary to determine a radical decrease in the circulation of the virus and the virus only reproduces in people and always passes from one person to another. Thus, the most urgent measure is: each person has to have contact with as few other people as possible – which requires stopping all non-essential activities for survival and a minimum quality of life. When this contact happens, only in cases where it is unavoidable, the environment needs to be ventilated, people have to wear a certified mask (surgical well-fitting, pff1 or 2, n95), they have to wash their hands frequently and keep their distance . In relation to both measures, inspection must be rigorous and exemplary. For these measures to be possible, it is absolutely essential that a national minimum income be universally implemented as quickly as possible, with the same promptness and agility that R$ 1,2 trillion was made available to banks and that refinancing and maintenance measures for small and medium-sized companies. It is necessary to carry out measures to strengthen the SUS and plan the provision of inputs for health and hire all professionals with training to work in health emergencies and their appreciation and creation of conditions for them to act in the best possible conditions (such as protection of their families, adequate remuneration and insurance). It is also necessary to survey and act in relation to the funerary system.

And in parallel with the decrease in the circulation of the virus, it is necessary to buy or produce, distribute and apply vaccines worldwide for whom it is intended (for the time being most of the approved vaccines have not been tested in adolescents under 16 years of age and children or in pregnant women). The fight for being in priority 1, 2, 3 or 4 is the wrong fight. It is necessary to buy a vaccine for everyone and this is the fight: to have the number of vaccines for 180 million Brazilian men and women as soon as possible. Brazil has the capacity to vaccinate between 2 and 5 million Brazilian men and women per day. Vaccination started almost 50 days ago, if we were vaccinating 2 million people a day from Monday to Saturday, we could already have more than 50 million Brazilians taking one dose and 25 million taking both. We've vaccinated less than 9 million to date with one dose and less than 3 million have taken both doses.

If measures are taken today, control of the situation will come in a few weeks. As it is a process that occurs in geometric progression, each day it takes to take action can postpone control of the situation from weeks to months and can mean 50 thousand deaths instead of 200 thousand deaths.

We must act immediately to avoid deaths! We know what to do!

Is it urgent!

Obs. 1 I am a math teacher. Epidemiology, virology, immunology, public health or related areas are not my object of study or work. What is systematized here is the result of my mathematical knowledge about exponential growth and everything I have read and heard from specialists in some scientific articles, videos and many reports and interviews by specialists such as Miguel Nicolelis, Natalia Pasternak, Átila Iamarino, Gonçalo Vecina Neto , Ethel Maciel, Margareth Dalcomo, Alexandre Padilha, among others. Naturally, the responsibility for what is written is mine alone. If you are an expert and find any error, inconsistency or any kind of problem in the information or even opinions, I would be very grateful if you could alert me through the electronic address elenira.blog@gmail.com so that I can correct or make the text more necessary.

Obs.2 The data cited are from March 14, 2021 and unfortunately change very quickly.

*Elenira Vilela She is a professor and member of the national board of the National Union of Federal Servants of Basic, Professional and Technological Education (SINASEFE).

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