By FABRÍCIO AUGUSTO MENEGON*
Preface to the book edited by Lauro Mattei
The biggest health crisis of the 2st century, at least up to the present moment, was the pandemic caused by the SARS-CoV-19 virus, which causes the disease that became known as Covid-XNUMX. The global situation caused changed our routine, turned the global economy upside down, remodeled our way of living, relating, studying and working. Undoubtedly, the legacy of the pandemic will not only be sanitary, although this is probably the easiest to remember.
When a global crisis of these proportions occurs, the response we expect from world authorities is strategic alignment for the execution of global and local actions to face it. And, preferably, that these actions be developed and led by the global health authority: the World Health Organization (WHO or World Health Organization). However, even with WHO's effort to seek ways to sensitize the authorities in each country to the seriousness of the problem and the perverse consequences of the pandemic, especially for the most vulnerable, the echo generated had different intensities and was heavily harmed by the fake news that appeared and spread at an impressive speed.
Among the various harmful impacts of the pandemic, let us remember the workers who continued to perform their so-called “essential” functions, such as health professionals, workers in the food sector, security forces, among others.
Places or situations where there was a high probability of spreading the virus, such as some work environments, were called “super spreaders”, or “super spreader”, in the English term. This was the case of the slaughterhouse and meat processing industry, where several outbreaks occurred in Brazilian cities and in other countries, caused by the need for capital to keep the workforce active.
For these workers, the spectrum of outcomes related to the pandemic varied between saving lives and losing one, passing through the suffering and anguish caused by witnessing the pain of others. Countless were the cases of absence from work due to Covid-19, many others were the deaths caused by having to remain working. Workers who left their homes to work and did not know if they would return contaminated, with the possibility of taking the disease into their homes. They are anonymous heroes who did not have the option of choosing remote work, they paid a high price for it and they do not even have the recognition and respect of their bosses and a large part of society.
We witnessed, often dismayed, the apathy and denial of the pandemic by some rulers, while praising the adoption of effective measures, aligned with scientific knowledge and health reality, on the part of others. Meanwhile, many people around the world were suffering from the disease and hundreds of thousands lost their lives. In Brazil alone, it is estimated that around 400.000 deaths from Covid-19 would have been avoided if effective health measures, including vaccination, had been taken quickly and with a commitment to social reality.[I]
On the world stage, Brazil stood out for the delay with which it decided to acquire vaccines against Covid-19, while other developed or developing countries quickly understood the fundamental importance of population vaccination to contain the spread of the pandemic. Despite the criticism of the mercantilist logic that we see throughout the process of purchasing vaccines, especially in richer countries (Canada, for example, bought enough vaccines to immunize nine times its population),[ii] Brazil had (and has) the potential to develop high-quality vaccines to meet the population's need, in addition to a network of more than 38.000 vaccination rooms of the Unified Health System (SUS) spread across the country.
The consequence of the pandemic for the Brazilian people was no longer perverse because our public health policy guarantees quality access for all. The SUS, despite criticism and attempts at financial and structural annihilation led by politicians and businessmen without any commitment to society, has once again shown its importance, guaranteeing service and care, in the big cities and in the corners of Brazil.
There is no pleading ignorance of the situation. There were numerous times that the Brazilian scientific community took a stand demanding an ethical and committed posture from the federal and state governments, including the state of Santa Catarina.
The role played by the Núcleo de Estudos de Economia Santa Catarina (Necat/UFSC) in the systematic preparation of bulletins with a high analytical degree on the development of the pandemic and its consequences was the basis of the agenda of the Santa Catarina and Brazilian media on countless occasions. Likewise, researchers from the Department of Public Health at UFSC worked in the production and analysis of data, issued letters and manifestos and appeared in the media as qualified interlocutors to inform society and governments, with scientifically based knowledge, about the health crisis imposed by the pandemic and the likely consequences that were already foreseen.
Our appeals were summarily ignored, or answered in a generic way and with tones of disclaimer. “If everything closes, the economy will break”, “we are doing what is possible”, “our actions follow a strategy based on best practices”, “municipal managers have autonomy to act…”, are phrases that we hear many times and that reveal the attempt to polarize the debate in “either we save the economy, or we save health”. History shows us that social development fundamentally depends on the positive interrelation between economic, social and health aspects. Polarizing them is a mistake for those who understand society in a shallow way, or deliberately do so with interests that are alien to the real social demands.
The current health scenario is no longer as frightening as we saw in the years 2020 and 2021. Vaccination of the population brought encouragement and cooled the strength of Covid-19. Evidently, we live on the lookout for new variants that appear from time to time and bring us fear of the possibility of a vaccine escape that could exacerbate the problem. This doesn't seem to be the biggest problem so far. But with each new wave, more cases emerge, more people die, more pressure is put on the health system, and the authorities' effective response remains time-consuming.
Until the moment this preface was written, Brazil did not have a national plan to face the Covid-19 pandemic. A consistent proposal for a plan was delivered to the Ministry of Health in July 2020 by the Frente pela Vida, a representation that includes scientific and bioethics entities and the National Health Council.[iii] Again, it was not even considered and debated by the national health authority. Meanwhile, we proudly boast the ranking of world leaders in Covid-19 deaths per million inhabitants[iv] and we are astonished at the fact that there is still no vaccine schedule against Covid-19 for the year 2023 (we are at the end of November 2022).
There is an urgent need for a change that will reposition us on the world stage as a protagonist and example of public health policy. It is imperative to rescue the power, legacy and structure of the Brazilian National Immunization Program (PNI), which was once a world reference. We demand that the public authorities fulfill their role.
Long live SUS! Long live the Brazilian people! Long live democracy!
* Fabricio Augusto Menegon Professor at the Department of Public Health and at the Graduate Program in Collective Health at UFSC.
Reference
Lauro Mattei (org.). The economic and social legacy of COVID-19 in Brazil and Santa Catarina. Florianópolis, Editora Insular, 2022, 400 pages.
Notes
[I] Research points out that 400 deaths could be avoided; government officials question.
Source: Senate Agency. Available in https://www12.senado.leg.br/noticias/materias/2021/06/24/pesquisas-apontam-que-400-mil-mortes-poderiam-ser-evitadas-governistas-questionam.
[ii] Mullard, A. How COVID vaccines are being spread up around the world: Canada leads the pack in terms of secured doses per capita. Nature. News section. 30/11/2020. Available in https://www.nature.com/articles/d41586-020-03370-6.
[iii] Entities present a National Plan to Combat Covid-19 to the Ministry of Health and Conass. Brazilian Association of Collective Health, news. Abrasco Communication with information from the National Health Council. 24/07/2020. Available in https://www.abrasco.org.br/site/noticias/especial-coronavirus/entidades-apresentam-plano-nacional-de-enfrentamento-a-covid-19-ao-ministerio-da-saude-e-ao-conass/50587/..
[iv] Our World in Data. Cumulative confirmed COVID-19 deaths per million people. Available in https://ourworldindata.org/covid-deaths.
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