epidemiological flat earthism


By Paulo Capel Narvai*

Ignorance, in its various forms, produces what could be characterized as a kind of epidemiological flat earth, which constitutes one of the main challenges to contain the COVID-19 pandemic in Brazil.

With epidemics, one should not joke. One should also not manipulate disease and death, commodifying them. Nor should the epidemiological phenomenon be ideologized and partisan, undermining its confrontation based on scientific evidence. However, the current episode starring the SARS-Cov-2 virus (Coronavirus of Severe Acute Respiratory Syndrome 2) shows that today, in Brazil, there is no room for this world of “it should be”. Around here, the highest authority of the Republic makes fun of the COVID-19 epidemic. 'Coronavirus Disease 2019'), entrepreneurs manipulate prices of products whose useless consumption is stimulated by ignorance and ideologues flat earthers mock the new coronavirus, which would be nothing more than a “comunavirus”. The scenario, disheartening, reveals an abject mix of party-political opportunism with greed and ignorance. The consequence is that our difficulties in controlling the pandemic increase.

Disseminating information is essential in fighting epidemics. I am referring to scientific information and not simply “news”. nor the fake news, certainly. Brazilian history records the regrettable episode of misinformation by the population about the meningitis epidemic in the early 1970s. The censorship imposed on the press by the civil-military dictatorship, preventing the circulation of information, contributed negatively, as it helped to increase circulation. of meningococcus by delaying vaccination too much. Press censorship caused preventable deaths1.

In the current COVID-19 pandemic, there is also an information war involving economic powers. Donald Trump, on the one hand, refers to the coronavirus as “a virus foreign” [sic] , and accuses China of using the epidemic to play with prices of commodities, oil and soybeans, above all. Zhao Lijian, spokesman for the Ministry of Foreign Affairs of China, responded by stating that SARS-Cov-2 was introduced into China by the United States, in a criminal act, on the occasion of the seventh edition of the Military World Games, in October 2019, in Wuhan, the city from which the epidemic would turn into a pandemic. The aim would be to create economic difficulties for the Chinese.2. The fact is that no one has any doubts about the pandemic's notable impact on economic activities across the planet. Stock markets, according to Nouriel Roubini, the economist who predicted the 2008 financial crisis, will fall by 30% to 40%3.

Another type of information war is the dispute over the monopoly of the “correct” information to be disseminated to “enlighten” the population and avoid “panic”, involving scientists and specialists from various fields. Doctors, in droves, but also nurses, biologists and even “paramedics”, have been populating social networks with their “scientific” truths, all claiming to be apolitical, technical, supported by their “experiences” and “experiences”, those of those who would be “hands-on”. “I am one for doing, not for talking”, I heard from one of them. Some say they are “tired” of seeing “nonsense” being said by lay people and, because they are “tired” and “can't take it anymore”, they come forward to show where the truth is and what to do. Each scientific discipline or medical specialty, sometimes ignoring the complexity of epidemiological phenomena, always has one of its luminaries ready to “explain” what is going on. “Scientifically”, as they believe. Everything that collides with their “scientific” certainties, even if it comes from other disciplines or specialties, does not deserve credit or respect. Some, more ideologized, deduce that other points of view, equally based on scientific knowledge, would only have the purpose of creating panic. They would be, only and only, things of that “against group”.

No, dear reader, don't worry, I'm not going to tell you where the truth is or what to do.

The basic biological and epidemiological characteristics involving SARS-Cov-2 are well known at this point in the development of the COVID-19 pandemic. The basics. But it is not known how things will evolve in tropical countries, as the epidemic is coming now. Brazil is in this expectation. What is known is enough, however, to recognize that it is not “a flu like any other”.

The worst way to deal with COVID-19 is to be paralyzed, “finding things” (which is a “fantasy” and is not “all that the mainstream media propagates”4 or that it is “just a flu”). The daydream about the epidemic was by none other than the President of the Republic, the main person responsible for the negligence of the federal government that did not give the epidemic the due attention in January, taking too long to react with regard to Brazilians who were in China and who only in February began to show signs of trying to articulate federal actions with states and municipalities. But until mid-March, the country did not know of any plan to ensure assistance to thousands of patients who, it is known, will seek assistance in public and private services. Pressured by civil servants specialized in epidemiological surveillance, by state and municipal governments, and by public opinion, the federal government put its plan in motion to coordinate the fight against the pandemic in Brazil. Coordination, register, which is your constitutional obligation.

In exercising this role, however, the Minister of Health quickly realized the difficulties he would face. In addition to the worsening underfunding of the SUS, caused by Constitutional Amendment 95/2016 (the EC of Death, which froze SUS resources for 20 years), with the scrapping of services, and the lack of control of the system in many municipalities, as a result of the privatization of health units at various levels of care, the coordination of actions to contain the pandemic has been greatly hampered by the lack of credibility of the main authority of the Republic. As is known, the role of coordination requires respect and trust in those who exercise it. In this case, Bolsonaro's boastfulness at the head of the position he is a representative of, appointing a clown to speak to journalists, distributing "bananas" to interlocutors who are not his preference (reported that he would have given a banana to the new coronavirus) and other attitudes bizarre, undermine its credibility and this contaminates the entire government under its command, notably harming the actions of its Minister of Health. His media appearance, wearing a mask, was another disaster in social communication required at this time.

In this context in which the federal government is unable to coordinate the national effort to contain the pandemic well, a kind of save yourself who can prevails, with state and municipal governments, and institutions and companies, taking contradictory, often conflicting, decisions. It's a kind of sanitary mess. The State of São Paulo took, from who knows where, an unbelievable quantitative criterion that set an “acceptable” limit for holding events at 500 people. The University of São Paulo used 100. Magic numbers, bets. The blunder becomes a game.

The high transmissibility of the coronavirus recommends “social distancing”. The low lethality of SARS-Cov-2 is, compared to other epidemics, somewhat reassuring. But no one should be fooled by this, as an epidemic such as COVID-19 requires the adoption of measures aimed at organizing the provision of the necessary health care. The fact that Brazil has a universal health system, the SUS, gives the country a good infrastructure for this, as we have 42.488 Basic Health Units (UBS) and 538 Emergency Care Units (UPA). They are part of what is conventionally called the basic network. Health professionals work in these health units, generally well qualified, poorly paid and under precarious working conditions, which constitute the backbone of the system. This network, it is hoped, will make a positive difference in the epidemiological battle that has already begun. It also mitigates the fact that the remission of the disease is spontaneous, but until this occurs, it will put intense pressure on the hospital network, given the need for hospitalization, and can lead to death. Estimates indicate thousands of deaths, especially of very elderly people (over 80 years). Bearing in mind that the sustained (“community”) transmission of the virus indicates that we are in a scenario where the spread of the coronavirus will inexorably occur, coordinating actions so that the occurrence of cases is distributed as slowly as possible in the timeline is essential , as a preventive measure. It is also necessary to coordinate patient care to reduce the number of deaths. Here, in the ability to coordinate, relying on the support of the epidemiological intelligence developed by Brazilian public institutions, lies another enormous strength of the SUS. The country has thousands of well-qualified public servants who work in the area of ​​health surveillance and who, in this context, represent an invaluable resource. It is the SUS whose performance, usually, is not seen. 

In this context, in which the coordination of actions assumes strategic importance, being as important as knowledge about SARS-Cov-2, it is evident that Bolsonaro and his oddities not only do not contribute to the proper management of epidemiological control by SUS bodies throughout the country, like the President of the Republic himself, becomes part of the problem. He and those who support him in a politically organized way, as is the case of a movement involved in the organization of public acts across the country on March 15th, against the National Congress and the Federal Supreme Court. Ignoring and scoffing at recommendations to cancel events and maintain social distancing, they remained resolute in their actions, claiming they shouldn't back down "because of a freaking coronavirus". Protesters took the denialism from pandemic to climax. One declared that “the coronavirus has never killed a person on the face of the earth. It won't kill. Old people die from pneumonia and other things,” he explained. The President of the Republic and his acolytes are the most relevant political dimension of the COVID-19 epidemic in Brazil.

Humanity's main struggle, alongside the challenges of survival, has always been the struggle against ignorance, against the unknown. Certainly, satisfying hunger, finding shelter and surviving disease are permanent challenges for the human species. But, assured of survival, the Homo sapiens has in ignorance, lack of knowledge, fantasies and beliefs, the greatest threat to the species. Their everyday confrontation has a long history and registers passages that do not place us in any pantheon of species, or anything like that. There is no beginning for the record of those who paid with their lives for daring to challenge the powerful, in the name of knowledge, but the milestone represented by the condemnation and death of Socrates is undeniable. The long list includes Giordano Bruno and made non-fatal but equally regrettable victims, such as Galileo, Spinoza, Darwin, Unamuno, Freire and Snowden, to reach contemporaneity. 

Linsey McGoey, Canadian author of the book “The Unknowers: How Strategic Ignorance Rules the World"6, coined the expression “strategic ignorance” to characterize a phenomenon that concerns the omission of people, companies and governments that, faced with knowledge that may threaten them in some way, choose to ignore it, even if it is not, strictly speaking, ignorant, technically speaking.

Just as there are epidemics and epidemics (COVID-19, for example, is very different from the Ebola epidemic, given the great difference in lethality between the two), there is ignorance and ignorance. Stupid ignorance, the product of complete stupidity, has nothing to do with strategic ignorance. But the worst ignorance seems to be arrogant ignorance.

The arrogant ignorant thinks he is above everything and everyone, notably the laws and rules of social life. Nothing that concerns “the people” and “things of the people” concerns him. He has "nothing to do with it" and believes nothing other than his convictions on any subject. Nor to think that, for some collective reason (the interest of public health, for example), they would dare to restrict his “sacred right to come and go”. Such is the case of people who, having had contact with individuals proven to be carriers of the SARS-Cov-2 coronavirus, decide that they will not follow the recommendations of public authorities. Recent news records episodes of people in this condition who deliberately frequented social spaces of human influx, such as restaurants, temples, and shopping centers5. The arrogant ignoramus does not allow himself to be touched, not even remotely, by the knowledge that comes from scientific evidence. These mean nothing to him. He is not heir, nor does he seem to need the sacrifices of Socrates and Giordano. In the bonfires of the Inquisition, and in the book burnings of Nazism, the arrogant ignorant had the fire in their hands.

Ignorance, in its various forms, produces what could be characterized as a kind of epidemiological flat earth, which constitutes one of the main challenges to contain the COVID-19 pandemic in Brazil.  


1. RCB Cockroach. Meningitis: a disease under censorship? Sao Paulo: Cortez; 1988.

2. Chinese Foreign Ministry Spokesperson believes US may have brought COVID-19 to Wuhan. Sputnik Brazil. 12 Mar 2020. Available at: https://tinyurl.com/yx5acpkl

3. "This crisis will spread and result in disaster." By Tim Bartz. Greater Charter. Feb 28, 2020. Available at: https://tinyurl.com/scm48pr

4. "It's much more fantasy", says Bolsonaro about the crisis in the markets caused by the coronavirus epidemic. By Mariana Sanches. BBC News Brasil. 10 Mar 2020. Available at: https://tinyurl.com/ropkxn7

5. McGoey L. The Unknowers: How Strategic Ignorance Rules the World. London: Zed Books; 2019.

6. Even with the coronavirus, a patient from Brasilia attended a mall, church, etc. Power Diary. 12 Mar 2020. Available at: https://tinyurl.com/r396z7o

* Paulo Capel Narvai is Senior Professor of Public Health at USP

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