During the covid-19 pandemic, I used this space on Journal of Unicamp to bring information based on the best science. Now, I return to close a cycle, commenting on the declaration by the World Health Organization (WHO) that put an end to the covid-19 pandemic as a public health emergency of international importance.
After just over three years, the WHO, through its director-general, Tedros Adhanom Ghebreyesus, declared, on May 5, 2023, the end of the covid-19 global health emergency. It is worth remembering that the emergency was declared by the WHO on January 30, 2020 and covid became a pandemic on March 11, 2020.
The WHO announced that, according to its experts, at this time, covid-19 no longer represents an international health threat.
In fact, this is an administrative measure, of a more bureaucratic nature, given that today we have fewer cases of Covid infection, fewer people being hospitalized, fewer deaths from Covid. There are consistent drops in all these indicators. And, when we are in an emergency, the WHO adopts exceptional attitudes, such as mechanisms for supplying vaccines and tests, changes in regulatory criteria and in the acquisition of medicines, in addition to the organization's political role as a source of reliable information and guidance during the emergency period. .
The fact is that many countries have already adopted measures ending states of emergency caused by Covid. However, andThere is a fear that, without the pandemic status, governments around the world could reduce investments, compromising the monitoring of the disease, the sequencing of samples and the identification of new variants.
The WHO promised to continue some of these actions, mainly because there are many other diseases that affect neglected populations and whose fight has been significantly hampered. Low-income countries need the WHO to be able to tackle various diseases, including Covid, which cannot continue to kill, given that we have safe and effective vaccines available.
But it's great to emerge from the global emergency, to leave the acute phase behind. This is a long-awaited, long-awaited moment, and we must celebrate because back then, at the beginning of the pandemic, there was a lot of fear and many uncertainties. But, with the WHO's decision, this moment should also serve as a reflection.
Covid-19 killed almost 7 million people according to official data, an amount certainly marked by a lot of underreporting. The WHO itself considers legitimate calculations indicating that around 20 million people died from the disease.
In Brazil, faced with a government that adopted a denialist and anti-science stance, a government whose actions in the pandemic proved to be a real disaster, making it difficult to effectively combat the pandemic, the disease killed around 702 thousand people, a number also certainly marked by underreporting. According to the Epidemiological Bulletin No. 148 from the Ministry of Health (MS), with data up to February 2023, there were 231.571 deaths in 2020, 383.876 in 2021, 62.875 in 2022 and 1.312 in 2023, totaling 679.634 deaths, an amount slightly lower than the current approximately 702 thousand, but an amount still under process of review and update.
According to data from epidemiological bulletins 44, 92 and 148 of the MS, since the beginning of the pandemic, there have been 3.528 deaths from covid-19 in the age group of 0-19 years, with 1.125 deaths in the age group less than 1 year, 615 deaths in the age group of 1-5 years and 1.783 deaths in the 6-19 age group. These numbers are being reviewed and updated for the year 2023.
The country was on the list of places with the highest contamination rates in the world. Brazil has around 2,7% of the world's population, but recorded around 11% of deaths caused by Covid. This is something unacceptable.
During the first year of the pandemic, we didn't have vaccines, there was a lot of fear, insecurity, doubts. We saw a lot of suffering and pain.
We will never be able to forget the images of crowded hospitals, field hospitals, and the denialists who invaded hospitals to say they were empty. We cannot forget the people who said Covid was a little flu, the people who underestimated the disease that soon became the most devastating pandemic of the century, the backhoes digging holes, the lack of oxygen in Manaus, the lack of character of those who defended chloroquine, ivermectin, rectal ozone therapy against covid, of the approximately 4 thousand deaths per day in April 2021. We had the worst Health Ministers this country could have, after the resignation of Minister [Luiz Henrique] Mandetta and his team.
We saw the pain and suffering and we cried with the pain and suffering of those who lost family members to Covid. We saw exhausted healthcare professionals. We go through periods of quarantine, lockdown, we wash our hands frequently, we wear masks, we maintain physical distancing, we feel the absence of hugs and gatherings with family, friends, work, we give classes, we attend countless lives, all remotely, in front of the coldness of computer and cell phone screens (which, in any case, brought us some comfort).
But a central factor in allowing the most acute phase of the pandemic to end was the improvement in the epidemiological scenario thanks to vaccines. Ah, the Covid vaccines, those marvelous creations, represented an extraordinary victory for science.
The world has undergone a historic vaccination campaign, with around 5,6 billion people on the planet taking at least one dose of a vaccine in a period of just over two years — around 70% of the world's population. There were approximately 13,4 billion doses applied in total. Vaccines have saved millions of lives and prevented an even greater tragedy.
But this latest WHO decision cannot cause confusion. The global emergency is over, but the threat is not. Covid is not over, it has not been eradicated. The virus continues to spread and Covid should still be a cause for concern. We need to continue monitoring the disease, sequencing samples and identifying new potentially worrying variants. And we must continue vaccinating the population. At the beginning of the pandemic, we did not have vaccines. Today we have safe and effective vaccines that protect against serious illness and death. With vaccines, people get sick less, die less and there is less chance of new dangerous variants emerging.
Today we still have new sublineages of the omicron variant circulating. We need to prevent a new, more dangerous variant from appearing. To achieve this, it is essential to continue vaccinating the population, especially the elderly, people with comorbidities, the most vulnerable. Pfizer's bivalent vaccine is available to everyone aged 18 and over. Today, just as important as applying the bivalent vaccine to priority groups is ensuring at least three doses of vaccines for those who have not yet completed this vaccination schedule.
We need to monitor possible new variants of Covid to help with future decision-making and it will be great if we have even better vaccines in the future.
We also need to continue ensuring access to vaccines, medicines, supportive care and life-saving interventions for vulnerable populations in low-income countries. The concentration of doses in the hands of a few countries at the beginning of the immunization process was one of the saddest facts of the health crisis and an example of the failure and incompetence of the international community in providing a well-orchestrated response to the pandemic. These therapeutic alternatives have to reach there, to the tip. The world needs to be less selfish in order to guarantee access to medicines, vaccines and all life-saving interventions for those who need them most. There cannot be so much imbalance, we cannot have countries accumulating doses of vaccines while the populations of the poorest countries suffer due to lack of access to these resources. Without a doubt, thousands of lives could have been saved if there had been a fairer and more equitable distribution of vaccines against Covid-19. We cannot accept that the trade sanctions regime dominates the debate and harms the conclusion of agreements in complex moments like this.
In a serious health crisis like Covid, we all have responsibilities.
During the pandemic, unfortunately, we saw the worst of human beings. Politicians, some journalists and press organizations, religious leaders, former athletes disguised as journalists linked to far-right media, pseudoscientists, some doctors, some professional bodies and councils, all united with the anti-vaccine movement, fueling an anti-science wave that planted doubts in the population and made the effective fight against the pandemic extremely difficult, spreading lies, fake news and disinformation, contributing to killing people.
We will need to continue this insane fight against anti-vaccine groups that are negligent in life, devoid of empathy, who have spread and continue to spread conspiracy theories and fake news killers against vaccines.
Denialists contributed to the death and illness of many people. We lost lives that were not supposed to be lost, people who were abandoned by a denialist government. I wrote in Journal of Unicamp about the process of disinformation and dissemination of fake news carried out by official bodies of the federal government, harming the health of the Brazilian population. And all those who adopted an anti-vaccine discourse should be placed in the dustbin of history.
But, even with the success of vaccines in controlling the pandemic, those people remain firm and on duty in their intention to lie, many of them to defend a far-right narrative that preaches disinformation and hatred with a view to fueling their power project. Some because they have political projects, others because they just want to make money, like these fraudsters and charlatans without solidarity who charge for false “vaccine detox” treatments to eliminate the supposedly toxic components present in vaccines. Vaccines that have been exhaustively studied, that have been approved by regulatory agencies around the world and that have gotten us out of this pandemic.
The vaccines were administered free of charge, but these charlatans, who never contributed to combating the pandemic, only told lies and today they are making huge profits from false treatments without any type of efficacy.
They say that the vaccines are experimental and sell fakes such as ozone therapy, ivermectin to sequester heavy metals, the spike protein, etc., all without any scientific proof. These charlatans are getting rich at the expense of the naivety of part of the Brazilian population. There are a lot of people out there frauding vaccination cards. And these people will distort this latest WHO decision, as, in fact, they are already doing.
But there were also many fantastic professionals who showed their value and the best of human beings.
Here in Brazil, the performance of our Unified Health System (SUS) stood out, as did several valuable professionals in the health sector, doctors, nurses, scientists, teachers and researchers from the most diverse areas – because all areas are human (the human, social, exact) –, from science popularizers, from a large part of the media, which defends life, from journalists talking about science. We were witnesses to the fantastic contributions of our research institutes such as Butantan and Fiocruz, our public universities (federal and state), some private universities, entities such as the Brazilian Society for the Progress of Science (SBPC), the Brazilian Academy of Sciences (ABC) and other scientific societies, which came out in defense of science, vaccines and life. And we overcame denialism and the growing anti-vaccine movement in Brazil. However, despite all this effort, we have fallen behind in childhood vaccination and the application of the bivalent vaccine. We need to continue this insane fight against misinformation. Enough of the denial of a misgovernment based on lies and fake news.
Thanks to vaccines, which saved millions of lives on the planet, the WHO was able to declare the end of the health emergency resulting from Covid. But we cannot forget this tragedy, as it was not just the 702 deaths. We have long Covid, which will require attention from health systems for a long time.
We need to remember and leverage what we have learned to prepare for future threats. We can no longer make the same mistakes.
This text does not necessarily reflect the opinion of Unicamp.
