On this September 7th, the date of independence, Brazil missed an excellent opportunity to organize a national day to fight the Covid-19 pandemic, with a national vaccination effort, across the country. It could have been a national uprising against the virus, organized by the Ministry of Health, with a campaign in all mass media to inform society about the importance of faster vaccination and broad vaccination coverage and the importance of maintaining non-pharmacological measures until we begin to have a more sustained drop in cases of infection, hospitalization and deaths.
It would have been beautiful to see the SUS and PNI applying millions of doses of vaccines and hope, with the Brazilian population embracing the cause, in a national pact for freedom!
But there was none of that. There was no celebration of life or independence. What we saw were protests marked by disrespect for health protocols against Covid-19. The only person who celebrated independence on September 7th was Sars-CoV-2, which kills, just like the virus of ignorance, which is also a killer. In these protests, we saw thousands of people crowded together without masks, in open places, but also in countless closed places, bars, restaurants, cafeterias, stores, public transport, etc.
What we saw were grotesque scenes starring people who support discrimination, torture, loss of human rights, racism, violence, cracking, homophobia, military intervention and the overthrow of the Federal Supreme Court (STF). It is a fait accompli that we all lost something of freedom on this September 7th. Brazil, accustomed to waking up sadder every day because of the pandemic, woke up on the 8th with a feeling that barbarism is taking over society, overcoming civility.
Brazil reached the sad mark of 585.205 deaths from Covid-19 (underreported), the second country in the world in deaths, behind only the USA. We are experiencing an unprecedented health crisis, but also a water and energy crisis, an economic disaster, allegations of corruption and delays in purchasing vaccines, millions of people are hungry, living below the poverty line, unemployment is breaking records, millions of people in informality, rampant deforestation, indigenous peoples being disrespected, escalating violence, housing shortages and lack of basic sanitation, rising inflation, high taxes, public institutions scrapped, science and scientists under attack and being persecuted, a divided society and sadder. There's a lot of things wrong.
On the streets, we witnessed a hostile climate, of intolerance, hatred, stupidity, confused with an ugly, radical and undemocratic "patriotism". It is sad to see a government that has not built anything good and is destroying institutions, spreading hatred and dividing the country even further. These coup threats appear to demonstrate strength, but they reveal the weakness, imbalance and contempt for the laws and the Constitution, of part of those who promoted them. These people tried to cause chaos to take the focus off their own inability to solve Brazil's real problems. We need to pacify the country to face this pandemic. Dying from Covid-19 has been normalized. Brazilian society is sick, families are divided. What country are we building for our children? Enough of the irresponsibility. Enough of psychopaths in power, on social media and in the streets threatening our institutions.
We could have used the date as a moment of unity for the Nation against a virus that has already killed almost 600 Brazilians, thousands of them who could be here today.
If it weren't for the STF and the governors, who saved thousands of lives, many of us wouldn't be here today either. The STF saved us from the denialism of a government that from the beginning relativized the health crisis, attacked science, scientists, journalists and public institutions, that defended herd immunity that led to the tragedy in Manaus and that resulted in the Gamma variant, who defended the farce of early treatment, which since the beginning of the pandemic has been attacking movement restriction measures, the lockdown, physical distancing and the use of masks.
This is no way to celebrate the date of independence. It was not a day of unity, of celebration, it was September 7th that brought more division, more hate speech and institutional rupture. What is actually left of Brazil after this September 7th, 199 years after independence? Will we relive this on a larger and more dangerous scale on September 7, 2022, when we celebrate 200 years of independence? A few weeks before the date of a presidential election in which we can democratically purge this evil that is plaguing Brazil?
May this grotesque, undemocratic spectacle not be forgotten. At this moment, we cannot remain silent, we cannot be afraid, this is not the time to be exempt, quiet, we need to have courage to defend democracy and our epistemic institutions and fight in defense of the people we love. Many of them don't have the strength to fight, they need each one of us.
We need the union of all the forces of the democratic field, left, center and right, to defend the constitutional order and the Democratic Rule of Law against the forces of the radical extreme right in this country, who defend agendas addressing the closure of the STF and military intervention in democracy.
We cannot negotiate with authoritarianism or with coup plotters and we have to defend social justice and freedom, fighting against extremism. There is no possibility of accepting undemocratic acts, democratic values are non-negotiable. Democracy is non-negotiable. We will continue to fight against the Sars-cov-2 virus, which kills, but also against the virus of ignorance and murderous lies and against anti-democratic and fascist movements.
There have been many setbacks in the last 2 years and eight months. We're going to get through this and we're going to have a lot of work to rebuild the country. There's no harm that lasts forever. Civility must overcome barbarism. Our people need ethics in politics, food, employment, health, housing, basic sanitation, security, education, peace, science, a protected environment, vaccines, democracy and peace.
Note I: This column was supposed to be published on September 09th in the morning. It was not. I updated the data and information. The President made a forced retreat and published a letter saying that he did not lead the anti-democratic acts with coup statements. Mind! This coup attempt failed, he did not have the support he expected from society, the Armed Forces, and other coup politicians. But let's not fool ourselves, the coup is underway, the authoritarian escalation will not stop and he will attack again. We need to remain mobilized, alert and strong and we cannot underestimate the threats. To keep democracy alive, we will need plural and mature voices.
And may the STF dismantle the fake news creation machine set up by the hate office to destroy our Democracy.
A Brazilian Press Association (ABI) sent to the president of the National Congress, a open letter with a request for return of the Provisional Measure (MP) No. 1.068/2021 which violates the Marco Civil da Internet and allows the free dissemination of fake news, offenses and conspiracy theories. A MP was forwarded by President Jair Bolsonaro, on the eve of undemocratic acts and an attempted coup against the Democratic Rule of Law.
ABOUT THE VARIANTS
Variante MU
The World Health Organization (WHO) is monitoring a new variant of interest (VOI), B.1.621, named “Mu” and identified in Colombia. The name “Mu” (Mü) comes from the Greek alphabet, like the other variants and is the 12th letter of a total of 24 letters (let's do our part to stop the virus from spreading and mutating, so we don't have to use all of them). these 24 letters, guys, please). A VOI is not yet considered a variant of attention or concern (VOC).
VOCs are more dangerous and more transmissible, can cause more severe symptoms and escape the immune system's response and the protective response of vaccines. The WHO continues to assess the risks posed by new variants of Sars-CoV-2, considering the evolution of the virus and epidemiological changes. The new Mu variant has already been identified in at least 39 countries in South America and Europe and received its name because it has many “mutations”, which can lead to the escape of the protective response conferred by vaccines.
Imagine a scenario in which mass vaccination is accelerated and people maintain non-pharmacological measures; this way the virus will not circulate, so it will not replicate; if the virus does not replicate, it does not mutate; If the virus does not mutate, there is no risk of vaccine escape. The vaccines have arrived, but we cannot rely solely on them to get us out of the pandemic. We also need a collective pact, attitudes of empathy and social responsibility. Missing articles, I know.
In the future, more transmissible but less virulent variants?
The question always comes up as to whether we will eradicate Covid-19 from the planet with vaccines. I don't believe. I think that we will not eradicate or eliminate the virus, but we will cohabit with it, which in this evolutionary process is trying to adapt to the host organism, us human beings. I believe that Covid-19 will become a milder common cold, with Sars-CoV-2 becoming an endemic virus. Until now, just over 224 million of people were infected by the new coronavirus and its variants.
There are few of the most worrying attention variants that have emerged: Alpha, Beta, Gamma and Delta. The variants that became dominant were the most transmissible (Alpha and Delta) and not those that have a greater capacity to escape the immune protection response and greater potential to cause more serious cases, such as Beta and Gamma. We also know that vaccination leads to a decrease in the evolutionary capacity of the virus to mutate, so, in a scenario of mass and faster vaccination, we can expect that the new variants of concern will tend to be more transmissible and less virulent.
What is worrying is the scenario of very slow vaccination in vulnerable populations in low-income countries, which could lead to the possibility of a more transmissible and lethal variant emerging.
If a new variant appears capable of evading the protective response provided by current vaccines, we will still be able to update vaccine platforms to contain the genetic material of these new variants. The way out will always be through science and vaccination, respecting non-pharmacological measures, with testing and isolation of infected people and tracking their immediate contacts and monitoring variants of interest and concern through genomic surveillance.
Vaccine effectiveness remains with the Delta variant
Phase 3 clinical trials showed efficacy values for vaccines in preventing infection with or without symptoms, hospitalizations and deaths. Although vaccines are losing some of their effectiveness after just the first dose, real-world effectiveness after the second dose remains very good, preventing serious cases, hospitalizations and deaths. All of the vaccines in use are wonderful tools against Covid-19 and continue to save millions of lives.
Science is seeking to understand why some vaccinated people are becoming infected. Is it because immunity is decreasing over time for everyone? Is it due to the drop in protection in the elderly and immunosuppressed who were vaccinated longer ago? SIs it caused by the increased transmissibility of the Delta variant? SIs it a combination of these factors? Infection rates in people immunized with the full vaccination schedule are extremely low and these people are at less risk of hospitalization than those who have not yet received any dose of the vaccine.
People vaccinated with one dose or the full vaccination schedule, when infected with the delta variant, have high viral loads, similar to the viral load of unvaccinated infected people. However, science still does not know whether this higher viral load means that vaccinated people can spread the virus more. In vaccinated people, it is possible that these copies of the virus are not more contagious than the variant that infected them and it may be that the amount of virus in the bodies of vaccinated people decreases more quickly than in unvaccinated people.
ABOUT VACCINATION IN BRAZIL
Booster doses: Update
All available vaccines against Covid-19 protect against hospitalization, serious illness and death. Vaccines work, but they need help from measures like social distancing, hand hygiene and wearing masks. The top priority at this time is to vaccinate as quickly as possible all people who have not yet completed their vaccination cycle, whether with two doses or a single dose of the Janssen vaccine.
At this time, the booster dose is only recommended for vulnerable populations with a weakened immune system, such as the elderly who took their second dose or a single dose of Janssen at least 6 months ago and for people with comorbidities who have completed their regimen. vaccinel at least 28 days ago. This booster dose or additional dose is being considered as a precautionary measure for the elderly and immunosuppressed.
In the city of São Paulo, the booster dose began to be applied from 06/09/2021 for seniors over 90 years old. Elderly people over 60 years of age, who took the second dose six months ago in the capital, can try to get vaccinated using the “xepa” doses of vaccines. You need to bring proof of vaccination, photo ID and proof of residence.
On the page Sampa vaccine, you will find information about vaccination sites in the city of São Paulo. For information about vaccination in the State of São Paulo, click on the website VaccineNow. On the website of LocalizaSUS, You find information about the National Vaccination Campaign against Covid-19.
ABOUT VACCINATION IN WORLD
Vacination in low-income countries and the Americas
There is an urgent need for immediate distribution of, pat least one billion doses of vaccines for 92 low-income countries, essential to start protecting around 5 billion people aged 15 and over. These 92 countries have only received 89 million vaccine doses to date.
The richest countries purchased just over double the doses needed to vaccinate their populations, but at this moment, it is time to show empathy and solidarity with people in low-income countries, who have not been able to vaccinate even their health professionals working. on the front line and not even the most vulnerable groups. 1,9% only of people in low-income countries have received at least one dose. How the world will emerge from the pandemicit's mine at this rate?
According to the website Our World in Data, to date, around 25% of the population of the Americas has been immunized with two doses or a single dose of Janssen. With the aim of increasing the distribution of vaccines in Latin America and the Caribbean, the Pan American Health Organization (PAHO) launched a platform to receive donations of vaccine doses and to purchase more doses with the aim of filling the lack of vaccines against covid-19.
The countries with the lowest vaccination rates are Haiti, Nicaragua, Jamaica, Guatemala, Venezuela and Honduras. At least 550 million doses of vaccines would be needed to ensure that all countries in Latin America and the Caribbean have 60% of their populations vaccinated, which may not even be enough to stop the spread of the Delta variant. The situation is very worrying in Haiti, where an earthquake occurred in mid-August and which began vaccinating its population only last month, and to date, only 0,3% of its population has received a dose of the vaccine. Hospitals are overloaded and a large part of the population is without medical care because they cannot reach hospitals. In Nicaragua the percentage of people who received a dose is 6,9%, in Jamaica it is 14,7%, in Guatemala it is 19,6%, in Venezuela it is 20,9%, and in Honduras it is 28,8 %.
ABOUT IMMUNIZATION
Complete immunization reduces cases of long Covid in infected people
Um study by British researchers, published in the scientific journal The Lancet on 01/09/2021, shows that people vaccinated with two doses of the Pfizer-Biontech, Moderna and AstraZeneca vaccines, who were infected by Sars-CoV-2, in addition to having a lower risk of contracting serious illness, have 50% less chance of having long Covid-19 or of registering symptoms for more than four weeks, when compared to unvaccinated people who were infected. Around 971,5 thousand people who received both doses were monitored by entering data into the application Zoe and only 2.370 people (0,2%) declared having been infected.
The research also indicated that elderly people with comorbidities are more susceptible, especially after receiving only the first dose. One study recent from USP shows that around 60% of 750 patients hospitalized at Hospital das Clínicas, who recovered from Covid-19, present sequelae of the disease such as muscle fatigue, memory loss, cardiological, respiratory and emotional problems for periods longer than a year.
Coronavac: Studies in children, adolescents and adults over 60 years of age
On 28/06/2021, a clinical trial double-blind, randomized, controlled, phase 1/2, published in the scientific journal The Lancet Infectious Diseases, showed the safety, tolerability and immunogenicity of CoronaVac in 552 healthy children and adolescents aged between 3 and 17 years. The study tested two doses of the vaccine, a lower dose of 1,5mg and another higher one, 3,0mg of inactivated virus.
The best response in terms of production of neutralizing antibodies was obtained with the highest concentration of the vaccine, which proved to be safe and well tolerated, with normal adverse reactions such as pain at the application site and a little fever. Efficacy results for this population will only be known after the completion of the phase 3 study.
On 01/06/2021, another clinical trial A randomized, double-blind, placebo-controlled phase 1/2 trial, published in the same journal, showed the safety, tolerability and immunogenicity of CoronaVac in healthy adults aged 60 years and over. The vaccine was administered in two doses at an interval of 28 days and used aluminum hydroxide as an adjuvant. In phase 1, each dose was 3 μg of inactivated virus in 0,5 mL of aluminum hydroxide solution.
In phase 2, participants were randomly assigned (2:2:2:1) using block randomization to receive CoronaVac at 1,5 μg, 3,0 μg, or 6,0 μg per dose, or placebo. Volunteers in the placebo groups received only the aluminum hydroxide solution. The rResults showed that CoronaVac is safe and well tolerated in older adults. Neutralizing antibody titers induced by the 3 μg dose were similar to those from the 6 μg dose and higher than those from the 1,5 μg dose, supporting the use of the 3 μg dose of CoronaVac in other phase 3 trials to assess protection against covid-19.
Read editorial about the CoronaVac vaccine published on 02/09/2021 in the magazine The New England Journal of Medicine.
CoronaVac batches suspended by Anvisa
About the quality of the 25 batches of CoronaVac vaccine sent to the PNI and banned by Anvisa (read official information from the Butantan Institute). A Anvisa suspended the application of these batches because the packaging took place in a Chinese factory that was not inspected by the agency nor approved by the Emergency Use Authorization in Brazil.
Butantan guarantees the safety of batches of immunization agents and that the quality of the doses was certified by the Institute's very strict quality control. Butantan sent the documentation to Anvisa and the suspension was a precautionary measure that should not generate alarmism. Find out more information.
New pandemics with deforestation? What is the future?
Um report prepared by the task force scientific on pandemic prevention, convened by the Harvard Global Health Institute and the Center for Climate, Health, and the Global Environment from the Harvard University School of Public Health, brings very worrying data on how the Deforestation can increase the chance of new pandemics. The report makes clear that environmental conservation is one of the most important strategies to prevent new diseases. There are thousands of viruses in balance in these ecosystems.
Deforestation leads to imbalances in the ecosystem, leading to climate change, which will impact the emergence of new diseases. The document list other fronts such as greater restrictions on the consumption of wild animals and the creation of a global network for surveillance of pathogens in humans, to identify Emergency hotspots for viral zoonoses, including assessments of the causes of the pandemic, conservation of tropical forests, improving aspects of biosecurity for livestock and farmed wild animals, especially when animal husbandry occurs close to large or rapidly expanding human populations.
Save the Amazon. Save the jungle or the world won't be saved. Before it reaches the point of no return.
Note II: The word covid-19 was incorporated as a new feminine noun in Spelling Vocabulary of the Portuguese Language, from the Brazilian Academy of Letters (ABL). The correct spelling of the disease caused by the Sars-CoV-2 virus infection is: covid-19, which is no longer considered an acronym, becoming a common name.
Observation III: The articles published do not reflect the opinion of Jornal da Unicamp. Its publication aims to stimulate the debate of ideas in the scientific, cultural and social spheres.
