Three years ago, on March 11, 2020, the World Health Organization (WHO) declared the covid-19 pandemic. Since then, more than 700 million people across the planet have been infected by the disease, with almost 7 million of them dying. In addition to fundamentally changing the way society lives, works and interacts, SARS-CoV-2 represented an enormous challenge for science, demonstrating that the scientific community, when working together, is an important ally in solving global problems. .
“It was very clear that when there is a lot of investment in science and the union of all people with the same objective, you get relatively quick answers”, comments infectious disease specialist Raquel Stucchi, from the Faculty of Medical Sciences at Unicamp. With the genetic sequencing of the virus obtained in February 2020, researchers were able to determine the DNA structure of the pathogen, enabling, for the first time in history, the use of this knowledge to build, in real time, public health responses to a pandemic.
One of these responses was the development, in record time, of safe and very effective vaccines in preventing serious forms of Covid, as knowing the structure of the infectious agent made it possible to investigate the ways in which it acts and produces the disease. In the case of SARS-CoV-2, this starts with the Spike protein, a kind of spine of the virus, which connects to a receptor called ACE2 to enter human cells. “Vaccines generally contain a weakened part of the infectious agent or a toxin produced by it so that the body produces antibodies, which are defense cells. And vaccines against Covid-19 were created to generate antibodies against this Spike protein”, adds Stucchi.
A novelty, however, was the use of vaccines that use RNA transport technology, the genetic material of the virus. In this type of immunizer, cells receive an RNA sequence containing the information necessary to produce a protein that stimulates the body's immune response. But it is important to emphasize: although it has never been applied to populations, this type of vaccine is not a new technology. The use of messenger RNA for the production of vaccines had been studied since the 1990s and already had well-established safety protocols. What the researchers did was just turn their focus to Covid-19.
Alessandro Faria, professor at the Institute of Biology (IB) at Unicamp, who heads the Department of Genetics, Evolution, Microbiology and Immunology, explains that the completion of this vaccine was speeded up because the entire world stopped to focus solely on this subject. Furthermore, he adds, there was a level of research funding never seen before. The United States, for example, paid almost 2 billion dollars to guarantee the purchase of 100 million vaccines that were still being produced by Pfizer, even though there was no confirmation that the venture would be successful.
“If you think science is expensive, try getting sick. This is a phrase from American philanthropist Mary Lasker that shows that early investment has results”, argues the professor. “Investing in development is cheaper, because it allows us to have national technologies, instead of buying them, and because we can redirect research according to our interests, as was the case with covid-19. Science seems like an expense, but it is perhaps the biggest investment, because it is something that easily pays for itself over time”, she guarantees.
Diagnostic front
Farias was one of the coordinators of Unicamp's Task Force against Covid-19 (FT), an initiative that put the university's infrastructure at the service of the fight against the disease. In addition to research on the topic, FT was responsible for a diagnostics front, led by the professor, which carried out more than 300 PCR tests, becoming the second largest testing structure in the state of São Paulo. Together with the Clinical Pathology Laboratory at the Unicamp Hospital de Clínicas, it became the first place in the country to receive validation for testing without a second test, which reduced the average waiting time for a diagnosis from 17 days to 24 hours.
According to the researcher, a challenge faced by the Task Force that ended up generating a positive balance was the scarcity of supplies on the market for carrying out testing, which were generally imported. Because of this, Unicamp established partnerships with several companies to produce national alternatives, which brought the country the ability to carry out tests with 100% Brazilian technology. “Testing was the basis for understanding what was happening, even weeks in advance, because if we saw the number of positive results rising, we knew that in a few days they would be even higher”, comments the professor.
Currently, Unicamp continues to carry out around 500 tests per week, although much of it is preventive, as in the case of tests on patients who will undergo transplants. According to the professor, the University is currently in a well-stabilized scenario, with a good quality of monitoring, but Covid-19 will continue to be part of society's routine for some time, mainly due to the way the pandemic was handled.
This is also the understanding of IB professor Ana Arnt, for whom Covid-19 is being mistakenly treated as the flu. Although the situation is relatively calm compared to previous years, 5 thousand people died as a result of the disease in the first two months of 2023, a number well above other infectious diseases that affected the population until 2019. “I think we will still live with the covid for a long time, because there is no vaccination coverage that can cover it in a short space of time. For example, it took us decades to control measles and polio in Brazil. So, we will have times of outbreak and, if everything goes well, with fewer and fewer deaths. But more people are still dying than should be,” she warns.
Science is not static
Ana Arnt's comment may seem discouraging, but the professor remembers that those who discussed Covid-19 without sensationalism were already warning about this in 2020. Since 2019, the biologist has coordinated Unicamp's Science Blog network, which was the first institutional vehicle for dissemination scientist to have an exclusive website on the topic. The Covid-19 Special, launched on March 21, 2020, contains more than 300 texts, produced by 110 authors, and almost 2 million views, having been an important ally in ensuring quality information during the health crisis.
“In the first six months of the pandemic, we woke up to hundreds of daily messages on our social networks, with doubts from people completely lost about what to do and how to do it”, reports the professor, remembering that an important field of action was combating misinformation that came from everywhere, including official vehicles. “We had no allies within the executive branch, in terms of representatives. Each official statement was a space for us to, the next day, combat the misinformation that was arriving”, she laments.
To some extent, this misinformation was appropriated by the fact that, at the beginning of the pandemic, the scientific community itself was still learning how the virus behaved, and some information coming from scientific authorities seemed to contradict itself. At that time, for example, protective guidance focused more on encouraging hand cleaning than on wearing masks and physical distancing, and many people used the changes in opinion to invalidate what scientists were saying. As Ana Arnt explains, this change in positioning is intrinsic and positive for the proper functioning of science.
Until scientists began to understand the mechanisms of SARS-CoV-2 in more detail, protective measures needed to be based on models of previous infectious diseases, such as H1N1, Zika and swine flu, because there was a health emergency and it was impossible to stay still. “Science is not static. It is a space for questions, not for certainties, and the change of opinion is linked to the understanding we have acquired. Cleaning hands and face is important for many infectious diseases and, perhaps, at that time when there was still no distancing, it may have contributed to reducing transmission”, he supposes.
Lessons for the future
Ultimately, science is made up of the accumulation of knowledge, and the models that emerge in an emergency end up being applied in the future. In 2010, due to the H1N1 epidemic, the Ministry of Health created the Interministerial Executive Group to monitor health emergencies with the aim of assisting in proposing faster health measures in new crises. This group was essential at the beginning of the covid-19 pandemic, generating the first epidemiological bulletin and a document on the emergency situation on January 23, 2020, a few days after China officially announced the outbreak of the disease.
For infectious disease specialist Raquel Stucchi, one lesson learned from the Covid-19 pandemic was that, today, society is prepared to act more quickly in public health emergencies. On the other hand, she also believes that we have not yet learned to deal with inequalities between nations. “We have acquired a great deal of knowledge about ways to control and prevent the disease, but the distribution of medications and vaccines is still very unequal, favoring rich countries and keeping economically disadvantaged nations at risk. Unfortunately, the pandemic was unable to change this”, she criticizes.
This becomes evident when it is noted that, in January 2023, 70% of the population of the African continent had not received any dose of the vaccine against Covid-19, according to data from the Centers for Disease Control and Prevention (CDC) in Africa. This discrepancy demonstrates that science does not occur disinterestedly and that, while the priority of nations in the pandemic was to develop a vaccine, there was not the same commitment to its equitable distribution among countries that cannot pay for it. In addition to intensifying inequality between countries, the absence of vaccines means that the virus continues to circulate freely, which will mean that the pandemic will continue to be a reality.
“In terms of public health, we are worth very little as individuals, because the other side matters for the protection of everyone”, comments Alessandro Farias. “Vaccines are perhaps the most altruistic concept there is, because we think we are protecting ourselves, but everyone who gets vaccinated contributes to protecting a portion of the general population. So we need to understand that being collaborative is something advantageous and that if we come together we will generate faster results, based on the vision of how much we are a unit. This, after all, is the idea of community”, concludes the professor.
