‘Dismemory in relation to Covid is very dangerous’, says Fiocruz doctor

The pulmonologist and researcher at Fiocruz Margareth Dalcolmo, 67, says she is concerned about the lack of memory of Brazilian society in relation to the Covid-19 pandemic and says that “we do not have the right” to forget what we went through.

“I am sad that the memory so harsh of Covid-19, which left so many scars, so much grief, has been forgotten. This lack of memory is very dangerous. It represents a kind of denial”, says the doctor, author of the book “Um Tempo Para Don’t Forget” (Editor Bazar do Tempo), about the pandemic.

The doctor says she was surprised by the election of parliamentarians who, during the pandemic, acted against scientific knowledge, such as former Minister of Health Eduardo Pazuello, the second most voted federal deputy in Rio de Janeiro.

On the 21st, Dalcolmo takes over the 12th chair at the National Academy of Medicine. She is the fifth woman in the institution founded in 1829, under the reign of Emperor Dom Pedro 1º.

Mrs. says that the pandemic is a time that cannot be forgotten. But the topic has practically disappeared from people’s daily lives. Is it time to forget? This memory worries me a lot. When we see elected parliamentarians, who had a harmful participation in Brazilian society, who discredited solid knowledge about non-pharmacological care, such as physical distancing and the use of masks, it surprises me. I am sad that the memory so harsh of Covid-19, which left so many scars, so much grief, has been forgotten.

This lack of memory is very dangerous. It represents a kind of denial. As a doctor, I recognize that when we go through a situation of extreme suffering, we tend to wait for that scar and forget about it. However, the Covid pandemic is collective.

Eduardo Pazuello’s administration at the Ministry of Health was marked by the lack of oxygen crisis in Manaus and by encouraging the use of chloroquine to prevent Covid. However, he was the second most voted federal deputy in Rio de Janeiro. Former minister Luiz Henrique Mandetta, who acted in favor of science, did not get a seat in the Senate. How do you evaluate these voter choices? Mandetta was a candidate for Mato Grosso do Sul, his state, and there was already a historic setback since his departure from the ministry. The power of agro is very strong in the Midwest, and former minister Tereza Cristina showed, during her time at the ministry, a lot of efficiency in what she did. So it was expected [o resultado].

Now, what is surprising is that a state like Rio de Janeiro, which has suffered so much, which has had the highest death rate from Covid, has elected General Pazuello, who was such a controversial minister, who had a disastrous stint in the Ministry. of health.

What can we expect from the Covid pandemic going forward? First, the pandemic is not over yet. We would need to rescue these thousands of Brazilians who were not fully vaccinated, with standard and booster doses, and, above all, vaccinate our children. We were one of the countries where the most children under five died.

But I don’t think we will have another heavy wave of Covid. Perhaps we will still have micro-epidemics of subvariants in a very heterogeneous way. It won’t be like the Spanish flu, which had a second wave even more tragic than the first.

Mrs. Do you believe that we will have to take annual vaccines to prevent Covid? I do not believe. We will have a second generation of vaccines. Every vaccine we’ve received to date has been built with the spike protein from the ancestral strain. [de Wuhan, na China]. Second-generation vaccines are being built with the spike protein of the omicron strain, which is the one that circulates in the world. And we have the prospect of nasal vaccines, which makes perfect sense for a virus that enters through the upper airway.

There are doctors who have not been vaccinated against Covid and who also do not recommend that their patients do so. Likewise, many doctors defended ineffective drugs for Covid. Did that surprise? More than surprising me, it disappointed me. It hurt me personally every time I saw a colleague [negacionista]. What was the big “breakthrough” [avanço] the science of the last two decades? Undoubtedly, it was the vaccines against Covid-19.

Brazil is a paradigmatic country because it was the one that put the most volunteers in the studies, but did not buy the vaccine in time. By October 2020, ten countries had already purchased 75% of all vaccines being produced. And Brazil was not one of them. We could have started vaccinating in December 2020 when the UK started, not January [de 2021]. We could have saved more lives.

But they stayed with that herd immunity speech, which we always said was wrong, and Manaus showed, in a dramatic and unnecessary way, that we were right. Four months after the first epidemic peak, no one else had immunity, there was no lockdown there, there was nothing, the gamma strain was born there and it was all that disgraceful.

Why is the coverage of childhood vaccination against Covid so low? There is a discredit, Brazilian families, especially low-income families, were contaminated by a harmful discourse of disinformation, which contradicts the Brazilian culture of extreme adherence and trust to vaccines.

I’ve graduated for 40 years and every time a father or mother arrives who proudly shows that card filled up, it’s a happiness. This cannot be jeopardized as it was now.

Brazil won the award for vaccinating and almost eliminating measles in 2016 and lost it in 2019. Brazil has eradicated polio and we are at risk of having polio again, with vaccination coverage that is no more than 67%. That is inadmissible.

Mrs. was infected by Covid at the beginning of the pandemic and has written about grief. How did you handle it? In the pandemic I lost friends, my sister almost died. I got sick at the end of April 2020, I contaminated myself working. I was afraid of dying, I kept waiting for the shortness of breath to arrive, I expressed all my wishes in a notebook, I even made a power of attorney, I said everything I wanted to be done in case I was intubated, which, fortunately, did not happen. .

There are many people still living this grief. People that the father, mother, spouse hospitalized and never came back. Life was interrupted without preparation. I saw a lot. People who changed their will, people who wanted to formalize a stable union. We don’t have the right to forget everything we experienced in the pandemic and are still living.

The pandemic has also had an impact on other diseases that have gone out of control. Mrs. is a tuberculosis specialist. What have you seen in the office? In cancer and cardiovascular disease, the tragedy was complete. We will still lose many Brazilians from cancer in the next two years due to lack of diagnosis or delay in treatment.

In the so-called endemic communicable diseases, and tuberculosis is a very paradigmatic example, we also had a bad impact. We had 40% fewer molecular tests applied for diagnosis. Many services stopped working, people were left without access to medicine, treatment was interrupted. We are going to have a boom in cases in the next few years.

like mrs. Have you seen these 2023 budget cuts in areas like health, science and education? As a doctor who attends and does research, as someone who works in a public institution of the relevance of Fiocruz, I am very concerned about the cuts being made against our future.

It’s not just cutting the utopia, our dreams, it’s cutting the future objectively. To the extent that you stop investing in the generation that will succeed us, any cut in science, technology and innovation is catastrophic.

We are an aging country. By 2040, 15% of the population will be over 60 years old. We have to have clear projects, knowledge generated for the care of an elderly population. Even with all the logistical, operational and political adversities we faced during the Covid-19 pandemic, Brazil managed to be the tenth country in scientific production on the subject. We produce all the time under a permanent tension between the official rhetoric and ours, of science

Brazilian society has to understand that what is at stake is not the interest of groups of researchers, it is a matter of the State. Failing to invest in this area puts us far behind this competition. Brazil is suffering from an exodus of precious brains because they cannot find conditions here to perform their functions. It should make a move to repatriate the brains that left.

Margareth Dalcolmo, 67

Doctor in Medicine at Unifesp (Federal University of São Paulo), she is a senior researcher at Fiocruz and was elected president of the Brazilian Society of Pulmonology and Tisiology for the period from 2022 to 2024. She is a member of the WHO expert group for the approval of essential medicines and is part of the World Bank’s regional committee of consultants for health projects in Sub-Saharan Africa on tuberculosis and occupational respiratory diseases. She has more than one hundred scientific articles published in Brazil and abroad. She is the author of the work “A Time Not to Forget – The Vision of Science in the Face of the Coronavirus Pandemic and the Future of Health” (published Bazar do Tempo).