Opinion – Marcia Castro: Life at risk, but with freedom?

Almost eleven months after the first person was vaccinated against Covid-19 in Brazil, about 77% of the population received one dose, 65% received two doses or a single dose, and almost 10% received a booster dose.

These numbers exceed the vaccination coverage of some countries that started vaccination before Brazil (such as the United States).

The rapid expansion of vaccination in Brazil reflects the legacy of public health campaigns since the beginning of the 20th century, the National Immunization Program, and the SUS (Unified Health System).

Against this legacy are the actions, omissions, and the speech of the presidency and the Ministry of Health. On the one hand, Brazil could have even greater vaccination coverage were it not for the deliberate delay in the purchase of vaccines, as shown in the final report of the CPI (Parliamentary Commission of Inquiry). On the other hand, the message of the presidency was not and still is not supportive of vaccination; the president did not get vaccinated and made it clear that he will not.

The emergence of the Omicron variant highlighted three important aspects.

First, the importance of genomic surveillance. Although South Africa has sequenced less than 1% of the samples, when an area of ​​the country recorded a disproportionate increase in Covid-19 cases, sequencing efforts were concentrated in this area, which made it possible to identify the new variant.

Globally, genomic surveillance is precarious and uneven. Brazil still does not have a genomic surveillance network with state representation. ITpS (All for Health Institute), founded in February this year, intends to contribute in this area.

Second, the geopolitics of the pandemic. There is inequality in the distribution of equipment, supplies and vaccines. The disparity in immunization coverage is critical (only 3.5% in low-income countries).

The decision of some countries to close the border to flights coming from South Africa and other African countries after the emergence of Ômicron is not a measure of containment but a discrimination, which penalizes correct, responsible and transparent attitudes.

Third, the need for leadership to quickly manage change during the pandemic with the goal of saving lives. Just as the virus mutates, adapts, the responses must also adapt. However, since the beginning of vaccination there has been no adoption of new measures to control the pandemic in Brazil.

The expansion of vaccination coverage is essential, but vaccination alone is not enough. The vaccine prevents severe cases, hospitalizations and death, but not infections, and the infected person, even without symptoms, can transmit the virus.

Therefore, it is inconceivable that measures to contain the virus through mass testing, and the adoption of the vaccine passport, are inconceivable, especially with the approach of summer and New Year’s Eve parties.

In this aspect, the recent controversy over the adoption of the vaccine passport started yet another regrettable chapter of the lack of governance in Brazil, which demanded the action of the STF (Supreme Federal Court). The health minister argued that the passport could discriminate against people and quoted the president as saying “sometimes it’s better to lose your life than to lose your freedom.”

Contrary to Anvisa’s recommendations, the government rejected the vaccine passport and decided that people who have not been vaccinated can enter Brazil as long as they undergo a five-day quarantine, inform the address where they will be, and undergo an RT-PCR test on the fifth day . There are no protocols and organized logistical structure for municipalities to track travelers for five days. This measure seems more like a deliberate action to undermine the credibility of the SUS.

On the day that this decision would be implemented, the STF determined the mandatory nature of the passport.

Nothing supersedes the right to life. If this were the maxim to inspire the actions of the Ministry of Health, the STF would not need to intervene.