Elected government will provide 5th dose against Covid if science recommends it, says member of the transition

Former Minister of Health and medical specialist in public health Arthur Chioro, who is part of the coordination of the Health team in the transitional government, said that the management of Luiz Inácio Lula da Silva (PT) will be guided by scientific evidence and that there will be an offensive against denialism.

“Do not doubt that, if a recommendation comes to institute a fifth dose [de vacina contra a Covid] from a certain age group, as long as there is scientific evidence, it will be fulfilled. It doesn’t cross people’s minds not to introduce a vaccine, a dose, a booster”, she told Sheet🇧🇷

Chioro claims that a robust vaccination campaign, not just for Covid, should be a priority at the beginning of the government.

The former Minister of Health is part of the team that will be in charge of preparing a report with recommendations so that the minister chosen by Lula can take the initial measures in the area. The doctor points out that there are also other priorities, such as ending queues, avoiding drug shortages and investing in mental health.

What are the priorities of the Health team? Produce diagnosis and make more emergency recommendations. We are immensely concerned about the pandemic, which is not over, PNI [Programa Nacional de Imunizações], pharmaceutical assistance, and inputs so that there is no discontinuity in the AIDS program and in the Popular Pharmacy. We are very concerned about women’s health, as well as queues involving primary and specialized care. We have been looking for answers to mental disorders since the first moment.

How does the group see Covid today? Is it necessary to continue with the vaccination? I will respond as a physician and researcher in the area of ​​public health. Although the minister [Marcelo Queiroga] saying that the pandemic ended in a formal act in April, the disease has not ended. The increase in the number of cases and hospitalizations shows the seriousness of the situation or the level of attention we need to have with Covid. I would say more. It calls for responsibility in relation to the intensification of vaccination coverage, the guidelines regarding the use of an alcohol gel mask, hygiene acts particularly for the elderly, with comorbidities and who frequent places that produce agglomeration.

Will the transition make recommendations for vaccination? From the 1st of January we will be guided by science, you have no doubt that if there is a recommendation to institute a fifth dose from a certain age group, as long as there is scientific evidence, it will be complied with. It doesn’t cross our minds not to introduce a vaccine, a dose, a booster. I believe that whoever takes over the portfolio as of January will have exactly this posture.

The states today work with different vaccination schedules. This is a problem? This is the result of the lack of coordination that became [Ministério da Saúde], resuming this coordination is fundamental. We never imagined working with a different vaccination schedule, precisely to prevent missing doses, which some received and others did not. Today it is difficult because it is a ministry that has no credibility, does not listen. The new minister will have to make a call for all forces to take a common action.

It is not possible to imagine that the Ministry of Health has to be changed for the current government to do what it has to do. Extend vaccination of the third dose for adults, guarantee vaccination for all babies from 6 months, guarantee the intensification of vaccination with Coronavac for children over 3 years old, guarantee the third dose for children over 10 years old . We have low vaccination coverage for polio and measles. Some issues are basic, it wouldn’t need any transition groups to make recommendations, but we will.

What would that call look like? We are going to carry out a large vaccination campaign in the first few weeks [de governo]🇧🇷 There it is a real call, summoning society, the media, personalities. President-elect Lula and [o vice-presidente eleito] Geraldo Alckmin will raise his arm, show his vaccination card, his grandchildren and great-grandchildren, because that weighs a lot.

We are going to make an offensive against the denialist, it is necessary to make a confrontation against fake news. And, of course, there are other very efficient mechanisms, such as having Bolsa Família conditionality again, [que exige] enrollment of children in kindergartens, schools [regra que foi suspensa a partir da pandemia]🇧🇷 These are conditions that were very successful, several studies show that Brazil’s success comes from this articulation of policies, this effort to reach mainly people who have less education and access to information.

Is there a plan to return with the Mais Médicos program? Of course, with another reconfiguration, not like in 2013. The number of doctors trained in Brazil is much higher today. I believe the vacancies are filled [por brasileiros] as long as there is adequate incentive and manages to mobilize the interest of physicians. The topic needs to be well discussed with medical entities, doctors, councils, Conass [Conselho Nacional de Secretários de Saúde]Conasems [Conselho Nacional de Secretarias Municipais de Saúde]🇧🇷 There will be a lot of debate, that’s important.

I believe it will not be necessary [chamar profissionais estrangeiros]🇧🇷 The intention is to improve the diploma revalidation process for Brazilian doctors abroad. The Revalidate [processo para quem se formou no exterior e deseja atuar no Brasil] will be done more often.

There are still places with few doctors. Do you think that telehealth will gain strength in the next government? Not only in Brazil, but in all health systems, whether with teleconsultation, teleconsultation carried out by the local team, telediagnosis, telemanagement, teleguidance for users, telemonitoring of chronically ill patients to find out, for example, if grandpa’s wound is being treated properly proper way. There is immense potential and there must be huge investment. It is a path of no return that will require regulation, improvement of standards, ethical issues. It is not that simple.

Is zeroing the SUS queue possible at the beginning of the government? We will only be able to answer that when we complete the diagnosis, which should come from conversations with the ministry, Conass and Conasems. There is nowhere in Brazil a coordination of data referring to queues. The realities are different from one health region to another, including queues. The queue profile in the interior of Maranhão is different [daquela] from the interior of São Paulo, because the needs are very different. The tendency is to open a stock [que leve em conta] regional realities and respond with strong national coordination.

You mentioned mental health. Is it something that needs resources? Yes, for several reasons. Fundamentally, because the impact on mild, moderate, and severe mental disorders, alcohol and drug abuse, and suicide attempts from the pandemic has grown significantly. All health professionals who are in the public service and in the private service identify, the offices are full, there are queues in the health units. The psychosocial care network will need to be prioritized so that we can take care of people’s mental health. Mental health gains a central space because of the importance of the subject and its prevalence.

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Arthur Chioro, 58

He was Minister of Health for then President Dilma Rousseff between 2014 and 2015. He is a professor at Unifesp (Federal University of São Paulo) and a specialist in public health. He is part of the government transition group in the area of ​​Health.