It was a Wednesday, March 11, when the WHO (World Health Organization) declared that Covid-19 was a pandemic – amid some criticism that the entity had taken time to reach that conclusion.
Two years later, even with vaccines available, at least for part of the world, the planet sees the highest moving averages of cases of the entire pandemic and still high levels of deaths associated with the superinfectious omicron variant.
In January of this year, the omicron brought the world’s moving average of cases to an unimaginable 3.4 million people infected per day. In December 2021, the variant had already raised the level of infections to more than 1.3 million cases. The previous highest values were around 700,000 or 800,000 daily infections, as in April and May 2021.
The good news amid the tsunami of infections is the slightly smaller number of people dying from the disease. At the worst moment of the omicron (so far), the moving average of deaths by Covid in the world was just above 10 thousand deaths per day. In January, April and May of last year, the values were close to 15 thousand deaths per day.
Brazil, for example, in the first half of 2021, was beset by the gamma variant, with more than 70,000 cases per day and average deaths above 2,000 and up to 3,000, in addition to the collapse of health systems.
In 2022, even with an absolute record for the moving average of cases, which reached 188,451 per day on January 31, the average number of deaths did not cross the line of 900 lives lost per day – a number of losses, however, still high.
The lesson that remains is that of vaccines, says Renato Kfouri, infectious disease specialist and director of the Brazilian Society of Immunizations. “They show, once again, how they are able to reduce the burden of disease”, says the specialist. “What would we be like if we didn’t have vaccines playing this role?”
Kfouri says it is possible to divide the pandemic into two periods.
One before the vaccine, in which we learned, basically, how to deal with patients, which drugs work or not and the need for non-pharmacological measures to try to stop the spread of Covid.
This period in Brazil was filled with misinformation and politicization of medical matters related to the pandemic, recalls Ethel Maciel, an epidemiologist and professor at the Federal University of Espírito Santo.
Chloroquine was, perhaps, the main drug embraced and propagated by Jair Bolsonaro (PL), despite the consecutive evidence that it does not work against Covid. Even the masks were the subject of fake news by the president and his supporters.
“Simple measures of control have become an object of political dispute”, says Maciel.
The epidemiologist says that the country has always had a vertical health policy, with the federal sphere acting initially and only after the instructions reach the municipalities. In the pandemic, according to her, there was a disruption of this, which may have been problematic especially for cities that did not have adequate technical bodies for decision-making.
“When the government doesn’t make decisions or makes decisions that clash with science, then something starts that we hadn’t seen in Brazil yet”, says Maciel.
Even vaccines have become a reason for politicization, with Bolsonaro discouraging immunization.
And it was thanks to vaccines that the second period of the pandemic began, says Kfouri. But even they were not able to definitively stop the pandemic, in part due to the concentration of doses in developed countries and the lack of immunizations and low vaccine coverage in other places, such as the African continent and some Eastern European countries.
The omicron, for example, emerged in South Africa in November last year, at a time when the country was struggling to better distribute Covid vaccines.
The variant surprised everyone. “We’ve never seen a virus spread on the planet like the Ômicron spread”, says the infectologist.
Even vaccinated people — including recent doses — have not been spared by the omicron, which currently dominates the world. Vaccine leakage was a danger constantly warned by the researchers, who reinforced the need for greater equity in the distribution of vaccines to prevent new variants (the greater the uncontrolled transmission, the greater the chances of new strains).
Despite being made weaker to avoid mild cases, vaccines continued to fulfill their role of protection against the severity of Covid and deaths very well.
Now, even in the midst of the almost unimaginable amounts of cases in recent months, conversations and even actions are starting to remove the pandemic character of Covid, something hasty for the moment, according to researchers.
After all, when we come out of the pandemic, we would start a moment when there is a certain predictability of the number of cases and deaths from Covid, we would know what to expect. Which still seems like a non-feasible reality for Sars-CoV-2 infections. And that is very clear when we look at the last few months.
In the UK, restrictions have almost completely dropped. The country, however, is already beginning to see signs of a new rise in cases.
In Brazil, mandatory masks are already falling in several states, which experts say makes sense for open environments. There is no obligation to wear face protection in closed areas, however, the researchers are concerned.
Anyway, Kfouri says that the coming months should be calm and honeymoon for Brazil and other countries, due to a large global immunity acquired, either by vaccination or by recent infections.
However, it is known that this must have an expiration date: until the next wave.
The researchers point out that an end is not yet on the horizon, that is, it cannot be declared yet that Covid is an endemic disease (as is the wish of Marcelo Queiroga, Minister of Health). First, because the pandemic is a worldwide event, to which only the WHO could decree an end.
In addition, remembers Kfouri, the burden of deaths and infections from Covid is very high, in Brazil for example, with more than 500 deaths per day, to consider the disease as endemic.
According to Maciel, it remains to be seen what levels of mortality and contamination we will be comfortable with to declare that Covid is finally at an acceptable level.
Meanwhile, the WHO continues to continually warn that the pandemic is not over yet.
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