Health retreats from declaring the end of the pandemic and aims for masks and ‘repeal’ of lenient rules

After promising to declare the end of the Covid-19 pandemic, a task that is only up to the WHO (World Health Organization), the Minister of Health, Marcelo Queiroga, modulated the speech and aims for milder changes.

The initial idea is to reinforce the version that the government overcame the health crisis, but use the repeal of secondary rules as a milestone.

An example is the restriction to export medicines, oxygen and other health items. The minister still wants to recommend the end of the use of masks, a measure already adopted by some governors.

A wing of the portfolio also defends releasing a document guiding the waiver of protection in some cases, while some Queiroga’s assistants fear that the measure will be judicialized.

On March 3, the president published a photo next to Queiroga and said that the minister “is studying to downgrade the Covid-19 situation in Brazil to endemic”.

Last week, Bolsonaro reinforced the idea. “From the beginning of next month, with the decision of the Minister of Health to put an end to the pandemic, we must return to normality in Brazil”.

Government technicians, however, warned Queiroga that there is no button within the reach of the Minister of Health capable of making this change. He then changed his speech and began to recognize that he will not end the pandemic in Brazil, as he had promised.

Queiroga can only close Espin (Public Health Emergency of National Importance), recognized in February 2020. This would be the main way to empty restrictions against Covid.

“Sometimes people confuse turning a pandemic into an endemic one. It is not the minister’s prerogative,” Queiroga said on the 17th. “What the minister does is, within the law, to establish a health emergency of national importance, in accordance with the international health regulation”, he added.

But the minister was also warned that revoking Espin has a high cost, because it is this status that gives backing to the emergency use of vaccines, purchases without bidding and other rules related to the pandemic.

Now the minister and his team are looking for a way to balance President Bolsonaro’s desire to celebrate a change in the Covid-19 scenario with the risk of changing sensitive rules to combat the pandemic.

The idea at the moment is to deliver some kind of “repeal” of rules, albeit of low impact, to feed the president’s speech, in addition to releasing a document discouraging the use of masks. This role, however, would not have the power to oblige public managers to overturn the decrees on pandemic care.

The minister’s aides say that the changes should be gradual and that the discussion on ending the health emergency should extend into April.

The proposals of health technicians must still pass through the scrutiny of Queiroga and President Bolsonaro, who since the beginning of the crisis has minimized the impact of Covid and defends the end of restrictions against the disease.

Rosana Leite de Melo, secretary of Secovid (Extraordinary Secretariat to Combat Covid-19), told sheet that Queiroga will still be given a document that should serve as a basis for the government’s decision on whether or not to end the health emergency.

The secretary defends that epidemiological data, from the SUS assistance network and about which standards will be reached before ending with the health emergency status.

Health technicians should propose, for example, only allowing restrictions to be relaxed when 80% of the population over 5 years of age present the complete primary vaccination cycle (both doses, in most vaccine models), in addition to observing data on the disease transmission and advancement of variants.

The ministry also wants to guarantee a minimum number of ICU beds inside hospitals to loosen pandemic rules.

Queiroga’s team estimates that about 170 rules could be impacted with the end of the emergency. Among the most sensitive is authorization for the emergency use of vaccines.

“As all other rules came as a result of Espin, it has to be analyzed legally. We are analyzing whether there is a possibility of creating provisions when decreeing the end of the emergency that do not harm the Brazilian population”, said secretary Rosana.

The government also analyzes the Covid-19 scenario in other countries. In recent days, China and some parts of Europe have seen an increase in cases.

The secretary also said that some measures, such as recommending the end of the use of masks, do not depend on the end of the health emergency. The expectation is that milder flexibilities will be proposed in the coming days.

Rodrigo Cruz, executive secretary of the Ministry of Health, said that there are many implications in declaring the end of the health emergency. Therefore, it is important to be confident in making the decision.

“We have had several conversations with different bodies and we understand that some flexibility can be made […] some public policies that needed to be accelerated due to the pandemic scenario are justified to continue because they had successful experiences in our evaluation, said Cruz in the 3rd Ordinary Meeting of the Intermanagers Committee tripartite.

In general, the change from a pandemic to an endemic one occurs when the disease is no longer a global health emergency and starts to present a stable, even if high, number of cases and deaths in a given location.

In recent weeks, Queiroga presented the scenario of the pandemic and an outline of the flexibilities to the presidents of Powers.

Health technicians also went to Anvisa (National Health Surveillance Agency) and should meet with representatives of the TCU (Union Court of Auditors) to address the same issue.

On Monday (21), representatives of several ministries met at Palácio do Planalto to plan the relaxation of some rules of the pandemic. Each area left the meeting with the task of evaluating which measures they can repeal without causing too much trouble.