Will Brazil become the new epicenter of the Coronavirus pandemic?

It started in China, migrated to Europe and today it haunts the United States. Everything indicates that the epicenter of the coronavirus pandemic changes places as the pathogen spreads to a new nation and its health authorities manage to create or not a quick and efficient response to stop it, in addition to providing adequate support to those who stay. sick.

The unpredictable behavior of this virus is one of the greatest anxieties in facing the pandemic. And doctors and scientists reinforce this point at any moment in the face of any futurology exercise. But the experience of other countries and the advances in epidemiological data and in the adopted containment measures help us to glimpse whether Brazil is at risk of suffering more or less with Covid-19.

After all, can our country become the new epicenter of the pandemic? We asked nine experts this question. Follow the answers below.

José David Urbaéz, infectious disease specialist at the Federal District Health Department and consultant to the Brazilian Society of Infectious Diseases (SBI) :

Unfortunately, I think so. The devices of social isolation , correctly applied by governors and mayors, insofar as they managed to flatten the development curve of the epidemic, paradoxically made the population interpret that the coronavirus problem “was not all that they were talking about”, abandoning it slowly and progressively containment.

To this is added a reductionist and absurd dichotomy of health versus economy, supported by several business sectors, in which the thought that “some deaths” by the coronavirus dominates would be less relevant than the economic downturn dominates.

We are in a country with enormous socioeconomic inequality. This means that a large part of the population does not have access to basic sanitation, lives in overcrowded conditions , has little or no understanding of the serious situation we are experiencing and will be exposed to a highly transmissible virus. The pandemic entered Brazil by the upper and upper middle classes, and now it penetrates the most socially vulnerable areas, where it will undoubtedly reach catastrophic proportions.

The public health infrastructure, SUS, has been dismantled for a long time, with reduced funds and investments, in all its areas, such as diagnosis, hospital and ICU assistance, primary care … More and more precarious, it will have significant difficulties to respond to the challenge posed by this epidemic. Despite this, it remains a system of great capillarity, which has response mechanisms for situations of seriousness, which greatly mitigates the consequences of the problem.

And finally, there is an extremely serious component: the decomposition of the spheres of state power, which has the head of the Federal Executive as a promoter of chaos and denialism, reducing the disease to a “gripezinha” , contrary to the recommendations based on scientific evidence , disallowing scientists and doctors, inducing viral exposure behaviors such as agglomerations in public acts … This will ultimately take a heavy toll on victims and the management of health services. It is perplexing to see a real war against isolation measures in such a delicate moment.

Coronavirus: has Brazil managed to flatten the death curve?

Gonzalo Vecina Neto, sanitary doctor, professor at the University of São Paulo (USP) and chairman of the board of the Hours of Life Institute :

It obviously depends. You cannot be categorical on this complex issue. It is not “yes” because I think that, in some way, there was some preparation in the states and municipalities and, in part, until now we have managed to live with the epidemic. We have signs of exhaustion of the SUS in Manaus and Fortaleza, but we still have time. However, if we leave the quarantine now, we risk becoming something like Italy.

We will also depend on the type of response that the private sector will give when placing its ICU beds to serve Brazilians. And it is not “no” for these reasons: quarantine, perspective of using private beds, position of the federal government now under new direction but with the same orientation …

I see no reason for that. There are several countries with a very large population and also exposed. I can’t imagine why it wouldn’t be India, Russia or the United States [current epicenter] . I see no chance that the problem in Brazil is much greater than in any other region in the world. But, for this not to happen here, it is very important that people follow public health guidelines, continue in social isolation as much as possible and wash their hands properly …

Virtually all countries in the world are already contaminated. I don’t see why Brazil would have a greater risk than other places, especially if people adhere to the care already disclosed.

Yes, Brazil, or any other country, may be the next center of the pandemic, as long as it does not take preventive actions based on scientific evidence. At the moment, obtaining epidemiological data on infection in the population, maintaining social distance and expanding the testing policy are initiatives that can help us to avoid being the next epicenter.

Wladimir Queiroz, infectologist at the Emílio Ribas Infectious Diseases Institute (SP) and a member of the SBI:

I believe it depends. It depends on how the isolation policy will be and how it will be maintained. If it is properly maintained, there is a chance that we will not be the new epicenter of the pandemic. If this is broken, I don’t think it will be without the new epicenter.

Gustavo Campana, medical director of Dasa:

My opinion is that Brazil should not become the epicenter of the pandemic and should not be the country with the highest number of cases. Especially since some measures were taken very early, such as social isolation and case detection. It was different from what happened in Italy, for example, where the first cases took a long time to be detected. Here Dasa validated the test in a pioneering way and we diagnosed the first episodes very quickly and social isolation happened before. This has an important impact so that we are not the epicenter of the epidemic.

The way the disease entered the country, ensuring that the first infected remained in isolation, also favored us. Now the virus continues to infect more people, but our health structures are better prepared, they had time … These are the two most important points: early social isolation and the implementation of tests, despite the country having gone through a “blackout” exams. One measure that helps us not to become the epicenter is to plan the return of social isolation in a progressive and organized way, so as not to overburden the health system.

It depends. It depends on how the coronavirus and the pandemic are being faced, it depends on how public policies are implemented and how society will react to it. Just as it depends on how people react to the infection itself, since immunity varies between patients and results in different forms of the disease. It depends on many things, unfortunately.

Paulo Eduardo Brandão, virologist, coronavirus specialist and professor at USP’s School of Veterinary Medicine and Zootechnics:

Yes. If we define the epicenter of the pandemic as being that of a country where there is a rapid rise in the number of infected, sick and dead, Brazil is already showing itself to be the center of the epidemic, in fact. And this is the result of the absence of large-scale tests, measures of social isolation throughout the national territory and adequate hospital capacity.

It depends. Brazil is a large and heterogeneous country and is able to control the epidemic properly, to flatten the curve and to have acceptable and manageable numbers. However, we have two reasons to fear the final effect of this epidemic here. The first is the heterogeneity of the population itself, with people living in difficult housing conditions to provide correct isolation and still without basic sanitation. People don’t have clean water at home. This is a factor in terms of explosive numbers.

The second factor is more social. The epidemic shows that the human being lives in community and the behavior of a person reflects on the entire population, as if it were a butterfly effect. If we can maintain that unity and behave consistently with each other, we will probably alleviate the problem. But if we turn normal and acceptable disagreements into disputes and act differently – against each other, instead of in favor of the other – we have all the potential to become the epicenter of the pandemic.

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