Rapid response to pandemics requires constant investment

The ability to respond quickly to public health emergencies, such as the covid-19 pandemic, requires permanent investment in science, technology and innovation, defended today (20) the president of Fiocruz, Nísia Trindade, at the opening of the webinar ” The covid-19 pandemic in transition”, promoted by the foundation.

“We have this illusion that the answer [à pandemia] it’s fast. It needs to be fast, but it doesn’t come out of nowhere, it comes from a base,” said Nísia. “Permanent and constant investment in science, technology and innovation is essential. None of the response came without a track record and without previous investments. This applies to the vaccine now fully nationalized by Fiocruz from the agreement with the University of Oxford and AstraZeneca”.

The Fiocruz president highlighted that this investment needs to be associated with social protection and public health, and said that the pandemic leaves as a learning experience the need to decentralize vaccine production centers and include more countries, in addition to reinforcing multilateralism.

“It seems that this speech sounds like naive rhetoric at a time when we live in a war and in a world marked by intensifying conflicts,” he said, citing the invasion of Ukraine. “We still don’t know the implication of this war, in this case the war in Ukraine, in relation to the whole global effort that needs to be done,” he added.

pandemic in transition

The webinar discussed the current scenario of the pandemic, marked by a drop in the number of cases and deaths caused by covid-19 in relation to previous waves of transmission.

Researcher at Fiocruz’s National School of Public Health (Ensp/Fiocruz) Carlos Machado drew attention to the impact that the disease had on the Brazilian population, which, despite representing less than 3% of the world‘s population, accounted for more than 10% of victims of the pandemic around the world.

“At the present time, in several countries and in Brazil, we are experiencing a very positive scenario. In Brazil, the existence of the SUS [Sistema Único de Saúde] allowed not only to reduce the impact of the pandemic on the population but also to advance in vaccination”, he said, reinforcing that the public health system will need more investments to deal with the sequels and cases of persistent covid-19, in addition to meeting the liabilities caused by diagnoses and treatments for other diseases that were delayed during the pandemic.

The coordinator of the Foundation’s Scientific Computing Program (Procc/Fiocruz), Daniel Villela, evaluated that it is not possible to expect an absence of circulation of SARS-CoV-2, given the transmissibility of its variants and the possibility of new mutations emerging. However, he considers that progression to an endemic regimen is more likely, in which the disease occurs with predictable regularity.

“What should be avoided is the climate that the pandemic is over, of having a scenario of neglected disease status”, he warned, highlighting the need to advance in the vaccination of children. “There is still a lot of room to move forward. The children were less affected at first, but they were, yes, affected, and they need attention.”

Professor at the Federal University of Espírito Santo Ethel Maciel opened her presentation by addressing the difficulty of establishing what would be the endemic pattern of a new virus, which only started to circulate from 2019. “We do not have this international consensus. It is still being built” .

She defended that the revocation of the decree of the Public Health Emergency of National Importance (Espin) in Brazil should be coordinated with the World Health Organization (WHO) and with the federative units.

“As we have an international organization that is analyzing the emergency, it would be much better if we coordinated things. We are not doing it. We are not doing it either from an international or internal point of view. There is a risk that the Ministry of Health will revoke the decree, and the governors maintain the state decrees”, he warned.

The professor argues that the repeal should take into account the continuity of surveillance and monitoring of the disease, including cases of persistent covid-19, whose treatment should be done in specialized centers that have not yet been created. “There is a risk that if we make the disease invisible, it will never happen.”

For researcher Eduardo Carmo, from Fiocruz Brasília, it is necessary to remember that, even with a drop in deaths caused by covid-19, they still remain at higher levels than those of other respiratory viruses. And he pondered that the transition to the end of the pandemic could take longer due to the relaxation of preventive measures and the reduction of testing. “The evolution of the agent and the disease is still unpredictable,” he said.

A member of Fiocruz’s Covid-19 Observatory, Raphael Guimarães defended that it is still necessary to communicate clearly to the population that the pandemic is not over and highlighted that Brazil is experiencing stagnation in vaccine coverage when there are still states with less than 70% of the population with the two doses of vaccine, in addition to less than half of the eligible population with a booster dose. “Relegation creates a false impression that everything is fine now, and that if everything is fine, I don’t need to get vaccinated.”

He argues that the positive scenario with fewer deaths and hospitalizations should serve to align surveillance and primary care practices, in addition to preparing the health system to address other health problems that were not discovered or treated during the pandemic.

Translated to english by RJ983

From Brazil, by EBC News

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