The peak of the Ômicron variant led to a record of covid-19 cases worldwide in early 2022, and the fall in the curve that followed it in Brazil brings what the Oswaldo Cruz Foundation (Fiocruz) considers a window of opportunity to control the pandemic, which turns two years old today (11). With fewer cases and hospitalizations, the pressure on health systems decreases and the chances of blocking the transmission of the virus and the formation of new variants increase, increasing vaccination coverage.
“At a time when there are many people immune to the disease, if there is a high complete vaccination coverage, there is the possibility of both reducing the number of cases, hospitalizations and deaths, as well as blocking the circulation of the virus”, highlighted the bulletin of the Covid Observatory. -19 from Fiocruz in early February when predicting the drop in confirmed cases in recent weeks.
The forecast of a more comfortable situation, however, still does not mean the end of the pandemic, reinforces the researcher Raphael Guimarães, who is part of the observatory. “We understand that Brazil should enter a more optimistic phase,” he says. “We have a reduction in new cases, a gradual decompression of the health system, a lower occupancy of beds, and we will also have a reduction in deaths.”
To take advantage of this promising moment, he points out that the country needs to advance in vaccination and reduce inequality in vaccine coverage, which occurs both between states, between municipalities and even between populations within each city.
“What we need to think about is that every public policy should have as a principle to minimize the inequities that occur at each geographic scale. A coordinated federal government policy is needed to reduce inequities between states. States need to have this reading to reduce inequality between municipalities, and municipalities, to reduce inequality between neighborhoods. And all this has to happen in a coordinated way.”
For the president of the Brazilian Society of Infectious Diseases, Alberto Chebabo, it is still difficult to say whether the drop in the number of cases, provided by vaccine immunity added to antibodies acquired by people infected by Ômicron recently, will be enough to indicate the end of the pandemic. . He points out that the expectation of a more positive scenario depends on not emerging a new variant of concern capable of causing a new wave of contagion.
Childhood vaccination against covid-19 of children aged 10 and over in Rio de Janeiro – Tânia Rêgo/Agência Brasil
“It will be much more of a retrospective question. You can’t say when the pandemic will end, you can look back and say when the pandemic ended”, he evaluates. “The expectation is that, if no new variant of concern appears, we will have a calmer period, with fewer cases and deaths. But the point is that in November of last year we were in a moment like this with the end of Delta, and Ômicron appeared. So it’s hard to make any predictions.”
Na semana passada, o presidente Jair Bolsonaro publicou em seu perfil no Twitter que o Ministério da Saúde estuda rebaixar a situação da covid-19 no Brasil para endemia, o que significa que a doença passaria a ser considerada parte do cotidiano, como outras doenças já monitored by health systems. In a note released on the same day, the Ministry of Health confirmed that it was already taking the necessary measures to reclassify the status of covid-19 in Brazil, which is currently identified as a pandemic.
Chebabo points out that the pandemic situation is international, affects all continents, and that’s why it was declared by the World Health Organization. “Who will define the end of the pandemic is not any country, it is the WHO itself, which declared the pandemic”, he says. who declares the end of the pandemic is the WHO based on data that it monitors around the world”, he adds.
wanted by Brazil Agencythe Ministry of Health stated that it “evaluates the extent of the endemic issue, together with other ministries and competent bodies, taking into account the epidemiological scenario and the behavior of the virus in the country”.
With 72% of Brits on two doses, England divided opinion when it announced last month a plan to live with Covid-19. The use of masks had been abolished in January, and the current initiative includes the elimination of restrictive measures such as the obligation to isolate for people who test positive, in addition to scheduling the end of this month to end the free distribution of tests for the diagnosis of the disease. illness. Scotland, Wales and Northern Ireland, which also make up the UK, have adopted separate plans that also ease restrictions.
Even if global numbers point to a drop in cases and deaths, not all countries are moving at the same pace. Cited at various points in the pandemic as an example for its ability to track cases, South Korea last week recorded the highest weekly number of deaths from covid-19 since the beginning of the health emergency, surpassing 1,000 deaths in seven days for the first time. , according to the WHO. Until January 2021, the country had not recorded more than 10,000 cases of covid-19 in a single day, and in March, this daily level had already reached 300,000. The situation in the Asian country has worsened even with 86% of the 50 million Koreans vaccinated with two doses or a single dose.
The World Health Organization also monitors the emergence of a new variant, which combines the genetic structures of Delta and Omicron, and for that reason it was called Deltacron. For WHO Director-General Tedros Adhanom, the pandemic is far from over. “She’s not going to end up anywhere until she ends up everywhere,” he warned again in a statement this week.
To take advantage of this promising moment, the researcher highlights that the country needs to advance in vaccination – Oswaldo Cruz Foundation (Fiocruz)
Endemic requires stabilization
The researchers point out that the transition from pandemic to endemic depends on the number of cases and deaths stabilizing at a low level and entering a predictable trajectory, even if there are recurring periods of greater circulation, as in the case of Influenza. From this stabilization, public health authorities are able to program themselves for the demand for care.
With the change to the endemic situation, preventive measures such as the use of a mask are no longer recommended for everyone, explains Alberto Chebabo, while the reinforcement of vaccination should continue to be an important form of prevention.
“Most measures will be abandoned in some way, because they cannot be sustained, but it is clear that some habits must continue, such as the use of a mask by those who have a respiratory disease, which should have happened before”, he quotes. , which adds that people with more vulnerable immunity can also maintain the use of a mask in crowded places. “But in the general population, none of these measures will be maintained, except for vaccination.”
The director of the Brazilian Society of Immunizations, Flávia Bravo, points out that the scenario of stabilization of epidemiological data will also be important to define how vaccination with booster doses against covid-19 will be carried out, and if it will in fact be necessary for everyone.
“There are several points that we have to discuss, it’s not just whether we’ll need it or not. You may only need it for some. It is possible to come to the conclusion that immunosuppressed patients, who respond worse and with a shorter duration, will need booster doses to raise the level of antibodies. We may come to the conclusion that even healthy people will need it. It will also depend on viral circulation,” he says. “How long the protection lasts, with no variants appearing, is easy to observe. We will continue to do case surveillance. That’s what science does, and it’s not just for covid, it’s for all diseases,” he highlights.
