COVID-19 and politics

Nowadays, the world experiences one of the most severe international public health issues of the past 100 years since the great pneumonia (Spanish flu) pandemic in 1918-1919. In late December 2019, Dr. Li Wenliang, an ophthalmologist at Wuhan Central Hospital in China, has used social media to report the likelihood of a new outbreak of coronavirus infection.⁽¹⁾ After a fruitless attempt to discredit the aforementioned physician, Chinese authorities have rapidly imposed mandatory quarantine on 60 million Chinese citizens. The outbreak caused by SARS-CoV-2 coronavirus, which was initially restricted to local markets in Wuhan City, has rapidly spread throughout the city and the Hubei province. Within 3 months, the virus crossed the Chinese borders and spread towards the entire world, a fact that forced the World Health Organization (WHO) to declare pandemic state. Nowadays, its epicenters lie on Europe and United States; most countries have closed their borders and adopted the lockdown regime.

In 2015, multimillionaire Bill Gates has warned about the excessive spending on armaments and military contingency plans at the expense of public health.⁽²⁾ He anticipated that the world would not be prepared to face an eventual pandemic. The prophecy has now come true! The current international public health crisis is a colossal challenge faced by several countries at political, economic and national health system level. Helpless citizens witness, on a daily basis, significant scarcity of hospital beds, ventilators and simple personal protective equipment such as gowns, masks and gloves; the richest countries are not an exception. There is already evidence of shortage of human resources among health professionals working at the forefront treatment of infected patients, since many of them were infected (over 6,400⁽³⁾ individuals in Italy and 3,400 in China⁽⁴⁾, whereas others remain in prophylactic quarantine; several professionals will reach the point of exhaustion very soon. Unfortunately, dozens of physicians have already died in countries such as Spain and Italy.

There was an interval of approximately 2 months between the beginning of the pandemic in Hubei province and the emergence of the first cases in Europe. In fact, China is not that far away, given the effects of globalization and the fastness of air travels; therefore, SARS-CoV-2 was absolutely expected to reach the rest of the world sooner or later. There was no political will to believe, right from the start, that the viral catastrophe would also reach us; to forget, at least for the moment, precious state budgets and gross domestic products; or to close schools, the economy and non-essential companies, in a fast and effective way. Moreover, there was no political courage to follow the advice by WHO experts, national health authorities and multiple scientific societies, which is unforgivable. The rest of the world did not learn from some good examples given by countries such as South Korea, Taiwan and Macau in the fight against the virus. The first reaction of States, and their governments, was to lightly neglect the public health crisis; consequently, they did not take feasible measures to stop the health crisis within a truly “invisible and unfair” war. The Western world reacted late, in a cluttered way, without plans or strategies, and exposed their lack of means and organization. Countries did not follow WHO’s advice to test the largest number of individuals possible, right away; they did not perform the systematic tracking of infected individuals, did not encouraged serious isolation, did not acquire enough equipment, did not properly prepare hospitals and took too long to raise awareness in the population. They reacted instead of acting! They just improvised. There is no convergent contingency plan, but multiple national plans that are different from each other and lack a well-defined international strategic line of action. In addition, health authorities themselves do not reach consensus, as seen in the case of masks: some entities advocate for their permanent use by the entire population, whereas others suggest that only infected individuals should do so. There are countries whose political class takes diametrically opposite paths; some authorities want to close every non-essential business and adopt social isolation, whereas others suggest maintaining individuals’ work and social life to reach group immunity. It is a real mess!

The disaster in the world economy is there to be seen - states, companies and families are bankrupted and unemployment rates are at steep rise! Economy paralysis may lead to greater drop in GDP than the one seen in the 2008 financial crisis due to the lockdown regime adopted to save lives; according to mathematicians, it would flatten the epidemiological curve. The world economy prepares itself to receive intensive and emergency care. Governments must take strong action, now. They cannot procrastinate, just as the treatment of patients infected with coronavirus cannot be postponed to a month from now. First, it is imperative making significant investments in national health systems to acquire all material types, to build hospitals, hire more health professionals and promote their careers. Next, it is necessary investing in families and companies by making cash available without counterparts, as Germany, the United Kingdom and the United States are already doing. It is necessary involving the European Central Bank and the International Monetary Fund in this process, since global shocks require global responses. Obviously, one can never forget that economies can rise again after any crisis, but human lives cannot!

At the time I wrote the last lines of this editorial, there were virtually 2.4 million individuals infected with the new coronavirus and approximately 158,000 deaths caused by it, worldwide.⁽⁵⁾ These figures reveal the brutal context we live in and, unfortunately, they will exponentially increase in the coming months. It is no longer the “Chinese virus”, but the world’s virus! All countries should join in a common effort to make available and share all information about CoVid-19 collected, so far. International collaboration is the only way to find the solution for this severe pandemic. It is essential learning from the mistakes of the present! Facts about the spread of the virus, diagnosis, treatment and prevention strategies are medical acts of public health, rather than political acts.

Everything will be different from now on. We will likely see increase in telework, which includes non-face-to-face medical consultations and will be significantly boosted by the progress of digitalization; strong hygiene rules at all levels - public, business, family and individual -, as well as new concepts of social behavior will have to be created. It is of paramount importance making individuals aware of the severity of this pandemic so they do not go out on the street and do not go to work in case they feel sick. In addition, sick children should not attend daycare centers and schools. A small cold in one person can be fatal pneumonia in another. I hope that the world will make the necessary changes to the current labor paradigm in favor of community health.

Let us keep in our memories the words of hope and the blessing Urbi et Orbi read by Pope Francis on a rainy and incredibly sad day, in an unbelievably empty St. Peter’s Square. My deep acknowledgment and admiration to all health professionals who, despite being exhausted and lacking resources, save human lives on a daily basis.

Will the world be better prepared to face the next pandemic?

Referências

• ¹
  Green A. Obituary: Li Wenliang. Lancet. 2020;395(10225):682.
• ²
  TED 2015. The next outbreak? We're not read? Conference by Bill Gates, 2015. [cited 2020 Apr 29]. Available from: www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?
  » www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?
• ³
  Itália tem 6,4 mil profissionais de saúde infectados por coronavírus [Internet]. Jornal Exame Online. 2020 Mar 30. 30. [citado 2020 Apr 29]. Disponível em: Disponível em: exame.abril.com.br/mundo/italia-tem-64-mil-profissionais-de-saude-infectados-por-coronavirus/
  » exame.abril.com.br/mundo/italia-tem-64-mil-profissionais-de-saude-infectados-por-coronavirus/
• ⁴
  The Lancet Editorial Board. COVID-19: protecting health-care workers. Lancet. 2020;395(10225);922.
• ⁵
  World Health Organization (WHO). Coronavirus disease 2019 (COVID-19). 2020; Situation report 91 [Internet]. Genève: WHO; 2020. [cited 2020 Apr 29]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  » https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Publication Dates

• Publication in this collection
  18 Sept 2020
• Date of issue
  Jul-Aug 2020