HOW TO COMPATIBILIZE THE HEALTH PROBLEMS OF THE POPULATION WITH THE ECONOMY PROBLEMS RESULTING FROM THE CORONAVIRUS

Fernando Alcoforado*

This article shows how to tackle the health problems resulting from the Coronavirus pandemic and make them compatible with the problems of the economy that will lead to a major recession in countries and globally. The definitive solutions to health problems require the existence of drugs capable of curing the disease resulting from Coronavirus and vaccines capable of preventing the population from contracting this disease. As long as these solutions do not exist, social distancing is imperative to avoid the collapse of health systems, as has already occurred in Italy, Spain and Ecuador. Social distancing results in the worsening of the population's social conditions due to the loss of income, whether of people with employment or not, the result of which is the default on payment of their commitments and the increase in hunger and misery of a large part of the population and , also, the drop in demand for goods and services with the worsening of the economic situation of companies that can be bankrupt, especially micro, small and medium-sized companies, and the drop in tax collection by the government at all levels, federal , state and municipal that would be driven to insolvency and would be unable to face the Coronavirus problem.

One fact is evident: the attempt by a very few irresponsible rulers, including Bolsonaro from Brazil, to adopt social isolation only for vulnerable people such as the elderly, under the pretext of maintaining jobs and economic activities, was adopted in Italy whose consequence it was the collapse of the health system. As it is demonstrated that this solution is not the most rational and responsible because it is detrimental to the life of the population, total social distancing is absolutely necessary until a drug is developed that cures and / or, above all, a vaccine capable of being developed to be used by the population as prevention against the disease. It is also demonstrated that no society will have the capacity to face pandemics without health infrastructure with sufficient capacity, as well as without investing heavily in research and development aimed at the manufacture of medicines and vaccines capable of combating current and future viruses. The Coronavirus pandemic highlighted the fragility of the health infrastructure with the insufficiency in hospital capacity and health posts and specialized human resources in several countries around the world, as well as the inability of medical research institutions to predict the emergence of new viruses, such as Coronavirus, aiming to prepare health systems with new drugs and vaccines for this purpose.

One fact is evident: vaccines move fortunes. Its discovery, however, is not immediate. In the time gap between the spread of contagion with a new virus and its complete prophylaxis, the consequences can be devastating. To make matters worse, there is no guarantee that drugs will emerge capable of immunizing humanity from all diseases caused by viruses. Such uncertainty can quickly turn into a panic. This is what has been happening with the recent outbreak of the new Coronavirus (2019-nCoV or Covid-19). In order to change this reality and humanity not to be surprised by new viruses, as it was now by the Coronavirus, therefore, it is necessary to implement health infrastructures with sufficient capacity in all countries with hospitals and health posts, as well as investing massively in research and development aimed at manufacture of medicines and vaccines capable of combating current and future viruses.

Vaccines are fundamental to fight diseases in the history of medicine. Throughout history, they have helped to significantly reduce the incidence of polio, measles and tetanus, among many other diseases. Today, they are considered the most cost-effective treatment in public health. What are vaccines? Vaccines are biological substances introduced into people's bodies in order to protect them from disease. In practice, they activate the immune system, "teaching" our bodies to recognize and fight viruses and bacteria in future infections. When introduced into the body, the vaccine stimulates the human immune system to produce the antibodies necessary to prevent the development of the disease if the person comes into contact with the viruses or bacteria that cause it. The application of vaccines, in some cases, causes reactions such as fever, pain around the application site and muscle pain.

When were vaccines created? The first traces of the use of vaccines, with the introduction of attenuated versions of viruses in people's bodies, are related to the fight against smallpox in the 10th century in China. It was in 1798 that the term “vaccine” first appeared, thanks to the experience of the English physician and scientist Edward Jenner. He heard reports that rural workers did not catch smallpox because they had already had bovine smallpox, with less impact on the human body. He then introduced the two viruses to an eight-year-old boy and realized that the rumor did indeed have a scientific basis. The word vaccine derives precisely from Variolae vaccinae, scientific name given to smallpox. In 1881, when French scientist Louis Pasteur began to develop the second generation of vaccines, aimed at combating avian cholera and anthrax, he suggested the term to name his newly created substance, in honor of Jenner. From then on, vaccines began to be mass produced and became one of the main elements to fight diseases in the world.

Who produces vaccines? In the international market, multinational producers GSK, Merck, Sanofi and Pfizer stand out. In Brazil, vaccines distributed in health centers are produced by national, international laboratories or by specialized institutes linked to the public power, such as the Butantan Institute (from the government of the State of S?o Paulo) or Bio-Manguinhos (from the federal government). In the case of influenza, for example, whose virus constantly changes, the process of formulating the vaccine is done under another logic. Throughout a year, countries around the world are analyzing the viruses that are collected. Twice a year, the WHO (World Health Organization) defines which ones will compose the vaccine for the following year. Vaccines are defined in the autumn of each hemisphere, since flu outbreaks usually occur in winter. From then on, a race against time to develop them begins. The race against time also happens in the case of epidemics, such as H1N1, which increase the demand for the substance and, consequently, its production.  

Unfortunately, the world has wasted the chance to produce a vaccine to contain Coronavirus, according to countless analysts and researchers. The Sars epidemic has been controlled and the study of Coronavirus vaccines has been abandoned. Today, almost 20 years after Sars, when a new Coronavirus, Sars-Cov-2, has already infected almost 1.5 million people, the world is once again wondering when a vaccine will be ready. One fact is evident: if the vaccine research program for SARS were not abandoned, there would be many more bases ready to work on this new virus closely related to the previous one. The new Coronavirus, called Sars-Cov-2, is a "close cousin" to the virus that caused Sars in 2002. We would already have an example of how these types of vaccines behave, and although the viruses are not exactly the same, they come from the same class, according to several researchers. So, why don't we learn from previous Coronaviruses to the point that we are more prepared today for covid-19? And why haven't vaccines been studied further? According to experts, it all comes down to money. The reality is that in capitalism, when there is a market, there is a solution. Today we have hundreds of vaccines for coronaviruses, but they are all for animals: pigs, chickens, cows, etc. They are vaccines to prevent diseases that can cost the poultry and livestock industry millions of dollars. It was thought that coronavirus outbreaks in humans could be more easily controlled. They made a bad mistake.

The reality now is that the world needs a vaccine against the new Coronavirus that causes covid-19. It will probably not be ready in the coming months. Maybe this will only happen in 12 or 18 months. This is because there are no sustainable programs to promote research. In the absence of a vaccine to protect the population, there is no alternative but the social distance that can last until 2022, according to research published in the journal Science. This research simulated a series of scenarios in relation to the evolution of the contagion of the new Coronavirus. Considering that the immunity developed by humans against the virus is permanent, it could disappear within five years, this is, in 2025. With that, the quarantine in developed countries, such as the United States, would need to last until the middle of 2021. After that period, the gradual opening should occur by mid-2022. The study estimates that each person infected with the new Coronavirus can infect three others. This transmission rate is higher than that of other Coronaviruses, which had the potential to infect two people in each case. Regarding measures of social distance, the study estimates that the reduction of new contagions for each infected person is up to 60%. The scenario includes the closing of commerce and schools and agglomerations in general.

Coronavirus and the social detachment of billions of people have shaken deeply the world economy to the point where some economists predict the most violent recession in modern history, perhaps worse than the Great Depression of the 1930s. The G20 economies will suffer an unprecedented blow to the first part of the year and will contract in 2020, according to countless economists. The Organization for Economic Cooperation and Development (OECD) has estimated that the world economy will suffer for many years. The current crisis is likely to be more serious than that of 2008, because this time it affects not only the financial system, but also the entire economy, with a collapse in production and, therefore, in supply and also in demand, due to the billions of people confined.

Transport, tourism and distribution are particularly affected, although some sectors are improving such as pharmaceuticals, the medical equipment industry and sanitary products, food and online commerce. According to the agency Moody's, the G20 countries should collectively reduce by 0.5% of the Gross Domestic Product (GDP) in 2020. In the United States, it will be -2% and in the euro area, -2.2% . China is expected to grow only 3.3%, a very weak rate for that country. For the United States, Goldman Sachs predicts a year of 2020 with falling GDP of 3.8% and Deutsche Bank is betting on the worst contraction of the American economy since World War II. In Europe, the German Economy Minister spoke of a 5% recession in 2020 in Germany and France, Moody's predicts -1.4%. For the United Kingdom, KPMG projects a slightly more severe drop of 2.6%. The IMF predicts that Brazil will have a 5% drop in GDP in 2020.

In the eurozone, with more protective labor regulations, unemployment is expected to rise to 12% by the end of June, thus reversing seven years of progress. In the United States, where employees can be laid off easily, economists predict a dramatic increase in the number of unemployed. James Bullard, president of the Federal Reserve, said in an interview with Bloomberg that unemployment could rise to 30% in the coming months. The Coronavirus epidemic is causing a lot of uncertainty about price developments, between the risks of economic depression and deflation if demand collapses for a long time, but with some inflationary pressures if currencies depreciate, if there is a shortage, etc.

The effects of social distancing measures to combat Coronavirus on the global economy are devastating because it will result in an economic depression that will last for many years thanks to the lack of strategic vision of governments that were unable to predict this pandemic, did not invest at the necessary level in the development of research for new vaccines, they did not invest in increasing the capacity of their health systems and did not develop their industries in conditions to produce hospital equipment and even masks for use by the population, all dependent on Chinese production. In order to face the economic depression, governments have to act to minimize the drop in consumption by the population and companies by maintaining essential economic activities by adopting measures to benefit the unemployed and the poor so as not to die of hunger and micro, small and medium-sized companies to not succumb to the crisis.

Measures for the benefit of the unemployed and the poor include the transfer of income from the government to families and the suspension of tax payments and the granting of low-interest loans to companies in exchange for not firing employees during social isolation. This set of measures, which has been adopted in several countries in the world, must be maintained as long as the social distancing of the population persists so as not to aggravate their social conditions, especially of the most vulnerable populations, and the economic conditions of micro, small and medium-sized companies. To cope with the drop in tax collection by the government at all levels resulting from the reduction of economic activities, the central government of each country must allocate resources in the volume necessary for regional and local governments to face problems with the health system and, also, the social problems concerning the most vulnerable populations while the social isolation of the population endures.

One fact that the Coronavirus crisis has highlighted is the need for countries in the world to pursue their productive self-sufficiency by abandoning the current, neoliberal and economic and financial globalization policy, responsible for dependence on the outside, especially in relation to China, prioritizing the production in the country of the products and services essential for its economic and social progress. It is absurd the dependence of countless countries on China's import of elementary items such as face masks and respirators. This crisis may represent the end of the irresponsible model of globalization inaugurated in 1990, after which each country adopted the policy of abdicating its domestic production by importing lower-cost goods and services from abroad that, in addition to deindustrializing the country, it became vulnerable because its dependence on the outside as evidenced in the current situation.

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EXAME. Estudo indica que distanciamento social pode durar até 2022. Available on the website <https://exame.abril.com.br/ciencia/estudo-preve-que-havera-algum-tipo-de-quarentena-ate-2022/>.

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* Fernando Alcoforado, 80, awarded the medal of Engineering Merit of the CONFEA / CREA System, member of the Bahia Academy of Education, engineer and doctor in Territorial Planning and Regional Development by the University of Barcelona, university professor and consultant in the areas of strategic planning, business planning, regional planning and planning of energy systems, is author of the books Globaliza??o (Editora Nobel, S?o Paulo, 1997), De Collor a FHC- O Brasil e a Nova (Des)ordem Mundial (Editora Nobel, S?o Paulo, 1998), Um Projeto para o Brasil (Editora Nobel, S?o Paulo, 2000), Os condicionantes do desenvolvimento do Estado da Bahia (Tese de doutorado. Universidade de Barcelona,https://www.tesisenred.net/handle/10803/1944, 2003), Globaliza??o e Desenvolvimento (Editora Nobel, S?o Paulo, 2006), Bahia- Desenvolvimento do Século XVI ao Século XX e Objetivos Estratégicos na Era Contemporanea (EGBA, Salvador, 2008), The Necessary Conditions of the Economic and Social Development- The Case of the State of Bahia (VDM Verlag Dr. Müller Aktiengesellschaft & Co. KG, Saarbrücken, Germany, 2010), Aquecimento Global e Catástrofe Planetária (Viena- Editora e Gráfica, Santa Cruz do Rio Pardo, S?o Paulo, 2010), Amaz?nia Sustentável- Para o progresso do Brasil e combate ao aquecimento global (Viena- Editora e Gráfica, Santa Cruz do Rio Pardo, S?o Paulo, 2011), Os Fatores Condicionantes do Desenvolvimento Econ?mico e Social (Editora CRV, Curitiba, 2012), Energia no Mundo e no Brasil- Energia e Mudan?a Climática Catastrófica no Século XXI (Editora CRV, Curitiba, 2015), As Grandes Revolu??es Científicas, Econ?micas e Sociais que Mudaram o Mundo (Editora CRV, Curitiba, 2016), A Inven??o de um novo Brasil (Editora CRV, Curitiba, 2017), Esquerda x Direita e a sua convergência (Associa??o Baiana de Imprensa, Salvador, 2018, em co-autoria) and Como inventar o futuro para mudar o mundo (Editora CRV, Curitiba, 2019).