Cássio Aoqui, Raquel Añón, Vanessa Prata – 28 de abril de 2020
No último domingo (26), completamos exatos 60 dias desde que o Ministério da Saúde confirmou o primeiro caso de pessoa infectada com a Covid-19 no Brasil.
Desde 26 de fevereiro, e mesmo antes, quando a doença impactava apenas outros países, centenas de iniciativas no combate ao vírus vêm emergindo das formas mais variadas em todo o país.
Ao mesmo tempo, o fluxo de informações, solicitações e propostas de ações ganharam velocidade e dimensão exponenciais, principalmente pela facilidade de disseminação pelo WhatsApp, acarretando como paradoxo a dificuldade de estabelecer uma relação de ajuda genuína e eficaz no enfrentamento da pandemia.
Na semana em que se iniciou outra contagem no Brasil —a de vítimas fatais—, sentindo a necessidade de organizar dados e ter uma visão mais sistêmica dessas iniciativas, nós da ponteAponte começamos a mapear voluntariamente ações para apoiar os envolvidos no direcionamento de esforços e recursos aportados.
Nascia em 23 de março o Mapeamento de iniciativas contra a Covid-19, hoje com cerca de 450 ações levantadas colaborativamente, entre campanhas de doações em dinheiro, plataformas online diversas, campanhas solidárias em geral, iniciativas de auxílio médico e psicológico, listas de cursos, livros e filmes gratuitos e notícias sobre as periferias brasileiras.
Até o momento, foram 1.250 acessos únicos de investidores sociais, filantropos e organizações de base comunitárias em geral.
Compartilhamos um recorte do que descobrimos no que tange ao investimento social privado a partir de 260 iniciativas mapeadas até 20 de abril e estudadas individualmente.
Parte do setor de filantropia e investimento social moveu-se rapidamente, liderada principalmente por atores já protagonistas do campo e organizações como institutos e fundações com experiência em contextos periféricos para arrecadação de dinheiro e produtos (alimentos, kits de higiene etc.).
Surgiram assim campanhas cada vez mais articuladas, como o pioneiro União SP, o Movimento União Rio, além de Família Apoia Família e Enfrente, envolvendo diversos atores como Instituto Península, Instituto Phi, Instituto ACP, Fundação Tide Setubal e uma rede de parceiros, muitos dos quais periféricos, com destaque para a CUFA (Central Única das Favelas).
Outros, contudo, tomaram a decisão de estruturar suas iniciativas emergenciais de investimento social a partir dos movimentos iniciais do setor com uma análise mínima do cenário. Foi o caso do Instituto Jatobás, que após consulta a rede e parceiros lançou o Enfrentamento Crise Covid-19, um arranjo que envolve geração de renda, inclusão produtiva e empreendedorismo cultural, e da Fundação André e Lucia Maggi com o Fundo Um Por Todos e Todos Contra a Covid-19 para atuar no Amazonas, Mato Grosso e Roraima, onde estão sediados.
Entre as empresas, em termos de investimento social, o movimento ganhou força na última semana de março e sobretudo a partir de abril, quando dezenas passaram a oferecer apoio financeiro, infraestrutura e apoio logístico –para muitos o primeiro passo, ultrapassando R$ 3 bilhões doados em grande parte graças a esse setor, como aponta o Monitor de Doações da ABCR.
Algumas empresas optaram por centralizar esforços em articulações dentro de casa. A EDP lançou o edital EDP Solidária Covid-19, articulando os negócios do grupo (EDP, EDP Renováveis e Instituto EDP), e o CCP lançou pelo Instituto a ação Seja Solidário sem Sair de Casa, um matchfunding triplo para o entorno dos seis shoppings que administra, em uma articulação peculiar: funcionários e parceiros mobilizaram doações, o instituto duplicou a arrecadação, e os sócios majoritários da empresa triplicaram o valor inicial.
Como era esperado, empresas que atuam no B2C, como Burger King e Magazine Luiza, foram as primeiras a anunciarem seus aportes, ainda no mês de março (na página Pacto contra a Covid-19, do Pacto Global, encontra-se uma lista abrangente e atualizada). Vale ressaltar que algumas grandes empresas que lançaram iniciativas de apoio não têm historicamente atuação nesse sentido, o que denota preocupação junto ao consumidor.
Boa parte das iniciativas reflete as já conhecidas culturas institucionais. A Ambev, por exemplo, moveu-se rapidamente e anunciou amplamente a produção e distribuição de álcool gel em 17 de março.
Sua concorrente direta de setor, a Coca-Cola, focou de início na segurança dos colaboradores para então divulgar em uma ação mundial de US$ 120 milhões o site https://estamosnessajuntos.com.br/ em 31 de março. Ambas as contribuições, porém, são relevantes, cada qual no seu tempo e com níveis de complexidade e estruturação diferentes.
Diversos intermediários desenvolvedores do campo tomaram a dianteira nas articulações e apresentaram papel de destaque nos primeiros 60 dias. O Pacto pela Democracia articulou variadas ações, notas de repúdio e conferências multissetoriais; a ABCR encampou o Monitor de Doações; membros do Movimento pela Cultura de Doação estruturaram algumas das campanhas mais bem sucedidas e lançaram uma edição extra do Dia de Doar, que acontecerá em 5 de maio. Por último, Rede Brasil do Pacto Global articulou um coletivo de empresas e lançou o Covid Radar, do qual somos curadores na frente Conexão Radar.
Há um dinamismo entre as plataformas online das mais diversas naturezas (arrecadação coletiva, georreferenciamento de casos, informações técnicas etc.), lançadas ou adaptadas para o cenário atual. Enquanto algumas já entraram em desuso desde a sua criação, principalmente dada a dificuldade de manutenção e monitoramento, outras seguem em funcionamento, como o #MapaCoronaNasPeriferias, do Favela em Pauta e Instituto Marielle Franco.
Consultorias e plataformas variadas também passaram a trabalhar com taxas reduzidas ou mesmo voluntariamente aconselhar investidores em matchmaking e realizar análises e gerar relatórios de inteligência.
Quase dois meses após a chegada da doença ao país, há uma diminuição no ritmo de novas iniciativas de investimento social sendo criadas no Sudeste, ocorrendo uma maior concentração e coordenação de esforços (por exemplo, centralizando novas campanhas ou até mesmo unindo as que estavam independentes em uma mesma plataforma).
Trata-se de um movimento bem-vindo: na terça-feira (21), cerca de um mês após o início do mapeamento, havia 270 iniciativas em nossa planilha –a maioria das novas entradas referentes a campanhas comunitárias, oriundas principalmente de associações de base e coletivos, e não de investimento social.
Para ampliar o alcance, é essencial planejar a distribuição geográfica das ações, ainda concentradas em SP e no RJ, bem como dentro dos próprios municípios, tendo cuidado com a já identificada concentração dos recursos em determinadas regiões, organizações e/ou lideranças (em parte justificada pelas parcerias preexistentes e de confiança e a presença de organizações consolidadas, entre outros fatores).
Um bom parâmetro é priorizar bairros e distritos onde há maior número de casos de infecção e fatalidades (como a Vila Brasilândia, na zona norte; Sapopemba, no sudeste; e Vila Rasa, São Mateus e Cidade Tiradentes, na leste).
Dada a urgência e o tempo de criação e efetivação desses investimentos sociais, fica o imenso desafio de se estruturarem todas essas iniciativas da maneira mais eficiente e eficaz possível, além de transparente e coordenada, equilibrando agilidade e qualidade. Muitos dos anúncios de grandes empresas, por exemplo, ainda não foram seguidos de informações concretas acerca de quem receberá os apoios ofertados e de que forma e quando eles acontecerão.
Ainda vemos bastante espaço para os investidores sociais privados atuarem com maior ênfase na que deve se consolidar como fase de pico de disseminação do vírus no país –que ainda não se manifestaram nesse sentido.
Para esse grupo, reiteramos a importância de atuar ao lado das comunidades e OSCs com as quais já trabalha, bem como em parceria com outros institutos, fundações, empresas e desenvolvedores do campo, entre outras recomendações, que podem ser acessadas no relatório.
Summary: Ethicists are calling on the global research community to resist treating the urgency of the current COVID-19 outbreak as grounds for making exceptions to rigorous research standards in pursuit of treatments and vaccines.
Ethicists from Carnegie Mellon and McGill universities are calling on the global research community to resist treating the urgency of the current COVID-19 outbreak as grounds for making exceptions to rigorous research standards in pursuit of treatments and vaccines.
With hundreds of clinical studies registered on ClinicalTrials.gov, Alex John London, the Clara L. West Professor of Ethics and Philosophy and director of the Center for Ethics and Policy at Carnegie Mellon, and Jonathan Kimmelman, James McGill Professor and director of the Biomedical Ethics Unit at McGill University, caution that urgency should not be used as an excuse for lowering scientific standards. They argue that many of the deficiencies in the way medical research is conducted under normal circumstances seem to be amplified in this pandemic. Their paper, published online April 23 by the journal Science, provides recommendations for conducting clinical research during times of crises.
“Although crises present major logistical and practical challenges, the moral mission of research remains the same: to reduce uncertainty and enable care givers, health systems and policy makers to better address individual and public health,” London and Kimmelman said.
Many of the first studies out of the gate in this pandemic have been poorly designed, not well justified, or reported in a biased manner. The deluge of studies registered in their wake threaten to duplicate efforts, concentrate resources on strategies that have received outsized media attention and increase the potential of generating false positive results purely by chance.
“All crises present exceptional situations in terms of the challenges they pose to health and welfare. But the idea that crises present an exception to the challenges of evaluating the effects drugs and vaccines is a mistake,” London and Kimmelman said. “Rather than generating permission to carry out low-quality investigations, the urgency and scarcity of pandemics heighten the responsibility of key actors in the research enterprise to coordinate their activities to uphold the standards necessary to advance this mission.”
The ethicists provide recommendations for multiple stakeholder groups involved in clinical trials:
Sponsors, research consortia and health agencies should prioritize research approaches that test multiple treatments side by side. The authors argue that “master protocols” enable multiple treatments to be tested under a common statistical framework.
Individual clinicians should avoid off-label use of unvalidated interventions that might interfere with trial recruitment and resist the urge to carry out small studies with no control groups. Instead, they should seek out opportunities to join larger, carefully orchestrated studies.
Regulatory agencies and public health authorities should play a leading role in identifying studies that meet rigorous standards and in fostering collaboration among a sufficient number of centers to ensure adequate recruitment and timely results. Rather than making public recommendations about interventions whose clinical merits remain to be established, health authorities can point stakeholders to recruitment milestones to elevate the profile and progress of high-quality studies.
“Rigorous research practices can’t eliminate all uncertainty from medicine,” London and Kimmelman said, “but they can represent the most efficient way to clarify the causal relationships clinicians hope to exploit in decisions with momentous consequences for patients and health systems.”
A grant to a New York nonprofit aimed at detecting and preventing future outbreaks of coronaviruses from bats has been canceled by the National Institutes of Health, Politico reports, apparently at the direction of President Donald Trump because the research involved the Wuhan Institute of Virology in China. The virology institute has become a focal point for the idea that SARS-CoV-2 escaped from the laboratory and caused the current COVID-19 pandemic, a scenario experts say is not supported by evidence. Instead, virologists The Scientist has spoken to say the virus most likely jumped from infected animals to humans.
The grant, first awarded in fiscal year 2014 and most recently renewed last year, went to EcoHealth Alliance, which describes itself as “a global environmental health nonprofit organization dedicated to protecting wildlife and public health from the emergence of disease.” The aims of the funded project included characterizing coronaviruses present in bat populations in southern China and conducting surveillance to detect spillover events of such viruses to people. The project has resulted in 20 publications, most recently a March report on zoonotic risk factors in rural southern China.
EcoHealth Alliance’s partners on the project include researchers at the Wuhan Institute of Virology, a BSL-4 facility that has for months been a focus of conspiracy theories that SARS-CoV-2 escaped or was released from a lab. On April 14, the The Washington Post published a column highlighting State Department cables about concerns regarding safety at the institute. (Experts tell NPR that, even in light of the cables, accidental escape of the virus from a lab remains a far less likely scenario than a jump from animals.)
Then, in an April 17 White House coronavirus briefing, a reporter, whom Politico identifies as being from Newsmax, falsely stated in a question that “US intelligence is saying this week that the coronavirus likely came from a level 4 lab in Wuhan,” and that the NIH had awarded a $3.7 million grant to the Wuhan lab. “Why would the US give a grant like that to China?” she asked. “We will end that grant very quickly,” Trump said in his answer.
An NIH official then wrote to EcoHealth Alliance to inquire about money sent to “China-based participants in this work,” Politico reports, and the organization’s head, Peter Daszak, responded that a complete response would take time, but that “I can categorically state that no fund from [the grant] have been sent to the Wuhan Institute of Virology, nor has any contract been signed.” Days later, NIH notified EcoHealth Alliance that future funding for the project was canceled, and that it must immediately “stop spending the $369,819 remaining from its 2020 grant”—an unusual move generally reserved for cases of scientific misconduct or financial improprieties, according to Politico.
In a statement about the cancellation, EcoHealth Alliance says the terminated research “aimed to analyze the risk of coronavirus emergence and help in designing vaccines and drugs to protect us from COVID-19 and other coronavirus threats,” and that it addresses “all four strategic research priorities of the NIH/NIAID Strategic Plan for COVID-19 Research, released just this week.” The organization will, it says, “continue our fight against this and other emerging diseases.”
David D. Kirkpatrick, The New York Times – 28 de abril de 2020
Na corrida mundial por uma vacina contra o novo coronavírus, o laboratório que está na frente fica na Universidade de Oxford.
A maioria das outras equipes teve de começar com pequenos testes clínicos em umas centenas de participantes para demonstrar que se trata de uma vacina segura. Ocorre que os cientistas do Jenner Institute da universidade começaram mais rapidamente os trabalhos em uma vacina porque já haviam provado em testes anteriores que tais inoculações – inclusive uma no ano passado contra um coronavírus inicial – não eram prejudiciais para o ser humano.
Isto lhes permitiu sair na dianteira e marcar os testes com a sua nova vacina contra o coronavírus com mais de 6 mil pessoas até o final do próximo mês, na esperança de demonstrar que não só é segura, como também funciona.
Os cientistas de Oxford agora afirmam que se as autoridades reguladoras concederem uma aprovação de emergência, os primeiros milhões de doses poderão estar disponíveis até setembro – pelo menos vários meses antes de qualquer outro esforço anunciado – desde que se revele eficaz.
Agora, eles receberam a promissora notícia de que isto será possível.
Os cientista dos National Institutes of Health’s Rocky Mountain Laboratory de Montana, inocularam, no mês passado, seis macacos rhesus com doses únicas da vacina de Oxford. Os animais então foram expostos a grandes quantidades do vírus que está causando a pandemia – exposição que fez com que outros macacos no laboratório ficassem bastante doentes. Mas mais de 28 dias mais tarde, todos os seis estavam saudáveis, disse Vincent Munster, o pesquisador que conduziu o teste.
“O macaco rhesus é o ser mais próximo do humano que nós temos”, disse Munster, observando que os cientistas ainda estavam analisando o resultado. Ele agora espera compartilhá-lo com outros cientistas na próxima semana e depois submetê-lo a uma publicação para a revisão de pares.
A imunidade em macacos não garante que uma vacina proporcione o mesmo grau de proteção aos seres humanos. Uma companhia chinesa que começou recentemente um teste clínico com 144 participantes, a Sino Vac, também afirmou que a sua vacina se mostrou eficaz em macacos rheseus. Mas com dezenas de experimentos atualmente em curso para encontrar uma vacina, os resultados apresentados pelos macacos são a mais recente indicação de que o esforço acelerado de Oxford está se destacando como o primeiro indicador de sucesso.
“Trata-se de um programa clínico extremamente rápido”, afirmou Emilio Emini, um diretor do programa de vacinas da Fundação Bill e Melinda Gates, que está dando o suporte financeiro a muitos experimentos concorrentes neste sentido no atual momento.
Saber qual será a vacina potencial que sairá destes esforços todos como a mais bem-sucedida será impossível enquanto não estiverem disponíveis os dados dos testes clínicos.
Em todo caso, será necessária mais de uma vacina, segundo Emini. Algumas poderão funcionar melhor do que outras em grupos como crianças e idosos, ou por custos e dosagens diferentes. Dispor de mais de uma variedade de vacinas em produção ajudará também a evitar gargalos na fabricação, ele afirmou.
Mas sendo a primeira a atingir uma escala relativamente tão ampla, a que será testada em Oxford, mesmo que fracasse, fornecerá lições tais sobre a natureza do coronavírus e sobre as respostas do sistema imunológico que poderão informar governos, doadores, laboratórios farmacêuticos e ouros cientistas na busca de uma vacina.
“Este amplo estudo britânico”, disse Emini, “se traduzirá na realidade também em um profundo aprendizado sobre algumas das outras”.
Todas as outras enfrentarão os mesmos desafios, inclusive para a obtenção de milhões de dólares em financiamentos, convencendo as autoridades reguladoras a aprovarem testes em humanos, demonstrando a sua segurança e – depois disso – provando a sua eficiência na proteção das pessoas contra o coronavírus.
Paradoxalmente, o crescente sucesso dos esforços para conter o avanço da covid-19, a doença causada pelo vírus, poderá apresentar mais um obstáculo.
“Somos as únicas pessoas do país que querem que o número de novas infecções continue por mais algumas semanas, a fim de podermos testar a nossa vacina,” o professor Adrian Hill, diretor do Jenner Institute, um dos cinco pesquisadores envolvidos na iniciativa, afirmou em uma entrevista em um edifício do laboratório esvaziado pelo fechamento imposto na Grã-Bretanha há um mês.
As normas éticas, como princípio geral, proíbem a tentativa de infectar participantes de testes humanos com uma doença grave. Isto significa que a única maneira de provar que uma vacina é eficaz é inoculando pessoas em um lugar em que o vírus se espalha naturalmente ao seu redor.
Se as medidas de distanciamento social ou outros fatores continuarem reduzindo a taxa de novas infecções no Reino Unido, ele disse, o teste talvez não possa mostrar que a vacina faz uma diferença: os participantes que receberam um placebo poderão não ser infectados mais frequentemente do que os que receberam a vacina. Os cientistas teriam de tentar novamente em outro lugar, um dilema que todos os outros experimentos para a obtenção de uma vacina também terão de enfrentar.
A iniciativa do Jenner Institute contra o coronavírus usa uma tecnologia que se concentra na alteração do código genético de um vírus conhecido. Uma vacina clássica usa uma versão mais fraca de um vírus para desencadear a resposta imunológica. Mas na tecnologia que o instituto está utilizando, um vírus diferente é modificado anteriormente a fim de neutralizar os seus efeitos e então torná-lo uma imitação de um vírus determinado – neste caso, o vírus que causa a covid-19. Injetado na corrente sanguínea, o impostor inócuo pode induzir o sistema imunológico a combater e matar a doença, proporcionando uma proteção.
Hill trabalhou com esta tecnologia por dezenas de anos para tentar agarrar um vírus de uma doença respiratória encontrado em chimpanzés a fim de provocar uma resposta imunológica humana contra a malária e outras moléstias. Nos últimos 20 anos, o instituto realizou mais de 70 testes clínicos de vacinas em potencial contra o parasita que causa a malária. Nenhum ainda levou a uma inoculação bem-sucedida.
No entanto, em 2014, uma vacina baseada no vírus do chimpanzé que Hill havia testado foi fabricada em uma escala suficientemente ampla para fornecer 1 milhão de doses. Isto criou um modelo para a produção em massa da vacina contra o coronavírus, no caso de ela se revelar eficiente.
A professora Sarah Gilbert, sua colega de longa data, modificou o mesmo vírus do chimpanzé para fazer uma vacina contra um primeiro coronavírus, na síndrome respiratória do Oriente Médio (MERS). Depois que um teste clínico, no Reino Unido, mostrou que era segura. Outro teste começou em dezembro na Arábia Saudita, onde surtos da doença letal ainda são comuns.
Quando em janeiro ela ouvia falar que cientistas chineses haviam identificado o código genético de um misterioso vírus em Wuhan, ela pensou que poderia ter a chance de pôr à prova a celeridade e a versatilidade da sua abordagem.
“Nós pensamos: ‘Bom, será que vamos poder tentar?’, ela lembra. “‘Será um pequeno projeto de laboratório, e depois publicaremos um paper’”.
Mas não permaneceu um “pequeno projeto de laboratório” por muito tempo.
Com a explosão da pandemia, eles passaram a receber muitas subvenções. Todas as outras vacinas foram postas em um freezer para o laboratório do instituto concentrar-se totalmente na covid-19. Entretanto, o fechamento do prédio obrigou todo mundo a não trabalhar na covid-19 e a ficar em casa.
Os doadores já gastam dezenas de milhões de dólares para dar início ao processo de produção em instalações no Reino Unido e na Holanda, antes mesmo que a vacina comprove que funciona, disse Sandy Douglas, um cientista de Oxford que supervisiona a produção de vacinas.
“Não há outra alternativa”, afirmou.
Mas a equipe ainda não chegou a um acordo com um fabricante da América do Norte, em parte porque os principais laboratórios farmacêuticos exigem, como sempre, direitos mundiais exclusivos antes de investir em um medicamento em potencial.
“Pessoalmente, não acredito que em uma época de pandemia deva haver licenças exclusivas”, disse Hill. “Por isso estamos conversando com vários laboratórios. Ninguém vai ganhar um monte de dinheiro com isto”.
Enquanto isso, com os dados sobre a segurança dos testes em humanos de vacinas semelhantes contra o Ebola, a MERS e a malária, os cientistas do instituto de Oxford convenceram as autoridades reguladoras britânicas a permitirem testes inusitadamente acelerados para aproveitar que a pandemia ainda está ao seu redor.
Na semana passada, o instituto começou a Fase I de um teste clínico que envolve 1.100 pessoas. No próximo mês, começará o teste crucial da Fase II e da Fase III que envolverá outras 5 mil. Ao contrário de qualquer outro projeto de vacina atualmente em andamento, esse deverá provar sua eficiência e segurança.
Os cientistas declararão vitória se uma dezenas de participantes que receberem um placebo adoecerem com a covid-19, em comparação com apenas um ou dois que forem vacinados. “Então faremos uma festa e contaremos para o mundo,” disse Hill. Todos os que receberem somente o placebo também serão vacinados imediatamente.
Se poucos participantes forem infectados no Reino Unido, o instituto planeja a realização de outros testes onde o coronavírus estiver se espalhando, provavelmente na África e na Índia.
“Precisamos caçar a epidemia”, disse Hill. “Se ainda estiver devastando alguns países, talvez possamos realizar testes nos Estados Unidos em novembro”. / TRADUÇÃO DE ANNA CAPOVILLA
Carl Bergstrom’s two disparate areas of expertise merged as reports of a mysterious respiratory illness emerged in January
Julia Carrie Wong, Tue 28 Apr 2020 11.00 BST
Carl Bergstrom is uniquely suited to understanding the current moment. A professor of biology at the University of Washington, he has spent his career studying two seemingly disparate topics: emerging infectious diseases and networked misinformation. They merged into one the moment reports of a mysterious respiratory illness emerged from China in January.
The coronavirus touched off both a pandemic and an “infodemic” of hoaxes, conspiracy theories, honest misunderstandings and politicized scientific debates. Bergstrom has jumped into the fray, helping the public and the press navigate the world of epidemiological models, statistical uncertainty and the topic of his forthcoming book: bullshit.
The following interview has been edited for length and clarity.
You’ve been teaching a course and have co-written a book about the concept of bullshit. Explain what you mean by bullshit?
The formal definition that we use is “language, statistical figures, data, graphics and other forms of presentation that are intended to persuade by impressing and overwhelming a reader or listener with a blatant disregard for truth or logical coherence”.
The idea with bullshit is that it’s trying to appear authoritative and definitive in a way that’s not about communicating accurately and informing a reader, but rather by overwhelming them, persuading them, impressing them. If that’s done without any allegiance to truth, or accuracy, that becomes bullshit.
We’re all used to verbal bullshit. We’re all used to campaign promises and weasel words, and we’re pretty good at seeing through that because we’ve had a lot of practice. But as the world has become increasingly quantified and the currency of arguments has become statistics, facts and figures and models and such, we’re increasingly confronted, even in the popular press, with numerical and statistical arguments. And this area’s really ripe for bullshit, because people don’t feel qualified to question information that’s given to them in quantitative form.
Are there bullshit narratives about the coronavirus that you are concerned about right now?
What’s happened with this pandemic that we’re not accustomed to in the epidemiology community is that it’s been really heavily politicized. Even when scientists are very well-intentioned and not trying to support any side of the narrative, when they do work and release a paper it gets picked up by actors with political agendas.
Whether it’s talking about seroprevalence or estimating the chance that this is even going to come to the United States at all each study gets picked up and placed into this little political box and sort of used as a cudgel to beat the other side with.
So even when the material isn’t being produced as bullshit, it’s being picked up and used in the service of that by overstating its claims, by cherry-picking the information that’s out there and so on. And I think that’s kind of the biggest problem that we’re facing.
One example [of intentional bullshit] might be this insistence for a while on graphing the number of cases on a per-capita basis, so that people could say the US response is so much better than the rest of the world because we have a slower rate of growth per capita. That was basically graphical malfeasance or bullshit. When a wildfire starts spreading, you’re interested in how it’s spreading now, not whether it’s spreading in a 100-acre wood or millions of square miles of national forest.
Is there one big lesson that you think that the media should keep in mind as we communicate science to the public? What mistakes are we making?
I think the media has been adjusting really fast and doing really well. When I’m talking about how to avoid misinformation around this I’m constantly telling people to trust the professional fact-based media. Rather than looking for the latest rumor that’s spreading across Facebook or Twitter so that you can have information up to the hour, recognize that it’s much better to have solidly sourced, well-vetted information from yesterday.
Hyper-partisan media are making a huge mess of this, but that’s on purpose. They’ve got a reason to promote hydroxychloroquine or whatever it is and just run with that. They’re not even trying to be responsible.
But one of the biggest things that people [in the media]could do to improve would be to recognize that scientific studies, especially in a fast-moving situation like this, are provisional. That’s the nature of science. Anything can be corrected. There’s no absolute truth there. Each model, each finding is just adding to a weight of evidence in one direction or another.
A lot of the reporting is focusing on models, and most of us probably don’t have any basic training in how to read them or what kind of credence to put in them. What should we know?
The key thing, and this goes for scientists as well as non-scientists, is that people are not doing a very good job thinking about what the purpose of different models are, how the purposes of different models vary, and then what the scope of their value is. When these models get treated as if they’re oracles, then people both over-rely on them and treat them too seriously – and then turn around and slam them too hard for not being perfect at everything.
Are there mistakes that are made by people in the scientific community when it comes to communicating with the public?
We’re trying to communicate as a scientific community in a new way, where people are posting their data in real time. But we weren’t ready for the degree to which that stuff would be picked up and assigned meaning in this highly politically polarized environment. Work that might be fairly easy for researchers to contextualize in the field can be portrayed as something very, very different in the popular press.
The first Imperial College model in March was predicting 1.1 million to 2.2 million American deaths if the pandemic were not controlled. That’s a really scary, dramatic story, and I still think that it’s not unrealistic. That got promoted by one side of the partisan divide. Then Imperial came back and modeled a completely different scenario, where the disease was actually brought under control and suppressed in the US, and they released a subsequent model that said, ‘If we do this, something like 50,000 deaths will occur.’ That was picked up by the other side and used to try to discredit the Imperial College team entirely by saying, ‘A couple of weeks ago they said a million now they’re saying 50,000; they can’t get anything right.’ And the answer , of course, is that they were modeling two different scenarios.
We’re also not doing enough of deliberately stressing the possible weaknesses of our interpretations. That varies enormously from researcher to researcher and team to team.
It requires a lot of discipline to argue really hard for something but also be scrupulously open about all of the weaknesses in your own argument.
But it’s more important than ever, right? A really good paper will lay out all the most persuasive evidence it can and then in the conclusion section or the discussion section say, ‘OK, here are all the reasons that this could be wrong and here are the weaknesses.’
When you have something that’s so directly policy relevant, and there’s a lot of lives at stake, we’re learning how to find the right balance.
It is a bit of a nightmare to put out data that is truthful, but also be aware that there are bad faith actors at the moment who might pounce on it and use it in a way you didn’t intend.
There’s a spectrum. You have outright bad faith actors – Russian propaganda picking up on things and bots spreading misinformation – and then you have someone like Georgia Governor Brian Kemp who I wouldn’t calla bad faith actor. He’s a misinformed actor.
There’s so much that goes unsaid in science in terms of context and what findings mean that we don’t usually write in papers. If someone does a mathematical forecasting model, you’re usually not going to have a half-page discussion on the limitations of forecasting. We’re used to writing for an audience of 50 people in the world, if we’re lucky, who have backgrounds that are very similar to our own and have a huge set of shared assumptions and shared knowledge. And it works really well when you’re writing on something that only 50 people in the world care about and all of them have comparable training, but it is a real mess when it becomes pressing, and I don’t think any of us have figured out exactly what to do about that because we’re also trying to work quickly and it’s important to get this information out.
One area that has already become contentious and in some ways politicized is the serology surveys, which are supposed to show what percentage of the population has antibodies to the virus. What are some of the big picture contextual caveats and limitations that we should keep in mind as these surveys come out?
The seroprevalence in the US is a political issue, and so the first thing is to recognize that when anyone is reporting on that stuff, there’s a political context to it. It may even be that some of the research is being done with an implicitly political context, depending on who the funders are or what the orientations and biases of some of the researchers.
On the scientific side, I think there’s really two things to think about. The first one is the issue of selection bias. You’re trying to draw a conclusion about one population by sampling from a subset of that population and you want to know how close to random your subset is with respect to the thing you’re trying to measure. The Santa Clara study recruited volunteers off of Facebook. The obvious source of sampling bias there is that people desperately want to get tested. The people that want it are, of course, people that think they’ve had it.
The other big piece is understanding the notion of positive predictive value and the way false positive and false negative error rates influence the estimate. And that depends on the incidence of infection in the population.
If you have a test that has a 3% error rate, and the incidence in the population is below 3%, then most of the positives that you get are going to be false positives. And so you’re not going to get a very tight estimate about how many people have it. This has been a real problem with the Santa Clara study. From my read of the paper, their data is actually consistent with nobody being infected. A New York Citystudy on the other hand showed 21% seropositive, so even if there has a 3% error rate, the majority of those positives have to be true positives.
Now that we’ve all had a crash course in models and serosurveys, what are the other areas of science where it makes sense for the public to start getting educated on the terms of the debate?
One that I think will come along sooner or later is interpreting studies of treatments. We’ve dealt with that a little bit with the hydroxychloroquine business but not in any serious way because the hydroxychloroquine work has been pretty weak and the results have not been so positive.
But there are ongoing tests of a large range of existing drugs. And these studies are actually pretty hard to do. There’s a lot of subtle technical issues: what are you doing for controls? Is there a control arm at all? If not, how do you interpret the data? If there is a control arm, how is it structured? How do you control for the characteristics of the population on whom you’re using the drug or their selection biases in terms of who’s getting the drug?
Unfortunately, given what we’ve already seen with hydroxychloroquine, it’s fairly likely that this will be politicized as well. There’ll be a parallel set of issues that are going to come around with vaccination, but that’s more like a year off.
If you had the ability to arm every person with one tool – a statistical tool or scientific concept – to help them understand and contextualize scientific information as we look to the future of this pandemic, what would it be?
I would like people to understand that there are interactions between the models we make, the science we do and the way that we behave. The models that we make influence the decisions that we take individually and as a society, which then feed back into the models and the models often don’t treat that part explicitly.
Once you put a model out there that then creates changes in behavior that pull you out of the domain that the model was trying to model in the first place. We have to be very attuned to that as we try to use the models for guiding policy.
That’s very interesting, and not what I expected you to say.
What did you expect?
That correlation does not imply causation.
That’s another very good one. Seasonality is a great example there. We’re trying a whole bunch of things at the same time. We’re throwing all kinds of possible solutions at this and lots of things are changing. It’s remarkable to me actually, that so many US states are seeing the epidemic curve decrease. And so there’s a bunch of possibilities there. It could be because people’s behavior is changing. There could be some seasonality there. And there are other possible explanations as well.
But what is really important is that just because the trend that you see is consistent with a story that someone’s selling, there may be many other stories that are also consistent, so inferring causality is dangerous.
SÃO PAULO – Os cartórios brasileiros registraram alta de 43% no número de mortes por causa indeterminada notificadas no País desde o início da pandemia de covid-19 em território brasileiro. Os dados, antecipados pelo Estado, serão divulgados nesta segunda-feira, 27, em novo painel do Portal da Transparência do Registro Civil, mantido pela Associação Nacional dos Registradores de Pessoas Naturais (Arpen-Brasil). Segundo especialistas, o aumento de óbitos sem causa definida pode estar associado a vítimas de coronavírus que morreram sem ter o diagnóstico da doença.
A alta refere-se ao período de 26 de fevereiro, data em que o primeiro caso de infecção por coronavírus foi registrado no Brasil, até 17 de abril – como os cartórios tem até dez dias para repassar os registros para a Central de Informações do Registro Civil (CRC Nacional), a reportagem optou por um recorte até dez dias atrás.
Em 2020, o País teve 1.329 mortes por causa indeterminada no periodo mencionado. Em 2019, 925 óbitos do tipo foram registrados pelos cartórios no mesmo intervalo. De acordo com especialistas, o dado pode ser mais um indício de subnotificação do número de óbitos por coronavírus no País. Com a falta de testes e a alta demanda sobre o sistema de saúde em algumas regiões, doentes podem estar morrendo sem ter uma avaliação médica.
Para Fátima Marinho, professora da Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG) e integrante do grupo de especialistas que auxiliou a Arpen-Brasil na elaboração do painel, é provável que o aumento de mortes por causa indefinida tenha como uma das razões a morte de pessoas por covid-19 que não tiveram acesso ao sistema de saúde. “Em uma situação de uma doença nova, uma pandemia, a gente espera um aumento de mortes em casa, sem que a pessoa sequer consiga ter atendimento médico. Isso pode estar acontecendo agora”, explica.
Se analisadas as mortes também por faixa etária, o aumento de óbitos por causa indeterminada é maior entre idosos, principal grupo de risco para complicações do coronavírus. O número de mortes sem causa definida entre pessoas com idade a partir de 60 anos passou de 568 em 2019 para 879 em 2020, alta de 54,8%. Já entre indivíduos com menos de 60 anos, a variação foi de 30,5% – subiu de 321 para 419 no mesmo intervalo de tempo.
Fátima diz que outra razão que pode estar impactando na alta de mortes por causas indeterminadas é o provável crescimento de óbitos por outras causas que não estão chegando aos hospitais pela dificuldade de conseguir leitos no meio da pandemia ou pelo eventual medo de pacientes em procurar unidades de saúde e se contaminarem. “Provavelmente teremos um aumento de mortes por infarto, AVC e outros problemas registrados em casa porque as pessoas estão adiando a ida ao pronto-socorro ou tendo que disputar leitos com pacientes com covid-19”, diz ela.
Salto em mortes por Síndrome Respiratória Aguda Grave
O portal da transparência mantido pela Arpen-Brasil também passa a disponibilizar o número de mortes por Síndrome Respiratória Aguda Grave (SRAG), que registrou aumento de 680% entre 26 de fevereiro e 17 de abril de 2019 e o mesmo período de 2020. Os números contemplam casos dessa condição respiratória em que não foi especificado o agente causador da síndrome, que pode ser coronavírus, mas também influenza ou outro vírus respiratório.
De acordo com o portal, o número de mortes do tipo passou de 156 para 1.217 no período citado. A alta nos óbitos por SRAG não especificada registradas em cartórios seriam outro indício de subnotificação. Ela é ainda maior em Estados com muitos casos da doença. No Amazonas, o aumento foi de 1.214%. No Ceará, de 3.828%. Em São Paulo, Estado com o maior número de infectados, o crescimento observado foi de 916%.
O número de mortes suspeitas ou confirmadas por covid-19 registradas nos cartórios também vem se mostrando maior do que as registradas pelo Ministério da Saúde (que considera só os óbitos confirmados por coronavírus). Na tarde desta segunda, por exemplo, os cartórios já registravam 4.839 vítimas com confirmação ou suspeita da doença. Já o Ministério contabilizava 4.543 registros.
Para Luis Carlos Vendramin Júnior, vice-presidente da Arpen-Brasil, a disponibilização dos dados dos cartórios ajudam a entender o avanço da epidemia. “Como temos esses dados com atualização diária, avaliamos que ampliar a transparência e divulgar dados também sobre mortes por SRAG e causas indeterminadas, além das que já vínhamos divulgando, vai auxiliar tanto o poder público quanto a imprensa e a população em geral na análise de números”, destacou.
Omar Rodriguez organizes bodies in the Gerard J. Neufeld funeral home in Elmhurst on April 22. Photo: Spencer Platt/Getty Images
Over the last few weeks, the country has managed to stabilize the spread of the coronavirus sufficiently enough to begin debating when and in what ways to “reopen,” and to normalize, against all moral logic, the horrifying and ongoing death toll — thousands of Americans dying each day, in multiples of 9/11 every week now with the virus seemingly “under control.” The death rate is no longer accelerating, but holding steady, which is apparently the point at which an onrushing terror can begin fading into background noise. Meanwhile, the disease itself appears to be shape-shifting before our eyes.
In an acute column published April 13, the New York Times’ Charlie Warzel listed 48 basic questions that remain unanswered about the coronavirus and what must be done to protect ourselves against it, from how deadly it is to how many people caught it and shrugged it off to how long immunity to the disease lasts after infection (if any time at all). “Despite the relentless, heroic work of doctors and scientists around the world,” he wrote, “there’s so much we don’t know.” The 48 questions he listed, he was careful to point out, did not represent a comprehensive list. And those are just the coronavirus’s “known unknowns.”
In the two weeks since, we’ve gotten some clarifying information on at least a handful of Warzel’s queries. In early trials, more patients taking the Trump-hyped hydroxychloroquinine died than those who didn’t, and the FDA has now issued a statement warning coronavirus patients and their doctors from using the drug. The World Health Organization got so worried about the much-touted antiviral remdesivir, which received a jolt of publicity (and stock appreciation) a few weeks ago on rumors of positive results, the organization leaked an unpublished, preliminary survey showing no benefit to COVID-19 patients. Globally, studies have consistently found exposure levels to the virus in most populations in the low single digits — meaning dozens of times more people have gotten the coronavirus than have been diagnosed with it, though still just a tiny fraction of the number needed to achieve herd immunity. In particular hot spots, the exposure has been significantly more widespread — one survey in New York City found that 21 percent of residents may have COVID-19 antibodies already, making the city not just the deadliest community in the deadliest country in a world during the deadliest pandemic since AIDS, but also the most infected (and, by corollary, the farthest along to herd immunity). A study in Chelsea, Massachusetts, found an even higher and therefore more encouraging figure: 32 percent of those tested were found to have antibodies, which would mean, at least in that area, the disease was only a fraction as severe as it might’ve seemed at first glance, and that the community as a whole could be as much as halfway along to herd immunity. In most of the rest of the country, the picture of exposure we now have is much more dire, with much more infection almost inevitably to come.
But there is one big question that didn’t even make it onto Warzel’s list that has only gotten more mysterious in the weeks since: How is COVID-19 actually killing us?
We are now almost six months into this pandemic, which began in November in Wuhan, with 50,000 Americans dead and 200,000 more around the world. If each of those deaths is a data point, together they represent a quite large body of evidence from which to form a clear picture of the pandemic threat. Early in the epidemic, the coronavirus was seen as a variant of a familiar family of disease, not a mysterious ailment, however infectious and concerning. But while uncertainties at the population level confuse and frustrate public-health officials, unsure when and in what form to shift gears out of lockdowns, the disease has proved just as mercurial at the clinical level, with doctors revising their understanding of COVID-19’s basic pattern and weaponry — indeed often revising that understanding in different directions at once. The clinical shape of the disease, long presumed to be a relatively predictable respiratory infection, is getting less clear by the week. Lately, it seems, by the day. As Carl Zimmer, probably the country’s most respected science journalist, asked virologists in a tweet last week, “is there any other virus out there that is this weird in terms of its range of symptoms?”
You probably have a sense of the range of common symptoms, and a sense that the range isn’t that weird: fever, dry cough, and shortness of breath have been, since the beginning of the outbreak, the familiar, oft-repeated group of tell-tale signs. But while the CDC does list fever as the top symptom of COVID-19, so confidently that for weeks patients were turned away from testing sites if they didn’t have an elevated temperature, according to the Journal of the American Medical Association, as many as 70 percent of patients sick enough to be admitted to New York State’s largest hospital system did not have a fever.
Over the past few months, Boston’s Brigham and Women’s Hospital has been compiling and revising, in real time, treatment guidelines for COVID-19 which have become a trusted clearinghouse of best-practices information for doctors throughout the country. According to those guidelines, as few as 44 percent of coronavirus patients presented with a fever (though, in their meta-analysis, the uncertainty is quite high, with a range of 44 to 94 percent). Cough is more common, according to Brigham and Women’s, with between 68 percent and 83 percent of patients presenting with some cough — though that means as many as three in ten sick enough to be hospitalized won’t be coughing. As for shortness of breath, the Brigham and Women’s estimate runs as low as 11 percent. The high end is only 40 percent, which would still mean that more patients hospitalized for COVID-19 do not have shortness of breath than do. At the low end of that range, shortness of breath would be roughly as common among COVID-19 patients as confusion (9 percent), headache (8 to 14 percent), and nausea and diarrhea (3 to 17 percent). That the ranges are so wide themselves tells you that the disease is presenting in very different ways in different hospitals and different populations of different patients — leading, for instance, some doctors and scientists to theorize the virus might be attacking the immune system like HIV does, with many others finding the disease is triggering something like the opposite response, an overwhelming overreaction of the immune system called a “cytokine storm.”
The most bedeviling confusion has arisen around the relationship of the disease to breathing, lung function, and oxygenation levels in the blood — typically, for a respiratory illness, a quite predictable relationship. But for weeks now, front-line doctors have been expressing confusion that so many coronavirus patients were registering lethally low blood-oxygenation levels while still appearing, by almost any vernacular measure, pretty okay. It’s one reason they’ve begun rethinking the initial clinical focus on ventilators, which are generally recommended when patients oxygenation falls below a certain level, but seemed, after a few weeks, of unclear benefit to COVID-19 patients, who may have done better, doctors began to suggest, on lesser or different forms of oxygen support. For a while, ventilators were seen so much as the essential tool in treating life-threatening coronavirus that shortages (and the president’s unwillingness to invoke the Defense Production Act to manufacture them quickly) became a scandal. But by one measure 88 percent of New York patients put on ventilators, for whom an outcome as known, had died. In China, the figure was 86 percent.
On April 20 in the New York Times, an ER doctor named Richard Levitan who had been volunteering at Bellevue proposed that the phenomenon of seemingly stable patients registering lethally low oxygen levels might be explained by “silent hypoxia” — the air sacs in the lung collapsing, not getting stiff or heavy with fluid, as is the case with the pneumonias doctors had been using as models in their treatment of COVID-19. But whether this explanation is universal, limited to the patients at Bellevue, or somewhere in between is not yet entirely clear. A couple of days later, in a pre-print paper others questioned, scientists reported finding that the ability of the disease to mutate has been “vastly underestimated” — investigating the disease as it appeared in just 11 patients, they said they found 30 mutations. “The most aggressive strains could generate 270 times as much viral load as the weakest type,” the South China Morning-Postreported. “These strains also killed the cells the fastest.”
That same day, the Washington Postreported on another theory gaining traction among American doctors treating the disease — that one key could be the way COVID-19 affects the blood of patients, producing much more clotting. “Autopsies have shown that some people’s lungs are filled with hundreds of microclots,” the Post reported. “Errant blood clots of a larger size can break off and travel to the brain or heart, causing a stroke or a heart attack.”
But the bigger-picture perspective the newspaper offered is perhaps more eye-opening and to the point:
One month ago, as the country went into lockdown to prepare for the first wave of coronavirus cases, many doctors felt confident that they knew what they were dealing with. Based on early reports, covid-19 appeared to be a standard variety respiratory virus, albeit a very contagious and lethal one with no vaccine and no treatment. But they’ve since become increasingly convinced that covid-19 attacks not only the lungs, but also the kidneys, heart, intestines, liver and brain.
That is a dizzying list. But it is not even comprehensive. In a fantastic survey published April 17 (“How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes,” by Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, and Catherine Matacic), Science magazine took a thorough, detailed tour of the ever-evolving state of understanding of the disease. “Despite the more than 1,000 papers now spilling into journals and onto preprint servers every week,” Science concluded, “a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen.”
In a single illuminating chart, Science lists the following organs as being vulnerable to COVID-19: brain, eyes, nose, lungs, heart, blood vessels, livers, kidneys, intestines. That is to say, nearly every organ:
And the disparate impacts were significant ones: Heart damage was discovered in 20 percent of patients hospitalized in Wuhan, where 44 percent of those in ICU exhibited arrhythmias; 38 percent of Dutch ICU patients had irregular blood clotting; 27 percent of Wuhan patients had kidney failure, with many more showing signs of kidney damage; half of Chinese patients showed signs of liver damage; and, depending on the study, between 20 percent and 50 percent of patients had diarrhea.
On April 15, the Washington Postreported that, in New York and Wuhan, between 14 and 30 percent of ICU patients had lost kidney function, requiring dialysis. New York hospitals were treating so much kidney failure “they need more personnel who can perform dialysis and have issued an urgent call for volunteers from other parts of the country. They also are running dangerously short of the sterile fluids used to deliver that therapy.” The result, the Post said, was rationed care: patients needing 24-hour support getting considerably less. On Saturday, the paper reported that “[y]oung and middle-aged people, barely sick with COVID-19, are dying from strokes.” Many of the patients described didn’t even know they were sick:
The patient’s chart appeared unremarkable at first glance. He took no medications and had no history of chronic conditions. He had been feeling fine, hanging out at home during the lockdown like the rest of the country, when suddenly, he had trouble talking and moving the right side of his body. Imaging showed a large blockage on the left side of his head. Oxley gasped when he got to the patient’s age and covid-19 status: 44, positive.
The man was among several recent stroke patients in their 30s to 40s who were all infected with the coronavirus. The median age for that type of severe stroke is 74.
But the patient’s age wasn’t the only abnormality of the case:
As Oxley, an interventional neurologist, began the procedure to remove the clot, he observed something he had never seen before. On the monitors, the brain typically shows up as a tangle of black squiggles — “like a can of spaghetti,” he said — that provide a map of blood vessels. A clot shows up as a blank spot. As he used a needlelike device to pull out the clot, he saw new clots forming in real-time around it.
“This is crazy,” he remembers telling his boss.
These strokes, several doctors who spoke to the Post theorized, could explain the high number of patients dying at home — four times the usual rate in New York, many or most of them, perhaps, dying quite suddenly. According to the Brigham and Women’s guidelines, only 53 percent of COVID-19 patients have died from respiratory failure alone.
It’s not unheard of, of course, for a disease to express itself in complicated or hard-to-parse ways, attacking or undermining the functioning of a variety of organs. And it’s common, as researchers and doctors scramble to map the shape of a new disease, for their understanding to evolve quite quickly. But the degree to which doctors and scientists are, still, feeling their way, as though blindfolded, toward a true picture of the disease cautions against any sense that things have stabilized, given that our knowledge of the disease hasn’t even stabilized. Perhaps more importantly, it’s a reminder that the coronavirus pandemic is not just a public-health crisis but a scientific one as well. And that as deep as it may feel we are into the coronavirus, with tens of thousands dead and literally billions in precautionary lockdown, we are still in the very early stages, when each new finding seems as likely to cloud or complicate our understanding of the coronavirus as it is to clarify it. Instead, confidence gives way to uncertainty.
In the space of a few months, we’ve gone from thinking there was no “asymptomatic transmission” to believing it accounts for perhaps half or more of all cases, from thinking the young were invulnerable to thinking they were just somewhat less vulnerable, from believing masks were unnecessary to requiring their use at all times outside the house, from panicking about ventilator shortages to deploying pregnancy massage pillows instead. Six months since patient zero, we still have no drugs proven to even help treat the disease. Almost certainly, we are past the “Rare Cancer Seen in 41 Homosexuals” stage of this pandemic. But how far past?
Many Americans have been living under lockdown for a month or more. We’re all getting antsy. The president is talking about a “light at the end of the tunnel.” People are looking for hope and reasons to plan a return to something — anything — approximating normalcy. Experts are starting to speculate on what lifting restrictions will look like. Despite the relentless, heroic work of doctors and scientists around the world, there’s so much we don’t know.
We don’t know how many people have been infected with Covid-19.
We don’t know the full range of symptoms.
We don’t always know why some infections develop into severe disease.
We don’t know the full range of risk factors.
We don’t know exactly how deadly the disease is.
We don’t have answers to more detailed questions about how the virus spreads, including: “How many virus particles does it even take to launch an infection? How far does the virus travel in outdoor spaces, or in indoor settings? Have these airborne movements affected the course of the pandemic?”
We don’t know for sure how this coronavirus first emerged.
We don’t know if people will continue to adhere to social distancing guidelines once infections go down.
We don’t know when states will be able to test everyone who has symptoms.
We don’t know if the United States could ever deploy the number of tests — as many as 22 million per day — needed to implement mass testing and quarantining.
We don’t know if we can implement “test and trace” contact tracing at scale.
We don’t know whether smartphone location tracking could be implemented without destroying our privacy.
We don’t know if or when researchers will develop a successful vaccine.
We don’t know how many vaccines can be deployed and administered in the first months after a vaccine becomes available.
We don’t know how a vaccine will be administered — who will get it first?
We don’t know if a vaccine will be free or costly.
We don’t know if a vaccine will need to be updated every year.
We don’t know how, when we do open things up again, we will do it.
We don’t know if people will be afraid to gather in crowds.
We don’t know if people will be too eager to gather in crowds.
We don’t know what socially distanced professional sports will look like.
We don’t know what socially distanced workplaces will look like.
We don’t know what socially distanced bars and restaurants will look like.
We don’t know when schools will reopen.
We don’t know what a general election in a pandemic will look like.
We don’t know what effects lost school time will have on children.
We don’t know if the United States’s current and future government stimulus will stave off an economic collapse.
We don’t know whether the economy will bounce back in the form of a “v curve” …
Or whether it’ll be a long recession.
We don’t know when any of this will end for good.
There is, at present, no plan from the Trump White House on the way forward.
We’re working on a project about the ways people’s lives might be permanently altered by the coronavirus, even after the pandemic subsides. In what ways do you think your life will change in the long term? What will be your new “normal”?
Blending nationalism and pseudoscience, the “cures” touted by an Indian ministry are raising public health concerns.
When it was announced in late March that Prince Charles, heir to the British throne, was well on his way to recovering from Covid-19, there was some celebration 4,000 miles away in India, a former British colony. But it was not colonial nostalgia that brought on the cheer, so much as the declaration a few days later by an Indian government minister that the Prince of Wales had been cured using Ayurveda — a blend of, among other things, herbal medicine, breathing exercises, and meditation.
At an April 2 press conference, Shripad Naik, India’s minister for alternative medicines, declared that the treatment’s supposed success “validates our age-old practice.” The British government swiftly issued a statement rejecting his claim. “This information is incorrect. The Prince of Wales followed the medical advice of the National Health Service in the U.K. and nothing more,” a spokesperson said the following day.
But this hasn’t deterred Naik’s Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy — or AYUSH for short — from promoting Indian alternative medicines as treatments for Covid-19. Established in 2014, the goal of AYUSH is to develop and popularize these treatments, many of which have their historical roots in India. Ayurveda, for example, has been practiced in India for thousands of years.
Now, Naik said, the ministry aims to confirm that Prince Charles was cured using a combination of Ayurveda and the pseudoscience known as homeopathy, which has its roots in Germany, so that the treatment can be rolled out to the masses. This is in stark contrast to the position of mainstream medicine, which has not yet confirmed any evidence-based medicine for Covid-19, and is still highly cautious of giving experimental drugs to patients.
And yet for many, the actions of the right-wing Indian government don’t come as a surprise. Aside from the popularity of alternative medicine in India generally, the ruling Bharatiya Janata Party (BJP) is known for supporting Hindutva, a form of nationalism that seeks to transform India from being a secular nation into an openly Hindu one. This partly plays out in the field of health, where alternative therapies that have their roots in India, such as Ayurveda, are considered more “Hindu” or “Indian” than modern medicine. Supporting them becomes an opportunity to push forward this nationalist agenda.
In the early days of the epidemic, AYUSH heavily promoted therapies that lack an evidence base, said Sumaiya Shaikh, a neuroscientist based at the Center for Social and Affective Neuroscience at Linköping University Hospital in Sweden. Shaikh is also editor of science at Alt News, an Indian website that works to expose misinformation.
Examples of treatments pushed by AYUSH included a homeopathic medicine containing diluted arsenic, an Ayurvedic drug developed by the ministry to treat malaria, and dietary changes including drinking warm water, putting sesame oil inside the nose, or consuming holy basil, ginger, cloves, and turmeric. The ministry suggested these interventions could prevent people from developing Covid-19 as well as treat its symptoms.
“There was some amount of criticism to that,” said Shaikh. And so in response, the ministry provided a list of “scientific evidence” to bolster its claims. Aside from the fact that homeopathy has been repeatedly shown to have no biological effects, Shaikh said that when she and her team reviewed the list, the only actual research they could find was one analysis that examined the the same homeopathic treatment in bovines with gastric infections. Despite this, the ministry’s promotion of the therapy increased demand in many Indian states.
This isn’t the first time the ministry has faced criticism for promoting unscientific claims or backing research derived from religious myths and beliefs. One of its repeated focuses has been cow urine, which is believed by many Hindus to have healing properties given the sacred nature of cows in Hinduism. The urine has been touted as a treatment for many illnesses, including diabetes, epilepsy, and AIDS. Naik himself has made several comments in parliament about how cow urine can cure cancer. In reality, its use can be dangerous.
In fact, so widespread is the belief in cow urine that on March 17, an activist working for the BJP in Kolkata organized a “gomutra (cow urine) party” to ward off Covid-19. He believed that drinking the urine would protect them from the disease. Unfortunately, one of the volunteers fell seriously ill after ingesting the urine.
The Ministry of AYUSH’s research portal carries papers on the uses of panchagavya, the five products derived from a cow, of which urine is one, supporting its use as a medical product. However, Ipsita Mohanty, who co-wrote a paper listed there titled “Diversified Uses of Cow Urine,” said in an email that she couldn’t definitively answer whether cow urine fights off Covid-19, as “it has not been proven by independent researchers.”
This reflects how AYUSH researchers and doctors seek validation, explained Shaikh. “If a paper gets published anywhere — doesn’t matter what type of journal it is or how bad the statistics are — they take it as scientific proof,” she said, adding that the alternative medicine community also has a lot of journals of its own. These are regulated and edited by the same people who are published in them, Shaikh said.
Despite being an advocate of cow urine, Mohanty urges doctors to not spread misinformation. “It is misleading to spread the rumor about something so important when more than half of our world is engulfed by Covid-19,” she said. “There is no vaccine nor any treatment for it. At this point, promoting cow urine against Covid-19 can be very fatal, as people might resort to it for treatment as their only hope.”
The Ministry of AYUSH did not respond to requests for comments from Undark.
“Practitioners of such therapies get their clientele from two distinct groups,” said Aniket Sule, a science education researcher and astronomer at the Homi Bhabha Center for Science Education. He is part of a steadily growing rationalist movement in India that is encouraging dialogue and critical thinking to counter misinformation, including within the realm of alternative medicine.
The first group Sule identified is patients from impoverished communities and remote villages, “who don’t have access to doctors prescribing modern medicines.” The other set of clients is the “affluent and educated class in the cities, who have read half-baked internet posts and develop strong skepticism towards modern medicines,” he said.
“Pushing such a narrative to gullible masses is akin to actively spreading misinformation, and senior functionaries of government should take strict action against such baseless propaganda,” he urged.
The ministry has faced some institutional backlash. The Press Council of India, the statutory body responsible for maintaining good media standards, has issued an order asking print media to stop publicity and advertisements of AYUSH-related claims for Covid-19 treatments.
But despite that, the Ministry of AYUSH continues not only to receive political backing but also a large share of the annual health budget. From 2019 to 2020, the Indian government allotted approximately $250 million for study and promotion of alternative medicines, a 15 percent increase from the previous year. According to Shaikh, only the defense ministry saw a larger proportional increase to its budget last year.
Indian scientists fighting disinformation say there is an underlying nationalist agenda to this move. Certain radical groups affiliated with the government have dreams of spreading Hindu values beyond India’s borders to create an “Akhand Bharat,” or “consolidated Hindu nation,” which would include annexing a large part of the Indian subcontinent. One of these is Rashtriya Swayamsevak Sangh, a militant organization that has a long history of promoting Hindutva. Its leader recently said that Ayurveda is part of India’s “soft power” in the South Asian region, said Shaikh.
The Press Council of India, the statutory body responsible for maintaining good media standards, has issued an order asking print media to stop publicity and advertisements of AYUSH-related claims for Covid-19 treatments.
Since coming to power in 2014, India’s current government (BJP) has increasingly backed divisive policies that consolidate the power of the majoritarian Hindu population. “Overall, this government has made virtue out of extreme and thoughtless nationalism. Increased support to all these questionable therapies is a natural byproduct of that,” Sule said, adding there is also a distinct motivation among many people who believe in these claims. “There are people who are so completely blinded by ‘glorious ancient India’ that they willingly walk into any trap if it is presented as ‘this is what our great ancestors did,’” he said.
Sule also thinks that AYUSH exists, in part, to protect commercial interests. There are nearly 800,000 practitioners of alternative medicine in India, he said, and over 650 colleges teaching related courses. The Ayurveda industry alone in India is worth $4.4 billion and is expected to grow by 16 percent in the next five years.
Shaikh, Sule, and others have been critical of the Ministry of AYUSH for years, exposing and unmasking its questionable research and dubious medical advice. “It is very dangerous, especially now. We are the only country that has a parallel ministry for alternative systems,” Shaikh said. “Why not just have the one ministry and then have everything under it? Use whatever herbs you want, but run them through appropriate trials, and if they work then they should be in the mainstream and everybody should benefit from them,” she said.
Shaikh doesn’t call for closing the ministry but insists the way it works needs to change.
“Don’t start with a belief system, start with the hypothesis,” she advised. “Don’t start with the basis that this drug is going to work. Start with realizing that ‘we don’t know and we want to find out.’ That is unbiased research.”
Many experts say that statements like Naik’s are false and dangerous, particularly now that the country is struggling to control the spread of the novel coronavirus, SARS-CoV-2, among its 1.35 billion people. With a lack of testing and a shortage of physicians, many experts feel the Indian government is failing its people by directing attention and resources to unsubstantiated and unscientific practices — especially when these practices themselves can be harmful.
“Government should be doing little or next to nothing,” Richard Ebeling wrote in a post about COVID-19 republished on March 24 by the Heartland Institute. “The problem is a social and medical one, and not a political one.”
“I just think we’re going to be fine. I think everything is going to be fine,” Heartland editorial director and research fellow Justin Haskins said about COVID-19 during a March 13 episode of the podcast In the Tank. “I really don’t think this is going to be a problem even two to three months from now.”
On Dec. 31, 2019, “a pneumonia of unknown cause” was first reported to the World Health Organization’s China Country Office — and in the months following that report, the disease now known as COVID-19 spread to infect millions of people worldwide and seems well on its way to killing hundreds of thousands — while experts warn that the presumed death toll may be significantly higher than we yet know.
As the virus spread, so too did misinformation: baseless predictions that the disease would not cause significant harm, claims of miracle cures, and conspiracy theories about the virus’s origins. That misinformation was often circulated by white-collar professionals — including many who have a history of casting doubt on climate science or seeking to debate issues that were already laid to rest within the scientific community. The overlap was so striking that it caught the attention of both former President Barack Obama and late-night host Jimmy Kimmel in March.
Some of that misinformation on COVID-19 came straight from President Trump. But a river of faulty information on the coronavirus also flowed from think tanks, experts (some self-proclaimed), academics, and professional right-wing activists who also have spurned climate science and sought to slow or stop action to respond to the climate crisis.
Some compared COVID-19 to the flu or other threats, suggesting that the flu was a larger threat and that action to slow the spread of the novel virus was an overreaction. As the toll from COVID-19 grew, others argued that the virus was the most important threat and that action to slow climate change was superfluous. Some circulated false or unproven cures and remedies while others touted the benefits of single-use plastics during the pandemic (without regard for the health of those living in places where plastics and petrochemicals are produced — like Saint John the Baptist parish, Louisiana, which on April 16, had the highest per-person COVID-19 death rate in the U.S.)
Some attacked renewable energy, some the Green New Deal, and others the World Health Organization (WHO). Some framed efforts to “flatten the curve” of infections as infringements on liberty or simply unnecessary while others persisted in using terms that the WHO has warned can lead to dangerous stigma and discrimination. And some climate science deniers have circulated conspiracy theories, like claims that the virus was a foreign “bioweapon,” that it’s linked to “electrosmog” and 5G networks, or alleged that “the World Health Organization has carried out the greatest fraud perhaps in modern history.”
The decades that fossil fuel companies spent funding organizations that sought to undermine the conclusions of credible climate scientists and building up doubt about science itself ultimately created a network of professional science deniers who are now deploying some of the same skills they honed on climate against the public health crisis at the center of our attention today.
Many of the operatives spreading COVID disinformation have influence because of the fossil fuel industry.
COVID denial reveals the deadly threat that climate denial poses to all aspects of public health and science.
The American Petroleum Institute’s 1998 “Victory Memo” outlined a broad roadmap to erode public confidence in climate change that went well beyond just the science. Their strategy included plans to “identify, recruit and train” messengers who could “participate in media outreach” on “the climate change debate.” It called for the use of both individuals and third-party organizations to assist in the industry’s efforts to stir doubt about climate science.
To delay climate change-related regulation and policy-making, the oil and gas industry sought to mislead the public and Congress and create distrust of the media.
Decades ago, an industry report drafted by a Mobil executive concluded that theories that had been advanced by climate “contrarians” didn’t hold water —— but the industry nonetheless funded their work on climate change, and now some of those same professionals are speaking out about COVID-19. In 1995, Lenny Bernstein, a Mobil executive, examined the work of climate “contrarians” in a draft report for the Global Climate Coalition (later published omitting that assessment). Bernstein’s draft concluded that “The contrarian theories raise interesting questions about our total understanding of climate processes, but they do not offer convincing arguments against the conventional model of greenhouse gas emission-induced climate change.” One of the arguments that the report draft specifically labeled “not convincing” was credited to Prof. Patrick Michaels, then based at the University of Virginia. In 2010, Michaels — at that point based at the Cato Institute — estimated in a CNN interview that perhaps 40% of his funding came from oil and gas companies.
In a March 9, 2020 article in the Washington Examiner, Michaels — now a senior fellow at the Competitive Enterprise Institute (CEI) — predicted that a proposed European Union law (one intended to slow climate change) would be far more damaging to the economy and to “environmental resilience” than COVID-19. “Make no mistake,” Michaels wrote. “The proposed EU climate law will reverse a lot more progress and a lot more economic and environmental resilience than any probable climate change or, for that matter, coronavirus.” (Another of the scientists whose work was discredited in the draft Global Climate Coalition report, Richard Lindzen, signed onto a March 23, 2020, open letter calling climate change a “non-problem” compared to COVID-19. “As a very first step, designated Green New Deal money must be redirected and invested in a significantly better global health system,” the letter argues. “The past 150 years also show that more CO2 is beneficial for nature, greening the Earth and increasing the yields of crops. Why do world leaders ignore these hard facts? Why do world leaders do the opposite with their Green New Deal and lower the quality of life by forcing high-cost, dubious low-carbon energy technologies upon their citizens?”)
COVID denial should forever discredit climate science deniers.
These attempts to exploit a global pandemic to further the climate denial machine’s anti-science agenda will mean loss of life, and unnecessarily imperil frontline medical personnel by allowing the virus to spread further and more quickly.
Some climate deniers have pushed outright conspiracy theories on COVID-19: claiming, as Piers Corbyn did, that the pandemic is a “world population cull” backed by Bill Gates and George Soros; alleging, as a former member of British Parliament did, that COVID-19 is just a “big hoax”; or, like Alex Jones, seeking to profit directly off of COVID-19 through false marketing, according to the Food and Drug Administration and the New York Attorney General, both of which have warned Jones to desist from marketing a toothpaste he claimed “kills the whole SARS-corona family at point-blank range.”
Judicial Watch filed a lawsuit claiming that COVID-19 “was prepared and stockpiled as a biological weapon to be used against China’s perceived enemies.” Principia Scientific International claimed that economies were about to be shut down because “the WHO Director caused a global coronavirus panic over a basic math error,” (referring to early World Health Organization fatality rate numbers). Steve Milloy tweeted out a link to a New York Times op-ed by Dr. Cornelia Griggs, who described working in a New York City hospital amid the pandemic, calling her a “Hysterical doc” and writing “Stop the panic.” (Less than a week later, Milloy tweeted that “#Coronavirus has given us the #GreenDream: —Deprivation — Destroyed economy — Police state”). On April 10 — at a time when over 92,000 deaths had been reported worldwide — Bjorn Lomborg wrote that “Significant data indicate corona is no worse than the common flu.” And former New York City mayor Rudy Giuliani tweeted out a list of leading causes of death on March 10, writing “Likely at the very bottom, Coronavirus: 27.” Six weeks later, more than 14,400 people in New York City had died after contracting the virus.
Not only does their pandemic messaging undermine climate science deniers’ credibility, it also puts on display some of the faulty thinking that can be seen in their discussions of both topics — you see the same logical fallacies at play. There’s the rejection of basic modeling techniques (and early models on both COVID-19 and on climate have ultimately proved tragically accurate). There’s a failure to grasp the ways that an exponential problem can accelerate. There’s a willingness to make assertions that aren’t supported by evidence as well as a willingness to issue blanket assurances that things will be fine without taking into account the evidence. And there’s a reliance on ad hominem attacks and innuendo. These communications tactics used on both issues mirror each other.
The individuals and organizations responsible for spreading disinformation on climate science and COVID-19 will forever cement their reputations on the wrong side of history.
Climate change and the COVID pandemic are both crises.
Some climate science deniers argue that COVID-19 is the “real” crisis — but that’s another logical fallacy, because it’s entirely possible to be confronted with multiple crises at the same time. Some claim that we have to choose between action to fight COVID-19 and action to fight climate change — but that ignores policy options proposed by some advocates who have highlighted ways to respond to the urgencies of COVID-19 and the climate crisis simultaneously.
Some climate science deniers conflate the impacts of slashing carbon emissions through a managed transition to renewable energy and electric vehicles with the slashed emissions that resulted from the dramatic drop in travel caused by shelter-in-place orders — two very different ways to arrive at a similar point. “Brendan O’Neill, editor of Koch-funded website Spiked, argued that ‘this pandemic has shown us what life would be like if environmentalists got their way.’ In a column titled ‘COVID-19: a glimpse of the dystopia greens want us to live in,’ O’Neill claimed government responses to the virus represent a ‘warped dystopia’ that environmentalists like George Monbiot have been calling for,” DeSmog UK reported.
By taking a close look at where those who advocate inaction on climate change erred or misled their audience about the pandemic, it’s possible to learn a great deal — and not only about who has provided reliable information about COVID-19 and who has misled.
There are striking parallels between this pandemic and the climate crisis. The virus’ spread has proven capable of accelerating at an exponential rate.
Similarly, climate scientists have warned for decades that climate change can accelerate exponentially. That means that for both crises, the earlier action is taken, the more effective it is, and more cost efficient too.
The world has never faced a hunger emergency like this, experts say. It could double the number of people facing acute hunger to 265 million by the end of this year.
Published April 22, 2020; Updated April 23, 2020, 6:39 a.m. ET
NAIROBI, Kenya — In the largest slum in Kenya’s capital, people desperate to eat set off a stampede during a recent giveaway of flour and cooking oil, leaving scores injured and two people dead.
In India, thousands of workers are lining up twice a day for bread and fried vegetables to keep hunger at bay.
And across Colombia, poor households are hanging red clothing and flags from their windows and balconies as a sign that they are hungry.
“We don’t have any money, and now we need to survive,” said Pauline Karushi, who lost her job at a jewelry business in Nairobi, and lives in two rooms with her child and four other relatives. “That means not eating much.”
The coronavirus pandemic has brought hunger to millions of people around the world. National lockdowns and social distancing measures are drying up work and incomes, and are likely to disrupt agricultural production and supply routes — leaving millions to worry how they will get enough to eat.
The coronavirus has sometimes been called an equalizer because it has sickened both rich and poor, but when it comes to food, the commonality ends. It is poor people, including large segments of poorer nations, who are now going hungry and facing the prospect of starving.
“The coronavirus has been anything but a great equalizer,” said Asha Jaffar, a volunteer who brought food to families in the Nairobi slum of Kibera after the fatal stampede. “It’s been the great revealer, pulling the curtain back on the class divide and exposing how deeply unequal this country is.”
Already, 135 million people had been facing acute food shortages, but now with the pandemic, 130 million more could go hungry in 2020, said Arif Husain, chief economist at the World Food Program, a United Nations agency. Altogether, an estimated 265 million people could be pushed to the brink of starvation by year’s end.
“We’ve never seen anything like this before,” Mr. Husain said. “It wasn’t a pretty picture to begin with, but this makes it truly unprecedented and uncharted territory.”
The world has experienced severe hunger crises before, but those were regional and caused by one factor or another — extreme weather, economic downturns, wars or political instability.
This hunger crisis, experts say, is global and caused by a multitude of factors linked to the coronavirus pandemic and the ensuing interruption of the economic order: the sudden loss in income for countless millions who were already living hand-to-mouth; the collapse in oil prices; widespread shortages of hard currency from tourism drying up; overseas workers not having earnings to send home; and ongoing problems like climate change, violence, population dislocations and humanitarian disasters.
Already, from Honduras to South Africa to India, protests and looting have broken out amid frustrations from lockdowns and worries about hunger. With classes shut down, over 368 million children have lost the nutritious meals and snacks they normally receive in school.
There is no shortage of food globally, or mass starvation from the pandemic — yet. But logistical problems in planting, harvesting and transporting food will leave poor countries exposed in the coming months, especially those reliant on imports, said Johan Swinnen, director general of the International Food Policy Research Institute in Washington.
While the system of food distribution and retailing in rich nations is organized and automated, he said, systems in developing countries are “labor intensive,” making “these supply chains much more vulnerable to Covid-19 and social distancing regulations.”
Yet even if there is no major surge in food prices, the food security situation for poor people is likely to deteriorate significantly worldwide. This is especially true for economies like Sudan and Zimbabwe that were struggling before the outbreak, or those like Iran that have increasingly used oil revenues to finance critical goods like food and medicine.
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In the sprawling Petare slum on the outskirts of the capital, Caracas, a nationwide lockdown has left Freddy Bastardo and five others in his household without jobs. Their government-supplied rations, which had arrived only once every two months before the crisis, have long run out.
“We are already thinking of selling things that we don’t use in the house to be able to eat,” said Mr. Bastardo, 25, a security guard. “I have neighbors who don’t have food, and I’m worried that if protests start, we wouldn’t be able to get out of here.”
As wages have dried up, half a million people are estimated to have left cities to walk home, setting off the nation’s “largest mass migration since independence,” said Amitabh Behar, the chief executive of Oxfam India.
On a recent evening, hundreds of migrant workers, who have been stuck in New Delhi after a lockdown was imposed in March with little warning, sat under the shade of a bridge waiting for food to arrive. The Delhi government has set up soup kitchens, yet workers like Nihal Singh go hungry as the throngs at these centers have increased in recent days.
“Instead of coronavirus, the hunger will kill us,” said Mr. Singh, who was hoping to eat his first meal in a day. Migrants waiting in food lines have fought each other over a plate of rice and lentils. Mr. Singh said he was ashamed to beg for food but had no other option.
“The lockdown has trampled on our dignity,” he said.
Refugees and people living in conflict zones are likely to be hit the hardest.
The curfews and restrictions on movement are already devastating the meager incomes of displaced people in Uganda and Ethiopia, the delivery of seeds and farming tools in South Sudan and the distribution of food aid in the Central African Republic. Containment measures in Niger, which hosts almost 60,000 refugees fleeing conflict in Mali, have led to surges in the pricing of food, according to the International Rescue Committee.
The effects of the restrictions “may cause more suffering than the disease itself,” said Kurt Tjossem, regional vice president for East Africa at the International Rescue Committee.
Ahmad Bayoush, a construction worker who had been displaced to Idlib Province in northern Syria, said he and many others had signed up to receive food from aid groups, but that it had yet to arrive.
“I am expecting real hunger if it continues like this in the north,” he said.
The pandemic is also slowing efforts to deal with the historic locust plague that has been ravaging the East and Horn of Africa. The outbreak is the worst the region has seen in decades and comes on the heels of a year marked by extreme droughts and floods. But the arrival of billions of new swarms could further deepen food insecurity, said Cyril Ferrand, head of the Food and Agriculture Organization’s resilience team in eastern Africa.
Travel bans and airport closures, Mr. Ferrand said, are interrupting the supply of pesticides that could help limit the locust population and save pastureland and crops.
As many go hungry, there is concern in a number of countries that food shortages will lead to social discord. In Colombia, residents of the coastal state of La Guajira have begun blocking roads to call attention to their need for food. In South Africa, rioters have broken into neighborhood food kiosks and faced off with the police.
And even charitable food giveaways can expose people to the virus when throngs appear, as happened in Nairobi’s shantytown of Kibera earlier this month.
“People called each other and came rushing,” said Valentine Akinyi, who works at the district government office where the food was distributed. “People have lost jobs. It showed you how hungry they are.”
Yet communities across the world are also taking matters into their own hands. Some are raising money through crowdfunding platforms, while others have begun programs to buy meals for needy families.
On a recent afternoon, Ms. Jaffar and a group of volunteers made their way through Kibera, bringing items like sugar, flour, rice and sanitary pads to dozens of families. A native of the area herself, Ms. Jaffar said she started the food drive after hearing so many stories from families who said they and their children were going to sleep hungry.
The food drive has so far reached 500 families. But with all the calls for assistance she’s getting, she said, “that’s a drop in the ocean.”
Reporting was contributed by Anatoly Kurmanaev and Isayen Herrera from Caracas, Venezuela; Paulina Villegas from Mexico City; Julie Turkewitz from Bogotá, Colombia; Ben Hubbard and Hwaida Saad from Beirut, Lebanon; Sameer Yasir from New Delhi; and Hannah Beech from Bangkok.
Nassim Nicholas Taleb is “irritated,” he told Bloomberg Television on March 31st, whenever the coronavirus pandemic is referred to as a “black swan,” the term he coined for an unpredictable, rare, catastrophic event, in his best-selling 2007 book of that title. “The Black Swan” was meant to explain why, in a networked world, we need to change business practices and social norms—not, as he recently told me, to provide “a cliché for any bad thing that surprises us.” Besides, the pandemic was wholly predictable—he, like Bill Gates, Laurie Garrett, and others, had predicted it—a white swan if ever there was one. “We issued our warning that, effectively, you should kill it in the egg,” Taleb told Bloomberg. Governments “did not want to spend pennies in January; now they are going to spend trillions.”
The warning that he referred to appeared in a January 26th paper that he co-authored with Joseph Norman and Yaneer Bar-Yam, when the virus was still mainly confined to China. The paper cautions that, owing to “increased connectivity,” the spread will be “nonlinear”—two key contributors to Taleb’s anxiety. For statisticians, “nonlinearity” describes events very much like a pandemic: an output disproportionate to known inputs (the structure and growth of pathogens, say), owing to both unknown and unknowable inputs (their incubation periods in humans, or random mutations), or eccentric interaction among various inputs (wet markets and airplane travel), or exponential growth (from networked human contact), or all three.
“These are ruin problems,” the paper states, exposure to which “leads to a certain eventual extinction.” The authors call for “drastically pruning contact networks,” and other measures that we now associate with sheltering in place and social distancing. “Decision-makers must act swiftly,” the authors conclude, “and avoid the fallacy that to have an appropriate respect for uncertainty in the face of possible irreversible catastrophe amounts to ‘paranoia.’ ” (“Had we used masks then”—in late January—“we could have saved ourselves the stimulus,” Taleb told me.)
Yet, for anyone who knows his work, Taleb’s irritation may seem a little forced. His profession, he says, is “probability.” But his vocation is showing how the unpredictable is increasingly probable. If he was right about the spread of this pandemic it’s because he has been so alert to the dangers of connectivity and nonlinearity more generally, to pandemics and other chance calamities for which COVID-19 is a storm signal. “I keep getting asked for a list of the next four black swans,” Taleb told me, and that misses his point entirely. In a way, focussing on his January warning distracts us from his main aim, which is building political structures so that societies will be better able to cope with mounting, random events.
Indeed, if Taleb is chronically irritated, it is by those economists, officials, journalists, and executives—the “naïve empiricists”—who think that our tomorrows are likely to be pretty much like our yesterdays. He explained in a conversation that these are the people who, consulting bell curves, focus on their bulging centers, and disregard potentially fatal “fat tails”—events that seem “statistically remote” but “contribute most to outcomes,” by precipitating chain reactions, say. (Last week, Dr. Phil told Fox’s Laura Ingraham that we should open up the country again, noting, wrongly, that “three hundred and sixty thousand people die each year “from swimming pools — but we don’t shut the country down for that.” In response, Taleb tweeted, “Drowning in swimming pools is extremely contagious and multiplicative.”) Naïve empiricists plant us, he argued in “The Black Swan,” in “Mediocristan.” We actually live in “Extremistan.”
Taleb, who is sixty-one, came by this impatience honestly. As a young man, he lived through Lebanon’s civil war, which was precipitated by Palestinian militias escaping a Jordanian crackdown, in 1971, and led to bloody clashes between Maronite Christians and Sunni Muslims, drawing in Shiites, Druze, and the Syrians as well. The conflict lasted fifteen years and left some ninety thousand people dead. “These events were unexplainable, but intelligent people thought they were capable of providing convincing explanations for them—after the fact,” Taleb writes in “The Black Swan.” “The more intelligent the person, the better sounding the explanation.” But how could anyone have anticipated “that people who seemed a model of tolerance could become the purest of barbarians overnight?” Given the prior cruelties of the twentieth century, the question may sound ingenuous, but Taleb experienced sudden violence firsthand. He grew fascinated, and outraged, by extrapolations from an illusory normal—the evil of banality. “I later saw the exact same illusion of understanding in business success and the financial markets,” he writes.
“Later” began in 1983, when, after university in Paris, and a Wharton M.B.A., Taleb became an options trader—“my core identity,” he says. Over the next twelve years, he conducted two hundred thousand trades, and examined seventy thousand risk-management reports. Along the way, he developed an investment strategy that entailed exposure to regular, small losses, while positioning him to benefit from irregular, massive gains—something like a venture capitalist. He explored, especially, scenarios for derivatives: asset bundles where fat tails—price volatilities, say—can either enrich or impoverish traders, and do so exponentially when they increase the scale of the movement.
These were the years, moreover, when, following Japan, large U.S. manufacturing companies were converting to “just-in-time” production, which involved integrating and synchronizing supply-chains, and forgoing stockpiles of necessary components in favor of acquiring them on an as-needed basis, often relying on single, authorized suppliers. The idea was that lowering inventory would reduce costs. But Taleb, extrapolating from trading risks, believed that “managing without buffers was irresponsible,” because “fat-tail events” can never be completely avoided. As the Harvard Business Reviewreported this month, Chinese suppliers shut down by the pandemic have stymied the production capabilities of a majority of the companies that depend on them.
The coming of global information networks deepened Taleb’s concern. He reserved a special impatience for economists who saw these networks as stabilizing—who thought that the average thought or action, derived from an ever-widening group, would produce an increasingly tolerable standard—and who believed that crowds had wisdom, and bigger crowds more wisdom. Thus networked, institutional buyers and sellers were supposed to produce more rational markets, a supposition that seemed to justify the deregulation of derivatives, in 2000, which helped accelerate the crash of 2008.
As Taleb told me, “The great danger has always been too much connectivity.” Proliferating global networks, both physical and virtual, inevitably incorporate more fat-tail risks into a more interdependent and “fragile” system: not only risks such as pathogens but also computer viruses, or the hacking of information networks, or reckless budgetary management by financial institutions or state governments, or spectacular acts of terror. Any negative event along these lines can create a rolling, widening collapse—a true black swan—in the same way that the failure of a single transformer can collapse an electricity grid.
COVID-19 has initiated ordinary citizens into the esoteric “mayhem” that Taleb’s writings portend. Who knows what will change for countries when the pandemic ends? What we do know, Taleb says, is what cannot remain the same. He is “too much a cosmopolitan” to want global networks undone, even if they could be. But he does want the institutional equivalent of “circuit breakers, fail-safe protocols, and backup systems,” many of which he summarizes in his fourth, and favorite, book, “Antifragile,” published in 2012. For countries, he envisions political and economic principles that amount to an analogue of his investment strategy: government officials and corporate executives accepting what may seem like too-small gains from their investment dollars, while protecting themselves from catastrophic loss.
Anyone who has read the Federalist Papers can see what he’s getting at. The “separation of powers” is hardly the most efficient form of government; getting something done entails a complex, time-consuming process of building consensus among distributed centers of authority. But James Madison understood that tyranny—however distant it was from the minds of likely Presidents in his own generation—is so calamitous to a republic, and so incipient in the human condition, that it must be structurally mitigated. For Taleb, an antifragile country would encourage the distribution of power among smaller, more local, experimental, and self-sufficient entities—in short, build a system that could survive random stresses, rather than break under any particular one. (His word for this beneficial distribution is “fractal.”)
We should discourage the concentration of power in big corporations, “including a severe restriction of lobbying,” Taleb told me. “When one per cent of the people have fifty per cent of the income, that is a fat tail.” Companies shouldn’t be able to make money from monopoly power, “from rent-seeking”—using that power not to build something but to extract an ever-larger part of the surplus. There should be an expansion of the powers of state and even county governments, where there is “bottom-up” control and accountability. This could incubate new businesses and foster new education methods that emphasize “action learning and apprenticeship” over purely academic certification. He thinks that “we should have a national Entrepreneurship Day.”
But Taleb doesn’t believe that the government should abandon citizens buffeted by events they can’t possibly anticipate or control. (He dedicated his book “Skin in the Game,” published in 2018, to Ron Paul and Ralph Nader.) “The state,” he told me, “should not smooth out your life, like a Lebanese mother, but should be there for intervention in negative times, like a rich Lebanese uncle.” Right now, for example, the government should, indeed, be sending out checks to unemployed and gig workers. (“You don’t bail out companies, you bail out individuals.”) He would also consider a guaranteed basic income, much as Andrew Yang, whom he admires, has advocated. Crucially, the government should be an insurer of health care, though Taleb prefers not a centrally run Medicare-for-all system but one such as Canada’s, which is controlled by the provinces. And, like responsible supply-chain managers, the federal government should create buffers against public-health disasters: “If it can spend trillions stockpiling nuclear weapons, it ought to spend tens of billions stockpiling ventilators and testing kits.”
At the same time, Taleb adamantly opposes the state taking on staggering debt. He thinks, rather, that the rich should be taxed as disproportionately as necessary, “though as locally as possible.” The key is “to build on the good days,” when the economy is growing, and reduce the debt, which he calls “intergenerational dispossession.” The government should then encourage an eclectic array of management norms: drawing up political borders, even down to the level of towns, which can, in an epidemiological emergency, be closed; having banks and corporations hold larger cash reserves, so that they can be more independent of market volatility; and making sure that manufacturing, transportation, information, and health-care systems have redundant storage and processing components. (“That’s why nature gave us two kidneys.”) Taleb is especially keen to inhibit “moral hazard,” such as that of bankers who get rich by betting, and losing, other people’s money. “In the Hammurabi Code, if a house falls in and kills you, the architect is put to death,” he told me. Correspondingly, any company or bank that gets a bailout should expect its executives to be fired, and its shareholders diluted. “If the state helps you, then taxpayers own you.”
Some of Taleb’s principles seem little more than thought experiments, or fit uneasily with others. How does one tax more locally, or close a town border? If taxpayers own corporate equities, does this mean that companies might be nationalized, broken up, or severely regulated? But asking Taleb to describe antifragility to its end is a little like asking Thomas Hobbes to nail down sovereignty. The more important challenge is to grasp the peril for which political solutions must be designed or improvised; society cannot endure with complacent conceptions of how things work. “It would seem most efficient to drive home at two hundred miles an hour,” he put it to me.“But odds are you’d never get there.”
Isaac Stanley-Becker and Tony Romm, April 22, 2020
A network of right-leaning individuals and groups, aided by nimble online outfits, has helped incubate the fervor erupting in state capitals across the country. The activism is often organic and the frustration deeply felt, but it is also being amplified, and in some cases coordinated, by longtime conservative activists, whose robust operations were initially set up with help from Republican megadonors.
The Convention of States project launched in 2015 with a high-dollar donation from the family foundation of Robert Mercer, a billionaire hedge fund manager and Republican patron. It boasts past support from two members of the Trump administration — Ken Cuccinelli, acting director of U.S. Citizenship and Immigration Services, and Ben Carson, secretary of housing and urban development.
It also trumpets a prior endorsement from Ron DeSantis, the Republican governor of Florida and a close Trump ally who is pursuing an aggressive plan to reopen his state’s economy. A spokesman for Carson declined to comment. Cuccinelli and DeSantis did not respond to requests for comment.
The initiative, aimed at curtailing federal power, is now leveraging its sweeping national network and digital arsenal to help stitch together scattered demonstrations across the country, making opposition to stay-at-home orders appear more widespread than is suggested by polling.
“We’re providing a digital platform for people to plan and communicate about what they’re doing,” said Eric O’Keefe, board president of Citizens for Self-Governance, the parent organization of the Convention of States project.
A longtime associate of the conservative activist Koch family, O’Keefe helped manage David Koch’s 1980 bid for the White House when he served as the No. 2 on the Libertarian ticket.
“To shut down our rural counties because of what’s going on in New York City, or in some sense Milwaukee, is draconian,” said O’Keefe, who lives in Wisconsin.
Polls suggest most Americans support local directives encouraging them to stay at home as covid-19, the disease caused by the new coronavirus, ravages the country, killing more than 44,000 people in the United States so far. Public health officials, including epidemiologists advising Trump’s White House, agree that sweeping restrictions represent the most effective mitigation strategy in the absence of a vaccine, which could be more than a year away.
Still, some activists insist that states should lift controls on commercial activity and public assembly, citing the effects of mass closures on businesses. They have been encouraged at times by Trump, whose attorney general, William P. Barr, said in an interview with radio host Hugh Hewitt on Tuesday that the Justice Department would consider supporting lawsuits against restrictions that go “too far.”
The swelling frustration on the right coincides with major policy changes in some states, especially those with Republican governors. Georgia, South Carolina and Tennessee have all begun relaxing their restrictions in recent days after bowing to pressure and imposing far-reaching guidelines.
The protests are reminiscent in some ways of the tea party movement and the demonstrations against the Affordable Care Act that erupted in 2010, which also involved a mix of homegrown activism and shrewd behind-the-scenes funding.
For the Convention of States, public health is an unusual focus. It was founded to push for a convention that would add a balanced-budget amendment to the Constitution. That same anti-government impulse is now animating the group’s campaign against coronavirus precautions.
“Heavy-handed government orders that interfere with our most basic liberties will do more harm than good,” read its Facebook ads, which had been viewed as many as 36,000 times as of Tuesday evening.
Asking for a $5 donation “to support our fight,” the paid posts are part of an online blitz called “Open the States,” which also includes newly created websites, a data-collecting petition and an ominous video about the economic effects of the lockdown.
The group’s president, Mark Meckler, said his aim was to act as a “clearinghouse where these guys can all find each other” — a role he learned as co-founder of the Tea Party Patriots. FreedomWorks, a libertarian advocacy group also active in the tea party movement, is seeking to play a similar function, creating an online calendar of protests.
“The major need back in 2009 was no different than it is today — some easy centralizing point to list events, to allow people to communicate with each other,” he said.
Meckler, who draws a salary of about $250,000 from the Convention of States parent group, a tax-exempt nonprofit organization, according to filings with the Internal Revenue Service, hailed the “spontaneous citizen groups self-organizing on the Internet and protesting what they perceive to be government overreach.”
So far, the protests against stay-at-home orders in states including Washington and Pennsylvania have captured headlines and drawn rebukes from some governors and epidemiologists. Experts say a sudden, widespread reopening of the country is likely to worsen the outbreak, overwhelming hospitals and killing tens of thousands.
The protesters so far have not aimed their ire at Trump, though it is his administration’s experts whose guidelines underlie many of the states’ actions.
Trump’s public comments — including his recent tweets calling for supporters to “liberate” states including Michigan, a coronavirus hot spot — have catalyzed some of the broader public reaction. Following those tweets, tens of thousands of people joined Facebook groups calling for protests in states including Pennsylvania and Ohio, where the efforts are coordinated by a trio of brothers who typically focus their efforts on fighting gun control.
In recent days, conservatives have set their sights on Wisconsin, where a few dozen protesters turned out at the Capitol to air their frustrations with Gov. Tony Evers, a Democrat, after he extended his state’s stay-at-home order until late May. Ahead of the demonstration, Moore, the Trump ally, revealed on a live stream that he was “working with a group” in the state with the goal of trying “to shut down the capital.”
Moore, who served as a Trump campaign adviser in 2016, said he had located a big donor to aid in the effort, though he never elaborated. “I told him about this, and he said, ‘Steve, I promise to pay the bail and legal fees for anyone who gets arrested,’ ” Moore said in the video. He likened his quest to the civil rights movement, adding, “We need to be the Rosa Parks here and protest against these government injustices.”
Moore, who has also worked at the right-leaning Heritage Foundation, did not respond to a request for comment.
In Michigan, among those organizing “Operation Gridlock” was Meshawn Maddock, who sits on the Trump campaign’s advisory board and is a prominent figure in the “Women for Trump” coalition. Funds to promote the demonstrations on Facebook came from the Michigan Freedom Fund, which is headed by Greg McNeilly, a longtime adviser to the family of Education Secretary Betsy DeVos.
McNeilly said the money used to advance the anti-quarantine protests came from “grass-roots fundraising efforts” and had “nothing to do with any DeVos work.”
Many of the seemingly scattered, spontaneous outbursts of citizen activism reflect deeply interwoven networks of conservative and libertarian nonprofit organizations. One of the most vocal groups opposing the lockdown in Texas is an Austin-based conservative think tank called the Texas Public Policy Foundation, which also hails the demonstrations nationwide.
“Some Americans are angry,” its director wrote in an op-ed promoted on Facebook and placed in the local media, telling readers in Texas about the achievements of protesters in Michigan.
The board vice chairman of the Texas Public Policy Foundation, oil executive Tim Dunn, is also a founding board member of the group promoting the Convention of States initiative. And the foundation’s former president, Brooke Rollins, now works as an assistant to Trump in the Office of American Innovation.
Neither Dunn nor Rollins responded to requests for comment.
The John Hancock Committee for the States — the name used in IRS filings by the group behind the Convention of States — gave more than $100,000 to the Texas Public Policy Foundation in 2011.
The Convention of States project, meanwhile, has received backing from DonorsTrust, a tax-exempt financial conduit for right-wing causes that does not disclose its contributors. The same fund has helped bankroll the Idaho Freedom Foundation, which is encouraging protests of a stay-at-home order imposed by the state’s Republican governor, Brad Little.
“Disobey Idaho,” say its Facebook ads, which use an image of the “Join or Die” snake woodcut emblematic of the Revolutionary War and later adopted by the tea party movement.
In 2014, the year before it launched the Convention of States initiative, Citizens for Self-Governance received $500,000 from the Mercer Family Foundation, a donation Meckler said helped jump-start the campaign. Mercer declined to comment.
While groups and individual activists associated with the Koch brothers have boosted this far-flung network, Emily Seidel, the chief executive of the Koch-backed Americans for Prosperity advocacy group, sought to distance the organization from the protest activity, which she said was “not the best way” to “get people back to work.”
“Instead, we are working directly with policymakers, to bring business leaders and public health officials together to help develop standards to safely reopen the economy without jeopardizing public health,” Seidel said.
But others see linkages to groups pushing anti-quarantine uprisings.
“The involvement of the Koch institutional apparatus in groups supporting these protests is clear to me,” said Robert J. Brulle, a sociologist at Drexel University whose research has focused on climate lobbying. “The presence of allies on the board usually means that they are deeply engaged in the organization and most likely a funder.”
Brulle said the blowback against the coronavirus precautions carries echoes of efforts to deny climate change, both of which rely on hostility toward government action.
“These are extreme right-wing efforts to delegitimize government,” he said. “It’s an anti-government crusade.”
WUHAN, China (Reuters) – Dressed in a hazmat suit, two masks and a face shield, Du Mingjun knocked on the mahogany door of a flat in a suburban district of Wuhan on a recent morning.
FILE PHOTO: Medical personnel in protective suits wave hands to a patient who is discharged from the Leishenshan Hospital after recovering from the novel coronavirus, in Wuhan, the epicentre of the novel coronavirus outbreak, in Hubei province, China March 1, 2020. China Daily via REUTERS
A man wearing a single mask opened the door a crack and, after Du introduced herself as a psychological counsellor, burst into tears.
“I really can’t take it anymore,” he said. Diagnosed with the novel coronavirus in early February, the man, who appeared to be in his 50s, had been treated at two hospitals before being transferred to a quarantine centre set up in a cluster of apartment blocks in an industrial part of Wuhan.
Why, he asked, did tests say he still had the virus more than two months after he first contracted it?
The answer to that question is a mystery baffling doctors on the frontline of China’s battle against COVID-19, even as it has successfully slowed the spread of the coronavirus across the country.
Chinese doctors in Wuhan, where the virus first emerged in December, say a growing number of cases in which people recover from the virus, but continue to test positive without showing symptoms, is one of their biggest challenges as the country moves into a new phase of its containment battle.
Those patients all tested negative for the virus at some point after recovering, but then tested positive again, some up to 70 days later, the doctors said. Many have done so over 50-60 days.
The prospect of people remaining positive for the virus, and therefore potentially infectious, is of international concern, as many countries seek to end lockdowns and resume economic activity as the spread of the virus slows. Currently, the globally recommended isolation period after exposure is 14 days.
So far, there have been no confirmations of newly positive patients infecting others, according to Chinese health officials.
China has not published precise figures for how many patients fall into this category. But disclosures by Chinese hospitals to Reuters, as well as in other media reports, indicate there are at least dozens of such cases.
In South Korea, about 1,000 people have been testing positive for four weeks or more. In Italy, the first European country ravaged by the pandemic, health officials noticed that coronavirus patients could test positive for the virus for about a month.
As there is limited knowledge available on how infectious these patients are, doctors in Wuhan are keeping them isolated for longer.
Zhang Dingyu, president of Jinyintan Hospital, where the most serious coronavirus cases were treated, said health officials recognised the isolations may be excessive, especially if patients proved not to be infectious. But, for now, it was better to do so to protect the public, he said.
He described the issue as one of the most pressing facing the hospital and said counsellors like Du are being brought in to help ease the emotional strain.
“When patients have this pressure, it also weighs on society,” he said.
DOZENS OF CASES
The plight of Wuhan’s long-term patients underlines how much remains unknown about COVID-19 and why it appears to affect different people in numerous ways, Chinese doctors say. So far global infections have hit 2.5 million with over 171,000 deaths.
As of April 21, 93% of 82,788 people with the virus in China had recovered and been discharged, official figures show.
Yuan Yufeng, a vice president at Zhongnan Hospital in Wuhan, told Reuters he was aware of a case in which the patient had positive retests after first being diagnosed with the virus about 70 days earlier.
“We did not see anything like this during SARS,” he said, referring to the 2003 Severe Acute Respiratory Syndrome outbreak that infected 8,098 people globally, mostly in China.
Patients in China are discharged after two negative nucleic acid tests, taken at least 24 hours apart, and if they no longer show symptoms. Some doctors want this requirement to be raised to three tests or more.
China’s National Health Commission directed Reuters to comments made at a briefing Tuesday when asked for comment about how this category of patients was being handled.
Wang Guiqiang, director of the infectious disease department of Peking University First Hospital, said at the briefing that the majority of such patients were not showing symptoms and very few had seen their conditions worsen.
“The new coronavirus is a new type of virus,” said Guo Yanhong, a National Health Commission official. “For this disease, the unknowns are still greater than the knowns.”
REMNANTS AND REACTIVATION
Experts and doctors struggle to explain why the virus behaves so differently in these people.
Some suggest that patients retesting as positive after previously testing negative were somehow reinfected with the virus. This would undermine hopes that people catching COVID-19 would produce antibodies that would prevent them from getting sick again from the virus.
Zhao Yan, a doctor of emergency medicine at Wuhan’s Zhongnan Hospital, said he was sceptical about the possibility of reinfection based on cases at his facility, although he did not have hard evidence.
“They’re closely monitored in the hospital and are aware of the risks, so they stay in quarantine. So I’m sure they were not reinfected.”
Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention, has said the virus may have been “reactivated” in 91 South Korean patients who tested positive after having been thought to be cleared of it.
Other South Korean and Chinese experts have said that remnants of the virus could have stayed in patients’ systems but not be infectious or dangerous to the host or others.
Few details have been disclosed about these patients, such as if they have underlying health conditions.
Paul Hunter, a professor at the University of East Anglia’s Norwich School of Medicine, said an unusually slow shedding of other viruses such as norovirus or influenza had been previously seen in patients with weakened immune systems.
In 2015, South Korean authorities disclosed that they had a Middle East Respiratory Syndrome patient stricken with lymphoma who showed signs of the virus for 116 days. They said his impaired immune system kept his body from ridding itself of the virus. The lymphoma eventually caused his death.
FILE PHOTO: A volunteer walks inside a convention center that was used as a makeshift hospital to treat patients with the coronavirus disease (COVID-19), in Wuhan, Hubei province, China April 9, 2020. REUTERS/Aly Song
Yuan said that even if patients develop antibodies, it did not guarantee they would become virus-free.
He said that some patients had high levels of antibodies, and still tested positive to nucleic acid tests.
“It means that the two sides are still fighting,” he said.
As could be seen in Wuhan, the virus can also inflict a heavy mental toll on those caught in a seemingly endless cycle of positive tests.
Du, who set up a therapy hotline when Wuhan’s outbreak first began, allowed Reuters in early April to join her on a visit to the suburban quarantine centre on the condition that none of the patients be identified.
One man rattled off the names of three Wuhan hospitals he had stayed at before being moved to a flat in the centre. He had taken over 10 tests since the third week of February, he said, on occasions testing negative but mostly positive.
“I feel fine and have no symptoms, but they check and it’s positive, check and it’s positive,” he said. “What is with this virus?”
Patients need to stay at the centre for at least 28 days and obtain two negative results before being allowed to leave. Patients are isolated in individual rooms they said were paid for by the government.
The most concerning case facing Du during the visit was the man behind the mahogany door; he had told medical workers the night before that he wanted to kill himself.
“I wasn’t thinking clearly,” he told Du, explaining how he had already taken numerous CT scans and nucleic acid tests, some of which tested negative, at different hospitals. He worried that he had been reinfected as he cycled through various hospitals.
His grandson missed him after being gone for so long, he said, and he worried his condition meant he would never be able to see him again.
He broke into another round of sobs. “Why is this happening to me?”
Reporting by Brenda Goh; Additional reporting by Jack Kim in Seoul, Elvira Pollina in Milan, Belen Carreno in Madrid, and Shanghai newsroom; Editing by Philip McClellan
Enquanto o mundo está parado, observamos a primavera florescer da nossa janela. E se, paradoxalmente, ser separado da natureza nos aproximar dela? Como repensar a coabitação entre homens e não-humanos?
Embora o vínculo do homem com o meio ambiente esteja diretamente envolvido nessa crise de saúde, devemos repensar nosso relacionamento com a natureza? É o que propõe Philippe Descola, a quem estamos recebendo hoje. Em 1976, ele partiu como estudante para descobrir os Achuars, um povo Jivaro localizado no coração da Amazônia, entre o Equador e o Peru. A experiência gerou uma longa reflexão sobre o antropocentrismo que abre o caminho para uma nova relação entre os seres humanos e seu ambiente.
A epidemia é uma consequência da ação humana sobre a natureza? É uma doença do Antropoceno? O que podemos aprender com o vínculo que certas pessoas têm com o meio ambiente?
Philippe Descola é professor emérito do Collège France, titular da cadeira de antropologia da natureza de 2000 a 2019. Ele é o autor de Les natures en question (Ed. Odile Jacob, 2017).
Qual a resposta dos achuars às epidemias?
“Não há lembranças do desastre. Estima-se que cerca de 90% da população ameríndia desapareceu entre os séculos XVI e XIX. Existe uma espécie de imaginação implícita do contato com a doença dos “brancos”. Portanto, quando os “brancos” chegaram nos remotos ambientes ameríndios, o primeiro reflexo dos ameríndios foi a desconfiança e o distanciamento.”
A doença é apenas um elemento em uma procissão de abominações provocada pela colonização. Philippe Descola
“Cada povo reagiu às suas epidemias de acordo com sua concepção de contágio. A noção de contágio levou algum tempo para se espalhar na Europa, diferentemente dos povos ameríndios. Foi isso que lhes permitiu adotar as ações corretas.”
Falando em “natureza”: um erro?
“A natureza é um conceito ocidental que designa todos os não-humanos. E essa separação entre humanos e não-humanos resultou na introdução de uma distância social entre eles”.
Você pode pensar que o vírus é uma metáfora para a humanidade. Temos o mesmo relacionamento instrumental com a Terra que um vírus. De certa forma, os seres humanos são o patógeno do planeta. Philippe Descola
“Essa ideia muito humana de que a natureza é infinita resultou nesse sistema singular, baseado em produtividade e lucratividade, que causou uma catástrofe planetária”.
O ideal do “mundo depois”
“Espero que o próximo mundo seja diferente do anterior. A pandemia nos dá um marcador temporário. Essa transformação, eu vejo isso com interesse, está tomando forma e vínculos com seres não-humanos são tecidos novamente. Temos que viver com uma mentalidade que não destrua o meio ambiente “.
A idéia não é possuir a natureza, mas ser possuído por um ambiente. Philippe Descola
This storm will pass. But the choices we make now could change our lives for years to come.
Yuval Noah Harari – March 20, 2020
Humankind is now facing a global crisis. Perhaps the biggest crisis of our generation. The decisions people and governments take in the next few weeks will probably shape the world for years to come. They will shape not just our healthcare systems but also our economy, politics and culture. We must act quickly and decisively. We should also take into account the long-term consequences of our actions. When choosing between alternatives, we should ask ourselves not only how to overcome the immediate threat, but also what kind of world we will inhabit once the storm passes. Yes, the storm will pass, humankind will survive, most of us will still be alive — but we will inhabit a different world.
Many short-term emergency measures will become a fixture of life. That is the nature of emergencies. They fast-forward historical processes. Decisions that in normal times could take years of deliberation are passed in a matter of hours. Immature and even dangerous technologies are pressed into service, because the risks of doing nothing are bigger. Entire countries serve as guinea-pigs in large-scale social experiments. What happens when everybody works from home and communicates only at a distance? What happens when entire schools and universities go online? In normal times, governments, businesses and educational boards would never agree to conduct such experiments. But these aren’t normal times.
In this time of crisis, we face two particularly important choices. The first is between totalitarian surveillance and citizen empowerment. The second is between nationalist isolation and global solidarity.
In order to stop the epidemic, entire populations need to comply with certain guidelines. There are two main ways of achieving this. One method is for the government to monitor people, and punish those who break the rules. Today, for the first time in human history, technology makes it possible to monitor everyone all the time. Fifty years ago, the KGB couldn’t follow 240m Soviet citizens 24 hours a day, nor could the KGB hope to effectively process all the information gathered. The KGB relied on human agents and analysts, and it just couldn’t place a human agent to follow every citizen. But now governments can rely on ubiquitous sensors and powerful algorithms instead of flesh-and-blood spooks.
In their battle against the coronavirus epidemic several governments have already deployed the new surveillance tools. The most notable case is China. By closely monitoring people’s smartphones, making use of hundreds of millions of face-recognising cameras, and obliging people to check and report their body temperature and medical condition, the Chinese authorities can not only quickly identify suspected coronavirus carriers, but also track their movements and identify anyone they came into contact with. A range of mobile apps warn citizens about their proximity to infected patients.
About the photography
The images accompanying this article are taken from webcams overlooking the deserted streets of Italy, found and manipulated by Graziano Panfili, a photographer living under lockdown
This kind of technology is not limited to east Asia. Prime Minister Benjamin Netanyahu of Israel recently authorised the Israel Security Agency to deploy surveillance technology normally reserved for battling terrorists to track coronavirus patients. When the relevant parliamentary subcommittee refused to authorise the measure, Netanyahu rammed it through with an “emergency decree”.
You might argue that there is nothing new about all this. In recent years both governments and corporations have been using ever more sophisticated technologies to track, monitor and manipulate people. Yet if we are not careful, the epidemic might nevertheless mark an important watershed in the history of surveillance. Not only because it might normalise the deployment of mass surveillance tools in countries that have so far rejected them, but even more so because it signifies a dramatic transition from “over the skin” to “under the skin” surveillance.
Hitherto, when your finger touched the screen of your smartphone and clicked on a link, the government wanted to know what exactly your finger was clicking on. But with coronavirus, the focus of interest shifts. Now the government wants to know the temperature of your finger and the blood-pressure under its skin.
The emergency pudding
One of the problems we face in working out where we stand on surveillance is that none of us know exactly how we are being surveilled, and what the coming years might bring. Surveillance technology is developing at breakneck speed, and what seemed science-fiction 10 years ago is today old news. As a thought experiment, consider a hypothetical government that demands that every citizen wears a biometric bracelet that monitors body temperature and heart-rate 24 hours a day. The resulting data is hoarded and analysed by government algorithms. The algorithms will know that you are sick even before you know it, and they will also know where you have been, and who you have met. The chains of infection could be drastically shortened, and even cut altogether. Such a system could arguably stop the epidemic in its tracks within days. Sounds wonderful, right?
The downside is, of course, that this would give legitimacy to a terrifying new surveillance system. If you know, for example, that I clicked on a Fox News link rather than a CNN link, that can teach you something about my political views and perhaps even my personality. But if you can monitor what happens to my body temperature, blood pressure and heart-rate as I watch the video clip, you can learn what makes me laugh, what makes me cry, and what makes me really, really angry.
It is crucial to remember that anger, joy, boredom and love are biological phenomena just like fever and a cough. The same technology that identifies coughs could also identify laughs. If corporations and governments start harvesting our biometric data en masse, they can get to know us far better than we know ourselves, and they can then not just predict our feelings but also manipulate our feelings and sell us anything they want — be it a product or a politician. Biometric monitoring would make Cambridge Analytica’s data hacking tactics look like something from the Stone Age. Imagine North Korea in 2030, when every citizen has to wear a biometric bracelet 24 hours a day. If you listen to a speech by the Great Leader and the bracelet picks up the tell-tale signs of anger, you are done for.
You could, of course, make the case for biometric surveillance as a temporary measure taken during a state of emergency. It would go away once the emergency is over. But temporary measures have a nasty habit of outlasting emergencies, especially as there is always a new emergency lurking on the horizon. My home country of Israel, for example, declared a state of emergency during its 1948 War of Independence, which justified a range of temporary measures from press censorship and land confiscation to special regulations for making pudding (I kid you not). The War of Independence has long been won, but Israel never declared the emergency over, and has failed to abolish many of the “temporary” measures of 1948 (the emergency pudding decree was mercifully abolished in 2011).
Even when infections from coronavirus are down to zero, some data-hungry governments could argue they needed to keep the biometric surveillance systems in place because they fear a second wave of coronavirus, or because there is a new Ebola strain evolving in central Africa, or because . . . you get the idea. A big battle has been raging in recent years over our privacy. The coronavirus crisis could be the battle’s tipping point. For when people are given a choice between privacy and health, they will usually choose health.
The soap police
Asking people to choose between privacy and health is, in fact, the very root of the problem. Because this is a false choice. We can and should enjoy both privacy and health. We can choose to protect our health and stop the coronavirus epidemic not by instituting totalitarian surveillance regimes, but rather by empowering citizens. In recent weeks, some of the most successful efforts to contain the coronavirus epidemic were orchestrated by South Korea, Taiwan and Singapore. While these countries have made some use of tracking applications, they have relied far more on extensive testing, on honest reporting, and on the willing co-operation of a well-informed public.
Centralised monitoring and harsh punishments aren’t the only way to make people comply with beneficial guidelines. When people are told the scientific facts, and when people trust public authorities to tell them these facts, citizens can do the right thing even without a Big Brother watching over their shoulders. A self-motivated and well-informed population is usually far more powerful and effective than a policed, ignorant population.
Consider, for example, washing your hands with soap. This has been one of the greatest advances ever in human hygiene. This simple action saves millions of lives every year. While we take it for granted, it was only in the 19th century that scientists discovered the importance of washing hands with soap. Previously, even doctors and nurses proceeded from one surgical operation to the next without washing their hands. Today billions of people daily wash their hands, not because they are afraid of the soap police, but rather because they understand the facts. I wash my hands with soap because I have heard of viruses and bacteria, I understand that these tiny organisms cause diseases, and I know that soap can remove them.
But to achieve such a level of compliance and co-operation, you need trust. People need to trust science, to trust public authorities, and to trust the media. Over the past few years, irresponsible politicians have deliberately undermined trust in science, in public authorities and in the media. Now these same irresponsible politicians might be tempted to take the high road to authoritarianism, arguing that you just cannot trust the public to do the right thing.
Normally, trust that has been eroded for years cannot be rebuilt overnight. But these are not normal times. In a moment of crisis, minds too can change quickly. You can have bitter arguments with your siblings for years, but when some emergency occurs, you suddenly discover a hidden reservoir of trust and amity, and you rush to help one another. Instead of building a surveillance regime, it is not too late to rebuild people’s trust in science, in public authorities and in the media. We should definitely make use of new technologies too, but these technologies should empower citizens. I am all in favour of monitoring my body temperature and blood pressure, but that data should not be used to create an all-powerful government. Rather, that data should enable me to make more informed personal choices, and also to hold government accountable for its decisions.
If I could track my own medical condition 24 hours a day, I would learn not only whether I have become a health hazard to other people, but also which habits contribute to my health. And if I could access and analyse reliable statistics on the spread of coronavirus, I would be able to judge whether the government is telling me the truth and whether it is adopting the right policies to combat the epidemic. Whenever people talk about surveillance, remember that the same surveillance technology can usually be used not only by governments to monitor individuals — but also by individuals to monitor governments.
The coronavirus epidemic is thus a major test of citizenship. In the days ahead, each one of us should choose to trust scientific data and healthcare experts over unfounded conspiracy theories and self-serving politicians. If we fail to make the right choice, we might find ourselves signing away our most precious freedoms, thinking that this is the only way to safeguard our health.
We need a global plan
The second important choice we confront is between nationalist isolation and global solidarity. Both the epidemic itself and the resulting economic crisis are global problems. They can be solved effectively only by global co-operation.
First and foremost, in order to defeat the virus we need to share information globally. That’s the big advantage of humans over viruses. A coronavirus in China and a coronavirus in the US cannot swap tips about how to infect humans. But China can teach the US many valuable lessons about coronavirus and how to deal with it. What an Italian doctor discovers in Milan in the early morning might well save lives in Tehran by evening. When the UK government hesitates between several policies, it can get advice from the Koreans who have already faced a similar dilemma a month ago. But for this to happen, we need a spirit of global co-operation and trust.
Countries should be willing to share information openly and humbly seek advice, and should be able to trust the data and the insights they receive. We also need a global effort to produce and distribute medical equipment, most notably testing kits and respiratory machines. Instead of every country trying to do it locally and hoarding whatever equipment it can get, a co-ordinated global effort could greatly accelerate production and make sure life-saving equipment is distributed more fairly. Just as countries nationalise key industries during a war, the human war against coronavirus may require us to “humanise” the crucial production lines. A rich country with few coronavirus cases should be willing to send precious equipment to a poorer country with many cases, trusting that if and when it subsequently needs help, other countries will come to its assistance.
We might consider a similar global effort to pool medical personnel. Countries currently less affected could send medical staff to the worst-hit regions of the world, both in order to help them in their hour of need, and in order to gain valuable experience. If later on the focus of the epidemic shifts, help could start flowing in the opposite direction.
Global co-operation is vitally needed on the economic front too. Given the global nature of the economy and of supply chains, if each government does its own thing in complete disregard of the others, the result will be chaos and a deepening crisis. We need a global plan of action, and we need it fast.
Another requirement is reaching a global agreement on travel. Suspending all international travel for months will cause tremendous hardships, and hamper the war against coronavirus. Countries need to co-operate in order to allow at least a trickle of essential travellers to continue crossing borders: scientists, doctors, journalists, politicians, businesspeople. This can be done by reaching a global agreement on the pre-screening of travellers by their home country. If you know that only carefully screened travellers were allowed on a plane, you would be more willing to accept them into your country.
Unfortunately, at present countries hardly do any of these things. A collective paralysis has gripped the international community. There seem to be no adults in the room. One would have expected to see already weeks ago an emergency meeting of global leaders to come up with a common plan of action. The G7 leaders managed to organise a videoconference only this week, and it did not result in any such plan.
In previous global crises — such as the 2008 financial crisis and the 2014 Ebola epidemic — the US assumed the role of global leader. But the current US administration has abdicated the job of leader. It has made it very clear that it cares about the greatness of America far more than about the future of humanity.
This administration has abandoned even its closest allies. When it banned all travel from the EU, it didn’t bother to give the EU so much as an advance notice — let alone consult with the EU about that drastic measure. It has scandalised Germany by allegedly offering $1bn to a German pharmaceutical company to buy monopoly rights to a new Covid-19 vaccine. Even if the current administration eventually changes tack and comes up with a global plan of action, few would follow a leader who never takes responsibility, who never admits mistakes, and who routinely takes all the credit for himself while leaving all the blame to others.
If the void left by the US isn’t filled by other countries, not only will it be much harder to stop the current epidemic, but its legacy will continue to poison international relations for years to come. Yet every crisis is also an opportunity. We must hope that the current epidemic will help humankind realise the acute danger posed by global disunity.
Humanity needs to make a choice. Will we travel down the route of disunity, or will we adopt the path of global solidarity? If we choose disunity, this will not only prolong the crisis, but will probably result in even worse catastrophes in the future. If we choose global solidarity, it will be a victory not only against the coronavirus, but against all future epidemics and crises that might assail humankind in the 21st century.
Yuval Noah Harari is author of ‘Sapiens’, ‘Homo Deus’ and ‘21 Lessons for the 21st Century’
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Yuval Noah Harari (Foto: World Economic Forum/Ciaran Mc)
Para Harari, autor dos best-sellers “Sapiens: uma breve história da humanidade e Homo Deus: uma breve história do amanhã”, intensificar a globalização é o caminho para se vencer futuras pandemias
247 – Em artigo publicado no Le Monde, um dos principais jornais franceses, Yuval Noah Harari, historiador e filósofo israelense, alertou para o risco de políticas isolacionistas em decorrência do coronavírus: “[S]em confiança e solidariedade globais, não seremos capazes de parar a epidemia de COVID-19 e provavelmente teremos que enfrentar outras epidemias parecidas no futuro.”
Ele se refere ao discurso dominante no atual momento de pandemia. De acordo com ele, “[N]os últimos anos, políticos irresponsáveis minaram a confiança que se poderia ter na ciência, nas autoridades públicas e na cooperação internacional.”
Por exemplo, declarações como “vírus chinês” de líderes mundiais e teorias da conspiração que visam atacar a China, como a de que a tecnologia 5G é responsável pela transmissão do coronavírus, geram um ressentimento geopolítico que pode levar ao isolacionismo.
Ele continua: “a melhor defesa que os homens têm contra patógenos não é isolamento, é informação. A humanidade venceu a guerra contra patógenos porque, na corrida armamentista entre patógenos e médicos, os patógenos dependem de mutações cegas e os médicos da análise de dados científicos.”
“A verdadeira proteção vem do compartilhamento de informações científicas confiáveis e da solidariedade internacional. Quando um país é atingido por uma epidemia, ele deve compartilhar de forma transparente os dados coletados sobre a infecção, sem medo de desastres econômicos, enquanto outros países devem poder confiar nessas informações.”
Para ele, o mundo globalizado gera uma dinâmica na qual um caso com potencial grave em um país isolado “não apenas ameaça iranianos, italianos ou chineses, mas sua vida também, diretamente. O mundo inteiro tem interesse em não deixar isso acontecer.”
Assim, ele conclui: “Se essa epidemia levar à uma maior desunião e desconfiança entre os homens, essa seria a maior vitória do vírus. No entanto, se ela levar à uma cooperação mais estreita, aí sim não teremos somente derrotado o vírus, como também todos os outros que estão por vir.”
It should be no surprise that I’m obsessed with science fiction. Considering that I’m both a graphic designer and work in cryptocurrency, it’s practically required that I pay homage to the neon-soaked aesthetics of Blade Runner 2049, have a secret crush on Ava from Ex Machina, and geek out over pretty much anything Neal Stephenson puts out.
However, with a once theoretical dystopia now apparently on our doorstep, we should be considering the trajectory of our civilization now more than ever. Suddenly, the megacorps, oppressive regimes, and looming global crises don’t seem so distant anymore.
What were once just tropes in our favorite works of science fiction are now becoming realities that are impacting our daily lives.
And here we are, wrestling with the implications of our new reality while trapped in our living rooms staring into glowing rectangles straight out of Ready Player One.
Recent events surrounding COVID-19 have put us at a bit of a crossroad. We have an opportunity in front of us now to continue down this path, or use this crisis as a wake up call to pivot our future toward a world that is more equitable, safe, and empowering for all. We are the heroes of our own journey right now.
Our worldview and idea of what is possible is largely shaped by the media we consume. You are what you eat after all. And while the news might inform us, it’s our fiction that inspires us to imagine what is possible.
Science fiction has always asked the big questions, while simultaneously preparing us for what may be around the corner.
Where are we heading?
What problems might we create for ourselves?
And wait…weren’t we promised flying cars?
Through captivating characters, suspenseful plots, and philosophical musings woven throughout, we use fiction above all else to tell great stories and entertain. But there is another purpose, which is to inspire the next generation about what the human mind is capable of and to shape our future for generations to come.
How many engineers got their start after seeing Star Wars? How many interface designers were inspired by Minority Report? Famously, Steve Jobs was inspired to create the iPad after first seeing a concept in 2001: A Space Odyssey.
The world needs this vision more than ever. And while I love the dystopian vibes of cyberpunk aesthetics as much as anyone, is there another world we can create that inspires us (and the next generation) to manifest a more sustainable, equitable, and free future for all?
I’ve recently come across a lesser known genre of science fiction called “solarpunk.” Like cyberpunk, it is a genre of speculative fiction wrapped in a signature aesthetic that paints a vision of the future we could create. The following definition from this reference guide summarizes it well:
Solarpunk is a movement in speculative fiction, art, fashion and activism that seeks to answer and embody the question “what does a sustainable civilization look like, and how can we get there?” The aesthetics of solarpunk merge the practical with the beautiful, the well-designed with the green and wild, the bright and colorful with the earthy and solid. Solarpunk can be utopian, just optimistic, or concerned with the struggles en route to a better world — but never dystopian. As our world roils with calamity, we need solutions, not warnings. Solutions to live comfortably without fossil fuels, to equitably manage scarcity and share abundance, to be kinder to each other and to the planet we share. At once a vision of the future, a thoughtful provocation, and an achievable lifestyle.
Apart from the clear aesthetic differences, a key difference here between solarpunk and cyberpunk is the emphasis on solutions, not warnings.
It appears that solarpunk is not interested in exploring potential paths that may go wrong. Rather, it assumes that the problems are already here and focuses most of its energy on solutions and a path forward. The warnings of cyberpunk tap into the fear of what might happen, and uses that as a premise for creating plot tension. Solarpunk encourages us to accept the reality of the present and move forward by focusing on solutions to the problems at hand.
There are also some clear differentiators on how society is structured and depicted in the two genres.
Economy dominated by large corporations
Environment is usually wrecked, oppressive
Powerful technology has created wealth gap
Drugs used as escape from reality
Man merging with machine
Decentralized symbiotic economic structures
Living in balance with environment
Technology empowers the individual
Drugs used to expand consciousness and augment reality
Man working alongside machine
Sunny with a chance of showers
A big difference here is how humanity chooses to harness the technology we create. Do we use it to evolve ourselves past our current biological form and catapult us toward merging with machines or do we show thoughtful restraint and use technology to bring us more in balance with our own biology and ecosystem?
This is the question for the ages, and yet I don’t think the answer has to be so black and white. In many ways, creating and using technology is the most natural thing that we can do as a species. A beaver gathering sticks to build a dam is no different than a person using an ax to build a roof over their head. The clean lines of an iPhone seem to contrast the squiggly lines of the raw materials it’s made of, but at the end of the day it’s all a byproduct of an exploding supernova.
“We are made of star stuff” — Carl Sagan
Technology does not need to be viewed as an alien phenomenon separating us from nature, but rather as an emergent phenomenon and inevitable byproduct of all natural systems.
Solarpunk ideas remind us that there is a path forward in which we can have our cake and eat it too. We can embrace the exponential rise of our understanding and control over the universe while using that knowledge to ensure that we do not destroy our environment, society and ourselves in the process.
Now I know what you might be thinking, because I am right there with you.
Is this too good to be true? Maybe.
Is reality likely to play out this peacefully? Unlikely.
Should that stop us from trying? No.
It’s called speculative fiction for a reason. It’s not productive to pretend that things will magically fall into place if we put out the right vibes into the universe. We need calculated progress, backing from the hard sciences, and an understanding that compromises and tradeoffs will always have to be made.
The goal of solarpunk is not to wish for a better future, but rather to propagate a series of values, approaches, and awarenesses into our collective psychology that allow us to continue pushing forward with our progress, without sacrificing our own humanity and connection to the natural world in that pursuit.
It is a well known concept that our expectations for the future are guided largely by our predictions of what it will look like. You don’t have to be stoned in a dorm room to think “Dude… the future only looks like the future because that’s what we say the future looks like.”
And yet our visions aren’t always correct. We constantly overestimate what can be done in one year and underestimate what can be done in 10 years. It is clear in drawings from the Victorian era that our predictions for the future are often misguided by our present moment.
When we say something looks futuristic, we are largely comparing that to other artifacts of our present, concept art, and this year’s latest blockbuster. It therefore puts a lot of pressure on the creators shaping our fictional worlds, for they are the first to the front lines in a war of ideas competing to define what the future of our world could and should look like.
Most of our stories about the future are largely dystopian. I understand how important the backdrop of an oppressive regime can be in creating an antagonist you love to hate, or how an experiment gone wrong can set up a hero’s redemption and a captivating plot arc, but I still find myself yearning for a different take on what our future could look like. Are we so sure that our path leads to dystopia that we can’t even explore alternative options, even in our imaginations?
I’m not trying to tell people what they should or should not create. In fact, I believe that our freedom to do so is a liberty that should be fought for at all cost. What I am asking, however, is why we as humans have a tendency to explore only the darkest visions of our future in the stories we tell ourselves? As fun as it is to dream up a techno dystopian future, I’d bet that most of us probably prefer not to live in a world that is oppressed, dangerous, and for some reason always raining.
I believe that, if we can manifest more visions of the future based not in what we are afraid of, but in what we are hopeful for, we’ll be surprised with what we accomplish and who we can inspire.
Imagine that Mr. Jones was intubated yesterday in an NYC hospital. He is not imminently dying, though his chances of surviving Covid-19 are uncertain. Mrs. Smith, another Covid-19 case, now requires intubation in the same hospital’s emergency room. She is twenty years younger than Jones, and without his diabetes and hypertension, so her prognosis for recovery is better. But yesterday Jones took the last ventilator in the ICU. If we leave Mr. Jones on the vent, Mrs. Smith will die. If we take Jones off the vent to give it to Smith, then he will die.
If we choose the younger, healthier Mrs. Smith over the older, sicker Mr. Jones, this might appear to be age discrimination. On the other hand, the coronavirus itself engages in age discrimination, killing those over 70 at a much higher rate — so age itself appears to be a medically relevant prognostic factor in many cases.
Most physicians are not trained as wartime medics. We have never before faced these battlefield triage decisions. And with the coronavirus pandemic, there are additional ethical complications. That NYC hospital is also running out of N95 masks and proper gowns to protect staff from infection. Health care workers certainly have a duty to care for the sick. Just as firefighters run into burning buildings while others run away, so also we treat contagious patients while others are socially distancing.
But just as firefighters never signed up to run into burning buildings in their boxer shorts, so also doctors and nurses did not sign up to treat infectious diseases without basic personal protective equipment — gowns, gloves, and masks that cost pennies apiece yet somehow are in short supply. When this PPE is gone, and doctors lack even the most basic barriers against infection, should the 70-year-old physician have to stay in the game? What about the 28-year-old pregnant medical resident who has an elderly immunocompromised grandfather living at home?
Suppose during this crisis we stretch the duty to treat contagious patients to heroic proportions. This is part of the physician’s job, so it is all hands on deck. After a few weeks of this strategy, and before more N95 masks arrive, half of the emergency and ICU physicians in this NYC hospital are home sick with the cursed virus, and one of the hospital’s docs is sick enough to need — guess what? — a ventilator. So this doctor returns to her hospital as a patient.
Should we then pull Mrs. Jones off the ventilator and offer it to the infected physician, who after all acquired Covid-19 while on the front lines heroically risking her own health to care for patients? If we are not convinced by the argument from reciprocity (that she deserves some reward for these efforts), what about the “multiplier effect”? If our central ethical principle under crisis conditions is to save as many lives as possible, it seems plausible that saving this ICU physician — if she recovers and returns to the fray — could help save the lives of more patients. Doctors are in short supply and cannot be easily replaced.
Okay, fine — perhaps we can prioritize doctors, all other things being equal in terms of prognosis. But many other workers are also critical to the pandemic response. Perhaps we can “replace” food service workers and janitors — as distasteful as it is to put it in those terms and think of our fellow human beings in that way — but what about the lead scientist on a project to develop a coronavirus vaccine? Or the police chief of New York? Or any police officer or firefighter, for that matter? What about a priority nudge for pregnant patients on the basis of this same multiplier effect? How should we draw the line around this category of “critical workers” or others who can get a bump up the triage list?
Draw the line too broadly, encompassing anyone still working during the crisis, and such priority quickly becomes meaningless. Draw it too narrowly and you exclude others who are also essential. In any case, if we consider some to be indispensable in this hour, does this not imply that others — the artists and poets, the homeless and unemployed — are dispensable? How will such practices shape our attitudes and impact social solidarity once the virus is gone and the dust has settled?
Suppose we attempt to resolve these puzzles by sticking only to objective clinical criteria: no special priority for anyone, no triage categories that are not directly related to prognosis. We do our best to predict which patients will have the best short-term survival outcomes, give them first priority on scarce resources like ventilators, and save as many people as possible. This seems sensible enough, until we realize that those Covid-19 patients with the best prognosis are typically the ones without medical conditions like diabetes, hypertension, and cardiac disease. But these people are often healthier because they eat healthy food (which is more expensive than McDonald’s), work out at fancy gyms (also expensive), and have access to good medical care (very expensive).
So a triage system that appears at first glance to be fair and medically objective turns out to have the potential for exacerbating social inequalities. The populations that were most vulnerable before a disaster are likely to be among the most vulnerable during a disaster. On the other hand, our mandate is to save as many lives as possible, not to right all wrongs. If devising a medically fair pandemic triage system is frightfully hard, devising a socially fair system seems impossible.
For the past several weeks, these and a thousand other bewildering questions have been keeping my colleagues and me awake at night. After working on these issues round the clock with colleagues at my hospital who specialize in ethics, critical care, anesthesiology, emergency medicine, and nursing, I recently joined a task force to devise a pandemic triage protocol for all hospitals in the University of California system. These are some of the most remarkable people I know, and most have skin in the game as physicians on the front lines.
UC hospitals are well prepared for a large coronavirus surge, but many of California’s smaller private and community hospitals may not be so fortunate. These times call for the sharing of resources between hospitals, for transfers of care, for institutional solidarity. Our hospitals’ resources belong not to us, but to the citizens of California, and even to those beyond our state borders.
We are not starting from scratch or reinventing the wheel in our deliberations. Many thoughtful ethicists and dedicated clinicians have examined these questions in the bioethics research literature. And several states have published guidelines on these thorny questions, often with input from citizens. Yet most of this background work was done when these questions were hypothetical, while the guidelines we are producing now may soon be deployed on the ground.
In the few moments when we slow down, we occasionally think about the opportunistic lawyers and prosecutors who will later go after doctors no matter what choices we make. This is not to mention the Monday morning quarterbacks who will second-guess these choices with the benefit of hindsight, limitless time, and much more retrospective data. Well, fine — let armies of graduate students earn their Ph.D.’s in the coming years by telling us what we could have done better.
Honestly, most of the time we just worry about our patients. We picture the droves of sick people, barely able to breathe, who will arrive any day now at our hospital doors in ever expanding numbers. We wonder how we will explain our decision to an anguished daughter when we have to look her in the eye and say, “We are sorry, your father will not be placed on a ventilator but will be transitioned to comfort care only.” How will we explain this when a month ago he would have received treatment without question, and might have recovered?
None of this makes sense and none of us thought we would ever be in this position. Yet here we are.
We have deliberated about duty, justice, equality, fairness, transparency. These principles can never be abandoned even in a crisis. Yet something lingers always in the background of our efforts. There is an inescapably tragic undercurrent to all of this, however upright our intentions. This one unsettling fact always remains to haunt us: If hospitals exceed their surge capacity, patients who otherwise would have lived will die. Lives will be lost simply because we lacked the resources to offer everyone the basics of modern medicine.
T. S. Eliot saw the limits of our ability to rectify all wrongs and balance the scales of justice when he wrote, “For us, there is only the trying. The rest is not our business.” My colleagues and I, like so many others in these strange times, are trying our best. But controlling and managing this pandemic is beyond our abilities, indeed, beyond anyone’s abilities. In the absence of a God’s-eye view, in the absence of unlimited resources, in the absence of a crystal ball that can perfectly prognosticate outcomes, physicians are left to humbly do whatever we can — even as we know that this will not be enough. For us there is only the trying. The rest is marked by tragedy.
Aaron Kheriaty, M.D., is an associate professor of psychiatry and human behavior, and director of the Medical Ethics Program, at the University of California Irvine School of Medicine.
Aaron Kheriaty, “The Impossible Ethics of Pandemic Triage,” TheNewAtlantis.com, April 3, 2020.
Paul Jürgens – Publicado em: 09/04/2020 | Atualizado em: 10/04/2020
Luiz Davidovich: o presidente da Academia Brasileira de Ciências espera que a positiva exposição midiática por que passa a ciência neste momento não cesse após a epidemia ser superada
A chegada do coronavirus ao País provocou um impacto sem precedentes na rotina do funcionamento das instituições e empresas brasileiras, e no dia da dia da população. Com o trabalho da Imprensa, não foi diferente. Em poucos dias, jornalistas reviravam suas agendas em busca de contatos no meio científico, na tentativa de entender o que estava em jogo com a chegada da Covid-19 e de oferecer informações seguras a seus leitores. Um dos jornais impressos de maior circulação no País anunciou há poucos dias que estava convidando cinco cientistas para, alternadamente, assinaram coluna diária em suas páginas, intitulada “A Hora da Ciência”. O Boletim FAPERJ foi ouvir o que os pesquisadores e gestores que atuam na área da Ciência, Tecnologia e Inovação pensam desse súbito interesse de todos os meios de comunicação pela pesquisa no País, e que legado isso pode deixar para as relações da comunidade científica com os jornalistas, uma vez superada a crise sanitária.
Para o presidente da Academia Brasileira de Ciências, o físico Luiz Davidovich, a crise atual envolve todo o planeta, atingindo ricos e pobres, que agora estão tendo a oportunidade de acompanhar os avanços mais recentes da ciência, que por meio de técnicas cada vez mais sofisticadas permite conhecer o modo de ação do vírus, e que motiva equipes em todo o mundo para encontrar remédios e vacina. “A comunidade científica está tendo a oportunidade de dar o seu recado, diariamente, de forma clara e objetiva, sem partidarismo político. A primeira pessoa a anunciar a vitória da humanidade contra esse inimigo invisível e insidioso não será um político. A notícia virá, em primeira mão, com um comunicado redigido com termos técnicos, do grupo de pesquisas que descobrir a vacina”, diz Davidovich, professor do Instituto de Física da Universidade Federal do Rio de Janeiro (UFRJ). Ele espera que a positiva exposição midiática por que passa a ciência neste momento não cesse após a epidemia ser dominada. “Temos muitas ameaças no horizonte, por exemplo, com novos vírus que aparecem frequentemente e a questão das mudanças climáticas.E certamente muitas descobertas que mudarão nosso quotidiano, em benefício da qualidade de vida, ainda estão por vir”, acrescentou.
O coordenador de estratégias de integração regional e nacional da Fundação Oswaldo Cruz (Fiocruz), Wilson Savino, avalia que uma parte significativa da população do planeta já tinha motivos para acreditar na ciência. Ele, no entanto, acredita que isso não necessariamente se traduz por tomadas de consciência em termos de atitudes e de ações. “Somente quando a vida está em perigo, e, no caso da pandemia de Covid-19 esse medo tem dimensão planetária, é que a percepção de que a ciência poderá dar respostas (res)surge”, diz. “A mídia não age de maneira diferente. Não apenas os atores da comunicação midiática sentem o mesmo, procurando informação da melhor qualidade possível junto aos cientistas e instituições científicas, mas também sabem que seus leitores e ouvintes estão ávidos por informação confiável sobre seus próprios destinos”, fala. Vice-coordenador geral das redes de Pesquisa em Arboviroses, que recebe apoio da FAPERJ, Savino, que também é membro da Academia Brasileira de Ciências, torce para que a avidez por respostas científicas para resolver questões relevantes na vida da sociedade não desapareça após o controle da pandemia. “Que a ciência tenha uma nova iluminação nos corações e mentes deste nosso Brasil”.
Eliete Bouskela: para a médica e pesquisadora, aproximação da sociedade com os cientistas pode trazer enormes benefícios
Primeira mulher a ocupar o cargo de diretora Científica da FAPERJ, a médica e pesquisadora Eliete Bouskela afirma que cientistas costumam abordar os problemas de forma mais racional e que isso também contribui para o aumento do interesse dos meios de comunicação pela ciência, sobretudo em um momento como esse, de pandemia. “Nós, pesquisadores, tratamos das questões de forma mais racional, transparente, e, quando necessário, não hesitamos em declarar que não temos uma resposta, que estamos buscando soluções”, diz. Professora Titular da Universidade do Estado do Rio de Janeiro (Uerj) e membro associado da Academia Francesa de Medicina, ela acredita que o atual escrutínio da imprensa pelo trabalho dos cientistas deve contribuir para aproximar a comunidade científica do resto da sociedade. “À medida que saímos da torre de marfim e construímos um canal de comunicação com a população, isso certamente resultará em um aumento do interesse das pessoas pelo conhecimento científico e pela carreira de professor e pesquisador. A aproximação da sociedade com os cientistas, que também fazem parte da sociedade, pode trazer enormes benefícios”, assegura.
“Mais fortes e maduros”. É assim que o médico e Professor Titular de Psiquiatria da Faculdade de Medicina da Universidade Federal do Rio de Janeiro (UFRJ) Antonio Egidio Nardi acredita que sairemos da crise sanitária atual. “Vidas serão perdidas e isso é muitíssimo lamentável. Mas a sociedade também ganhará com esta crise relacionada à Covid-19, por exemplo, com a valorização da educação e dos investimentos em ciência e saúde”. Segundo o pesquisador, é possível observar que tanto nos sites informais, quanto na mídia de qualidade, já se discute, com algum embasamento científico, a origem da pandemia, a forma de propagação, como evitar o contágio rápido e as possibilidades de tratamento. “Artigos científicos comentários de pesquisadores e editoriais de revistas com credibilidade circulam nas mídias sociais de forma surpreendente. A ciência está viva, sendo mundo valorizada. O conhecimento científico está atingindo um grande público. Este é o objetivo primordial da ciência e das sociedades científicas: ajudar a sociedade a viver melhor”, destaca. “A sociedade pós-pandemia será melhor e saberá reconhecer o valor de pesquisas, dos profissionais de saúde e da educação de qualidade”, aposta o médico, membro da Academia Nacional de Medicina e que recebe apoio da FAPERJ para suas pesquisas por meio do programa Cientista do Nosso Estado.
Idealizador e ex-diretor do Parque Tecnológico da UFRJ, o engenheiro Mauricio Guedes, que desde julho de 2018 ocupa o cargo de diretor de Tecnologia da FAPERJ, acredita que a humanidade está tendo uma rara oportunidade para repensar o seu modelo de sociedade. “Essa grande exposição midiática sobre as atividades ligadas à ciência, com horas e horas de transmissões ao vivo nas tevês e pela Internet, e também em reportagens que agora ocupam quase todo o espaço disponível em jornais e revistas, certamente trará uma contribuição decisiva para que a população e os meios de comunicação reconheçam o valor da pesquisa e o papel central dos cientistas e tecnólogos no nosso futuro”, observa. “Enxergo aqui uma nova chance de entendermos o mais rápido possível que universidades e empresas precisam se unir para promover o avanço do conhecimento, ao mesmo tempo em que criam soluções em grande escala para o enfrentamento desta crise planetária”, diz. “O mundo não será como antes”.
Para o médico e imunologista Cláudio Tadeu Daniel-Ribeiro, coordenador do Centro de Pesquisa Diagnóstico e Treinamento em Malária no Instituto Oswaldo Cruz (IOC/Fiocruz), o papel da mídia tem sido exemplar, confrontando informações e tentando esclarecer dúvidas da população. “Nesse contexto dramático e assustador, temos a sorte de ver uma imprensa que busca os fatos, lá onde o conhecimento é produzido; na ciência, para esclarecer a sociedade, desinformada, parte por não saber como e onde ter acesso a dados fidedignos, parte por que leigos, agindo em nome de vísões tão desinformadas quanto descoladas da realidade dos fatos, insistem em propalar notícias e opiniões incorretas, que confundem a população”, diz.
Professor TItular de Fisiologia e Biofísica Instituto de Biofísica Carlos Chagas Filho da UFRJ, Antonio Carlos Campos de Carvalho alerta que só a ciência pode oferecer soluções que minimizem os estragos que esta crise fará no mundo. “Em situações de crise mundial, como a atual, a sociedade e os governos sempre se voltam para a ciência, buscando projetar cenários e as melhores respostas para o problema. Sem a ciência, a mídia já percebeu que estaremos sujeitos a achismos de pessoas desqualificadas para lidar com a crise”, diz. “Se nossos governantes entenderem que a ciência é capaz de trazer soluções racionais para nossos problemas, veremos adiante um apoio maciço às universidades e institutos de pesquisa através das agências de fomento, como a FAPERJ. Só ciência e tecnologia geram inovação e progresso social e econômico. O que sustenta nossa economia atualmente é o agronegócio, fortemente impactado justamente pelos avanços científicos e tecnológicos, promovidos, no passado, por diversas instituições nacionais de pesquisa. Com o avanço das técnicas de edição de genomas, vários países terão ganhos significativos de produtividade e temo pelo que pode acontecer com a economia brasileira se perdermos nossa posição de liderança no agronegócio mundial”, analisa o assessor para área da Saúde da Diretoria Científica da FAPERJ.
À frente da Assessoria de Relações Internacionais da FAPERJ, a pesquisadora Vânia Paschoalin acredita que, frente a uma situação de muito agravo à saúde humana, onde um vírus reemergente provoca mortes e sofrimentos, a humanidade parece ter entendido a importância da ciência para salvar vidas, diminuir o sofrimento humano e proporcionar bem estar e saúde. “Os cientistas sempre estiveram à disposição para explicar, com conhecimento e profundidade, o que lhes é perguntado. Assim, acabaram por assumir, neste momento, um papel muito importante de esclarecimentos e direções, devido à credibilidade que a sociedade sempre conferiu a eles”, avalia. Para a diretora-adjunta de Pós-Graduação do Instituto de Química da UFRJ, a humanidade está passando por muitas mudanças neste momento e o interesse dos jornalistas em ouvir os cientistas é reflexo disso. “Espero que tenhamos um apreço ainda mais respeitoso pela Ciência e pelo trabalho obstinado dos cientistas daqui para a frente, e que isso seja revertido em verbas regulares a pesquisa, de maneira que os cientistas possam gerar e disponibilizar conhecimentos para o bem da humanidade”, conclui.
Em dez países, 85% dos entrevistados disseram que precisam ouvir mais os cientistas e menos os políticos; no Brasil, esta porcentagem foi de 89%
09/04/2020 – 12:31 / Atualizado em 09/04/2020 – 13:35
RIO – A pandemia do coronavírus, que já matou cerca de 80 mil pessoas e adoeceu cerca de 1,3 milhão (dados oficiais da Organização Mundial da Saúde do último dia 8), fez crescer no mundo inteiro a confiança na Ciência.
Segundo pesquisa da Edelman Trust Barometer, sobre a “Confiança e o Coronavírus”, 85% dos entrevistados disseram que precisam ouvir mais os cientistas e menos os políticos. No Brasil, esta porcentagem foi de 89%.
Sobre porta vozes confiáveis, os cientistas são os mais citados no geral (83%), seguido pelo médico pessoal (82%), assim como no Brasil (91% e 86% respectivamente). Autoridades governamentais receberam 48% (geral) e 53% (Brasil) das indicações — era possível escolher mais de uma resposta.
— Talvez a notícia que mais esperamos nos dias de hoje é a descoberta de uma vacina contra o coronavírus. E ela será dada por um cientista — declarou o físico Luiz Davidovich, presidente da Academia Brasileira de Ciências. — A Ciência está muito presente nesse momento atual no mundo inteiro. Aqui no Brasil, na mídia e na fala do nosso ministro da Saúde. O tempo inteiro, (Luiz Henrique) Mandetta enfatiza o papel da Ciência no combate ao coronavírus. Cientistas do mundo todo se comunicam, trocam informações e estão nessa corrida contra o tempo. Não sei o que acontecerá depois desta pandemia, mas os governos e as pessoas em geral deveriam manter seus apoios e confiança nos cientistas.
A pesquisa foi feita entre 6 e 10 de março de 2020, por sondagem on-line em 10 países: África do Sul, Alemanha, Brasil, Canadá, Coreia do Sul, Estados Unidos, França, Itália, Japão e Reino Unido. Foram 10 mil entrevistados (1.000 por país) e todos os dados têm representatividade nacional em termos de idade, região e gênero. A margem de erro é de três pontos percentuais para mais ou para menos.
Mostrou ainda que a maioria se disse preocupada com a politização da crise: na Coreia do Sul este índice foi o maior (67%), seguindo pela África do Sul e Estados Unidos (62%), França e Alemanha (61%) e Brasil, com 58%, mesma porcentagem no total geral.
Davidovich afirma que antes desta pandemia, a “atitude anticiência” mostrava-se presente em vários países do mundo, inclusive no Brasil. Citou a falta de investimentos e apoio na área e também exemplos dos movimentos contra a vacinação e o “exótico” terraplanismo, que ganhou força nos Estados Unidos a partir de 2014.
— Quando um presidente de um país, poderoso como os EUA, fala contra as evidencias cientificas com relação às mudanças climáticas, por exemplo, ele afeta o mundo inteiro. Isso vai ser corrigido depois desta epidemia, em que os cientistas seguem como fonte mais confiável?
Para o antropólogo Ruben George Oliven, titular do programa de pós-graduação de Antropologia Social da Universidade Federal do Rio Grande do Sul, acredita que pesquisa mostra o quanto o cientista e os profissionais da saúde estão valorizados nos tempos atuais. Mesmo que a pesquisa tenha sido feita em países tão diferentes. Observou que no Brasil, os discursos antagônicos entre a presidência e o Ministério da Saúde colocam as autoridades governamentais em xeque.
— Mesmo num país como Brasil, em que a religiosidade é importante e os lideres religiosos não estão citados na pesquisa, as pessoas confiam no cientista. Diferentemente do político, que precisa estar bem com todo mundo para se reeleger, que tem discursos diferentes para diferentes grupos, o cientista tem alto grau é visto como alguém que se dedica a descobrir a verdade. Está numa especie de altar, ao lado dos profissionais da saúde — comenta Oliven, que destaca ainda o médico pessoal. — O meu medico é a pessoa que me trata, no qual eu deposito confiança e o que ele diz tem grau de veracidade muito grande. É o que caracteriza uma boa relação médico-paciente.
Ana Julião, gerente geral da Edelman, agência global de comunicação e responsável pela pesquisa, afirma que a empresa faz pesquisas sobre confiança, no mundo inteiro, há 20 anos e tem observado uma polarização entre informação e opinão:
— Essa crise gera um medo natural nas pessoas e faz com que os cientistas sejam os mais confiáveis. Nesse momento, a gente vê o quanto a informação é muito mais importante que a opinião.
Sobre a busca por informações, a pesquisa mostrou que a Italia destacou as fonte governamentais (63%). Na África do Sul (72%) e no Brasil (64%), as mídias sociais são citadas como principal fonte de informação. Mas a maioria, sete países, buscam dados prioritariamente com os veículos de comunicação, cujo índice total (incluindo todos os pesquisados) é de 64%. No Brasil, a imprensa (59%) aparece em segundo e depois, as fontes do governo (40%).
No total geral, depois da imprensa, aparecem: fontes do governo nacional (40%), mídias sociais (38%), organizações globais de saúde como a OMS (34%), autoridades sanitárias nacionais (29%), amigos e familiares (27%) e fontes do governo local (26%).
Segundo a pesquisa, no Brasil, 85% dizem se preocupar com fake news sobre a pandemia. Além disso, 52% admitem ter dificuldade para encontrar informações confiáveis e de credibilidade sobre o coronavírus e seus efeitos e 89% afirmam que precisam ouvir mais os cientistas e menos os políticos.
No geral, levando em consideração os dez países pesquisados, 74% se dizem preocupados com notícias falsas, 45% tem dificuldade para encontrar dados confiáveis e 85% confiam mais na ciência do que nos políticos.
A filosofa Carla Rodrigues, professora da Universidade Federal do Rio de Janeiro, observa ainda que a pesquisa foi feita no início de março e que houve, no Brasil, uma explosão de fake news nos últimos dias. Assim, segundo ela, as pessoas devem ter mais dificuldade para buscar dados confiáveis. Também destacou o fato da pesquisa mostrar que entre os porta vozes mais eficientes não está as autoridades governamentais.
— Esse número de 52% seria muito maior, sem dúvida. Principalmente por causa da politização criada em torno do coronavírus. Há cerca de duas semanas, a quantidade de fake news é enorme e se criou uma confusão sobre o tema — diz Carla, que acrescenta que nos últimos anos se intensificou o uso de fake news como instrumento de mobilização contra diversas instituições. — Incluindo a Ciência que foi muito enfraquecida. Nesse contexto, é muito mais difícil fazer com que as instituições responsáveis pelo combate a pandemia sejam respeitadas. Ou seja, mais um obstáculo a enfrentar.
A “busca pela verdade”, pelos cientistas, segundo Carla, é constante, mutante, e que é preciso ter cuidado. Isso porque as descobertas serão, em sua maioria, superadas e não se pode usar este fenômeno para desacreditar a classe.
— O coronavírus é um problema novo. E a Ciência vai continuar a pesquisar e investigar. A resposta será sempre atualizada e passível de revisão. Muitas vezes este fenômeno é usado para desacreditar a Ciência. Mas, a boa Ciência não é absoluta, não tem uma verdade final. Ainda bem.
The initiative has collected over 140,000 biological samples from animals and found over 1,000 new viruses, including a new strain of Ebola. Predict also trained about 5,000 people in 30 African and Asian countries, and has built or strengthened 60 medical research laboratories, mostly in poor countries.
Dennis Carroll, the former director of USAID’s emerging threats division who helped design Predict, oversaw it for a decade and retired when it was shut down. The surveillance project is closing because of “the ascension of risk-averse bureaucrats,” he said.
Because USAID’s chief mission is economic aid, he added, some federal officials felt uncomfortable funding cutting-edge science like tracking exotic pathogens.
Congress, along with the administrations of George W. Bush and Barack Obama, were “enormously supportive,” said Dr. Carroll, who is now a fellow at Texas A&M’s Bush School of Government and Public Service.
“But things got complicated in the last two years, and by January, Predict was essentially collapsed into hibernation.”
The end of the program “is definitely a loss,” said Peter Daszak, president of the EcoHealth Alliance, a nonprofit global health organization that received funding from the program. “Predict was an approach to heading off pandemics, instead of sitting there waiting for them to emerge and then mobilizing. That’s expensive.”
“The United States spent $5 billion fighting Ebola in West Africa,” he added. “This costs far less.”
It has long been known, of course, that AIDS originated in chimpanzees and probably was first contracted by bushmeat hunters. Ebola circulates in bats and apes, while SARS was found in captive civet cats in China.
These discoveries led to new ways of preventing spillovers of infections into human populations: closing markets where wildlife is butchered for food,; putting bamboo skirts on sap-collection jars to keep bats out; or penning pigs and camels in places where they cannot eat fruit that bats have gnawed.
Predict teams have investigated mysterious disease outbreaks in many countries, including a die-off of 3,000 wild birds in a Mongolian lake. One team proved that endangered otters in a Cambodian zoo were killed by their feed — raw chickens infected with bird flu.
A Predict laboratory helped identify bat-borne viruses that a boys’ soccer team might have been exposed to while trapped for weeks in a cave in Thailand.
Allowing Predict to end “is really unfortunate, and the opposite of what we’d like to see happening,” said Dr. Gro Harlem Brundtland, the former prime minister of Norway and former World Health Organization director-general.
Even though USAID is “incredibly proud and happy over the work Predict has done,” the program is closing because it reached the end of a 10-year funding cycle, said Irene Koek, acting assistant administrator of the agency’s global health bureau.
“We typically do programs in five-year cycles, and it had two,” she said. Some similar research will be part of future budget requests, “but it’s still in the design-and-procurement cycle, so exactly what will continue is a bit of a black box.”
In mid-October, the agency said it would spend $85 million over the next five years helping universities in Africa and Asia teach the “one-health” approach that Predict used. (“One health” describes the nexus between animal, human and environmental medicine).
But it will not involve the daring fieldwork that Predict specialized in.
Some Predict projects will be taken over by other government agencies, such as the Pentagon’s Defense Threat Reduction Agency or the National Institutes of Health. But those agencies have different missions, such as basic research or troop protection. They do not share USAID’s goal of training poor countries to do the work themselves.
As an agency that gives money to countries, USAID often has a friendlier, more cooperative relationship with governments in poor nations than, for example, Pentagon-led efforts might.
“I’ve always been impressed with the way they were able to work with ministries of health,” said Dr. James M. Hughes, a former chief of infectious diseases at the Centers for Disease Control and Prevention who was on Predict’s advisory board. “They have a high level of trust, and they help countries comply with the International Health Regulations.”
(Those regulations, in force since 2007, require countries to report all major disease outbreaks to the World Health Organization and allow the W.H.O. to declare health emergencies.)
USAID still supports some health-related programs like the President’s Malaria Initiative and the President’s Emergency Plan for AIDS Relief. But Dr. Carroll described those as “cookbook portfolios.”
How to fight those diseases is well-known, he explained, so the agency just comes up with a budget for drugs, diagnostic kits, insecticides, mosquito nets, condoms or other long-established interventions.
Predict more often placed medical detectives in the field, training local doctors, veterinarians, wildlife rangers and others to collect samples from wild and domestic animals.
It can be highly specialized work. Getting blood samples from pigs or wild rodents is fairly routine, but catching birds, bats or monkeys alive is not. Gorillas are harder. (Scientists usually content themselves with just collecting gorilla feces.)
Predict also experimented with novel ways to catch and release animals unharmed, to transport samples without refrigeration and to use DNA testing that can scan for whole viral families instead of just known viruses, said Dr. Christine Kreuder Johnson, associate director of the One Health Institute at the University of California, Davis.
Predict sponsored epidemiological modeling to predict where outbreaks are likely to erupt. It also sought ways to curb practices, such as hunting for bushmeat or breeding racing camels, that encourage eruptions.
The Zaire strain was found in a bat that roosts in caves and mines, said Dr. Jonathan Epstein, an EcoHealth Alliance veterinarian, while the Bombali type was in a species that roosts in houses.
Distinctions like that are important for telling people — especially people who eat bats — which species are dangerous.
“We generated an illustrated book on how to keep bats out of houses by putting screens on windows or mesh below the roof thatch,” he said. “That’s the kind of thing Predict paid for.”
Predict served as a proof of concept for a much more ambitious idea that Dr. Carroll proposed several years ago: the Global Virome Project, which envisioned trying to compile a genetic atlas of all the viruses circulating in all animals. By some estimates, there are more than 800,000 such viruses waiting to be discovered.
“Predict needed to go on for 20 years, not 10,” Dr. Epstein said. “We were getting to the point of having a trained work force that could gather animal samples and labs that could test for unknown viruses, not just known ones.”
“Once it stops, it’s going to be hard to maintain that level of proficiency.”
Em um texto anterior, escrito há exatamente um mês, eu calculei que, se a taxa de mortalidade no Brasil se igualasse à da Itália, 166 das minhas amizades no Facebook estariam mortas no final da pandemia; considerando apenas aquela com as quais tenho contato mais frequente ou pessoal, e adicionando indivíduos mais velhos que não usam o Facebook, calculei o tamanho do meu luto previsto: 65 pessoas queridas. E perguntei: quem é que está preparado para perder, em poucas semanas, cinco dúzias de afetos?
Naquele momento, eu não havia recebido a notícia de mortes relacionadas ao COVID-19 de uma das minhas amizades sequer. Percebi que meu texto provocou aversão em alguns conhecidos; outro disseram-me que foi o que fez a ficha cair.
Quinze dias depois, republiquei no meu blogue uma entrevista com David Kessler, um especialista em luto. Na entrevista, ele afirmava que muitas pessoas estavam sentindo-se emocionalmente alteradas, e que tratava-se de uma forma de luto direcionada não a pessoas, mas a contextos e modos de vida. Certamente há muitas variedades de certeza e de segurança que não voltarão jamais. Com relação à estranheza do distanciamento social, ele diz que existem fases que são idênticas às fases típicas do processo psicológico do luto:
Existe a negação, que acontece bastante no início: “este vírus não vai nos afetar”. Existe a raiva: “vocês estão nos fazendo ficar em casa e tirando nossos trabalhos”. Existe a barganha: “ok, se estabelecemos o distanciamento social por duas semanas, tudo vai melhorar, certo?”. Existe a tristeza: “eu não sei quando isto vai terminar”. E, finalmente, a aceitação: “isto está acontecendo; eu tenho que descobrir como seguir adiante”.
Kessler ressalta que as fases podem não ocorrer de forma linear no tempo. Em livro mais recente, ele acresceu uma sexta fase: a descoberta de significado.
Menos de uma semana após a publicação da entrevista, meu sogro faleceu de COVID-19. Tenho a impressão de que, das minhas 2660 amizades no Facebook, os parentes consanguíneos do meu sogro e eu fomos os primeiros a sentir o baque. Poucos dias depois, começaram as postagens, esparsas e discretas, de pais e avós que haviam falecido. Comecei a escutar isso também nas conversas pessoais, fora das redes sociais, de forma crescente.
No dia 16 de abril, rodou o país notícia de modelo matemático que previa que o sistema de saúde no país entraria em colapso no dia 21 de abril. Amanhã. Ontem, no noticiário da noite, repórteres desorientados informavam que, na maior metrópole do país, o número de leitos disponíveis de UTI se esgotaria em poucos dias.
Estamos afetados por uma quantidade imensa de lutos encavalados. É impossível estar dentro do furacão e não elaborar sentidos e narrativas. A mais imediata e intuitiva é a que afirma que é preciso fazer isso tudo valer, e o faremos se sairmos melhores do que entramos. Frente à imagem prevista dos corpos empilhados em containers refrigerados, produzidos pela tsunami de mortes que nos aguarda, velamos a ideia de que éramos, humanos, o topo da cadeia alimentar e que não tínhamos predadores. Que deste luto emerja a compreensão coletiva de que o futuro só existirá se reconstruirmos nossa relação com ecossistemas e demais seres vivos, como vizinhos e não como patrões (que nunca fomos).
Pelo desgoverno de quem nos dirige, velamos o sentimento de que o progresso, em qualquer de suas variações, ocorreria de qualquer modo, independente de nossas ações e de nossas capacidades. Que deste luto emerja a consciência de que o mundo é resultado das relações que construímos, e portanto só existirá felicidade se os mundos da política e da economia forem construídos sobre bases que a promovam.
Na impossibilidade de sentir fisicamente o calor humano do abraço de tanta gente querida, alguns até o final da pandemia, outro para sempre, velamos nossas ilusões a respeito de vidas vividas com pressa e sem cuidado, com produtividade e sem delicadeza, com metas e sem sentido. Que deste luto emerja a consciência de que ninguém é capaz de constituir-se, como pessoa e mesmo como organismo, sem a troca incessante com os demais; e se queremos um futuro de paz e serenidade, as trocas que nos constituem mutuamente têm que ser pautadas por essas qualidades.
Há, no entanto, o luto mais difícil, o mais literal: o da morte fria, brutal, a um palmo de distância, dilacerando os sentimentos e a capacidade de raciocínio. É também o mais importante dos lutos, porque garante a continuidade da nossa vida psíquica e emocional, se o vivermos bem. É preciso viver o luto, com coragem. Mas não é preciso que se viva o luto sem apoio e ajuda. Como afirmou David Kessler, o significado é parte fundamental da experiência do sofrimento, não apenas no luto, mas em todas as situações difíceis. Ocorre, no entanto, que se sairmos da psicologia e olharmos para a antropologia ou para a história, veremos que a humanidade é riquíssima em tecnologias e ferramentas para lidar com o sofrimento e com o luto, e a ideia de que o sentido emerge apenas no final do processo é, no meu entendimento, desperdiçar oportunidades e sofrer mais do que o necessário. É como ter um problema psicológico e colocar-se a responsabilidade de reinventar a própria psicologia no processo de cura. Obviamente as coisas não precisam ser assim.
Um problema aqui é que, além da própria psicologia e da psiquiatria, boa parte das demais tecnologias é classificada como “religião”, o que afasta muita gente. Isso é, em geral, uma bobagem, e ocorre em função de como nosso pensamento e percepção das coisas são colonizados por realidades culturais que não refletem de forma clara o nosso mundo cotidiano. Estou me referindo ao fato de que a suposta guerra entre “ciência” e “religião” não é sobre ciência, de forma genérica, nem religião, de maneira ampla, mas à ciência que dominavas as atenções do império britânico na época de Darwin (um naturalismo que via no mundo o reflexo do liberalismo individualista que dominava o pensamento inglês) e a religião hegemônica dentro do mesmo império britânico (um protestantismo literalista que se colocava em rota de colisão com outros literalismos, como o científico). Quando nossos cientistas brasileiros bradam a respeito das incompatibilidades entre ciência e religião, estão se referindo a um tipo específico de ciência e à religião que mimetiza o que Darwin tinha no seu tempo, de forma exacerbada: o neopentecostalismo. Com um pouco de imaginação, pesquisa e estudo, facilmente se descobre que, quanto mais o tempo passa, maiores e mais frutíferas são as colaborações entre o budismo e a ciência; o papa Francisco gerou uma volta de cento e oitenta graus na relação entre o Vaticano e a ciência, e tornou-se o primeiro papa declaradamente ambientalista da história; as obras de Alan Kardec, que fundamentam as práticas do Espiritismo Kardecista e de boa parte da Umbanda, dizem repetidamente que a fé só é verdadeira se pautada por pensamento racional e em harmonia com a ciência. Finalmente, há tempos a psiquiatria descobriu que sistemas de crenças que não induzem à culpa têm efeito efetivamente positivos no tratamento de doenças mentais, não sendo apenas “placebos”.
Além disso, dizer que a religião não tem nada a ver com a ciência é um equívoco: a ciência mostra, de forma clara, que a construção de narrativas que promovem coesão social e dão sentido à existência, como as religiões, foram fundamentais no desenvolvimento de todas as sociedades humanas – e continuam sendo. Yuval Harari, em seu livro Sapiens, por exemplo, diz de forma provocadora que o capitalismo e o socialismo (e muitas outras coisas) são formas de religião.
O luto precisa ser vivido, mas pode ser vivido mais fácil e positivamente. Em texto anterior, listei uma longa série de organizações e profissionais das áreas de psicologia e psiquiatria que organizaram-se para ofertar apoio gratuito e virtual às pessoas psicologicamente afetadas pela pandemia. Nas próximas semanas, este tipo de apoio será fundamental. Aqui, listo abaixo organizações religiosas localizadas na cidade de São Paulo que oferecem canal de comunicação e serviços de apoio, com o objetivo de oferecer consolo e ajudar as pessoas a encontrarem sentido e propósito no sofrimento pelo qual estão passando. Como os atendimentos estão sendo feitos de forma remota, por telefone ou internet, não é necessário residir em São Paulo para fazer uso dos serviços.
Se você conhece instituição religiosa que organizou-se para oferecer serviços no contexto presente e não está listada aqui, por favor envie esta informação para o autor ou deixe comentário abaixo.
– Marcus Tullius, coordenador nacional da Pastoral da Comunicação, informou que não há atividade centralizada, em função da quantidade e abrangência geográfica de fiéis, e que estes devem entrar em contato com as suas paróquias. As paróquias e os padres locais estão se organizando para atenderem as comunidades. É possível encontrar paróquias na lista de paróquias da Arquidiocese de São Paulo: http://arquisp.org.br/buscar-paroquias
Fusão de imagem de microscópio mostra o novo coronavírus em paciente infectado com foto de altar com diversas referências religiosas (National Institutes of Health / AFP)
“As dores humanas podem ter sentido, mesmo quando não têm solução”, pontuou o professor João Décio Passos, do programa de pós-graduação de ciência da religião da PUC-SP. Diante dos desafios transbordantes, pessoas católicas, evangélicas, esotéricas e das religiões de matrizes africanas têm mobilizado tanto recursos simbólicos de suas crenças como bússolas para navegar no amplo emaranhado de incertezas quanto se informado por fontes científicas para definir suas ações.
De um lado, uma parte da classe média urbana escolarizada – não necessariamente adepta de uma igreja em particular – tem apelado para uma noção ampla de “espiritualidade”, destaca Rodrigo Toniol, professor de antropologia da Unicamp (Universidade Estadual de Campinas). Há o imaginário de que a quarentena é um momento propício para olhar para si mesmo e suas idiossincrasias. Nesse caso, pondera o antropólogo, o próprio sujeito produziria a relação com o sagrado, descartando qualquer mediador (sacerdotal ou institucional). Abundam as “tecnologias da espiritualidade” – os aplicativos de meditação, de mindfulness, de yoga – imersas num referencial de terapias alternativas.
Por sinal, Toniol recebeu recentemente a informação de que, em um hospital de referência em São Paulo, uma paciente diagnosticada com Covid-19 foi orientada por uma terapeuta a desenhar mandalas como estratégia para cura. Após aderir à proposta, a paciente teria sentido melhoras físicas e aumentado o índice de saturação de oxigênio em seu corpo.
Há de se notar, em paralelo, a emergência de leituras esotéricas sobre a pandemia. Segundo essas narrativas, a espécie humana estaria passando por uma “purificação natural e necessária”, constata Passos. As respostas defendem uma lógica de crises predeterminadas, como uma crise sanitária a cada 100 anos. Nesses casos, a pandemia teria uma origem fora da História (do contexto biológico e social) e adviria de forças externas ou sobrenaturais. A solução dependeria de unções com óleo, colocação de crucifixo nas portas, correntes de oração etc. “A religião teria uma solução ritual (mágica) para a pandemia. Deus é quem estaria no comando, e não as ciências”, comenta o professor da PUC.
Desde a virada do milênio, os discursos sobre o apocalipse andavam desaparecidos no vocabulário evangélico, relembra Jacqueline Moraes Teixeira, pesquisadora e professora da USP. Nos anos 1980 e 1990, o fim dos tempos era dado como certo, com abundantes sinais de calamidade: a ausência de carne na mesa, as altas taxa de desemprego, a queda do muro de Berlim. Entretanto, recentemente, período que coincide com a produção da novela “Apocalipse”, que foi ao ar na Record entre 2017 e 2018 (e que será reprisada pela mesma emissora durante a quarentena), a narrativa voltou a ganhar fôlego, destaca a antropóloga. Nesse sentido, o Sars-CoV-2 emergiu como um novo sinal do apocalipse.
Para devotos do candomblé ou da umbanda, tal postura não faz sentido, pondera Vagner Gonçalves da Silva, do departamento de antropologia da USP. Isso porque, nessas religiões, as divindades podem trazer a doença com o objetivo de punição e, simultaneamente, de purificação. Isto é, a doença não é entendida como algo somente negativo, afinal, ao adoecer se aprende a cura e se valoriza a saúde. Nesse sentido, o vírus não é entendido na chave do demoníaco, mas como uma oportunidade para pensar no equilíbrio com a natureza, uma forma de valorizar o axé dos lugares e na força do sagrado. Ao contrário das cosmologias cristãs de expiação, no caso das religiões de matrizes africanas, as divindades não são aprisionadas no binômio maniqueísta de bem e mal.
De toda forma, parece haver um elemento comum de partilha no cenário contemporâneo, apesar das diferentes respostas religiosas.
A gramática científica
“Até o século 17 e 18, os agentes biológicos globais que matavam muita gente eram chamados de praga, afinal, o que organizava a experiência era a Igreja e a religião”, explicou Rodrigo Toniol. Com as revoluções científicas e a ascensão do Estado como princípios organizadores da vida social, os modelos explicativos se alteraram e fenômenos antes denominados como “pragas” passaram a ser compreendidos como “pandemias”.
No debate público recente, termos como “cloroquina”, “achatar a curva”, “isolamento” e “quarentena” tornaram-se comuns no vocabulário da população brasileira. “Por mais variadas que estejam sendo as experiências e interpretações sobre o que está acontecendo agora, a gramática tornou-se científica-estatal”, analisa Toniol.
O papa Francisco, por exemplo, adotou o isolamento social e, em seus discursos, demonstrou estar em sintonia com as orientações dos especialistas e entidades de saúde, conforme explica João Décio Passos. As fundamentações científicas orientaram o pontífice a adotar uma postura inédita: a suspensão das atividades religiosas, inclusive aquelas relacionadas à Semana Santa, essenciais na tradição católica. Ainda nesse sentido, pondera Passos, Francisco “não expressou em nenhum momento qualquer explicação religiosa sobre a origem da doença, bem como ofereceu rituais de cura para a mesma. Suas atitudes respeitaram a distinção entre o que é da ciência e o que é da fé”.
No caso de religiões de matrizes africanas, “houve uma transformação muito grande em relação ao que foi a epidemia da Aids no começo dos anos 1980”, comenta Vagner Gonçalves. Na época, uma parcela de pais e mães de santo defendia que a doença não iria afetar as pessoas em seu terreiro pela proteção do Orixá Obaluaiê. Décadas depois, a postura, ao menos entre os terreiros nos quais o pesquisador tem contato, mudou: terreiros suspenderam as festividades religiosas em consonância com as orientações da OMS e do Ministério da Saúde.
Mesmo quem deseja negar o conhecimento epidemiológico e as posturas de entidades governamentais parece mobilizar a gramática científica e estatal para vociferar suas convicções, afirma Toniol. A Igreja Universal do Reino de Deus, por exemplo, tem recorrido ao vocabulário científico para defender suas posições, salienta Jacqueline Moraes Teixeira. Logo após o governo estadual paulista decretar a quarentena e impedir as igrejas de várias orientações a realizar cultos com aglomeração de pessoas, Renato Cardoso – genro de Edir Macedo e bispo principal da IURD – fez uma live reclamando a necessidade de procurar outras bases científicas para garantir que, de um lado, o vírus não se espalhasse e, de outro, a produtividade econômica fosse mantida.
Nas redes sociais evangélicas, “há uma disputa acirrada sobre o conhecimento científico”, descreve Teixeira. Mesmo o que é fake news se traduz em formato que emula a ciência. Além disso, a antropóloga nota entre fiéis uma tentativa de procurar um conhecimento “puro”, “despido de um discurso político”. Segundo o diagnóstico dessas pessoas, “a esquerda defenderia o isolamento social, a direita defenderia o fim do isolamento” e, por isso, seria necessário acessar uma ciência pura que estaria despida de qualquer política ou posicionamento.
Apesar dessa vontade, é notável como interesses políticos calculam os passos munidos de referenciais científicos e como o campo religioso municia as ações públicas para as decisões sanitárias.
O papa Francisco tem assumido, por exemplo, um papel de global player, avalia Toniol: “Ele tem produzido uma estética da política ao apresentar o Vaticano vazio e com uma iluminação calculada para que ele caminhasse no meio da chuva. Isso resultou na foto do início do século 21”. A imagem, desse modo, fazia uma defesa do isolamento endossado pelo Vaticano.
Decisões científicas também afetam as práticas religiosas. Nos terreiros com os quais mantém contato, Vagner Gonçalves relata o impacto do isolamento nas festividades. Afinal, nessas religiões, o contato é mediado pelo corpo: “quando o Orixá incorpora uma pessoa, ele abraça outras e faz transferência do axé nesse contato corpo a corpo. As ‘emanações’ do corpo como saliva, suor, sopro são fontes de axé…”. Para atender as orientações governamentais e, simultaneamente, manter viva a relação com o sagrado, os terreiros não deixaram de fazer os rituais privadamente. Por exemplo, as oferendas a Obaluaiê – a divindade associada às epidemias – passaram a ser fotografadas e enviadas nas listas dos terreiros. Mesmo assim, o isolamento tem impactado a sobrevivência material das pessoas, “são comunidades, no geral, de poucos recursos financeiros. O sacerdote vive do jogo de búzios, dos ebós (oferendas), dos rituais de limpeza espiritual e tudo isso cessou”, relata Gonçalves. Como alternativa, as comunidades têm pedido contribuição de seus filhos para manutenção e sustento das pessoas.
Posições políticas e religiosas também disputam os significados da ciência. Segundo pesquisa do Datafolha, houve uma divisão significativa na base de apoio ao presidente Bolsonaro, sobretudo entre católicos e evangélicos. Jacqueline Moraes Teixeira pondera que, mesmo nos segmentos protestantes no Brasil, notou-se uma divisão entre aqueles que desacreditaram inicialmente o vírus e aqueles que adotaram prontamente o isolamento social – como algumas denominações batistas que, em 2018, apoiaram o então candidato Bolsonaro.
Diante desse impasse, o presidente e líderes evangélicos ligados ao governo procuraram uma estratégia religiosa capaz de fazer frente à orientação científica do isolamento. O jejum emergiu como uma alternativa. Isso porque, afirma Teixeira, no imaginário cristão, o jejum é um momento de sacrifício individual em que se intensifica a relação com Deus. “Ninguém faz jejum em aglomeração, em templo”, destaca Teixeira, “Esse jejum foi uma tentativa de trazer para perto do governo essa gama de evangélicos que defendem as políticas de isolamento social”. Dessa maneira, o jejum produziria uma nova narrativa, lastreada em uma política teológica, para o governo se conectar com uma base política que se desfazia e acenar para um tipo de isolamento religioso.
Simultaneamente, nas redes de fiéis começaram a circular as imagens dos templos evangélicos com as portas fechadas e as pessoas ajoelhadas do lado de fora. “Isso traz um peso histórico. Essas igrejas quase nunca estão fechadas, desde as 6h da manhã até a madrugada elas ficam abertas”, relembra Teixeira. Essa foi uma postura política adotada por igrejas como a IURD para se contrapor ao decreto do governo estadual paulista que impede aglomerações. Na regra, os edifícios poderiam manter as portas abertas para prestar atendimentos individuais, por isso a decisão de trancar as igrejas produziu um efeito simbólico e político. Afinal, templos cerrados sugerem o caos e a proximidade com o apocalipse.
Sob essa imagem, a articulação entre política e religião ganhou novas dimensões, afinal, essa narrativa “consegue colocar a gestão do governo Bolsonaro numa posição que faz sentido para algumas pessoas – embora não seja unânime”, comenta Teixeira. “O governo passa a ser lido por segmentos evangélicos como um governo do fim do mundo. Ele não vai ser coerente – não precisa ser coerente –, não vai resolver os problemas, ele não vai tirar as pessoas do seu sofrimento… ele é um governo apocalíptico”. Por esse motivo, para alguns segmentos da população, a forma de administração da doença não geraria incômodo ou preocupação, afinal, estaria afinada com essa leitura cosmológica cristã.
Nesse universo de referências intrincadas e emaranhadas, o que se pode inferir é a articulação entre religião, ciência e política. Apesar de imaginarmos essas esferas como campos separados, nota-se, na prática, universos mutuamente constituídos e repletos de interpelações.