RIO DE JANEIRO, BRAZIL – Physician, neuroscientist and full professor at Duke University (USA), Miguel Nicolelis coordinated the Scientific Committee of the Northeast Consortium for Covid-19 throughout the coronavirus pandemic.
He left the group in late February after months of providing projections and advising governors on the measures they should adopt to halt the contagion curve and prevent the collapse of public and private hospitals – a catastrophe that is looming, in his opinion.
“We are heading toward an explicit war situation. We may have the greatest humanitarian catastrophe of the 21st century on our hands,” said the doctor.
According to his calculations, in the coming days the country will begin to register 2,000 daily deaths. Hours later, the Ministry of Health reported 1,910 covid-19 deaths, another record. “The likelihood of us exceeding 3,000 daily deaths in the coming weeks has become a reality,” he predicts. He argues that increasing the number of beds is useless at this point, and that the only solution is to decree a national lockdown for the next three weeks.
What to expect in the coming weeks or days?
We are heading toward an explicit war situation. We may have the greatest humanitarian catastrophe of the 21st century on our hands. The likelihood of us exceeding 2.000 daily deaths in the coming days is very real. The possibility of us exceeding 3.000 daily deaths in the coming weeks is now real.
If you have 2,000 daily deaths over 90 days, or 3,000 deaths over 90 days, this means between 180,000 and 270,000 people dying within three months. We would double the number of deaths. This is genocide already, except no one has used the word yet. What is 250,000 deaths when the vast majority could have been prevented?
São Paulo reverted to the red phase and closed down non-essential businesses and services. What could happen to the state?
I think São Paulo will collapse. Campinas has already collapsed. Rio Preto collapsed. Ribeirão Preto is on the same path. The city of São Paulo is not going to withstand it. The Emilio Ribas Hospital is now 100% full and with a waiting line. The Clínicas Hospital, which has one of the highest numbers of ICU beds in Brazil, is at 80% occupancy and is going to collapse.
States have been focusing on the opening of new beds. Does opening new beds help?
There are no more doctors, no more nurses. Everyone knows, and politicians know too, that the virus grows exponentially faster than the capacity to create, equip and assign people to ICU beds.
There is no way to fight this by simply adding more hospital beds. It is the typical makeup strategy. You increase the beds, but sometimes the beds are not even functional, but they are added to the balance and the occupancy rate drops.
What should be done then? Governors and Health Secretaries this week pressured President Bolsonaro for measures.
We need to decree a lockdown for at least 21 days and pay financial aid for people to stay home. Governors know that the federal government is not going to do anything, they are trying to shift responsibility.
I have been suggesting since November to create a National Commission with civil society, governors and the Supreme Court, which needs to decree a judicial guardianship of the Ministry of Health. An intervention. And this National Commission would be responsible for making decisions and overseeing the whole logistics.
But the population no longer complies with restrictive measures. Would you agree to a lockdown?
The population has never been given the right message of how serious the pandemic is because we have no statesman in the country. People are talking about the presidential succession in 2022 when the country is dying in the pandemic.
There has been no political decision and no strategic vision. Elected people have failed to think about the citizens as a priority, rather than the economic and political lobbies that support them. A decision needs to be made.
John Barry, the greatest American historian of pandemics, wrote that even with modern science, what decides the fate of a society in a pandemic is political decision, the political choice of leaders to defend the population. This is why you are elected, to lead even in times when the right thing to do is unpopular. You have to persuade the population that it needs to be done.
In case there is no national lockdown, as everything suggests… Doesn’t the virus have its own dynamic, where infection spikes, reaches a peak, and then starts dropping because of seasonality, among other issues?
Not when you have a virus mutating out of control and if new variants are more lethal and more contagious. Each variant has its own dynamic. As you said, it rises, peaks, and drops. But if you have dozens of variants superimposed on each other…
They have just detected the California variant in Minas Gerais, because someone flew in from the United States and carried it in. We recommended closing the airports in August. We reiterated it in September. And evidently Infraero didn’t pay any attention. In Brazil we have the combination of all variants, including our own. That is the time bomb.
That being the case, can people who have been infected with covid-19 months ago eventually be reinfected?
If you were infected with the initial Brazilian variant, the antibodies you developed are nine times less efficient to fight the new Amazonas variant. Why do we need to get the influenza vaccine every year? Because variants emerge. But what we are experiencing in terms of the number of coronavirus infections is very serious, so the chance of the virus mutating is much higher.
You mentioned in another interview the possibility of a funeral collapse. How might this occur?
Porto Alegre is already starting to see this: a hospital was forced to buy containers to store the bodies because they were unable to cope with them. This is Manaus. The population of São Paulo is nine times larger than that of Manaus. Greater São Paulo is 20 times bigger. If the city of São Paulo collapses, the whole state of São Paulo will collapse.
It is just like a war: when an important battalion is taken down, all the armed forces are compromised. It is a cascading effect. My metaphor is that we are Stalingrad, we are surrounded at this point.
Interview: El Pais