Northeast Consortium moves to tackle the COVID-19 pandemic

Work developed ahead of the Northeast Consortium and as vaccines coordinator at the National Forum of Governors, he is highlighted as a great articulator of the Northeastern Executive Chiefs

Although the mainstream Brazilian media has little repercussion for what happens outside the Brasilia, Rio de Janeiro and São Paulo axis, the work and performance of the governor of Piauí, Wellington Dias (PT), has reverberated throughout Brazil due to the results presented in favor of the Country, especially in the assistance and solution of the pandemic by resolving the acquisition of millions of vaccines by the states. After taking office as president of the Northeast Consortium and vaccines coordinator at the National Forum of Governors, Wellington Dias, began to exercise an expanded articulation role involving all the governors of the country, with immense repercussion due to the effects of the actions that benefited the different states, surprising the entire national scene and not only the northeastern states.

To learn more about the subject, the Communication Advisory of the Brazilian Society of Tropical Medicine (SBMT), interviewed the governor who highlighted the integrated action of the governors of the Northeast in the fight against the COVID-19 pandemic of in the region and the results achieved by the joint action of the Northeastern managers and the consequences of the lack of a central command to face the most serious health crisis faced by the world.

Read the full interview.

SBMT: Recently, you announced measures to strengthen the health network in Piauí. Could you tell us about the current situation?

Governor Wellington Dias: In Piauí, we continue to increase the number of hospital beds, but we face serious difficulties due to exhaustion regarding our professionals, especially those who work in ICUs. We expanded another 10 ICU beds this week in Parnaíba, in a partnership with the city, in addition to 20 clinical beds. There are still another 10 ICU beds that we are providing to start up activity in Teresina with the Prontomed Group, from the private sector.

The actions we took with 21 days of reducing the circulation of people with restrictive measures for social distancing, and measures with the primary care network, expanding the Active Search program, in which professionals go from house to house, examining people and giving assistance for quarantine and treatment, are leading to a reduction in transmissibility and the level of hospitalization, reducing the waiting time for beds, which shortened the waiting line by an average of 6 days to 2.5 days. But we still have waiting in lines in 5 of the 8 health regions in Piauí.

SBMT: Regarding the joint state restrictions to contain Covid-19, what has actually been accomplished?

Governor Wellington Dias: It was the first time since March 2020, in the absence of a national coordination by the federal government, as with other countries, that we have signed decrees with preventive and restrictive measures in the 27 units of the federation at the same time. First at Carnival and then in the week of March 4 to April 4, Easter Sunday. It is not easy to do so. They are governors of different parties, pro-government and oppositionists, but it worked, with a reduction in transmissibility in Brazil, although still with a high number of daily confirmed case and several health regions with a waiting list for a bed, but already much better than 14 days ago and impacting on the reduction of deaths in the last seven days. I wonder if we had the federal government supporting us, participating in this effort. How many lives would we have saved?

SBMT: The Northeast Consortium recently announced the purchase of 37 million doses of the Russian Sputnik V vaccine. Are the regions governors also looking for other pharmaceutical companies to negotiate?

Governor Wellington Dias: Yes. First, we must materialize the delivery of the Sputnik V vaccine. It has become too bureaucratic and we run the risk of losing the April batch, as it does not have an import license this week. We had to go to the STF [Federal Supreme Court], in order for Brazil to receive the first of 37 million doses of the Sputnik vaccine, which is already in use and is highly safe, with almost no side effects and no serious effects and still with high efficacy. What is the one thing Brazil needs the most in April? Vaccines.

We are also fighting and we had agendas with the United Nations (UN) and the World Health Organization (WHO), so that they can guarantee the delivery of the 8 million doses of the AstraZeneca vaccine, relative to Brazils quota in the Vaccine Consortium. We made an agenda and said that we know about the shortage of vaccines for many countries and the problems of AstraZeneca and its contracts. It turns out that the worsening of the pandemic in Brazil is a risk for other countries, for the world, with the production of variants with increasing risk. Humanitarian aid now with vaccines for Brazil, for vaccination of the risk groups, means protecting the world. We also resort to the US and UK government also to act on the release of vaccines from AstraZeneca and anticipate the Pfizer vaccines. And we had promises of aid. In China, it worked to rescue Brazil from the second dose crisis and there is still a lack of support on the issue of the so-called intubation kit and antigen tests. We did not give up and we will continue to seek solutions to alleviate the crisis and manage to save lives.

SBMT: Could you tell us about the main obstacles and victories of the Northeast Consortium?

Governor Wellington Dias: There are many obstacles. I think that a governor in Brazil, and, especially in the current situation, needs to be prepared to work hard every day, to be hit hard and still be always excited for this day and the next day! Its like changing a tire of a moving car.

But following science was a wise decision. Studies indicate that if in the Northeast Brazil had the mortality level in Brazil, this year we would have 28,000 more deaths. When I imagine 28.000 lives saved! So, the Pact for Life is worth it. The risks, accusations, lawsuits, fake news and criticisms were small in face of the result we achieved.

But the Northeast Consortium is not only for the pandemic, it is also for looking after Northeast Social Security, Northeast Integrated Intelligence in Security, Northeast Joint Purchases and Northeast Scientific Committee. This is a reality. And now we have 18 technical chambers for 18 projects in the region. Successful experience in one or more states or even in other countries that we can replicate in the Northeast.

Northeast Family Agriculture, Northeast Integrated Security Force, Northeast Education, Northeast Culture, Northeast Health Integrated Network, Northeast Clean Energy, Northeast Tourism, Northeast Research and Innovation, Northeast Infrastructure and Northeast Foreign Policy. These projects will bear good fruit for the development of the region in all areas.

SBMT: In addition to acting for the acquisition of vaccines against Covid-19, the consortium also struggles to guarantee social protection to the populations most vulnerable to the pandemic. How is this being done?

Governor Wellington Dias: Hunger, unemployment and precarious employment are on our doorsteps. We want to go beyond the transfer of income or solidarity with the distribution of food baskets – and what a wonder of solidary people are the people of the Northeast! But as for the States, we want to join social programs with the opportunity to alphabetize to those who are illiterate or have stopped studying for some reason and aiming at a job, a profession or training for entrepreneurship and even with a credit line to start a business. We want to look especially at family farmers in the Northeast, who represent 50% of family farmers in Brazil and expanding productivity and income here makes a big difference. And with healthy food production. So, it is an option for the Northeast: Food – education – employment/business. And still supporting entrepreneurs to invest in the Northeast.

SBMT: What is your opinion about the National Vaccine Consortium of Brazilian Cities (Conectar)?

Governor Wellington Dias: Every initiative to bring more vaccines to Brazil must be supported. Vaccines are missing for the first dose and the most critical is the lack of vaccines for the second dose. The lack of planning, integration and initiative led to this. We announced on February 17 that we would have this hole in April. Nobody listened in the central power and they took the governors as enemies. That is exactly the problem.

SBMT: Could you tell us about the lack of a national organization to combat Covid-19?

Governor Wellington Dias: Our proposal since the beginning of 2020 was an integrated committee, they came to create this year and leaving the States and Municipalities out. In a Federative Republic, vaccinations are carried out by municipalities. In other words, they threw the heart of SUS into the trash can: which is to operate in a network and in an integrated manner.

SBMT: Unfortunately, Brazil has become the epicenter of the pandemic. How to deal with the health vs. economy dilemma?

Governor Wellington Dias: I can imagine 21 days of restrictive action or lockdown in an integrated way: federal government, all states and all municipalities, removing around 70% of people in Brazil and still using the Family Health Strategy teams taking care each of 2 thousand people, with PPEs, exams, equipment needed to go from house to house examining and taking care of each person. Does the person have symptoms or confirmed diagnosis for coronavirus? Quarantine. Screening of contacts and quarantine, support for isolation, treatment and appropriate medication for those who need it, medical teams accompanying field teams. Probably with three or four moments of this, as other countries did, in Brazil we would have about 120 thousand deaths by Covid-19. Too much? Yes, but 250 thousand men and women who died would still be among us. And the economy? It would suffer less, with less losses, less unemployment.

We do advocate compensation for entrepreneurs, linked to insurance or job protection. The financial aid that came up to December 2020 would go on continuously, why did it stop? Has the calamity ceased? No. I said and I repeat: when the country went from January to March without financial aid to the poorest, hunger did not go on vacation.

Brazilian GDP was forecast to drop 10% in 2020 and dropped 4%. Can you imagine the economic and social effect with a 10% drop? Unemployment, company breakdown, fall in public revenues. The social protection and support network for entrepreneurs saved the current economy and jobs.

SBMT: Do you believe that if Brazil had followed the example of China, today the scenario would be different?

Governor Wellington Dias: They had far fewer deaths, almost no unemployment and had social protection and still registered high economic growth in 2020 and early 2021. But look at the United States of America with the year 2020 with the negationist President Trump and now 2021 with the few months of President Joe Biden. Biden, following science and with investments in the net of protection to the people and companies of U$ 2.3 trillion, changed everything in that country.

SBMT: A total of 22 of the 27 Brazilian governors decided to face President Jair Bolsonaro and recently signed a pact for life to prevent the worsening health crisis caused by Covid-19 and the collapse of the health system. As coordinator of the National Forum of Governors, what is your opinion about the future of Brazil?

Governor Wellington Dias: We want to follow science and the Northeast is a good example that in the midst of this tragedy, the region with less material and human resources, had a better result, we saved more lives.

The Pact for Life was an initiative of the Governors Forum and is a call from the public and private sectors for priority areas. First: follow science. And following science, supporting preventive measures, prioritizing vaccines and by the rule of the National Immunization Plan, free of charge and for all Brazilian demands, maintaining the social protection and solidarity network, support for patient care, accreditation of the hospital network and guarantee of medicines , oxygen, inputs and for Covid-19 and non-Covid networks, taking care of post-Covid, people with sequelae, and finally we presented to the UN the proposal to break patents for Covid-19, vaccines, with technology transfer to expand production of IFA and vaccines.

SBMT: China had two pillars in the fight against Covid-19. Measures to prevent transmission, such as wearing masks, strict social distancing, quarantine and hygiene measures. The other pillar was contact tracking based on PCR testing. In your opinion, why did Brazil not even try to implement this strategy?

Governor Wellington Dias: As I said before, the lack of national coordination and planning, the denial of science, all of this generated this genocide. China, with these measures, followed science. Not following science has a price and the most dramatic: paid with human lives, already about 400,000. It looks like its just a number. But when we look at each other around us and the pain of relatives, friends, co-workers, artists, athletes, entrepreneurs, poor and rich. We are far from imagining the extent of the damage.

SBMT: Would you like to add something?

Governor Wellington Dias: If we have a serious schedule of vaccine deliveries, we will be able to think about the Organized Recovery Plan for the Economy of Brazil. Piauí has already prepared its plan. But we need more vaccines. We were to end April with the whole phase I vaccinated, about 53 million people over 60 years old or under 60 years old with comorbidities and plus indigenous people, health personnel etc., due to that false schedule of 17/02, presented to governors. And with the disorganization and lack of initiative and commitment, we should reach less than 35 million people vaccinated. A shame!

Vaccinating this group at highest risk, which accounts for 70% of hospitalizations and deaths in Brazil, since March last year, would simply result in the end of lines, the collapse of the hospital network and supplies and the unbearable effort of thousands of health professionals. And the reduction of, at least, 50% in the number of average daily deaths that Brazil reached in March and April.