SPECIAL | They made Amazon a guinea pig – Impact and deaths

Cassandra Castro – from Cenarium

BRASILIA – The encouragement to the use of the so-called “Covid Kit” by patients affected by Covid-19 contributed, directly and indirectly, to the great number of deaths in Brazil during the pandemic. This is what experts in epidemics, infections, and viruses heard by CENARIUM MAGAZINE point out. For them, many died because their health conditions were aggravated by intoxication, by the mistaken administration of medication, and by the delay in seeking a health unit, believing in the false hope of a cure through medication.

In the evaluation of the epidemiologist of the Oswaldo Cruz Foundation in the Amazon (Fiocruz/Amazon) Jesem Orellana, the use of drugs with no proven efficacy in the treatment of Covid-19 had direct and indirect influences on the second peak of the pandemic in Manaus, at the beginning of this year, which resulted in a large number of deaths. For Orellana, in a direct way, the deaths may have occurred due to intoxication by hydroxychloroquine, chloroquine, and ivermectin, among others that can cause serious side effects, such as impairing vision, liver, kidneys, and thus leading to death. But the specialist points out that these are exceptional cases, directly associated with the misuse of medications.

“Some studies show that in some regions of the country with higher compliance [to the “Covid Kit”], there is a higher amount of hospitalizations and deaths from Covid-19″, Jesem Orellana, epidemiologist from Fiocruz Amazon.

According to Orellana, the indirect causes are the most important. They would have happened, probably, due to people having taken the drugs with no proven efficacy against Covid-19 and ended up abandoning the use of masks and precautions to prevent the dissemination and infection by the new coronavirus. “Even there are some studies showing that in some regions of the country with greater compliance [with the “Covid Kit”], in terms of political support for President Jair Bolsonaro, who has always defended the use of these drugs, there is a greater amount of hospitalizations and deaths from Covid-19″, highlights the specialist.

The epidemiologist states, however, that the population should not be blamed for this type of behavior, attitude, and decision. Orellana believes that it is necessary to reflect on where the notions that end up contaminating the social imaginary with “untrue, criminal” information come from. “We keep blaming the population and not the real culprits, like president Jair Bolsonaro and all this horde of followers he has, anti-scientific, extreme right-wingers, who end up disseminating these types of unfounded narratives”, he concluded.

Application and mistaken

The infectious diseases physician Edimilson Migowski, PhD in Infectious Diseases, researcher and professor at the Medical School of the Federal University of Rio de Janeiro (UFRJ), attributes what happened in Manaus to doses of medication administered in an inappropriate way. “I want to believe that it was due to misinformation or an accident, not something on purpose to burn the hydroxychloroquine once and for all. This has to be investigated. In his opinion, the deaths that occurred in Manaus were the result of exaggerated, toxic doses, which caused greater lethality among the patients.

Migowski affirms that he believes in the effectiveness of the use of some medications, but within the genuine concept of immediate or early treatment. The doctor gives the example of Nitazoxanide, also known as Annita. According to him, the mechanisms of action of this drug indicate clinical and scientific evidence of its effectiveness in the immediate treatment of Covid-19.

Aggravation

The infectious disease doctor Eliana Bicudo, master and doctor in Tropical Medicine from the University of Brasilia (UnB) evaluates that encouraging the use of the “Covid Kit” in Brazil ended up worsening the pandemic in the country. “I have cases of patients who died because they were at home delaying the proper procedure, the use of oxygen, of corticoids in adequate doses, because the ‘Dr.’ insisted, and so did the patient, on staying on hydroxychloroquine, ivermectin, zinc, vitamin D, and others. The “Covid Kit” in patients who insisted on keeping using this scheme, delayed the search in hospitals for the proper treatment”, explained the doctor.

To Eliana, there was also in Manaus the convergence of many factors that ended up allowing, including, the mutation of the virus to the P1 variant that dominated Brazil.

“It doesn’t save lives”

The infectologist Julival Ribeiro, PhD in Tropical Medicine from the University of Brasilia and member of the Brazilian Society of Infectology, says that the “Covid Kit” does not save lives. He points out that drugs such as chloroquine or ivermectin, which are used in the treatment of certain diseases, have not had their efficacy proven in studies done by the scientific community. “We are in the 21st century and medicine has to be based on scientific evidence. You have to do all the clinical trials, tests, and experiments. Unfortunately, since the beginning of the pandemic, we see that there is a lot of negativity in relation to what it represents, more than 500 thousand deaths, thousands of cases that affected the Brazilian population”, he emphasizes.

The specialist sees with concern the influence of the country’s authorities over non-expert people, in a totally unscientific recommendation of the use of the “Covid Kit”. He tells that he always answers a question: “Why didn’t the United States, India, United Kingdom, Germany, France, go after this fallacy saying that the “Covid Kit” prevented and saved these people?” Ribeiro says that these countries were careful to observe patients, conduct studies, and only recommend procedures and medications that showed scientific evidence of offering real improvements to patients. An example was the research that indicated the use of oxygen masks, the intubation procedure, the proof of the benefit of administering corticoids in some patients, measures based on scientific evidence.

Julival Ribeiro commented on the drama experienced in Manaus with the shortage of oxygen in hospitals. “They would have to do tests, have beds for people, provide oxygen”. The infectologist laments last year’s denialism and the consequences of it: “While they were offering the “Covid kit”, we didn’t have enough tests and, especially, what delayed too much to treat Covid-19, which was the vaccine. It was supposed to start at the end of 2020. The federal government lacked very broad articulation with all the states and cities.”

"I have cases of patients who died because they were at home delaying the proper procedure, because the 'Dr.' insisted, and so did the patient, on staying on hydroxychloroquine, ivermectin, and others", Eliana Bicudo, medical infectologist.