segunda-feira, março 16, 2020

O dilema no combate ao Covid-19


Morrer da doença, ou da cura?


Este parece ser o dilema colocado aos estrategos da guerra contra o Covid-19...

Quando Graça Freitas repetiu o que alguém lhe disse sobre o milhão de infectados em Portugal, não estava longe das previsões mais respeitáveis. Na realidade, estima-se que entre 20 a 60% da população será atingida pelo vírus. Pode sê-lo em seis meses, num ano, em ano e meio, ou em dois, mas dificilmente escaparemos à proliferação do Covid-19 e dos seus mutantes. A gestão do tempo é o pomo da discussão teórica e táctica que envolve o combate à pandemia. O ponto de vista inglês diverge, como sabemos, da visão chinesa, que o resto da Europa tende agora a aceitar. Novos surtos apareceram, entretanto, em fevereiro, na China, embora tenham sido ocultados da opinião pública. Acabaremos por ouvir falar deles em breve...

A população precisa de ganhar progressivamente imunidade ao Covid-19 e seus mutantes, única forma de este se tornar relativamente inócuo para a saúde humana. Falta, porém, saber se é possível. As vacinas são uma forma de ganhar esta imunidade, ainda que temporária, mas para a maior parte dos vírus que nos causam problemas, não há vacina, apenas graus diferenciados de imunidade. Ou seja, haverá vacinas contra o Covid-19, mas ninguém sabe ainda se resultarão. Por outro lado (outro pomo de discórdia silenciosa), a contenção é necessária, mas não pode ser exagerada, em primeiro lugar, porque não derrota por si só o vírus, apenas atrasa a sua disseminação e penetração nos corpos humanos, e em segundo lugar, porque se exagerarmos a extensão e duração das quarentenas poderemos estar a matar a economia, e esta morte arrastará muitas mais mortes que o próprio Covid-19!

Eis, em suma, o problema equacionado num post de 11/3 de Gail Tverberg, e que vale a pena ler na íntegra:

An economy is in many ways like a human being or other animal. Its operation cannot be stopped for a month or more, without bringing the economy to an end.  
... 
I sometimes write about the economy being a self-organizing networked system that is powered by energy. In physics terms, the name for such a system is a dissipative structure. Human beings are dissipative structures, as are hurricanes and stars, such as the sun. 
Human beings cannot stop eating and breathing for a month. They cannot have sleep apnea for an hour at a time, and function afterward. 
Economies cannot stop functioning for a month and afterward resume operations at their previous level. Too many people will have lost their jobs; too many businesses will have failed in the meantime. If the closures continue for two or three months, the problem becomes very serious. We are probably kidding ourselves if we think that China can come back to the same level that it was at before the new coronavirus hit. 
In a way, keeping an economy operating is as important as preventing deaths from COVID-19. Without food, water and wage-producing jobs (which allow people to buy necessary goods and services), the deaths from the loss of the economy would be far greater than the direct deaths from the coronavirus.
...
China’s shutdown in response to COVID-19 doesn’t seem to make much rational sense. 
It is hard to understand exactly how much China has shut down, but the shutdown has gone on for about six weeks. At this point, it is not clear that China can ever come back to the level it was at previously. Clearly, the combination of wage loss for individuals and profit loss for companies is very high. The long shutdown is likely to lead to widespread debt defaults. With less wages, there is likely to be less demand for goods such as cars and cell phones during 2020. 
China was having difficulty before the new coronavirus was discovered to be a problem. Its energy production has slowed greatly, starting about 2012-2013, making it necessary for China to start shifting from a goods-producing nation to a country that is more of a services-producer (Figure 1).

Figure 1. China energy production by fuel, based on 2019 BP Statistical Review of World Energy data. “Other Ren” stands for “Renewables other than hydroelectric.” This category includes wind, solar, and other miscellaneous types, such as sawdust burned for electricity.

...
We also need to be looking for new approaches for fighting COVID-19. One approach that is not being used significantly to date is trying to strengthen people’s own immune systems. Such an approach might help people’s own immune system to fight off the disease, thereby lowering death rates. Nutrition experts recommend supplementing diets with Vitamins A, C, E, antioxidants and selenium. Other experts say zinc, Vitamin D and elderberry may be helpful. Staying away from cold temperatures also seems to be important. Drinking plenty of water after coming down with the disease may be beneficial as well. If we can help people’s own bodies fight the disease, the burden on the medical system will be lower.


—in “It is easy to overdo COVID-19 quarantines”

Posted on March 11, 2020, by Gail Tverberg 

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