Increase in dengue and covid cases worries – 02/16/2024 – Sou Ciência

We are experiencing a busy start to the year. One of the elements of greatest concern and which has major consequences is climate change. Intense rains, great extremes in temperatures, destruction of the environment – accompanied by destruction of infrastructure, lack of care for the most vulnerable population and many tragedies. These are no longer floods or floods: they are real rivers that form in just a matter of minutes.

In addition to the loss of lives and living and working conditions, we see the effects on human and animal health. We are very far from the concept of One Health, in which health must be seen in a broader way, with harmony between animal health and the environment so that, in fact, there can be human health. Climate authorities (or not), politicians, entities and even scientists should already be more aware that climate change alters and unbalances the health triad and, therefore, brings new or revamped diseases. In scientific jargon, emerging and re-emerging.

We have covid-19 (no, it hasn’t gone away) and we have dengue, currently together and accompanied by high temperatures and almost irreversible socio-environmental catastrophes. In some regions there is a simultaneous increase in the number of cases of both diseases, which further complicates care, especially in the public system. Although they have different cycles (that is, the virus and its transmission cycle are not the same in covid and dengue), both are the result of warming and heavy rains.

A new increase in the number of Covid cases, especially in these last epidemiological weeks, has been accompanied by a considerable number of deaths, still the most proportionally significant among severe respiratory diseases. Certainly, the official Covid-19 numbers are underestimated, as people stopped testing or carried out self-tests that ended without notification. Covid-19 cannot help but be a concern, especially with the new variants and low immunization with updated vaccines. Here we still have science denialist groups, who continue to work strongly against vaccines, spreading untruths about their effects and offering cures without scientific proof.

The resurgence of dengue (yes, we’ve had this before) with the abrupt number of cases brings new concerns and complexities. There was a strong acceleration in the number of cases, which went from 0.7% to 13% in nine weeks in terms of positivity in tests for the virus. This factor, combined with the unpreparedness of structures to handle so many simultaneous cases, led states to declare an emergency.

Unlike Covid-19, transmission of the dengue virus depends on the host mosquito, the Aedes aegypti, which can be strongly combated and can help prevent the proliferation of other viruses that cause diseases such as the Zika virus and the Chikungunya virus. This is because these viruses are part of the arbovirus family.

With regard to immunization, fortunately science has already guaranteed the existence of a vaccine investigated and approved by Anvisa. Soon we will also have a fully Brazilian vaccine, which has been developed for a long time and which we hope will soon be ready to be approved and mass produced. However, the limiting factor in relation to them is that, currently, there are not enough vaccines to meet global demand, which has limited the number of people who can now take it.

Therefore, the most important strategy now is to combat mosquitoes. There needs to be a major national effort, with states and municipalities, public health agents, as well as public and private institutions to expand information to the population in order to eliminate mosquito outbreaks – as we already know that 75% of transmissions occur through mosquito outbreaks that are inside homes. Working in schools, squares and public places is also important. The measures are simple: remove stagnant water; cover containers with water (such as water tanks); change the water in the containers that store it weekly (and which must always be covered) and do not allow trash to accumulate. Support is needed from all State structures, especially the neediest and most vulnerable population, in addition to support for health professionals and the SUS structure.

Certainly, the heavy rains and the inability to have a good basic infrastructure for the vast majority of the population contribute to the proliferation of the mosquito that transmits the dengue virus, the Aedes aegypti, which also needs to be remedied. We cannot forget the origin of all this, and we return to the beginning of our text: it is necessary to act structurally to reduce the effects of enormous climate changes – and it is clear that one of the most striking effects falls on human health, along with of the planet. Without acting on the causes, more epidemics will come, more suffering, more expenditure. Therefore, above all, it is necessary to act to reverse climate change itself, before we no longer have a solution.

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