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Editor's Note

EDITOR'S NOTE

Dear reader,

I write this letter not really knowing how it will find you. For a while now, we've been living with the expectation - better, with the certainty - that we will be hit by what was first called the swine flu (before they decided to leave the animals out of it, apparently to appease hog breeders). Press reports have been alarming, with constant references to the Spanish flu. The public health authorities have been polishing their declarations, which are oh so slowly drowning out a cacophony of outlandish suppositions and conflicting recommendations. The newspaper that finds its way to my door every morning has just published the verbal tantrum of an infectologist displeased with the Brazilian government's decision to take off the pharmacy shelves the only medicine thought to have any efficacy against the flu (at least until the much-awaited vaccine arrives). As a professional, I understand and, as a citizen, I respect my government's decision, taken to protect the common good. In a country where self-medication is the rule, the idea behind this move is to prevent indiscriminate use of the drug from triggering mutations in the virus, though the latter are inevitable given the nature of these beings that virtually straddle the threshold of life and are so adept at changing to adapt to new hosts. But when push comes to shove, I am (also) governed by another logic as legitimate as the first: the survival of my loved ones. I get up from my desk at a public institution that is directly engaged in the endeavor to prepare for the approaching 'war', an institution that I admire from the bottom of my heart...I get up from the desk where I have, with the greatest objectivity possible, been busy reading historical analyses of that other event, whose recurrence the experts have long foretold, and I pick up the phone and dial my daughter's doctor. "Doctor, what should I do to be prepared? What do I need to have at home?" And the good doctor, who works at a public hospital, tells me, "I don't know. We don't know yet. There's going to be this meeting, and that meeting, and then another meeting, and as soon as I learn anything, I'll let you know."

After seeing all those images of people wearing masks in countries where the flu is already a reality, where schools and movie theaters have closed their doors, I stop off at a medical supply store on my way home, only to discover they've sold out. While no one was paying attention, a host of distraught citizens wiped out their entire stock.

The ground beneath my 'normalcy' trembles and, in a city where hospital care is already chaotic, its structure famously broken, I wonder what I will have to do when the crisis turns us all into a swarm of desperate particles, with every man, woman, and child for themselves. When the Mexican president urged people to stay in their homes during a religious holiday in April, it reminded me of the story I heard from the granddaughter of a survivor of the 1918 flu: he saved his family by forcing them into complete isolation, while the dancer sowed death throughout our city. Will I have to do the same?

This panic of mine over the announced 'global pandemic' began waning as I realized the initial ado had been exaggerated. But I wanted to talk to you about these impressions anyway, because we live in a time when we are forced to shift from our role as spectators to that of actors. In past times of crises, collective and individual action acquired meaning within frameworks deciphered by historians in hindsight. Now, on the verge of seeing ourselves inside the frame again, swept up by events over which we have little control -and I include you, reader, as much an atom as I - it is vital that we know the experiences of those who came before us, so we may take our actions grounded in sound reason and insight.

To the collective to which I belong, to the historians who have the habit of reading these pages, I would like to point out how little we have done to help orchestrate social actors to prepare for this crisis, despite omnipresent references to the crisis of 1918.

I think it's an excellent time to (re-)read what História, Ciências, Saúde - Manguinhos has already published on the topic, such as the dossier included in volume 12, number 1, January-April 2005.

In its pages, Christiane Maria Cruz de Souza wrote about the impact of the Spanish flu in Salvador and other areas of Bahia, revealing the frailty of public health and assistance policies in a society whose inequalities were laid barer by the epidemic. In the article "Revisiting the Spanish flu: the 1918 influenza pandemic in Rio de Janeiro," Adriana da Costa Goulart analyzed how the epidemic served the purpose of political engineering and also examined its impact on the representation of certain political and social actors, who saw themselves as the privileged protagonists of the modernization of Brazilian society. In "Among doctors and for the lay: fragments of the medical discourse during the 1918 flu epidemic," Liane Maria Bertucci-Martins explored discussions on the nature of the illness and the treatment options put forward in the context of the crisis. A most timely interview in the same issue featured Marilda Mendonça Siqueira, researcher at the Oswaldo Cruz Foundation's Respiratory Viruses and Measles Laboratory. Here you will find out just how long preparations have been underway so that measures will be in place when all hell breaks loose.

Christiane Maria Cruz de Souza also wrote "A epidemia de gripe espanhola: um desafio à medicina baiana," in volume 15, number 4, October-December 2008, as well as a review of the book A gripe espanhola em São Paulo, 1918: epidemia e sociedade (Paz e Terra, 2003), by Cláudio Bertolli Filho, one of the first Brazilian scholars to focus on the history of this public health issue. In our May-August 2003 issue (v. 10, no. 2), Luiz Antonio Teixeira commented on another must-read: Gina Kolata's Flu, the story of the great influenza pandemic of 1918 and the search for the virus that caused it (Simon & Schuster, 2001).

As the ancients used to say, no evil lasts forever, nor indeed for long.

Jaime Benchimol

Editor

Publication Dates

  • Publication in this collection
    21 July 2009
  • Date of issue
    June 2009
Casa de Oswaldo Cruz, Fundação Oswaldo Cruz Av. Brasil, 4365, 21040-900 , Tel: +55 (21) 3865-2208/2195/2196 - Rio de Janeiro - RJ - Brazil
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