Sindemia, infodemia, pandemia de COVID-19: Hacia una pandemiología de enfermedades emergentes

https://doi.org/10.18294/sc.2021.3748

Publicado 4 noviembre 2021 Open Access


Naomar Almeida-Filho PhD en Epidemiología. Investigador I-A, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Profesor Titular jubilado, Instituto de Saúde Coletiva, Universidade Federal da Bahia. Profesor Visitante, Instituto de Estudos Avançados, Universidade de São Paulo, Brasil. image/svg+xml




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Palabras clave:

Sindemia, Pandemias, COVID-19, Enfermedades Emergentes, Brasil


Resumen


Como base para una teoría de la coocurrencia de procesos epidémicos y pandémicos, en primer lugar, se introduce el concepto de sindemia, creado en la epidemia de VIH/sida para comprender componentes sociales, conductuales y culturales de enfermedades emergentes, tal como la actual pandemia de COVID-19. En segundo lugar, se destaca la noción de infodemia, que tiene gran potencial para comprender los impactos de la pandemia desde planos que generalmente se descuidan en los enfoques epidemiológicos convencionales. En tercer lugar, como complemento e ilustración, se presenta un estudio de caso “microarqueológico” de la infodemia resultante de la pandemia de COVID-19, centrado en la situación concreta de Brasil. Luego, se analizan las correlaciones entre la evidencia científica, los modelos de intervención y las medidas para controlar la pandemia en varios países y su adopción o rechazo en la realidad brasileña, estructurada sobre profundas desigualdades económicas, inequidades sociales e inequidades en salud.


Referencias bibliográficas


1. Agamben G, ŽiŽek Z, Nancy JL, Berardi F, López Petit S, Butler J, Badiou A, Harvey D, Han PC, Zibechi R, Galindo M, Gabriel M, Yañez González G, Manrique P, Preciado P. Sopa de Wuhan: Pensamiento contemporáneo en tiempos de pandemias. Buenos Aires: ASPO (Aislamiento Social Preventivo y Obligatorio), 2020.

2. Mignolo W. Epistemic disobedience and the decolonial option: A manifesto. Transmodernity. 2011;1(2):44-66.

3. Sousa Santos B. Introducción a las epistemologías del sur. En: Meneses MP, Bidaseca K, coords. Epistemologías del Sur. Buenos Aires: CLACSO, Coimbra; 2018. p. 25-64.

4. Arreaza ALV. Epidemiologia crítica: por uma práxis teórica do saber agir. Ciência & Saúde Coletiva. 2012;17(4):1001-1013.

5. Breilh J. Epidemiología crítica: ciencia emancipadora e interculturalidad. Buenos Aires: Lugar Editorial; 2003.

6. Das V. Critical events: An anthropological perspective on contemporary India. New Delhi: Oxford University Press; 1996.

7. Fecher B. Embracing complexity: Covid-19 is a case for academic collaboration and co-creation. Elephant in the Lab [Internet] 2020 [citado 10 mar 2021]. Disponible en: https://tinyurl.com/2xwr5me3.

8. Elliot N. Mediating nature. London: Routledge; 2006.

9. Samaja J. Epistemología de la Salud. Buenos Aires: Lugar Editorial; 2004.

10. Almeida-Filho N. Modelagem da pandemia Covid-19 como objeto complexo (notas samajianas). Estudos Avançados. 2020;34(99):97-117.

11. Horton R. Offline: COVID-19 is not a pandemic. The Lancet. 2020;396:874.

12. Singer M. A dose of drugs, a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic. Free Inquiry in Creative Sociology. 1996;24(2):99-110.

13. Mendenhall E. Beyond comorbidity: a critical perspective of syndemic depression and diabetes in cross-cultural contexts. Medical Anthropology Quarterly. 2015;30(4):462-478.

14. Kohrt BA, Carruth L. Syndemic effects in complex humanitarian emergencies: A framework for understanding political violence and improving multi-morbidity health outcomes. Social Science & Medicine. 2020. doi: 10.1016/j.socscimed.2020.113378.

15. Singer M. Introduction to syndemics: A critical systems approach to public and community health. New York: Jossey-Bass; 2009.

16. Tsai AC, Venkataramani AS. Syndemics and health disparities: a methodological note. AIDS and Behavior. 2016;20(2):423-430.

17. Mendenhall E, Singer M. What constitutes a syndemic? Methods, contexts, and framing from 2019. Current Opinion in HIV and AIDS. 2020;15(4):213-217.

18. Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Annals of Family Medicine. 2009;7(4):357-363.

19. van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity. The European Journal of General Practice. 1996;2(2):65-70.

20. Tsai AC. Syndemics: a theory in search of data or data in search of a theory? Social Science & Medicine. 2018;206:117-122.

21. Tsai AC, Mendenhall E, Trostle JA, Kawachi I. Co-occurring epidemics, syndemics, and population health. The Lancet. 2017;389(10072):978-982.

22. Pranata R, Lim MA, Huang I, Raharjo SB, Lukito A. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. Journal of the Renin-Angiotensin-Aldosterone System. 2020;21(2):1470320320926899.

23. Rubino F, Amiel SA, Zimmet P, Alberti G, Bornstein S, Eckel RH, Renard E. (2020). New-onset diabetes in COVID-19. The New England Journal of Medicine. 2020;383:789-790.

24. Akoumianakis I, Filippatos T. The renin-angiotensin-aldosterone system as a link between obesity and coronavirus disease 2019 severity. Obesity Reviews. 2020;21(9):e13077.

25. Gravlee CC. Systemic racism, chronic health inequities, and COVID-19: A syndemic in the making? American Journal of Human Biology. 2020;32(5):e23482.

26. Khazanchi R, Beiter ER, Gondi S, Beckman AL, Bilinski A, Ganguli I. County-level association of social vulnerability with COVID-19 cases and deaths in the USA. Journal of General Internal Medicine. 2020;35(9):2784-2787.

27. Laster Pirtle WN. Racial capitalism: a fundamental cause of novel coronavirus (COVID-19) pandemic inequities in the United States. Health Education & Behavior. 2020;47(4):504-508.

28. Singer M, Stopka T, Cara S, Springer K, George B, Kaveh K, Gorry de Puga A, Heimer R. The social geography of AIDS and hepatitis risk: qualitative approaches for assessing local differences in sterile syringe access among injection drug users. American Journal of Public Health. 2000;90(7):1049-1056.

29. Singer M. Pathogen-pathogen interaction: A syndemic model of complex biosocial processes in disease. Virulence. 2010;1(1):10-18.

30. Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. The Lancet. 2017;389:941-950.

31. Almeida-Filho N. Towards a unified theory of health-disease: II. Holopathogenesis. Revista de Saúde Pública. 2014;48(2):192-205.

32. Shrestha S, Bauer CXC, Hendricks B, Stopka TJ. Spatial epidemiology: An empirical framework for syndemics research. Social Science & Medicine. 2020. doi: 10.1016/j.socscimed.2020.113352.

33. Fernández Iriarte M, Pompei J. No hay dos sin tres: Pandemia, infodemia y ahora también sindemia. Farmacia y Bioquímica en Foco [Internet]. 2021 [citado 13 ene 2021]. Disponible en: https://tinyurl.com/6zef2err.

34. Zarocostas J. How to fight an infodemic. The Lancet. 2020;395:676.

35. Patel MP, Kute VB, Agarwal SK, COVID-19 working group of Indian Society of Nephrology. “Infodemic” COVID 19: More pandemic than the Virus. Indian Journal of Nephrology. 2020;30(3):188-191.

36. Eysenbach G. Infodemiology: The epidemiology of (mis)information. American Journal of Medicine. 2002;113(9):763-765.

37. Eysenbach G. Infodemiology and infoveillance: framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet. Journal of Medical Internet Research. 2009;11(1):e11.

38. Porta M, ed. A Dictionary of Epidemiology. New York: Oxford University Press; 2014.

39. Rothkopf D. When the Buzz Bites Back. The Washington Post [Internet] 11 May 2003 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/ywfumxz6.

40. Eysenbach G. How to fight an Infodemic: The four pillars of infodemic management. Journal of Medical Internet Research. 2020;22(6):e21820.

41. World Health Organization. Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation [Internet]. 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/nsenunnr.

42. Organización Panamericana de la Salud, Revista Panamericana de Salud Pública. Número especial sobre infodemiología y manejo de la infodemia en la era de la interdependencia digital: convocatoria de artículos [Internet]. 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/u9bt4zes.

43. Omvärlden. “Vi står upp mot dem som försöker så splittring och förtvivlan” [Internet]. 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/d59rv8ck.

44. Garcia LP, Duarte E. Infodemia: excesso de quantidade em detrimento da qualidade das informações sobre a COVID-19. Epidemiologia e Serviços de Saúde. 2020;29(4):e2020186.

45. Darnton R. The true history of fake news. The New York Review [Internet]. 2017 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/6bdrv58d.

46. Yap A, Snyder LG, Drye S. The information war in the digital society: A conceptual framework for a comprehensive solution to fake news. Academy of Social Science Journal. 2018;3(7):1214-1221.

47. Levinson P. Fake news in real context. New York: Connected Editions; 2016.

48. Lasco G. Medical populism and the COVID-19 pandemic. Global Public Health. 2020;15(10);1417-1429.

49. Alcantara J, Ferreira R. A infodemia da “gripezinha”: uma análise sobre desinformação e coronavírus no Brasil. Chasqui: Revista Latinoamericana de Comunicación. 2020;(145):137-162.

50. Rocha C. O isolamento vertical defendido por Bolsonaro sob análise. Nexo [Internet]. 25 mar 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/36yz9bcf.

51. Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nature Reviews Microbiology. 2021;19:141-154.

52. Friedman T. A plan to get America back to work. The New York Times [Internet]. 22 mar 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/kd4w6pn8.

53. Katz D. Is our fight against Coronavirus worse than the disease? The New York Times [Internet]. 20 mar 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/88y3wyah.

54. Gabbatt A. Did a New York Times article inspire Trump’s ‘back to work’ plan? The Guardian [Internet]. 27 mar 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/49eu9yra.

55. Jones D, Helmreich S. A history of herd immunity. The Lancet. 2020;396:810-811.

56. Gallotti R, Valle F, Castaldo N, Sacco P, Domenico M. Assessing the risks of “infodemics” in response to COVID-19 epidemics. Nature Human Behaviour. 2020;4:1285-1293.

57. Great Barrington Declaration. The Great Barrington Declaration [Internet]. 2020 [citado 10 ene 2021]. Disponible en: https://gbdeclaration.org.

58. Associação Brasileira de Saúde Coletiva. A farsa do manifesto Great Barrington [Internet]. 9 oct 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/yx4mpfa5.

59. Associação Brasileira de Saúde Coletiva. Plano Nacional de Enfrentamento da Pandemia de Covid-19 [Internet]. Rio de Janeiro: Abrasco; 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/9mcfm25f.

60. Pires LN. Carvalho L, Xavier LL. COVID-19 e desigualdade no Brasil. CEBES [Internet]. 6 abr 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/fmnd4s6s.

61. Almeida-Filho N. Desigualdades en salud: nuevas perspectivas teóricas. Salud Colectiva. 2020;16:e2751.

62. Falavigna M, Colpani V, Stein C, Azevedo L, Pontes C, Bagattini AM, Brito GV, et al. Diretrizes para o tratamento farmacológico da COVID-19: Consenso da Associação de Medicina Intensiva Brasileira, da Sociedade Brasileira de Infectologia e da Sociedade Brasileira de Pneumologia e Tisiologia. Revista Brasileira de Terapia Intensiva. 2020;32(2):166-196.

63. Agência Câmara de Notícias. Falta de remédios prejudica tratamento da Covid-19 nas UTIs, alertam médicos. Câmara dos Deputados [Internet]. 2020 [citado 10 ene 2021]. Disponible en: https://tinyurl.com/rb7n4k7u.

64. Shamasunder S, Holmes S, Goronga T, Carrasco H, Katz E, Frankfurter R, Keshavjee S. COVID-19 reveals weak health systems by design: Why we must re-make global health in this historic moment. Global Public Health. 2020;15(7):1083-1089.

65. Sousa Santos B. O futuro começa agora: da pandemia à utopia. São Paulo: Boitempo; 2021.

66. Samaja J. Desafios a la epidemiologia (pasos para una epidemiologia ‘miltoniana’). Revista Brasileira de Epidemiologia. 2003;6(2):105-120.