Pulmonologist Ubiratan de Paula contracted covid-19 in May last year and needed to be intubated for six days. In all, he was hospitalized for 24 days – 16 in an Intensive Care Unit (ICU).
“I stayed away for two months after I was discharged. I didn’t have the muscle strength to work, and my lung function only normalized after nine months”, says the doctor at the Instituto do Coração (InCor) of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (USP).
Ubiratan is 69 years old and it took him three months to recover his taste and smell. To date, tests on a bicycle and treadmill show reduced exercise capacity.
The doctor’s account is just one example of the so-called “long covid”, in which the coronavirus causes more lasting damage. The most common are weakness, shortness of breath, headache, inattention, memory loss, which lead to more or less severe reflexes in work activities.
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The debate over the long-term effects of the new coronavirus resurfaced this week after the Jair Bolsonaro (non-party) government sued the Supreme Court (STF) to try to bar compensation to health professionals who were unable to work by covid.
This is not the case with Ubiratan, but with some of his patients.
“There is one who came to InCor to consult with me before the covid. Nowadays, he needs to come with a companion because he can no longer remember the route”, exemplifies Ubiratan de Paula.
“Others were left with reduced lung function or are no longer able to perform their work. These symptoms can persist for more than a year. Some people had serious events, such as a myocardial infarction or stroke with severe sequelae, or a fibrosis that was left in the lung.”
According to the pulmonologist’s report, it is not uncommon for these problems to lead to the removal of health professionals.
“Sometimes we have up to four on leave at the same time, for 15 days or more, and it’s difficult to replace it with experienced professionals. This overloads the team a lot, with people working in more places, with longer working hours, increasing exposure to covid”, he says.
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Studies show that the “long covid” affects about 10% of patients. The severity of sequelae varies and, especially when there is comorbidity, they can last a lifetime.
what does the legislation say
Law 14,128, of March 2021, determines that the Union guarantee financial compensation of BRL 50,000, in a single installment, to health professionals and workers who cared for covid patients and became “permanently incapable of work.” The same indemnity applies “or to your spouse or partner, your dependents and your necessary heirs, in the event of death.”
Bolsonaro excluded that piece of law earlier this year, but the veto was overturned by Congress.
Last Wednesday (25), the government made a new attempt to stop this indemnity. The lawsuit sent to the STF was signed by the Union’s attorney general, Bruno Bianco.
The government’s argument is that the approval of the text violated constitutional principles, since the issue would be the responsibility of the Executive. Another problem pointed out in the action is that the funding source is not foreseen.
“The text of the referred diploma was extremely imprecise in establishing the beneficiaries of the financial compensation and the hypotheses that would entail the right to this indemnity”, the text adds.
Law 14,128 includes professionals from security, cleaning, administrative sectors, community agents and everyone who has been exposed to covid as a result of their work in Health. According to the Bolsonaro government, this scope brings legal uncertainty to the Union.
Célia Medina, supervisor of the Mais Médicos program in São Paulo, closely monitors the reality of health workers and defends the payment of compensation.
“We have people who, even after the acute phase of the disease, continue for a long time to feel weakness, chest pain, mental problems, difficulty in elaborating their thoughts, and also emotional problems. Depression after covid, for example, is very frequent”, he says.
“And many of them, due to these sequels, end up not having the necessary income for their survival.”
Securing financial compensation, according to Medina, would help reduce the damage to labor legislation caused by the current government.
“There are a significant number of people who lose their jobs and, precisely due to the loss of labor rights in this government, they are left to their own devices. It is very important that the STF does not accept the president’s veto”, he says.
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The definition of “disabled for work” is subject to expert analysis, and pulmonologist Ubiratan de Paula draws attention to the need to improve assessment processes.
“It is essential that there is an adequacy of Social Security on the recognition of long covid, since often the symptoms are subjective, and not for that reason are less serious”, he warns.
“Problems such as the difficulty in remembering the path to the hospital, as I mentioned, require specific tests, and Social Security needs to be willing to make this adjustment”, concludes the InCor physician.
Bolsonaro’s action is under analysis by minister Carmen Lúcia. Last Thursday (26), she asked the federal government for more information to make its decision on the veto. The expectation is that there will be a definition of the case this week.
Edition: Rodrigo Durão Coelho