26. WITHOUT VACCINE: Garrincha the bird

A vaccine is a hoax. It presents the body with something that resembles a virus —a deactivated version, or a component of a virus— so that our immune system learns to defend itself against the real virus and to remember how to do it so that we are protected for a long period of time. It’s a cunning plan to protect us from disease, but it is not an easy task. You don’t always get the vaccine.

To date (05-20-2020), COVID-19 has killed some 350,000 people. This figure represents only half of the deaths caused annually by another pandemic, that of AIDS. If SARS-CoV-2 came to us from the “bat league,” the HIV/AIDS virus arrived via the “chimpanzee league.” Currently, there are about 38 million people with AIDS on the planet. Every year about two million people become infected with HIV, so it would be wise to have a vaccine. However, since HIV was discovered in 1984, an AIDS vaccine has not been made available. Why?

AIDS is an especially complicated virus to be controlled with a vaccine. On the one hand, it experiences mutations very frequently, causing changes in its genetic material that produce variants of the virus, especially by changing the glycoproteins in its envelope, which makes it difficult to be detected by antibodies 31. It is as if they show you a photo of Messi or Pogba, they tell you that you have to mark them, but on matchday they go out onto the field with different skin colour or hairstyle, and you find it difficult to locate them. The same thing can happen to antibodies. They are lost if the virus they have to counteract changes (mutates).

Now imagine that you go out into the field and that Messi and Pogba, in addition to changing their skin colour, become invisible because they sneakily apply a blindfold to your eyes. You sense that the ball and the game move from one side to the other, but you don’t see the opposing players. Something like this causes HIV, it “hides” from the immune system, because it attacks it directly and blinds it. Just as the ACE2 protein is the receptor for SARS-CoV-2 in human cells, the CD4 protein is the anchor point of HIV to some cells of our immune system, which are damaged in the presence of the virus. Remember that HIV produces an immunodeficiency.

And breathe. SARS-CoV-2 neither mutates as fast nor hides from the immune system like HIV. I tell you this to show that the path to a vaccine can have its complications. In nearly 40 years of research, the development of more than 100 AIDS vaccines has begun, but so far none have been approved for general use. Despite this, more than half of those infected with AIDS have access to antiretroviral drug therapies that allow them to live with the disease chronically. Millions of people benefit from these drugs, including Eduardo Esidio, a Brazilian who played on the left-wing and who was diagnosed with AIDS in 1998, at the age of 27.

When Eduardo Esidio became infected with HIV, he was playing for Club Universitario de Deportes, Peru’s most successful club side. After the diagnosis, it was pointed out by many, and even the Peru coach, Juan Carlos Oblitas, that no-one would challenge Esidio for a header, knowing that he had AIDS.

Magic Johnson was diagnosed with AIDS in 1991, and in 1992 he played in the Barcelona Olympics with the best Dream Team that has ever existed in any sport. The United States appeared at the Badalona Olympic Palace with this starting team: Magic Johnson, Michael Jordan, Larry Bird, Pat Ewing and Charles Barkley. Despite the example of Magic Johnson, Eduardo Esidio was dropped and fell into a deep depression. Esidio returned to play, and in his first season as a carrier of HIV, he scored 37 goals and became the league champion. Esidio was the man charged with taking the decisive penalty which would secure the title for Universitario. When Esidio scored that penalty, half of Lima fell on top of him to hug him. At that time, they couldn’t care less if Esidio had AIDS or leprosy.

An AIDS vaccine hasn’t at yet been developed, but very efficient vaccines against other diseases have been produced. Polio (polio) vaccine is an example. In 1988, with 350,000 registered polio cases, the WHO launched a vaccination campaign that has managed to practically eradicate it (only 37 cases worldwide in 2016). Polio, like COVID-19, is caused by an RNA virus. In the case of polio, those affected are children, usually under the age of five. The polio virus infects the intestine, but the cells most sensitive to its attack are the neuromotor neurons —neurons that connect our nervous system with the muscles— mainly those of the legs. In the most severe cases, polio can cause death by affecting muscles that control lung breathing, but the most common sequelae remain in the legs, often only in one leg, where the muscles are stunted during the growth of children, causing deformations. Polio wreaked havoc in Spain in the post-war period, and as a consequence the country has some 300,000 people with sequelae of polio, my dear father among them.

The Brazilian Garrincha, for many the best dribbler in history, also suffered from polio. Formally, Garrincha was Manuel Francisco dos Santos. Like most popular nicknames, Garrincha was derogatory and tested the individual’s resilience. Garrincha is a plump, small bird of the jungle that has the distinctive characteristic of eating cockroaches. In fact, it is also known as a common roach. I have read that Garrincha was meant as a tribute to Manuel’s pace as it’s a fast bird. However, I’m pretty sure that the people of the city of Magé in the state of Rio de Janeiro, where Garrincha grew up, were not flattering Manuel with their choice of nickname.

As a consequence of polio, Garrincha’s right leg was six centimetres shorter than his left and both feet turned inward. With those physical handicaps, no one could have predicted Manuel to make it as a professional footballer. To compound matters, Manuel became addicted to tobacco at 10 and later developed an insatiable thirst for alcohol. To top it all off, a psychologist for the Brazilian national team labelled him as “mentally weak” in a report. However, the resilient Garrincha took advantage of his club feet to mesmerize the opposition with his dribble, and his mental weakness made him unaware he was taking risks on the field; to the delight of his adoring public. He played in the World Cup tournaments in both 1958 and 1962, in Sweden and Chile,  alongside Pelé, and guided Brazil to glory on both occasions. Garrrincha died an alcoholic at the age of 49. So many fans wanted to say their farewells, so his wake was held at the Marcanã stadium.

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