Brazil becomes a global epicentre for COVID-19, as political turmoil hampers medical response

Brazil becomes a global epicentre for COVID-19, as political turmoil hampers medical response

With cases rising rapidly, a military general with no medical experience leading the Ministry of Health, and a president admitting there’s no proof his preferred treatment will work, Brazil has become one of the countries hardest hit by the coronavirus. 

As health systems, from Sao Paulo to the Amazon, strain under the growing number of cases, policy experts say there’s little hope that the country can change course when the president is one of their biggest obstacles.

“It’s unbelievable what’s happening in Brazil. When the biggest science denier in the country is the president himself, what can we scientists do?” said Natalia Pasternak, a microbiologist and researcher at the Institute of Biomedical Sciences at the University of Sao Paulo.

Brazilian President Jair Bolsonaro has been among the world leaders most dismissive of the coronavirus, initially downplaying it as a “little flu,” then later responding “so what” when asked about the country’s rising death toll.

His own Ministry of Health had opposed him, promoting physical distancing and quarantines, but Bolsonaro fired popular Health Minister Luiz Henrique Mandetta in April, and then forced his replacement Nelson Teich to resign last week. Both were trained doctors. 

“I don’t see any hope in the short term,” Pasternak said. “I think the numbers are going to keep piling up and a lot of people are going to die until we solve the political situation.”

‘A grave situation’

The World Health Organization (WHO) now considers South America the new epicentre of the pandemic, in large part because this week Brazil overtook the United Kingdom for third place in the overall number of COVID-19 cases. 

Brazil has more than 310,000 cases and more than 20,000 deaths, according to statistics kept by Johns Hopkins University. The country’s Ministry of Health believes the numbers are likely higher because of a lack of effective testing.

WATCH | Bolsonaro minimizes COVID-19 surge in Brazil, promotes hydroxychloroquine:

The number of coronavirus cases is surging in Brazil, but President Jair Bolsonaro continues to minimize the situation. Bolsonaro is also advocating the use of hydroxychloroquine, an unproven treatment also promoted by U.S. President Donald Trump. 2:01

“Are people dying? Yes they are, and I regret that. But many more are going to die if the economy continues to be destroyed because of these (lockdowns),” Bolsonaro said earlier this month.

On Thursday, Brazil reported more than 18,500 infections, while also suffering a record 1,188 daily coronavirus deaths, eclipsing its previous high set earlier in the week. 

“It’s a very grave situation,” said Humberto Costa, a Brazilian senator and former health minister under former president Luiz Inácio Lula da Silva. 

In Sao Paulo, the country’s largest city, fresh graves continue to be dug up in the sprawling Formosa cemetery. Health officials say they’re losing the battle against the virus and the system will be overrun. City and state officials moved holidays up from June and July to this weekend to create an extended break to encourage physical distancing.

In Manaus, the largest city in the Amazon rainforest, the mayor is warning that Indigenous tribes will be decimated by the coronavirus. Amazonas state, where Manaus is located, is one of the hardest hit regions of the country.

“I fear genocide and I want to denounce this thing to the whole world. We have here a government that does not care about the lives of the Indians,” Manaus Mayor Arthur Virgilio Neto said. 

‘Politicizing the Problem’

While other countries have waited for some signs of the virus slowing down before reopening the economy, Bolsonaro has continually pushed for Brazilians to get back to work, putting him at odds with state governors and mayors trying to curb the spread through lockdowns and quarantines.

“He denies the severity of the disease and he only makes political calculations about what’s best for him,” Costa said.

Observers say Bolsonaro is thinking first about re-election in two years, promoting an economic agenda that resonates with the country’s poorest, who can’t afford to isolate themselves at home.

A health-care worker is seen at a field hospital set up to treat patients suffering from the coronavirus in Guarulhos, Sao Paulo state, Brazil, on May 12. (Amanda Perobelli/Reuters)

“He’s following his instinct that the economy needs to reopen and the country cannot face an economic crisis so deep,” said Marcio Coimbra, a political strategist in the capital, Brasilia.

“The middle class and upper class are against the president,” Coimbra said. “But on the other side, the poor people who need to work, they are there supporting the president.”

Costa said Bolsonaro’s actions now are laying the groundwork for what will happen in a few months’ time if the country’s economy continues to suffer because of lockdowns meant to stop the spread of COVID-19.

Bolsonaro “will say, ‘I told you that the virus was a little problem, the governors and mayors made the wrong measures,'” Costa said. 

‘Problems at the Health Ministry’

Some of Bolsonaro’s highest profile clashes have been with his own Ministry of Health. In April, he fired Health Minister Luis Henrique Mandetta who had gained in popularity with his daily technical briefings.

His replacement, Nelson Teich, resigned last week, after refusing to promote Bolsonaro’s desire for wider use of the anti-malaria drug hydroxychloroquine as a treatment for COVID-19. Interim Health Minister Eduardo Pazuello immediately approved the plan, going against the recommendations of WHO experts in Brazil.

WATCH | Brazil’s worsening COVID-19 crisis:

Brazil’s worsening COVID-19 crisis SUMMARY: Brazil’s already weak health-care system and an incoherent response from its political leaders to the COVID-19 pandemic have made it much more difficult for the country’s hospitals to deal with the growing number of cases, says Oliver Stuenkel, a professor and author from the Getulio Vargas Foundation in  Sao Paulo. 6:42

 “We are at war: Worse than being defeated is the shame of not having fought,” Bolsonaro wrote in a post on his official Facebook page in response to his critics. 

Pazuello is a military general known as a logistics expert, with no health background. Costa said Pazuello is staffing the ministry with people with military experience, rather than health expertise, which will further hamper the country’s efforts to fight the virus.

“They are politicizing the problem, it’s not a question of science, it’s not a question of medicine, it’s just a question of politics,” Costa said.

Like his ally U.S. President Donald Trump, Bolsonaro has pushed hydroxychloroquine as a solution to the pandemic, despite admitting that there’s no proof it works.

Health policy expert Miguel Lago said Bolsonaro’s support for the drug is more about politics than medicine. 

“Bolsonaro is a very smart politician and he’s trying to understand what can fit a narrative where he appears to be a great leader,” said Lago, executive director of the Institute for Health Policy Studies, a non-profit group based in Rio de Janeiro. 

Hope in local governments

Lago said the only hope for Brazil’s efforts lies in state governors and local politicians ignoring directives from the president. States have enforced their own measures in defiance of Bolsonaro’s views, including mandatory masks in public and limits on traffic in major cities 

“After two months, we shouldn’t be expecting anything good from the federal government in the sense we should only rely on our local governments.” 

A Kambeba Indigenous woman sits as she waits to be tested for the coronavirus on the banks of the Negro river at the village Tres Unidos, Amazon state, Brazil on May 21. (Bruno Kelly/Reuters)

Impeachment has been discussed in Brazil. The speaker of the lower house, Rodrigo Maia, has more than 30 requests to remove Bolsonaro, but hasn’t acted on them.

The president has maintained control of a fractured Congress, by striking a deal with a centrist group of parties that represent about 40 per cent of votes. 

“If he keeps delivering power for votes in Congress, he’ll be able to stay in power until the end of his term,” Coimbra said.

‘No light at the end of the tunnel’

Costa said the peak of COVID-19 cases could come sometime in the middle of June; some projections show Brazil could end up with more than 100,000 dead and more than a million people infected.

According to statistics from the Brazlian tech company Inloco, just over 42 per cent of Brazilians are practising physical distancing, down from a high of around 62 per cent around the end of March.

WATCH | Bolsonaro minimizes COVID-19 surge in Brazil, promotes hydroxychloroquine:

More than 16,000 people have died due to COVID-19 in Brazil. 0:46

Pasternak said the president’s example, holding rallies, shaking hands and hugging supporters, sends the wrong message to Brazilians who look to him for leadership. She worries about the direction the country is headed.

“I don’t see any light at the end of the tunnel right now.”

Published at Sat, 23 May 2020 08:00:00 +0000