RIO DE JANEIRO (AP) – Brazil is currently responsible for a quarter of the daily COVID-19 deaths worldwide, far more than any other country, and health experts warn that the country is on the brink of even greater disasters.
The seven-day average of 2,400 deaths in the country will reach 3,000 in weeks, six experts told the Associated Press. That’s almost the worst level the US has seen, even though Brazil has two-thirds of its population. Peaks in the daily death toll could soon reach 4,000; Friday there were 3,650.
Having glimpsed the precipice, there is a growing recognition that shutdowns are no longer avoidable – not just among experts, but also among many mayors and governors. The restrictions on the activities they put in place last year were halfheartedly and consistently sabotaged by President Jair Bolsonaro, who sought to avoid economic downfall. He is still not convinced that action should be taken, leading local leaders to pursue a patchwork of measures to prevent the death toll from rising further.
It may be too late, with a more contagious variant sweeping through Brazil. For the first time on March 25, there were more than 100,000 cases per day, and many more. Miguel Nicolelis, a professor of neurobiology at Duke University who advised several Brazilian governors and mayors on fighting pandemics, expects the total death toll to reach 500,000 in July and exceed the US by the end of the year.
“We have exceeded levels we could never have imagined for a country with a public health system, a history of efficient immunization campaigns and health professionals unmatched in the world,” said Nicolelis. “The next stage is the collapse of the health system.”
The system is already buckling, with nearly all of the states’ intensive care units close by or at capacityDr. José Antônio Curiati, a supervisor at the Hospital das Clinicas in Sao Paulo, the largest hospital complex in Latin America, said the beds are full, but patients keep coming in. The city’s oxygen supply is not guaranteed and the supplies of sedatives needed for intubation in intensive care units will soon run out.
“Four thousand deaths a day seem to be just around the corner,” said Curiati.
On March 17, nurse Polyena Silveira in the northeastern state of Piaui was crying next to a COVID-19 patient who died on the ground for lack of beds in her public hospital. A photo capturing the moment went viral and served as a national wake-up call.
“After he was gone, I had two minutes to regret before moving on to the next patient,” Silveira, 33, told the AP. “In eight years as a nurse, I had never felt more pain than that night. I am almost my limit, physically and mentally. “
Fiocruz, Brazil’s state science and technology institute, called for a 14-day lockdown on Tuesday to cut transmission by 40%. Natalia Pasternak, a microbiologist who chairs the Question of Science Institute, pointed to a local example of success: The medium-sized city of Araraquara in Sao Paulo state implemented lockdown last month and the number of cases and deaths has declined.
Pasternak declined to estimate the looming daily death toll in Brazil, but said the trend is for continued growth if nothing is done.
“We need coordinated action, and it probably won’t happen because the federal government has no real interest in taking preventive action,” Pasternak said. “(Mayors and governors) try to take preventive measures, but separately and in their own way. This isn’t the best approach, but it’s better than nothing. “
Minas Gerais, Brazil’s second most populous state, has closed non-essential stores. The state of Espirito Santo will be closed on Sunday. Brazil’s two largest cities, Rio and Sao Paulo, have imposed extensive restrictions on non-essential activities. Their state authorities brought forward the holidays to create a 10-day rest period, which began on Friday.
However, restrictive measures are as strong as citizen compliance. And Bolsonaro continues to undermine their willingness by viewing even a partial shutdown as an assault on someone’s right to earn a fair daily wage. He has lashed out at local leaders, especially governors, who dare to defy him.
“We need to open our eyes and understand that this is not a joke,” Rio Mayor Eduardo Paes said in a recorded message on the eve of the 10-day shutdown, stressing that no mayor wants to cause unemployment. “People die and if everything goes on as it is, nothing will be done, only God knows what can happen. Nobody knows the limit of this disease. Nobody knows how many variants can arise. “
Hundreds of protesters marched along Copacabana Beach in Rio the next morning. Most wore green-and-yellow shirts typical of pro-Bolsonaro rallies, and many refused to wear masks. They chanted “We want to work!” and turned vitriol on Paes.
World Health Organization director Tedros Adhanom Ghebreyesus on Monday called on everyone in Brazil to respond seriously – “be it the government or the people.”
“It is a concerted effort of all actors that will really reverse this upward trend. It’s actually really fast and accelerates very, very quickly, ”he said. “We are particularly concerned about the (weekly) mortality rate, which doubled from 7,000 to 15,000 in just one month.”
The spread of the virus has been fueled by the more contagious P.1 variant, which has become a cause for concern beyond Brazil’s borders, not just in South America. It has already been identified in the US this week in New YorkDr. Anthony Fauci, America’s top infectious disease expert, said on Wednesday that his team will meet with Brazilian authorities and are “quite concerned” about the situation in Brazil.
The US has seen the death toll plummet amid a massive vaccine rollout since late January, and the seven-day average has fallen below 1,000. In contrast, the rollout of vaccines in Brazil is tense at best. The government put big bets on one vaccine supplier, AstraZeneca, while for months declining offers to purchase others. It was only after delivery delays by AstraZeneca jeopardized the rollout that the Brazilian Ministry of Health started buying – but too late for most deliveries to arrive in the first half of this year.
The country has fully vaccinated less than 2% of its citizens, which experts generally regard as an embarrassment to a country long considered a global model for vaccination programs.
More than 500 of the country’s most influential economists and executives wrote an open letter this week call for mass vaccination and condemn the situation. They said the controversy over the economic consequences of social distancing is a false dilemma and that all levels of government should be ready to put in place an emergency stop.
While Brazil’s economy didn’t contract as much as regional peers last year, the worsening health crisis is casting a shadow over 2021, said William Jackson, chief emerging markets economist at Capital Economics. GDP will not return to pre-crisis levels until the end of this year at the earliest, signifying a relatively weak recovery compared to other emerging markets.
Monica de Bolle, a Brazilian senior fellow at the Peterson Institute for International Economics in Washington, is more pessimistic and expects another recession in 2021. Exactly how bad things will get in the coming months will depend on whether the P.1 variant is already dominant, and has been proven to cause or be more serious re-infections.
Regardless, there is no more time to delay a decisive action, she said.
“All in all, it’s a huge disaster,” says de Bolle, who has done postgraduate studies in immunology and genetics. “Could have been avoided; was not. Now very difficult to solve. The only real solution is a very hard lockdown with the population really sticking to it, which might be a hard sell. “
Savarese reported from Sao Paulo. AP reporter Marcelo de Sousa and video journalist Mario Lobão contributed from Rio.