Brazil’s hospitals are collapsing as a highly contagious variant of the coronavirus spreads across the country, the president is pushing for unproven treatments, and the only attempt to make a national plan to contain COVID-19 has failed.
Over the past week, Brazilian governors have been trying to do something President Jair Bolsonaro stubbornly rejects: draft a proposal for states to help curb the deadliest outbreak of the virus to date in the country. The effort was expected to include a curfew, a ban on mass events, and restrictions on the hours that non-essential services can operate.
The final product, unveiled on Wednesday, was a one-page document with general support for the activity restriction, but without specific measures. Six governors, still afraid of confronting Bolsonaro, refused to sign him.
Piauí state Wellington Dias told The Associated Press that unless pressure on hospitals is eased, more and more patients will have to go through the disease without a hospital bed or the hope of hospital treatment.
“We have reached the limit throughout Brazil; The exceptions are rare, “said Dias, who heads the governors’ forum.” The possibility of dying unaided is real. “
Those deaths have already begun. In Brazil’s wealthiest region, Sao Paulo, at least 30 patients died this month while awaiting a place in the ICU, according to a count published Wednesday by news website G1. In Santa Catarina, in the south of the country, 419 people are waiting to be transferred to a bed in an intensive care unit, and in neighboring Rio Grande do Sul ICs have a capacity of 106%.
Alexandre Zavascki, a doctor in Rio Grande do Sul’s capital, Porto Alegre, described the constant arrival of patients with respiratory problems.
“I have many colleagues who sometimes stop crying. This is not the medicine we are used to practice. This is a drug adapted to a war scenario, “said Zavascki, who oversees the treatment of infectious diseases in a private hospital.” We see that a large part of the population refuses to see what is happening, they resist the facts. These people might be the next to walk into a hospital and they want beds, but they won’t be there.
The country, he added, needs “tougher measures” from local authorities.
Despite the president’s objections, Brazil’s Federal Supreme Court upheld the power of cities and states to impose restrictions on activities. Still, Bolsonaro has consistently condemned his moves, arguing that the economy must remain active and that isolation would cause depression. The measures were relaxed in late 2020, when COVID-19 infections and deaths fell, the municipal election campaign began and the Brazilians returning home were tired of quarantine.
The latest rally will be powered by the P1 variant, which the health minister said last month is three times more portable than the original. It first became dominant in the Amazon city of Manaus, and in January forced hundreds of patients to be flown to other regions.
Brazil’s inability to contain the virus since then is increasingly seen as a concern, not only by its Latin American neighbors, but also a warning to the world, said the World Health Organization director-general (WHO ), Tedros Adhanom Ghebreyesus, at a press conference on March 5.
“Across the country, the aggressive use of public health measures, of social measures, will be very, very crucial,” he said. “Without doing things that affect transmission or suppress the virus, I don’t think there can be a downward trend in Brazil.”
The more than 10,000 deaths reported in Brazil last week was the worst figure since the start of the pandemic, and this week’s count is on track to get even higher after recording about 2,300 deaths on Wednesday alone, bringing the record of the day before is exceeded.
“Governors, like much of the population, are fed up with all this passivity,” said Margareth Dalholm, a leading pulmonologist at the state-run Fiocruz Institute. The proposed pact is vague and will remain symbolic unless it is far-reaching and confronts the federal government, he added.
Last week, the National Council of State Health Ministers called for a nationwide curfew and quarantines in regions where hospital capacity is close to the maximum. Again, Bolsonaro protested.
“I will not pronounce it,” the politician said at a ceremony on Monday. “And one thing you know for sure, my army won’t take to the streets to force people to stay at home.”
The restrictions could be noticed outside the presidential palace after federal district governor Ibaneis Rocha imposed a curfew and partial incarceration. Rocha warned on Tuesday that he could increase restrictions, with the exception of pharmacies and hospitals, if people don’t ignore the rules. Currently, the waiting list for occupying a bed in an IC in the region is 213 people.
Bolsonaro told reporters on Monday that the curfew is “an insult, unacceptable” and that even the WHO believes lockdowns are not enough because they disproportionately affect the poor. While the United Nations Health Service acknowledges the “profound negative effects” of this measure, it points out that some countries have no choice but to impose very strict measures to delay infections, and that, in addition to caring for patients, governments use extra time to test and detect cases.
This nuance escaped Bolsonaro. His government continues to look for miracle solutions that, at this point, have served nothing more than to feed false hope. Every idea seems worth considering, except that of public health experts.
Bolsonaro’s government has spent millions to manufacture and distribute anti-malarial pills, which in rigorous studies showed no benefit. However, the president approved this drug. He also supported treatment with two drugs to combat the parasites, neither of which has proven effective. On Wednesday, he again praised his ability to avoid hospitalization at a ceremony in the presidential palace.
Bolsonaro also sent a committee to Israel this week to evaluate an untested nasal spray that he has dubbed a “ miracle product. ” Dalholm, whose sister is in the ICU, called the trip “really pathetic.”
Camila Romano, a researcher at the Institute of Tropical Medicine at the University of Sao Paulo, hopes the test her lab is developing to identify variants of concern, including P1, will help monitor and control its spread. In addition, it requires stricter measures from the government and that citizens do their bit.
“Every day there is a new surprise, a new variety, a city whose health system is collapsing,” said Romano. “Now we are in the worst phase. If this is the worst phase, (because) unfortunately we do not know what to come.”