RIO DE JANEIRO (AP) – Brazil’s COVID-19 death toll, which exceeded 250,000 on Thursday, is the world’s second highest for the same reason the second wave has yet to fade: prevention has never become a priority, experts say .
Since the start of the pandemic, Brazilian President Jair Bolsonaro scoffed at the “little flu” and denounced local leaders for restricting activities; he said the economy must keep humming to avoid worse.
Even when he approved pandemic welfare benefits for the poor, they were not heralded as a means of keeping people at home. And Brazilians are staying on the road while the vaccination has begun – but the rollout has turned out to be much slower than expected.
Brazil just didn’t have a response plan. We’ve been through this for the past year and still we don’t have a clear plan, a national plan, ”Miguel Lago, executive director of the Brazilian Institute for Health Policy Studies, which advises public health officials, told the Associated Press. ‘There is no plan at all. And the same goes for vaccination. “
While daily cases and deaths have declined in other countries, Latin America’s largest nation is parked on an elevated plateau – a stark repeat of mid-2020. In each of the past five weeks, Brazil has averaged over 1,000 daily deaths cases. Official data showed a confirmed death toll of 251,498 on Thursday.
At least 12 Brazilian states are in the middle of a second wave worse than 2020, said Domingos Alves, an epidemiologist who tracks COVID-19 data.
“This scenario is getting worse,” Alves told the AP, adding that the virus was spreading more quickly among the population. In the state of Amazonas, where the capital Manaus saw hospitals run out of oxygen last month, more than 5,000 deaths occurred in the first two months of the year, about the same number as in all of 2020.
“It’s the most difficult moment we’ve had since the first case was confirmed,” Carlos Lula, chairman of the National Board of Health Secretaries, said Thursday in the O Globo newspaper. “We have never had so many states with so many problems at once.”
Alves and other public health experts said the spread is exacerbated by the authorities’ reluctance to follow recommendations from international health organizations to introduce tougher restrictions.
It’s up to governors and mayors to impose lockdowns or other restrictions to control the virus. The states of Sao Paulo and Bahia recently introduced curfews, but experts say the moves are late and insufficient.
“They are not containment measures; they are palliative measures that are always taken afterwards, ”said Alves, who is also an adjunct professor of social medicine at the University of Sao Paulo. “‘Lockdown’ has become a curse word in Brazil.”
Miguel Nicolelis, a prominent Brazilian neuroscientist, warned in January that Brazil either had to be closed or we wouldn’t be able to bury our dead in 2021. He had advised the northeastern states on how to combat COVID-19, but recently left his position, dissatisfied with their refusal to lock it up, Folha de S. Paulo newspaper reported.
“At the moment, Brazil is the largest open-air laboratory, where it is possible to observe the natural dynamics of the coronavirus without any effective containment measure,” he wrote on Twitter on Tuesday. “Everyone will witness the epic destruction.”
There are some exceptions, but they remain marginal and have not led to a wider movement.
Sao Luis, the capital of the northeastern state of Maranhao, was the first Brazilian city to be completely shut down last May. It was successful despite Bolsonaro’s efforts to undermine the restrictions and cast doubt on its effectiveness, said the state’s governor, Flávio Dino.
“It was very difficult to step back and take preventive action,” Dino said, adding that the first obstacle was economic and social, especially after the federal government’s emergency pandemic relief program ended last year.
Lago noted that Bolsonaro rarely even commented on the pandemic and has effectively moved on to other priorities, including gaining support in Congress for relaxing gun control laws and pushing through economic reforms. His government is trying to restore some COVID-19 welfare benefits, but for a smaller group of needy Brazilians.
The only preventive measure that Bolsonaro consistently supported was the use of treatments such as hydroxychloroquine, which showed no benefit in rigorous studies.
Bolsonaro’s government has also taken a hands-off approach to the vaccination campaign. It relied primarily on a deal to purchase a single vaccine, AstraZeneca, which was slow in coming. National immunization efforts to date are based largely on China-made CoronaVac shots secured by the state of Sao Paulo, although the federal government is now trying to buy others.
Brazil’s decades of experience with successful vaccination programs and the large nationwide public health network have led many experts to believe that immunization – even if it started with a delay – would be a relatively quick affair. In previous campaigns, the country of 210 million people was able to vaccinate as many as 10 million people in one day, health experts noted.
Five weeks after the first shot, Brazil has only vaccinated 3.6% of its population. That’s more than double that of Argentina and Mexico, but less than a quarter of that of Chile, according to Our World in Data, an online research site comparing official government statistics.
“There is no way to be fast with a vaccine shortage; that’s the crucial point, ” said Carla Domingues, who coordinated Brazil’s national vaccination program for eight years until she left her position in 2019. Until there is more supply, the speed will be slower, because you have to keep selecting who gets vaccinated. “
Meanwhile, the virus continues to run rampant in Brazil and take its toll.
In the city of Araraquara, Sao Paulo, there have been more deaths this year than last year, and intensive care utilization exceeded full capacity, with people on waiting lists to go to the ICUs and receive treatment. Local authorities responded on Sunday by announcing a full lockdown – making Araraquara only the second city to impose such a restriction.
“We never thought we would get to this point,” Fabiana Araújo, a nurse and coordinator of the city committee told COVID-19. “It was the only option.”
—— AP writers David Biller contributed from Rio and Mauricio Savarese from Sao Paulo.