RIO DE JANEIRO (AP) – The death toll from COVID-19 in Brazil, which surpassed 250,000 on Thursday, is the second highest in the world for the same reason that its second wave is not over yet: prevention has never been a priority, say experts.
Since the beginning of the pandemic, the president of Brazil, Jair Bolsonaro, scoffed at the “little flu” and criticized local leaders for imposing restrictions on activity; he said the economy should continue to function to avoid worse difficulties.
Even when he approved welfare payments for the poor, they were not advertised as a means of keeping people at home. And Brazilians remain away from home while vaccination started – but implementation has been much slower than expected.
“Brazil simply did not have a response plan. We went through this last year and we still don’t have a clear plan, a national plan, ”Miguel Lago, executive director of the Brazilian Institute of Health Policy Studies, who advises public health officials, told the Associated Press. “There is no plan. The same applies to vaccination. “
While the daily cases and deaths of other countries have fallen, the largest nation in Latin America is stationed on a high plateau – a sad repetition of mid 2020. In each of the past five weeks, Brazil has averaged more than 1,000 daily deaths. 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 even worse than the one faced in 2020, said Domingos Alves, an epidemiologist who follows the data from COVID-19.
“This scenario is going to get worse,” Alves told the AP, adding that the virus spreads more quickly among the population. In the state of Amazonas, where the capital, Manaus, ran out of oxygen in hospitals last month, there were more than 5,000 deaths in the first two months of the year, almost as many as in the whole of 2020.
“It is the most difficult moment that we have lived since the confirmation of the first case,” Carlos Lula, president of the National Council of Health Secretaries, told O Globo on Thursday. “We have never had so many states with such difficulty at the same time.”
Alves and other public health experts said the spread is exacerbated by the authorities’ reluctance to follow the recommendations of international health organizations to implement stricter restrictions.
It is up to governors and mayors to impose blockades or other restrictions to contain the virus. The states of São Paulo and Bahia have recently introduced night curfews, but experts say the changes are too late and insufficient.
“They are not containment measures; they are palliative measures, always taken after the fact ”, said Alves, who is also an adjunct professor of social medicine at the University of São Paulo. “’Lockdown’ has become a dirty word in Brazil.”
Miguel Nicolelis, a leading Brazilian neuroscientist, warned in January that Brazil would have to go into confinement or “we will not be able to bury our dead in 2021”. He had been advising states in the Northeast in the fight against COVID-19, but recently left office, dissatisfied with their refusal to enter the blockade, 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 devastation.”
There are some exceptions, but they remain marginal and have failed to inspire a broader movement.
São Luís, capital of the northeast of the state of Maranhão, was the first Brazilian city to enter into total blockade last May. It was successful, despite Bolsonaro’s efforts to undermine restrictions and sow doubt about its effectiveness, according to state governor Flávio Dino.
“It has been very difficult to manage distance and prevention measures,” said Dino, adding that the first obstacle was economic and social, especially after the federal government’s emergency pandemic aid program ended last year.
Lago noted that Bolsonaro rarely comments more about the pandemic and has effectively moved to other priorities, including securing support in Congress to loosen gun control laws and pass economic reforms. His government is trying to reestablish some COVID-19 social security payments, but to a smaller group of needy Brazilians.
The only preventive measure that Bolsonaro consistently supported was the use of treatments like hydroxychloroquine, which has shown no benefit in rigorous studies.
Bolsonaro’s administration also took a direct approach to the vaccination campaign. It was mainly based on an agreement to buy a single vaccine, AstraZeneca, which was slow to arrive. The national immunization effort so far has been based mainly on CoronaVac shots made in China, guaranteed by the state of São Paulo, although the federal government is now trying to buy others.
Brazil’s decades of experience with successful vaccination programs and its large national public health network have led many experts to believe that immunization – even if it started late – would be a relatively quick process. In previous campaigns, the nation of 210 million was able to vaccinate up to 10 million people in a single day, health experts noted.
Five weeks after the first injection, Brazil vaccinated only 3.6% of its population. That’s more than double that of Argentina and Mexico, but less than a quarter of Chile, according to Our World in Data, an online survey site that compares official government statistics.
“There is no way to be quick with a lack of vaccines; This is the crucial point ”, said Carla Domingues, who for eight years coordinated the National Vaccination Program in Brazil, until leaving office in 2019.“ Until there is a greater offer, the speed will be slower, because you have to continue selecting who can be vaccinated. “
Meanwhile, the virus continues to spread throughout Brazil and takes its toll.
In the city of Araraquara, in the state of São Paulo, more deaths occurred this year than last year and the occupation of the intensive care unit exceeded its total capacity, with people on the waiting list to enter the ICU and receive treatment. Local authorities responded on Sunday by announcing a total blockade – making Araraquara the second city to impose such a restriction.
“We never imagined that we would reach this point”, said Fabiana Araújo, nurse and coordinator of the municipal commission to combat COVID-19. “It was the only option.”
—— AP writers David Biller contributed from Rio and Mauricio Savarese from São Paulo.