Brazil becomes global epicenter for COVID-19 as political turmoil hampers medical response

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With rapidly increasing cases, a military general with no medical experience at the head of the Ministry of Health and a president admitting that there is no evidence that his preferred treatment will work, Brazil has become one of the most hardest hit by coronavirus.

As health systems from Sao Paulo to the Amazon suffer from the growing number of cases, political experts say there is little hope that the country will change course when the president is one of their biggest obstacles.

“It’s amazing what’s going on in Brazil. When the country’s greatest scientific denier is the president himself, what can we scientists do? Said Natalia Pasternak, microbiologist and researcher at the Institute of Biomedical Sciences at the University of Sao Paulo.

Brazilian President Jair Bolsonaro was among the most contemptuous world leaders against the coronavirus, minimizing it at first as a “little flu”, and then answering “if what” when asked about the increase in the number dead in the country.

His own health ministry opposed him, encouraging physical removal and quarantine, but Bolsonaro sacked popular health minister Luiz Henrique Mandetta in April, then forced his replacement Nelson Teich to resign last week . Both were trained doctors.

“I see no hope in the short term,” said Pasternak. “I think the numbers will continue to add up and a lot of people will die until we resolve the political situation. “

“A serious situation”

The World Health Organization (WHO) now sees South America as the new epicenter of the pandemic, largely because this week Brazil overtook the United Kingdom for third place in the total number of cases of COVID-19.

Brazil has more than 310,000 cases and more than 20,000 deaths, according to statistics from Johns Hopkins University. The country’s health ministry says the numbers are likely higher due to a lack of effective tests.

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

The number of coronavirus cases is increasing in Brazil, but President Jair Bolsonaro continues to play down the situation. Bolsonaro also advocates the use of hydroxychloroquine, an unproven treatment also promoted by US President Donald Trump. 2:01

“Do people die?” Yes, they are, and I regret it. But many more will die if the economy continues to be destroyed because of this (foreclosure), “said Bolsonaro earlier this month.

Brazil reported more than 18,500 infections on Thursday, while recording a record 1,188 coronavirus deaths per day, overshadowing its previous record earlier in the week.

“This is a very serious 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, new graves continue to be unearthed in the sprawling cemetery of Formosa. Health officials say they are losing the battle against the virus and the system will be overwhelmed. City and state officials moved the June and July vacation to this weekend to create an extended break to encourage physical distance.

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

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

“Politicizing the problem”

While other countries waited for signs of a slowdown before reopening the economy, Bolsonaro kept pushing Brazilians back to work, putting him at odds with state governors and mayors trying to curb spread by lockouts and quarantines.

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

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

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

“He follows his instinct that the economy must reopen and that the country cannot cope with such a deep economic crisis,” said Marcio Coimbra, political strategist in the capital, Brasilia.

“The middle and upper classes are against the president,” said Coimbra. “But on the other hand, the poor who need to work, they are there to support the president. “

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

Bolsonaro “will say,” I told you the virus was a small problem, governors and mayors took the wrong steps, “” said Costa.

“Problems at the Ministry of Health”

Some of Bolsonaro’s most significant clashes have taken place with his own Ministry of Health. In April, he fired health minister Luis Henrique Mandetta, who had grown in popularity with his daily technical briefings.

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

WATCH | Worsening of the COVID-19 crisis in Brazil:

Worsening COVID-19 Crisis in Brazil SUMMARY: Brazil’s already weak health system and an inconsistent response from its political leaders to the COVID-19 pandemic have made it much more difficult for hospitals in the country to cope the growing number of cases, says Oliver Stuenkel, professor and author of 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 training. Costa said Pazuello is employing 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 is not a question of science, it is not a question of medicine, it is just a question of politics,” said Costa.

Like his ally, President Donald Trump, Bolsonaro has pushed hydroxychloroquine as a solution to the pandemic, although he has no evidence that it works.

Health policy expert Miguel Lago said Bolsonaro’s support for the drug was more a matter of politics than medicine.

“Bolsonaro is a very intelligent politician and he is trying to figure out what may correspond to a narrative where he seems 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 the president’s directives. States have applied their own measures in disregard of Bolsonaro’s views, including mandatory masks in public and traffic limits in major cities

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

An indigenous Kambeba woman sits waiting to be tested for coronavirus on the banks of the Negro River in the village of Tres Unidos, Amazon state, Brazil, on May 21. (Bruno Kelly / Reuters)

Dismissal has been discussed in Brazil. The president of the lower house, Rodrigo Maia, received more than 30 requests for the dismissal of Bolsonaro, but did not respond to these requests.

The president maintained control of a fragmented Congress, concluding an agreement with a centrist group of parties which represent around 40% of the vote.

“If he continues to provide power for votes in Congress, he can remain in power until the end of his term,” said Coimbra.

“No light at the end of the tunnel”

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

According to statistics from Brazilian technology company Inloco, just over 42% of Brazilians practice physical distance, compared to a peak of around 62% in late March.

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

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

Pasternak said the example of the president, organizing rallies, shaking hands and hugging his supporters, is sending the wrong message to the Brazilians who are counting on him for leadership. She worries about the direction the country is taking.

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

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