Brazil’s COVID-19 Crisis Spirals Out Of Control: ‘An Open-Sky Laboratory For Viral Mutations’

Brazil recorded its 300,000th COVID-19 death this week, a grim marker of a health care crisis that promises to worsen in the coming months in South America’s largest nation.

The United States is the only country to record more total COVID-19 deaths than Brazil, but in the U.S., vaccine rollout has at least offered a glimmer of hope that the pandemic may soon be over. Brazil’s darkest days may still lie ahead, especially as far-right President Jair Bolsonaro maintains the denialist, conspiratorial approach that he has taken toward the virus since it broke  last year.

Once a global leader in mitigating epidemics and infectious disease outbreaks, Brazil’s public health system is experiencing the biggest collapse in the country’s history, according to Fiocruz, a Brazilian public health institute. The health systems in all but two of Brazil’s states are in dire condition, the institute said, leaving hospitals stretched for beds, oxygen and other basic medicines necessary to treat the coronavirus. 

On Tuesday, Brazil recorded more than 3,100 deaths, making it alone responsible for nearly one-third of the day’s global death toll. States and cities across the country are struggling to prevent further death and deal with the sheer number of bodies overwhelming morgues and cemeteries. 

“This is probably the most dangerous place in the world right now,” Dr. Miguel Nicolelis, a neuroscientist at Duke University, said from São Paulo on Thursday.  “It is the worst tragedy in Brazilian history, by a long shot.”

Nicolelis, who is widely considered one of Brazil’s most influential and respected medical scientists, helped form a committee to lead a coordinated COVID-19 response among the country’s northeastern states last year. He spoke at length with HuffPost about Brazil’s crisis this week.

A health worker tends to a patient at the intensive care unit for patients infected with COVID-19 at the reference hospital R

A health worker tends to a patient at the intensive care unit for patients infected with COVID-19 at the reference hospital Ronaldo Gazolla on March 24 in Rio de Janeiro, Brazil.

“It’s like a battlefield,” Nicolelis said. “It feels like Brazil is in the middle of a major war.”

Bolsonaro, meanwhile, seems to be fighting for the other side. He initially dismissed the virus as a media conspiracy and referred to it as a “little flu” last year. He has cycled through health ministers amid feuds over the efficacy of the antimalarial drug hydroxychloroquine and other unproven treatments. 

“Very soon we will resume our normal lives,” he assured Brazilians during a televised address to the nation Tuesday evening, according to The Guardian. “We are tireless in our fight against coronavirus — this is our mission and we will fulfill it.”

The truth is exactly opposite, and early predictions that Bolsonaro would oversee the worst COVID-19 outbreak in the world now seem grimly prescient. At the current rate, Nicolelis projected, Brazil could reach 500,000 deaths by the end of July and pass the United States as the global leader in total deaths by the beginning of 2022.

“Brazil above all,” the Rio de Janeiro newspaper Jornal Extra blared on its cover Wednesday morning, mocking Bolsonaro’s nationalist slogan. 

Undermining The Global Pandemic Response

Public health experts have grown increasingly worried that Bolsonaro’s inability and unwillingness to properly manage Brazil’s crisis are putting the rest of the world at risk, too, as the country becomes an incubator for new viral strains.

“The pandemic is not going to be controlled if Brazil is out of control,” Nicolelis said. “We are talking about a country with 210 million people that is highly connected to the entire world. The irresponsibility of the Brazilian president is undermining the entire world’s effort to get out of the pandemic.”

The P1 variant, which was first detected January in passengers who arrived in Japan after visiting Brazil, has become the dominant strain of the coronavirus in some Brazilian states and has spread far beyond its borders. It first appeared in the United States in January and has been confirmed in more than a dozen states. It has been detected across Europe as well.

The vaccines now available appear effective against the P1 variant. But many South and Central American nations that do not have widespread access to vaccines yet remain vulnerable. Uruguay, which borders Brazil to the south and has vaccinated a larger portion of its population than most other nations in the region, has seen infections and deaths spike in recent weeks, a rise that may be attributable to the new strain crossing the border.

Even the U.S., which is now vaccinating more than 2 million people per day, is at risk from new variants, Nicolelis said.

“I hate to bring bad news, but the P1 is old news,” he said. “Brazil is the largest open-sky laboratory for viral mutations right now. These variants are going to find a way out of Brazil. … It’s a time bomb, and the clock is ticking.”

Brazilian President Jair Bolsonaro speaks to the press after meeting with the heads of the three government branches and thei

Brazilian President Jair Bolsonaro speaks to the press after meeting with the heads of the three government branches and their ministers to discuss possible solutions to the pandemic at the Alvorada Palace in Brasilia on March 24.

A Leader ‘Suffocating’ His Country 

Bolsonaro’s mishandling of the crisis and his blatant refusal to acknowledge its depth have drawn renewed scrutiny to his presidency, even from supporters. Disapproval of Bolsonaro’s response to the pandemic hit 54%, the highest point in his presidency, in a poll conducted earlier this month. Major cities rang out with protests as he addressed the nation on Tuesday, with angry Brazilians banging pots and pans from their homes. Demonstrations have taken place outside hospitals in Rio and other major cities, too ― although Bolsonaro supporters who have taken the president’s cues and opposed lockdowns and social distancing have staged their own rallies against new local orders meant to combat the virus.

A third member of Brazil’s Senate died of COVID-19 last week, and on Wednesday, 16 members of its national Congress co-authored an op-ed that accused Bolsonaro of “suffocating” Brazil with “a denialist agenda.” The group was made up of members from the political left, right and center, and included multiple former Bolsonaro allies. House Speaker Arthur Lira, meanwhile, acknowledged growing calls for Bolsonaro’s impeachment on Wednesday.

“Congress’ political remedies are well-known. All of them are bitter. Some are fatal,” Lira, a Bolsonaro ally, said without specifically mentioning the president

Brazil has doled out nearly 17 million vaccine doses and ranks fifth in the world in the overall number of vaccinations administered so far, a fact Bolsonaro touted this week. Its rollout has been slower than expected, in part because wealthier nations have acquired the bulk of available vaccines. But Bolsonaro hasn’t helped: He refused to purchase additional doses early on, and his skepticism of the vaccines has likely fueled hesitance among some Brazilians.

People stand in line to receive the coronavirus vaccine at a vaccination post at the Santa Cecilia Basic Health Unit on March

People stand in line to receive the coronavirus vaccine at a vaccination post at the Santa Cecilia Basic Health Unit on March 15 in São Paulo.

Whatever the cause, Brazil — which not long ago was considered a pioneer for its ability to develop and administer vaccines or other treatments for AIDS, the yellow fever, the Zika virus and other infectious diseases — likely won’t vaccinate enough of its people to fully put the pandemic behind it before the end of 2021, Nicolelis said. (There is, however, some good news on this front: The Butantan Institute, a São Paulo public health institution and Brazil’s largest supplier of vaccines, has created its own vaccine and is ready to begin testing its efficacy, local newspaper Folha de S.Paulo reported Friday.) 

Much like in the United States, where former President Donald Trump downplayed the seriousness of the pandemic throughout 2020, governors and mayors across Brazil have tried to implement their own responses to the pandemic. But without a more comprehensive federal response, the state-by-state approach will likely go just as poorly as it did in the U.S. 

“I am convinced that until this guy’s removed from office, Brazil is not going to handle this crisis properly,” Nicolelis said of Bolsonaro. “It may continue to mitigate it, regionally or state by state. But that doesn’t work. You cannot handle this without a national effort.”

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