The ‘little flu’ that ravaged a nation: Brazil’s COVID-19 nightmare

Illustration credit: Gabriella Nero

As COVID-19 arrived at the shores of Latin America earlier this year, Brazil’s president Jair Bolsonaro seemed remarkably unphased: it’s nothing more than a gripezinha (‘little flu’), he insisted to journalists, dismissing growing concerns as unnecessary ‘hysteria’.

And yet, just four months after its first confirmed case on 26th February, this ‘little flu’ has torn through Latin America’s largest nation, which now trails only the United States in its number of infections and deaths. Although the official figures stand at more than 1,000,000 of the former and over 50,000 of the latter, estimates by health experts suggest the actual case load in the country could be up to seven times higher than reported due to a widespread lack of testing, whilst a projection by the Institute for Health Metrics and Evaluation (IHME) sees the death toll reaching 125,000 by early August.

The country’s economy, still ailing from its last recession, is expected to shrink by 8 per cent this year, with 5 million citizens having lost their jobs in the first quarter of 2020 alone. Meanwhile in the capital Brasilia, Bolsonaro’s government has been marred by ongoing corruption investigations, shaken by a series of resignations and gripped in a political deadlock with state authorities.

With the curve of infection showing no signs of flattening, the economy in free fall and political tensions reaching boiling point, global onlookers and Brazilians alike find themselves puzzling over the same question: where did it all go wrong?

“Brazil is facing two viruses, COVID-19 and Bolsonaro”

Brazil, like every other nation, is no stranger to disease outbreak. Where its response to COVID-19 differs, however, is in the country’s marked failure to quell its spread. As the virus took hold in Europe, many hoped that Brazil would use the gift of foresight and lessons learned from previous pandemics to prevent similar devastation from reaching its citizens. However, despite receiving the Gates Award for Global Health in 2003 for its admirable response to HIV/AIDS and its largely successful containment of the Zika virus in 2015, the country is now on track to become one of the countries worst affected by the current pandemic.

Brazil’s free Unified Health System (SUS), modelled in part on Britain’s NHS, has kept its head largely above water, but has been stretched to breaking point in some parts of the nation, with bed occupancy in Intensive Care Units (ICUs) reaching over 90% in three states. Cities hit hardest by the disease, such as Manaus, have already seen their health care system collapse entirely.

Giovanna Souza, a medical student studying in São Paulo, speaks of the increasingly urgent threat posed to the country’s health facilities as the virus tightens its grip: “my experience as a medical student is seeing SUS and its workers fighting everyday to keep it ‘alive’,  since so many people depend exclusively on our public health care system”. With experts suggesting that the peak is yet to come, many are questioning why the country’s health infrastructure has found itself in such a fragile situation.

Whilst many state governors have adopted strict social-distancing measures to lessen the strain on SUS, they have been forced to do so in open defiance of the federal government’s abject refusal to impose a nationwide lockdown. Sarah Maslin, Brazil correspondent for The Economist, points to a breakdown in cooperation early on in the pandemic: “When Zika hit and when H1N1 hit, it was harder in some places than others, but there was a unified strategy to address [the virus]. That kind of infrastructure could have been put into fast-drive for this pandemic. They were starting to do that a little bit in March, with the co-ordination and the daily meetings [between federal and state authorities]. But because of the president’s own disbelief in science and belief that it would be better for him politically […] to keep business open and not take the threat seriously, he steered the health ministry another way.”

Giovanna also sees government response as being hindered by a health ministry in chaos: “We currently don’t have a health minister in the middle of this crisis after two health ministers (who were doctors) quit in [the space of] less than 3 months. Right now, the person temporarily responsible is an army general without experience in the health area.” Luiz Henrique Mandetta was, indeed, promptly dismissed by the president in mid-April for supporting stricter social-distancing measures. His replacement, Nelson Teich, quit less than a month later, leaving the inexperienced ex military general Eduardo Pazuello to steer a rapidly sinking ship. The turmoil within the department has been compounded by the president’s recent threat to quit the World Health Organisation (WHO), which he criticised as a “partisan political organisation”.

Giovanna also highlights the damaging impact of Bolsonaro in particular on the population’s willingness to adhere to local restrictions, lamenting that “[the] president has been minimising the gravity and impact of the pandemic in our country since day one”. In an interview with Sky News, the governor of São Paulo seemed to share this widely-held frustration, going so far as to see Bolsonaro’s consistent criticism of state authority as a pandemic in itself : “it’s difficult when you have two viruses to combat: the coronavirus and Bolsonaro-virus.”

Where Trump goes, Bolsonaro follows

Bolsonaro’s alarmingly lax response to the pandemic has had him dubbed as the ‘Trump of the Tropics’. Much like his North American counterpart, Brazil’s populist president has come under fire for his frequent dismissal of the virus, promoting unproven medical treatments, verbal attacks on state governors and consistent undermining of health officials. Both men also – unsurprisingly – preside over the only two countries to have passed the grim milestone of 1 million confirmed cases.

The list of similarities does not stop there. Reactions to Bolsonaro’s handling of the pandemic have been equally, if not more polarised than those garnered by Trump. From being pictured coughing and spluttering at an anti-lockdown rally in March to his triumphant greeting of protestors against the Supreme Court on horseback last month, Bolsonaro has not shied away from fanning the political flames burning across the country. Maslin, who currently resides in São Paulo, has seen these political tensions spill out onto the city streets: “The two sounds that you hear in Brazil are people banging pots and pans to protest the president […] or people honking their horns in car rallies in favour of [him]”.  This widening gap of opinion has also been reflected in opinion polls, with the most recent survey by Datafolha placing Bolsonaro’s approval rating at 32 percent and government rejection at 44 percent. Although the Brazilian political system ensures that a low approval rating need not completely jeopardise his chances of reelection, a spiralling death toll combined with the ramifications of a growing corruption scandal is set to spell growing trouble for the president as the pandemic rages on.

Such chaos within Brazil’s government also provides a fertile breeding ground for the spread of misinformation amongst the population. Whether it be 5G conspiracy theories or messages claiming that beer kills the virus, Maslin is not surprised that Whatsapp chains have become a significant source of information for many: “It’s understandable” she says, “that people are listening to [fake news] just as much as they’re listening to the confusing noises coming from above.” That the communication vacuum from federal authorities has been filled with yet more mixed messaging can only bode ill for the country’s chances of stopping the virus’ spread.

Doomed from the start?

Whilst many have accused Bolsonaro of prioritising money over lives, his desire to protect the economy does have some basis in precedent. There is a chilling irony to the fact that the virus, which was brought to Brazil by a wealthy man returning from Europe, is now taking the greatest toll on the poorest communities.

In a nation where inequality is rife and deeply entrenched in the social fabric, existing vulnerabilities that extend far beyond one administration cannot be overlooked. Infection and mortality rates in Brazil’s favelas, impoverished and crowded neighbourhoods which often lack access to basic sanitation and running water, are amongst the highest in the world. Government aid packages have been welcomed by workers in Brazil’s vast informal sector, but for the many millions relying on hand-to-mouth cash takings to survive, such handouts are simply not enough. The threat of the virus is, ultimately, subordinate to the threat of starvation, making any long-term lockdown unsustainable. As Maslin observes, the choice for many working-class Brazilians is plain: “If you’re too poor to stay home, you go out and work.”

Even with case numbers beginning to stabilise in the country’s urban centres, concerns are growing as the virus reaches more remote regions. 16 year old Lara Faustino, who lives in a small town in the state of Minas Gerais, fears what will happen if COVID-19 reaches her area, which suffers from a “lack of the necessary infrastructure” needed to combat the virus. Scenes of mass graves in the Amazonian city of Manaus have shown just how quickly this disease can plunge an ill-prepared, underfunded community into tragedy.

Brazil is not alone on this front: longstanding structural vulnerabilities inherent across Latin America have undermined the effectiveness of even the strictest of pandemic responses. Peru, despite being in lockdown since March, has been unable to avoid the worst of the crisis: it now finds itself contending with the seventh highest number of cases in the world and a frighteningly high excess death rate. President Vizcarra spoke of unique challenges the virus poses to the continent, admitting last month that “results haven’t been exactly what we expected. This isn’t just a health or sanitary crisis, but a social and economic crisis without precedent.” With WHO branding Latin America as the new ‘red zone’ for COVID-19 earlier this month, it seems that some of the root causes of Brazil’s current health crisis may stem back significantly further than Bolsonaro’s election in 2018.

A future unknown

As this article has shown, it is all too easy to become lost in the murky waters of the blame game. When searching for answers, one is faced with an expansive web of possible causes that are essentially impossible to untangle. One thing, however, is crystal clear; Brazil finds itself embroiled in a political, economic and public health crisis with no end in sight. As the virus continues to wreak havoc across the country, the fate of its leader – and its millions of citizens – still hangs very much in the balance.

Where does Brazil go from here? Our Americas editor spoke with Gustavo Ribeiro, Editor of the Brazilian Report, to find out – click here to see what he had to say.