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Brazil, a time bomb

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The sick and the dead with a shovel, hospitals and cemeteries overwhelmed. The Covid-19 continues its mad race in Brazil. Since the beginning of the month, the country has witnessed, in dismay, a appalling escalation of deaths, more than 2,000 on average every day. Thursday March 18, this indicator broke its macabre record for… the 20th consecutive day. By its total record, the Latin American giant remains the second most affected country in the world, behind the United States, with approximately 288,000 deaths out of 12 million contaminations. But in daily figures, it is now the one where the virus kills the most.

One in four deaths from Covid-19 in the world is now Brazilian! “We are on the way to becoming the global focus of the epidemic,” worries Gulnar Avezedo e Silva, president of Abrasco, a major association for the defense of public health. Elsewhere, the disease is receding. In Brazil, it is progressing, at the risk of irradiating in other countries. ” A potential global health threat, to which some 108 countries (including Switzerland) have responded by closing their borders.

Transmission out of control

The spread of the virus has been accelerating for four months already, thanks to the end of year celebrations and summer holidays in the southern hemisphere. Its out of control transmission (the reproduction rate is 1.23, according to Imperial College) has led to the emergence of more contagious variants – three so far. After the long but not very restrictive quarantine last year, the Brazilians are tired. Only a third still respect the isolation measures.

“The worsening of the health situation is simultaneous throughout the country, which is experiencing a hospital and health collapse without precedent in its history,” notes Fiocruz, the Brazilian equivalent of the Institut Pasteur. In 24 of the 27 states, the intensive care bed occupancy rate is over 80%. In 15 of them, this rate exceeded 90%. Adding more beds is no longer useful: there is a lack of nursing staff. The stocks of drugs and oxygen are running out. The specter of a nationwide reproduction of the horror scenario seen in the Amazon city of Manaus last January is becoming clearer.

A “curable flu”

How did a country with an internationally recognized health vigilance system come to this? Blame it on Jair Bolsonaro, the far-right president, accused of letting the virus run so as not to harm the economy. “The government has never presented an integrated plan to fight the virus,” adds Gulnar Azevedo e Silva, who speaks of “deliberate omission”. Left to their own devices, cities and federated states each had to put in place its own arsenal of measures. “

Faced with the virulence of the epidemic rebound, several regions have tightened travel restrictions, but their room for maneuver is limited, despite their formal autonomy. “Without strict containment throughout the territory, Brazil risks reaching 4,000 deaths per day, warns the president of Abrasco. But how to impose such a measure when the president himself opposes it, favors gatherings and criticizes the wearing of masks? Mayors and governors say one thing and Bolsonaro says another. The Brazilian response to the epidemic could have been much firmer if there was a single message, a strategy coordinated by the central state. ” However, Bolsonaro fought until the idea of ​​a vaccine strategy, swearing until recently that “the best vaccine is to catch the disease”. According to him, a “flu” curable thanks to “early treatments” whose effectiveness is not recognized. What good then is buying the vaccine?

If Brazil has finally decided to negotiate with the laboratories, the vaccination campaign is progressing slowly, for lack of doses. In a country known for its capacity for mass immunization, less than 7% of the population received a first dose. Yet just over half of Brazilians disapprove of the management of the health crisis. Bolsonaro’s resilience seems foolproof. Whatever happens, 30% of Brazilians remain loyal to him.

Under pressure from the return to favor of his main opponent, former President Lula, he however sacked his third Minister of Health in a year, a general unrelated to the medical community. But the new incumbent, cardiologist Marcelo Queiroga, quickly dampened any hope of change, warning that he would stick to government policy. As the newspaper writes The state of Sao Paulo, “The real Minister of Health is Bolsonaro himself”.

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