Contradictory Messaging and Uncoordinated Response Has Skyrocketed COVID-19 Cases in Brazil

Brazil’s chaotic response to the COVID-19 pandemic suffers from misaligned priorities, political vendettas, and constant contradiction among all levels of government. Since its first confirmed case on 25 February, Brazil has recorded 514 846 cases as of 1 June , the second highest number in the world, and 33 274 deaths. However, the lack of adequate testing makes people there believe the actual number of cases could be ten times higher than reported. Although several pre-existing inequalities may be attributed to COVID-19’s rapid spread, the lack of coordination from the country’s federal government contributed to the devastating health crisis the country finds itself in now. And yet the country successfully mitigated the effects of previous epidemics.

Brazil’s experience with the Zika virus demonstrated its state capacity to respond to epidemics. In addition to multiple medical testing and treatment methods at hospitals, the government made genetically modified mosquitoes to help reduce the spread of Zika and developed mathematical models based on socioeconomic, demographic, and mosquito behavioural factors (to name a few) to help predict the paths along which Zika would spread. During the HIV crisis, the country worked to reject patents by major pharmaceutical companies and manufacture its own generic medication. Brazil successfully handled past epidemics and it had the capabilities to control the spread of the new coronavirus in the beginning.

However, in an effort to prioritize the economy, President Jair Bolsonaro repeatedly publicly downplayed the seriousness of COVID-19, referring to it as “a little flu.”  Beyond his rhetoric, Bolsonaro’s actions have also proven consequential. He has consistently stood against the public health measures that health and state ministers have tried to implement by attending protests against social-distancing measures. The country is now on its third health minister since the start of the pandemic—the first was fired for recommending social-distancing measures and the second quit over disagreements about hydroxychloroquine’s effectiveness in combating the virus.

The president’s erratic and inconsistent messaging has led to confusion and reduced compliance for social-distancing measures. A recent study using data collected through cell phone geolocation highlighted the impact of contradictory statements on the general population through the course of the pandemic. Compliance was near 70 percent in March and is now slightly over 40 percent throughout the country.

However, despite its dismissive president, Brazil’s decentralized system provided major support in-state efforts to control the virus. First, individual states enforced their own lockdowns to limit person-to-person interaction. On 17 March, the state of Santa Catarina closed non-essential services including shopping centres, restaurants, and gyms and on 21 March, the state of Sao Paulo and individual cities implemented a lockdown that still continues.  Second, states have started to work together to procure masks, ventilators, and test kits, often without the permission or assistance of the federal government. However, poorer states with less adequate healthcare systems are struggling disproportionately.

The Amazonas, home to a large portion of Brazil’s Indigenous population, has experienced the greatest number of cases relative to population. This arises from a series of systemic inequalities that the region faces. The Amazonas is a remote region with few hospitals over a large area that are ill-equipped with personal protective equipment (PPE). Many of these communities lack the capacity to wash with soap and water and they generally share utensils among themselves, severely increasing the risk of infection. In the past, Indigenous groups secluded their communities within the forests during pandemics. However, in recent decades, many Indigenous groups have become reliant on external government assistance and have come into contact with illegal loggers, hunters, and missionaries.

Existing structural inequalities also exacerbated the COVID-19 threat in favelas where many residents work in the informal economy. In these low-income slum neighbourhoods, 9  and 47 percent of residents are Black and mixed-raced respectively. Many people living in favelas are informal workers who lack savings and cannot sacrifice food on the table for social distancing. The current economic package that provides 600 reals (USD 114) per month is not enough to sustain families,  especially given that supplies like water bottles can cost USD 5 each. Although residents were supposed to be able to access the economic relief package through a cell phone app, it did not work properly and people had to stand in bank lines to receive it. Many people describe how they are unable to pay rent and need daily work to put food on the table. In the absence of government leadership, many favela leaders have taken to advising people to stay at home. They find their biggest challenge lies in attempting to debunk Bolsonaro’s contradictory messaging.

Such inconsistent messaging has exacerbated pre-existing inequalities in Brazil and stifled state interventions.  Failure to isolate imported cases and an ensuing community spread into the favelas was a key turning point for the country to contain the virus. Consolidated leadership, timely actions, and execution of policies can improve the containment of the virus. But contradictory messages from any level of government, especially the head of state, can only plunge the country into further turmoil and loss of life.