The Impending Coronavirus Catastrophe: Brazil is a Sitting Duck
By Ryan Lloyd and Amy Erica Smith
“It won’t be a gripezinha that takes me down.” A gripezinha--just a little cold. With those words last Friday, March 20, President Jair Bolsonaro dismissed the dangers of the novel coronavirus. This has become a new favorite theme of his. Visiting President Donald Trump in Florida on March 10, Bolsonaro called media reporting on the coronavirus “fantasy.”
Yet the gripezinha had ideas of its own. Twenty-one members of Bolsonaro’s entourage tested positive after returning from Miami. Relying on information from Bolsonaro’s son Eduardo, Fox News and the Rio de Janeiro newspaper O Dia reported on March 13 that Bolsonaro himself had tested positive. A few hours after the story came out, Eduardo backtracked, and Bolsonaro claimed he had tested negative. Public speculation on Bolsonaro’s status continues--abetted by recently leaked news that the Armed Forces Hospital where Bolsonaro and his wife were tested omitted the names of two positive tests from its report to Brasilia public health officials.
Undeterred by the invisible threat, and against the advice of his own Minister of Health, Bolsonaro encouraged his supporters to proceed with planned demonstrations against the Brazilian Congress and Supreme Court on March 15. What’s more, he ignored his doctors’ orders to self-quarantine for another week and joined them. Abandoning his protective mask, he took selfies, bumped fists, and by one count, shook hands with 272 people, .
COVID-19 infections are just beginning to spread widely in the developing world. After entering the world in China, the novel coronavirus has until now spread most rapidly and extensively in rich countries--likely because of their connectivity to China and each other via air travel.
Brazil looks to be at the unfortunate vanguard among middle- and low-income countries. As of today, Brazil has around 3,000 cases and nearly 80 deaths--by far the highest in Latin America or Africa.
The disease could prove catastrophic in Brazil. Long-term, structural factors substantially raise Latin America’s COVID-19 risk, and Brazil’s political environment will aggravate the risk further.
A saying goes that “when the U.S. sneezes, Latin America catches a cold”--in other words, downturns in the U.S. hurt Latin America even more. Though the axiom was formulated to describe international trade, it might apply to coronavirus as well.
The first risk factor in Latin America is the large informal economy. Popcorn vendors and shoeshines lack labor rights such as unemployment insurance or sick leave. A popsicle vendor under national quarantine in Lima, Peru, poignantly told a BBC reporter that she would soon have to melt and drink her own popsicles. People in such conditions will feel urgent need to keep working, no matter what their governments say about social distancing.
Second, Latin America’s urban poor and working classes tend to live in cramped quarters in high density neighborhoods, often lacking access to clean water and sewage. In such places, people won’t be able to follow standard advice such as for handwashing.
A physician with whom we spoke, who asked to remain anonymous, said that until now, most of the COVID-19 cases he had seen had been among the wealthy and upper-middle classes. Such a pattern likely results from the country’s initial contagion through international travel. But the situation “will get a lot worse” when COVID-19 starts to spread in working class neighborhoods, he worried. “Poor people will suffer more. People who live in slums will have lower chances of survival.”
A third risk factor, perhaps surprisingly, is demographics. Over the past several decades, the age distribution in much of Latin America has changed dramatically, as birth rates dropped and life expectancies grew. The Brazilian Institute of Geography and Statistics (IBGE) now estimates that 14.1% of Brazil’s population is 60 or older, falling into the high-risk category for coronavirus. Compared to low-income countries such as Nigeria, where birth rates are still very high, Brazil’s age profile puts it at substantial risk.
Fourth, health services tend to be underfunded in Latin America, especially for the poor. On the positive side, Brazil’s 1988 Constitution established a universal health system that has dramatically expanded access to health care. The system’s successes fighting diseases from dengue to AIDS have created a deep reservoir of expertise.
Nonetheless, hospital beds will be in short supply. According to two doctors interviewed (both of whom wished to remain anonymous for fear of repercussions), public and private health care systems are running short of COVID-19 test kits, not to mention other supplies, such as masks and goggles.
A doctor in a private hospital in Brasilia reported that “we don’t have any more surgical masks. To get one, you have to request one from the nurse, and only one is allowed per floor.” A physician from Sao Paulo reported that his hospital had directed physicians and nurses to use one single N95 mask for an entire month. Even in private hospitals, which are mostly available to the wealthy and upper-middle class, supplies are running low. As one physician said, “It’s predicted that we will run out of supplies everywhere.”
Finally, austerity policies stemming from neoliberal reforms will constrain Latin American governments’ responses to both the health care and economic crises. A 2018 Brazilian constitutional amendment restricting public spending currently prevents a massive public stimulus such as in the US. Though commentators are calling to revoke the amendment, doing so will require a level of parliamentary cooperation that will be hard to come by.
Here’s where Brazil differs from some other countries in Latin America: the Bolsonaro administration is actively downplaying the threat. Brazil-watchers know Bolsonaro as a culture warrior who has embraced the country’s previously marginal climate change skeptic movement. He often resorts to macho partisan bluster when backed into corners. Unsurprisingly, Bolsonaro blames the outbreak on China, Brazil’s largest trading partner. Eduardo Bolsonaro tweeted last week that the outbreak was “China’s fault.” In response, China’s ambassador to Brazil speculated that Bolsonaro had contracted a “mental virus” in the U.S.
Instead, Bolsonaro’s administration has focused on its economic response. The administration proposed an executive decree allowing employers to suspend labor contracts--and then partially retracted it following widespread citizen and legislator revolt.
Absent federal leadership, the states of Rio de Janeiro and São Paulo, as well as the Federal District, each shut down non-essential businesses last week. Angered at these responses, Bolsonaro called São Paulo Governor João Dória, a “lunatic,” accused Rio Governor Wilson Witzel of declaring independence from Brazil, and advocated keeping churches open, since they serve as a “last refuge.” In a national address on March 24th, Bolsonaro claimed that the media was attempting to whip up hysteria, that life should return to normalcy, and that schools should reopen since only the elderly were at risk of death.
Governors are now in open revolt, and Bolsonaro’s approval rating has dropped. Millions of people in large cities across the country have engaged in pot-banging protests and chants of “Bolsonaro out!” from their balconies each of the past ten evenings. A group of lawyers requested a psychiatric evaluation of Bolsonaro, arguing that he appears incapable of fulfilling his presidential functions. It is worth noting that if he were impeached, Vice President Hamilton Mourão, a retired general, would take office in a country ruled by a military dictatorship as recently as 1985.
Could Brazil avoid a catastrophe? If heat affects transmission, Brazil might be less vulnerable, but heat is unlikely to reduce transmission rates sufficiently to beat the virus.
More potentially impactful is Brazil’s large well of expertise running successful public health campaigns. One physician thinks the health system should, “do campaigns like for dengue….When the Minister [of Public Health] appears on TV with technical language and says that if we don’t flatten the curve the system will collapse, the population doesn’t understand the risks involved. We’re lacking clear communication with people, in simple terms.”
Absent changes, “we won’t be able to flatten the curve," remarked one doctor. "There will be a boom that’s faster than we want. Public health in Brazil will collapse.”
Meanwhile, in the state of São Paulo, soccer games, dance parties, and church activities continue in certain quarters, despite lockdowns. Rio de Janeiro, however, has found an alternative solution. Drug traffickers and paramilitary groups that control low-income neighborhoods have been establishing their own curfews. “We want the best for the population,” said one message widely circulated on social media. “If the government doesn’t have the capacity to find a way, organized crime will find a solution.” And we are still to find out if Bolsonaro himself contracted COVID-19.
In the meantime, Brazil waits.
Ryan Lloyd is a Visiting Assistant Professor in International Studies at Centre College.