By José Maurício Domingues, September 2020
The coronavirus hit like a tsunami over the planet. International organizations and national states definitely knew that the risk of a devasting pandemic was high – the World Health Organization (WHO), in particular, had warned of this possibility, even likelihood, but global preparedness lagged. When, at the beginning of 2020, the looming risk became a concrete threat to the lives of individuals and the wellbeing of collectives, it left to the WHO and national states to cope with its brutal impact. The coronavirus – SARS-2 – and its related Covid-19 disease elicited similar responses across the world, but there are far-reaching differences in the way they were dealt with, even though epidemiological knowledge, the coordinating role of the WHO and similar state capabilities have featured in all of them. Lockdowns, quarantines, ‘social distancing’; the same medicines and treatment techniques came to the fore, allowing each national state to show their strength.
Brazil, though, is certainly an outlier. Its President, the extreme-right politician and former army captain Jair Bolsonaro, tried to imitate the United States’ President, Donald Trump. He behaved as a negationist and made the same mistakes, even more aggressively and callously. He initially based his overall public position (discourse) on the need to keep the economy open and avoid recession, assuming, as he put it, that people die of different things anyway – with the fit ones surviving what he classified as a ‘little cold’ – and that in war some soldiers become casualties. This was a harsh mix of military mentality and natural (beyond social) Darwinism. Yet, Brazil is a large country and neither the governors of the 26 Brazilian states and 1 federal district (where the capital, Brasilia, is located), nor the majority of mayors of the country’s cities followed him down this road.
There are many deaths in Brazil – more than 120,000 in late August and probably more than 150,000 by the year’s end. It could have been much worse had those other public authorities not adopted many of the measures recommended by the WHO and had Brazil not had an underfunded but encompassing system of quasi-universal public health care – the Unified Health System (SUS).
In what follows I examine the main strategies, appropriate measures, shortcomings and problems faced during the outbreak so far. I also dwell to some extent on the political crisis that developed in conjunction with the sanitary emergency.
At this point, short of a vaccine, it is unclear how Brazil will control the coronavirus outbreak, though in some regions of the country things had improved by early September. It is as though, as Nelson Teich, Bolsonaro’s second health care minister put it, the country was ‘waiting for a miracle’.
Facing up to the crisis
Brazil is a very unequal country, possibly the worst globally. But it has a strong sanitary and epidemiological tradition, which includes full-scale vaccination campaigns, powerful and highly internationally rated health care foundations – Fiocruz Foundation as well as the Butantan Institute – and a well-developed medical science. The medical profession is strong and sizeable. In the 1980s the so-called ‘sanitary movement’, led by the left (the Brazilian Communist Party – PCB, mainly), created the aforementioned SUS. Despite being underfunded, it is present across the country (though less so in the countryside and poorer areas). This has from the very beginning provided Brazil with the means and resilience in the face of the quick spread of the coronavirus. Halfway through the pandemic, however, this community was side-lined especially at the federal level, as we will see below.
The first case of coronavirus in Brazil was dated February 26, although the virus seems to have been circulating before. Soon lots of people were dying and numbers increased sharply. Public authorities started to mobilize amid the growing apprehension of pandemic diffusion across the country – initially triggered by wealthy Brazilian tourists who had arrived from Europe. What to do became an extremely contentious issue.
When the sanitary crisis started, Bolsonaro’s health minister Luiz Henrique Mandetta had been in office for a year and one month. A physician and centre-right politician belonging to the Democratic Party (which was not formally part of the government), Mandetta recognized the threat. He assumed great protagonism, gave significant prominence to the SUS and articulated a response together with state governors of different political persuasions. In fact, already in February the National Congress had approved a quarantine law. With extremely dire predictions being made, state governors almost panicked and in mid-March most of the country had gone into partial lockdown. Some main cities were hit hard by the virus, with sad consequences especially in the poorer ones where public health facilities are scarce (notably in Belém do Pará, in the north of Brazil), but richer ones such as São Paulo and Rio de Janeiro became also main epicentres. Bolsonaro then clashed with the minister and governors, trying to stop the quarantines, while recommending chloroquine as a treatment (army laboratories were ordered to produce huge quantities right away). The Supreme Federal Court (STF) ruled that governors could decide on what measures to adopt.
Mandetta spoke every day on TV and became highly popular, orienting people and showing compassion and concern. This led Bolsonaro, who stuck to his aggressively scornful and Darwinist approach, to dismiss him on April 16. Nelson Teich, also a physician linked to private health and an earlier supporter of Bolsonaro, but not a professional politician, took over the ministry but on May 16 resigned: Bolsonaro contradicted all his orientations, insisting on opening the economy and on chloroquine-based treatment. General Eduardo Panzuelo assumed as interim minister. Despite being criticized for remaining active in the military, he has to this day kept the post, having stuffed the ministry with several other army men. Actually, many health experts that were crucial in the decades-old continuity of efforts left the health ministry during the pandemic.
Yet epidemiologists’ dire predictions did not materialize. This does not mean that tragedy has not befallen Brazil – the more than 120,000 deaths so far and the many more to come cannot be discounted. While figures have gone down or stabilized in the main capital cities, the outbreak is still spreading across the countryside. The daily death count has stayed far above 1,000 for months now, and the virus has also reached indigenous communities. But the actions of state governors and mayors helped prevent the worst, along with the resilience of the public health system, not to mention high-quality private medicine. Even community organization in some slums such as in Rio de Janeiro and São Paulo helped to avoid an explosion of deaths.
That said, there is no end to the crisis in sight, except for the hope that vaccines now at their last trial stage work and can be quickly distributed – already in 2020. Since levels of contamination and the number of cases remain high in Brazil, it has become a playing ground for testing their effectiveness, including the more advanced Oxford/AstraZeneca (Fiocruz, in agreement with this laboratory will soon receive and produce 100 million doses from December 2020 to June 2021, if things go according to plan) as well as the Chinese Coronavac, the German BioNtech and Pfizer and the Russian one. Yet, Brazil tests very little overall and there is virtually no contact tracing; the double method that has allowed the partial control of the coronavirus outbreak in other countries. The government has not played a coordinating role at all, also spending at this point less than half of the resources made available by Congress to fight the pandemic. Unfortunately, a lot of corruption in state governments regarding the acquisition of emergency equipment – especially though not only ventilators – has already been revealed in astonishing magnitude, evincing what comprises a chronic national problem.
Masks are now mandatory, cities are slowly opening according to scientific criteria that is, however, based on approximate data. The situation and deaths have been normalized and are accepted as a feature of life, though people mostly remain frightened and careful.
Like in almost every country, Brazil’s economic situation is appalling and was initially met by denial. Bolsonaro’s economy and finance minister, Paulo Guedes, is a backward and stubborn right-wing neoliberal who worked for General Pinochet as young man. His prescription for Brazil was a deepening of ‘deregulations’, privatizations and cutting back. In January, before the sanitary crisis, the economy had already slightly contracted, after years of recession and then extremely mediocre growth. Unemployment was rampant. With the coronavirus the forecasts are of course much worse. The International Monetary Fund (IMF) has predicted a 9.1% contraction for 2020, with very limited recovery in 2021. Guedes insists the slump will be of ‘mere’ 4.7%, followed by a V-recovery (the predicted low standing at around -5%). Though he resisted the emergency Keynesianism adopted by all countries, he had nevertheless to bow to reality and created lifelines for business (which banks have withheld) and state governments. He set up emergency cash transfers for especially the huge numbers of people informally employed in Brazil’s backward tertiary sector (a measure actually proposed by left-wing Congresspeople). Suspension of labour contracts and temporary diminution of wages were also adopted.
Guedes hopes things will get back to normal soon – an unlikely course of events. He is supported by Bolsonaro and the ‘business’ community, especially the financial market. Privatizations have been promised for this year, to reduce the mounting public deficit, which, big enough before the crisis, is seen as a threat by the mainstream economic and business establishment. The main measure that would somehow deviate from this is the extension of the social liberal framework to support the poor and especially Bolsonaro himself. The Workers’ Party (PT) introduced the social liberal ‘Family Grant’ programme, which at its height included more than 13 million families. Guedes was trying to at least trim it. Now the programme will be broadened and receive a new name, ‘Brazil Income’: a new governmental brand. Bolsonaro thinks it will help boost his popularity and eventually guarantee him a second term in 2022. No further stimulus measures are envisioned for now, but this may change once political pressure increases.
Extreme-right hysteria and political crisis
Bolsonaro is a fascist who dreams of the 1960s-1970s, when a military regime ruled Brazil. His government is right-wing, though not extreme-right. He has however also from the outset clashed with the liberal and democratic features of state and political systems. His political prospects, despite his usual crassness looked good until the coronavirus outbreak demanded proper responses. He showed himself, due to ideology and lack of competency, incapable of providing them. Supposing he had the support of large sectors of the armed forces – especially since his government is staffed by thousands of army men, including generals in top posts, and right-wing perspectives are dominant in the armed forces – he sought confrontation with whoever disagreed with him. He insisted on misguided advice and outrageous behaviour, medically and politically, in order to keep his support – until then, a stable share of 30% of the electorate. He even seriously tried to create the atmosphere for a coup he would himself lead.
The strategy backfired. Brazil is a relatively consolidated liberal democracy, actually apparently more than many believed. As a liberal democracy, it is also largely oligarchic – above average, in fact. Although the left was initially his main target, Bolsonaro clashed precisely with the main representatives of this liberal oligarchy. Risking eventually an impeachment process, he had to tone down his voice and change tack, though he himself remains unchanged, while Guedes offers him no actual way out of the economic crisis. Politically, the situation has therefore stabilized and, due to the economic measures his government implemented, Bolsonaro’s popularity has amazingly increased: he benefited from the partial lockdown introduced by governors and the cash transfers pushed forward by the Congressional left. Yet, in sanitary terms, things are far from being solved and the political situation remains, in essence, volatile.
The is the fourth paper in the Covid-19, States and Societies series. More information about the series and access to all the papers HERE.