By Elio Gaspari
In December 1849, U.S. ships from California passed by the Brazilian coast and the doctor of the foreigners' ward at the Santa Casa de Misericórdia in Rio de Janeiro suspected that he was facing yellow fever cases. He visited taverns frequented by sailors and informed the Imperial Academy of Medicine that an epidemic could reach the country. The academics said his suspicion was unscientific.
In February 1850 the fever had ravaged part of the city and in April, Senator Bernardo Pereira de Vasconcelos, leader of the conservatives, went to the gallery and declared, "I am also convinced that the population of Rio de Janeiro has reacted too much in terror, that the epidemic is not as damaging as many have been persuaded, it is not yellow fever that reigns. ”
Six days later, Vasconcelos died of yellow fever.
Denialism and anti-scientific attitudes do not just belong to the 19th century, nor are they typical only of Brazil, but in Rio de Janeiro in 1904, the biggest popular uprising in the history of the city took place. It is known as the "Vaccine Uprising" and nearly overthrew the government. Prejudices against the mandatory smallpox vaccine, added to the opportunism of politicians, journalists, and the dissatisfaction of some military personnel, contributed to the uprising. The revolt would be a pretext for an uprising against President Rodrigues Alves. His inflexibility, refusing to take his family out of the palace and having the “traitors” shot, saved his government.
In the 21st century, in the face of Covid-19, some of the ghosts of past epidemics have been arising once more. Like Bernardo Pereira de Vasconcelos, President Jair Bolsonaro saw exaggeration in the concern about the arrival of the coronavirus. In the second week of March, when at least five cases of Covid-19 had been detected in Brazil, and Harvard had already canceled an event with the participation of Brazilians, among them a Supreme Court judge, Bolsonaro said that "other flus kill more than this." "The coronavirus issue is not all that the mainstream media propagates or that everyone is saying." Or "It won't be a little cold that will knock me down" "
(This article was written on June 21, when Brazil has already registered more than one million cases of contagion and 50,000 deaths. ")
Bolsonaro escalated his denialist attitude. He went to the United States and returned with 24 infected people in his party, including two ministers. "Hysteria", "fantasy" or even "neurosis," he called it. He expresses a consistent personal concern. In part it was explainable, because in Brazil, as everywhere, the opposition took advantage of the difficulties brought about by the epidemic: "You cannot want to throw a possible spread of the virus on my back." In fact, it didn't work, but denialism led him to combat social isolation, accusing the governors who had imposed him of being "job exterminators." The governor of São Paulo would be a "lunatic,” he said.
(A Federal Supreme Court decision recognized the legality of quarantines imposed by state governments.)
At that time (March 15), the president exposed the real utilitarian basis of his negativism: "If the economy sinks, Brazil sinks. And what is the interest of these political leaders? If the economy ends, any government ends. My government ends. It is a power struggle. "
Unlike D. Pedro II, who visited institutions with yellow fever and lonely patients, in response to the concern of his friend, the Countess of Barral, Bolsonaro only visited one hospital in June, to be inaugurated, when it was still empty.
On March 19, a domestic worker who lived in a suburb of the city and worked in the home of a family in the in the city’s wealthiest neighborhood, died in Rio de Janeiro. She had been contaminated by her employer, who had returned from Italy. (As the virus spread from people who returned from abroad, some people called it "coronarrico")
Bolsonaro fought for power. It is impossible to know how this type of combat can be useful during an epidemic, but his subsequent actions are inexplicable.
In April, when the dead rose to 474, he got angry: "So what? I'm sorry. What do you want me to do? I'm a Messiah, but I don't perform miracles.” His full name is Jair Messias Bolsonaro.
The president persisted in opposing the quarantine and became a propagandist for the drug chloroquine. The Health Minister had assumed the position after a meaningless parliamentary life, but he was a doctor and knew his profession. With long daily interviews he became a popular figure in a government of declining prestige. Luis Henrique Mandetta committed two sins: he defended quarantines and always mentioned the limitations and risks of chloroquine. He was fired in mid-April, when the number of dead had risen to 1,952, and 30,891 more had been infected.
Another doctor, recruited from Bolsonaro's supporters, replaced Mandetta. It should be noted that in his 20-year electoral campaign, the president had significant support from the medical profession, especially from those who work in the private network. That support seems to have disappeared.
Dr. Nelson Teich stayed exactly one month in the position. He was dismissed because he would not go along with the defense of chloroquine. His brief term was marked by the militarization of the ministry. He accepted that a general take over as. Interim minister; he is still there today, joined by 20 other officers. Teich’s regime gained notoriety for two measures: it suspended the daily interviews inaugurated by Mandetta and changed the system for disclosing the statistics of the dead and the cases of contagion.
The magic with the numbers lasted only one day. The country’s principal media outlets formed a consortium that collects daily data provided by Brazilian state governments and releases the consolidated figures every evening. Nobody misses the statistics from the Ministry of Health.
One can imagine that in a country with a denialist president, three ministers of health during an epidemic and another 50,000 dead, everything went wrong. Fortunately, it is not so. Brazil has one of the largest public health systems in the world, with about 200,000 professionals, and so it doesn’t deserve what is happening. The network has collapsed in many states, but millions of people have been cured, thanks to people who almost always work in precarious conditions. It is estimated that 32,000 doctors and medical workers have already been infected. On the day that the death toll reached 50,000, becoming the second country in the world with the most victims after the United States, Brazil was the first in the deaths of doctors and nurses: 229. In Brasília, nurses who demonstrated near the presidential palace, asking for safe working conditions, were harassed by Bolsonaro-supporting militiamen. In Rio, in a similar demonstration, the police arrested ten professionals. On that day the city had 33,589 cases of Covid, with 3,657 deaths.
Epidemics bring up problems that in normal times hide in the labyrinths of bureaucracies. In this regard, Covid-19 has revealed the weaknesses of Brazil's federal, state and municipal government. With the arrival of the coronavirus, the Brazilian state tried to be helpful and attentive. In some cases, it was only idle talk. For instance, Economy Minister Paulo Guedes said that an English friend was willing to offer 40 million monthly tests to detect the presence of the virus. Until today neither the friend nor the tests have appeared.
In some cases, the situation is even worse. Trying to show themselves helpful, state governments made purchases and signed contracts using emergency rules. This resulted in robberies in at least five states. In São Paulo, businessman Zheng Xiao Yun (Marcos Zheng), president of a Shanghai Association in Brazil, was arrested and accused of stealing a load of 15,000 Covid-19 tests .
Respirators were paid for and did not arrive, and when they did, they were not suitable for Covid-19 patients. Rio de Janeiro has already had five former governors arrested for corruption. One of them, Sérgio Cabral has been convicted 13 times and is in prison, sentenced to 282 years. In 2018 a former judge was elected who presented himself as champion of morality. During the epidemic he contracted for the construction of seven field hospitals on an emergency basis. Scandals exploded before any of them opened. Among those involved in these contracts was at least one person who had sold government services to Cabral.
The pandemic, with its internal and external impact, is expected to lead to a ten percent contraction in the Brazilian economy. The pressures of businessmen, as well as those of traders who may go bankrupt if the quarantine is not lifted, contributed to Bolsonaro's denialism. Brazilians who need to work are taking risks in the streets and epidemiologists worry about a new wave of contagion. With 50,000 dead, the country still has not have reached the peak of the epidemic and, due to Brazil’s size, the disease is still spreading in the interior of the country.
During the AIDS pandemic, Professor Dieter Koch-Weser (1906-2015) was at Harvard Medical School. His life was marked by the twists and turns of the 20th century. He was born in Germany, his father was a minister in the Weimar Republic and, with Hitler's rise, he joined a group that decided to emigrate to Brazil. The group went to the forests of Paraná and founded a community in Rolândia. Koch-Weser graduated in medicine at the University of São Paulo and, years later, went to the United States. He dedicated himself to public health and saw the emergence of the Brazilian Unified Health System.
He could have told us much better what is happening in the country during the Covid-19 epidemic.
Elio Gaspari is a Brazilian journalist and 2004-2005 DRCLAS Lehman Visiting Fellow.