Eduardo Parati
This week, Brazil’s COVID-19 death toll topped the 365,000 mark amid an unprecedented surge of the pandemic. There were 21,000 deaths last week as the daily rolling average of cases and deaths increased by 0.9 percent and 1.1, respectively. Thursday registered more than 66,000 cases and 2,900 deaths. A new report by the Oswaldo Cruz Foundation (Fiocruz) points to a tendency for the number of new cases to stabilize at such high rates. Meanwhile, 14 states plus the federal district registered an increase in the rolling average of deaths.
The Brazilian Medical Society’s recent publication of ethical protocols underlined the collapse of the healthcare system, in which doctors are having to choose who gets treatment due to the depletion of medical supplies – including sedatives and muscle relaxants need for intubation -- and the overwhelming of ICUs. Currently, 16 states and the Federal District are reporting an ICU occupation rate above 90 per cent.
Brazil’s COVID crisis was described Thursday as a “humanitarian crisis” by the international medical aid agency Doctors Without Borders (known by its French acronym, MSF), which has teams in parts of the country. The government’s criminal response to the pandemic “has put Brazil into a permanent state of mourning and led to the near collapse of Brazil’s health system,” MSF said in a statement
The terrible death toll in the country has resulted in eight states reporting a population decrease in the first 12 days of April, in which the number of death certificates outnumbered the number of birth certificates. Between April 1-15, the heavily populated Southeast registered 34,592 births and 40,084 deaths, which corresponds to a decline in population of 5,492. In March, the Southern region had already registered a population decrease, with 34,402 births against 34,719 deaths.
The state of Rio de Janeiro registered a population drop for six consecutive months between December of last year and March, with 76,541 births and 85,166 deaths, meaning a decrease of 8,625 in population.
Such a drop in population is unprecedented in Brazil’s history. It coincides with the publication of a new Harvard University study showing that Brazil’s life expectancy fell by 1.94 years in 2020, from 76.7 to 74.8. While the country has recorded the second highest death toll in the world, the life expectancy decrease is more severe than in the US, the country with the highest number of deaths, which registered a drop of 1.13 years, from 78.8 to 77.8.
With the ruling class being exposed for an even greater crime than the Manaus surge in January, leading newspapers are ignoring or downplaying the significance of the population decreases, while promoting the reopening of the economy that is being carried out throughout the country.
In an interview with the Globo media conglomerate’s podcast, amid the decision by the federal government to gut the 2021 National Census budget for the second time, former IBGE (Brazilian Institute of Geography and Statistics) president and current member of the census advisory board, Sérgio Besserman, downplayed the unprecedented scale of deaths. Responding to reports of a decrease in population, he said that “death certificates are required immediately, while birth certificates can wait, and I would not have registered a birth certificate for months”.
The issue is not a lack of information on the number of births, – which registered an actual increase – but the enormous surge in death certificates as a direct result of the pandemic. According to ARPEN (the national association of civil registration), whereas in March of last year there were 28,820 births, compared to 15,762 deaths in the South, March of 2021 registered 34,211 births against 34,459 deaths. It was also reported that 52.3 per cent of deaths in March in the most populous southern state of Rio Grande do Sul had been due to COVID-19. That contrasts to February, when the percentage was 24.31.
Ali Mokdad, professor at the Institute of Health Metrics and Evaluation (IHME), predicted that Brazil’s monthly death toll will reach the horrific 100,000 mark in April, one third higher than the number of lives lost in March. Mokdad also pointed out that, in case another surge happens in the coming winter, the death toll could be even higher “because the amount of vaccines available for Brazil at the moment is not enough to guarantee herd immunity until winter”.
The vaccine distribution campaign is facing consecutive delays, with the initial estimate by the federal government of 47 million shots in April dropping to 26 million. Most shots are Coronavac or AstraZeneca vaccines. At the present rate, inoculation of most of the population would take until late next year.
The government, meanwhile, has stalled the approval of a new round of emergency relief, which left the most vulnerable without any assistance for more than three months. The new round of installments is a criminally reduced version, cutting the value of the relief by more than half and creating stricter eligibility criteria, decreasing the number of recipients from 68 million to 45.6 million. This criminal policy is being openly defended by Brazil’s fascistic President Jair Bolsonaro, who declared recently he would not have approved any emergency relief if it was up to him.
Malnutrition and food insecurity in Brazil during the pandemic
According to data published by the research group Food for Justice at the Free University of Berlin Institute of Latin American Studies, 125.6 million people, or 59.4 per cent of the Brazilian population, have not had access to quality or adequate amounts of food since the pandemic began. The study interviewed 2,000 adults between August and December.
The study showed that there were significant decreases in fruit (41 per cent), meat (44 per cent), cheese (40.4 per cent) and vegetable (36.8 per cent) consumption during the pandemic.
It also found that 63 per cent of respondents used their emergency relief to buy food, and 27.8 to pay their bills. The study’s finding that households receiving the benefit were three times as likely to be living under food insecurity than those that did not indicates the desperate conditions confronted by millions of workers. It is also a testament to the criminality of ending the federal benefit and introducing a new delayed and shrunken version, forcing millions to confront malnutrition and starvation.
State governments and Bolsonaro support “herd immunity” policy
While Bolsonaro openly defends reopening the economy, the state government are completely aligned with the same murderous herd immunity policy, with governors themselves carrying out reopenings.
Governors are denouncing the federal government for the current healthcare crisis, pointing out that in August the federal government made the decision to cancel the purchase of 13 types of critical medications for the treatment of severe COVID-19 cases, called “intubation kits”, resulting in a shortage of medical supplies in ICUs today. There are currently 11 states facing a critical shortage of the kits.
However, in the country’s most populous state, São Paulo, the administration of right-wing Brazilian Social Democratic Party (PSDB) Governor, João Doria invoked a drop in the occupation rate of ICUs to just below 90 per cent as justifying the reopening of the economy. On Monday, the state government downgraded its COVID restrictions from the “emergency phase” to the “red phase”. Sporting events are now allowed without spectators, and products can be bought outside of restaurants and stores. Schools were already allowed to open with 35 per cent capacity even during the previous phase, and factories, businesses and stores received only a “recommendation” to set up intermittent schedules. Some regions with ICU occupations near 85 per cent are already being considered for a transition to the “orange phase”, which allows in-person customer service for restaurants and stores.
On Wednesday, two days after loosening restrictions, the state sent a letter to the Health Ministry declaring the situation in the state “severe”, and warning that the failure to provide intubation kits would result in a collapse of the health system.
On February 24, as Brazil was registering record ICU occupation rates and more than 350,000 new cases per week under the impact of the Manaus variant, the governor of São Paulo refused to close schools and non-essential activities. He instead announced a limited plan, closing down non-essential businesses at night, which left most of the economy open, declaring that “dead people can’t be consumers”.
On March 16, with ICU occupation rates above 100 per cent in dozens of cities, including those in the “ABC” industrial belt, Governor Doria extended the closure of non-essential businesses during the night and stopped in-person classes, but refused to implement a lockdown.
This was to serve mainly as a temporary backstop against the collapse of the entire healthcare system. The restrictions, imposed weeks before the first installment of the new and reduced federal emergency relief and months after the last installment of the old plan, barely diminished mobility in the cities, with workers forced to go out to provide for basic necessities.
On March 26, education was included as an “essential” activity, amid estimates that the daily toll of the pandemic could reach 5,000 between April and May. On March 30, in-person classes were authorized for private and local and state public schools, starting this week.
This policy is being replicated throughout the country, including in states governed by the Workers Party (PT), which are reopening their economies as well.
Last Saturday, with the weekly death rate in the state of Ceará reaching 823 and more than 25,000 new cases, the PT administration of Camilo Santana falsely stated that there was a “reduction in deaths and occupation of emergency units” and announced the reopening of restaurants, shopping malls, department stores, churches and schools. Non-essential production, nurseries and in-person education for three-year-olds or younger were never closed in the state, and the governor announced the reopening of schools for older age groups this week.
Federal and state governments, including those run by the so-called “opposition” of the PT, rerfused to allow any public health measures to impinge on the profit interests of the ruling elite. In October, in the run-up to the November local elections and amid clear signs that Brazil was on track to become the new global epicenter, the mainstream media was promoting a study to investigate whether Manaus had reached “herd immunity”, i.e., whether infections had reached a number high enough for the population to become collectively immune. The authors of the study stated that a positive conclusion should not be used for public health policy. However, the media’s reason for highlighting it was precisely to provide a justification for keeping the economy open.
The immediate result of the “herd immunity” policy in Manaus was its transformation once again into a coronavirus epicenter in January, with patients dying in corridors and outside of hospitals without critical oxygen cylinders. The federal government had ignored the need for extra supplies to prepare for the second Manaus surge.
On Saturday, National Health Counsel president Fernando Pigatto declared that “we are in the worst moment of the pandemic” and supported a national lockdown starting immediately to stop the spread of the coronavirus. He insisted that this measure be accompanied by emergency relief and assistance for small business owners.
Alcides Miranda, doctor and professor at the Federal University of Rio Grande do Sul, stated that “there was a bet on the idea of keeping the economy functioning ‘normally’ at the cost of herd immunity. That brought a dramatic cost of tens of thousands of preventable deaths”.
There is an alternative path, one that places human lives above profit, that could have prevented hundreds of thousands of unnecessary deaths and can still save the lives of many hundreds of thousands more. It requires international coordination in the implementation of a scientific policy to put an end to the pandemic and the provision of massive resources for healthcare and infrastructure to protect the lives of workers and poor and guarantee a full income.
This is only possible through the independent mobilization of the working class in the struggle for its own program to stop the spread of COVID-19. This includes a full lockdown along with full compensation for all workers and families so that they can shelter at home. This requires a socialist policy, including the expropriation of the vast wealth accumulated by Brazil’s ruling oligarchy amid mass death in order to pay for essential healthcare and social needs.
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