Brazil could have stopped 400,000 Covid deaths with better government response, expert says

Brazil could have saved 400,000 lives if the country had implemented stricter social distancing measures and launched a vaccination programme earlier, according to an eminent epidemiologist who is leading the first study to quantify the scale of the country’s Covid disaster.

Such policies would have prevented 80% of the half a million Covid deaths registered in one of the hardest-hit countries in the world, said Pedro Hallal, a professor at the Federal University of Pelotas.

“The responsibility for these numbers is entirely on the federal government’s back –and particularly on the president’s,” Hallal told the Guardian.

“It was not the federal government who said that the pandemic was a ‘little flu’. It was not the government that encouraged people to go out without a mask, or who said that the vaccine could turn you into an alligator. That was all the president, and it’s his responsibility,” Hallal said.

Hallal said that the Covid-19 mortality average was more than four times higher in Brazil than the rest of world – 2,345 per million in Brazil versus 494 globally.

Hallal, who last week testified before a senate inquiry into the government’s handling of the crisis, also estimated that 95,000 to 145,000 deaths occurred due to the country’s inaction in acquiring vaccines. The inquiry has heard damning evidence that the government of Jair Bolsonaro dismissed several vaccine offers from pharmaceutical companies in 2020 even as coronavirus raged through Brazil.

Brazil’s vaccination program finally started in late January, but it has been constantly interrupted by shortages of both imported doses and supplies for the domestic manufacture of CoronaVac vaccines (which requires an active pharmaceutical ingredient shipped from China).

The program recently gained some momentum with new shipments, including the donation of 3m doses by the United States, and at least one dose has now been given to 33% of Brazil’s 212 million citizens, according to figures by a group of media outlets.

But the program is far from running smoothly. The percentage of citizens who are fully vaccinated has remained stuck at under 12% for nearly a month, as millions of Brazilians fail to return for their second dose.

The effect of such incomplete treatment remains unclear but with Brazil still struggling with the P1 variant, health experts say that many people will need to start their vaccinations again.

The reasons for the incomplete vaccination include a shortage of vaccines, a lack of close follow-ups by medical staff, and the failure to launch a national campaign stressing the importance of the second dose.

“We needed a national campaign calling people to get fully vaccinated – which did not happen,” said the epidemiologist Carla Domingues.

Domingues, who coordinated a successful national immunisation program between 2011 and 2019, said that leadership was critical to its success. “At the launch of every [previous] vaccination campaign in Brazil, the president was at a vaccine unit encouraging people, but the current president has not appeared at any unit since the beginning of the Covid rollout.”

On the contrary, Bolsonaro has actively discouraged the campaign, refusing to be vaccinated himself and spreading falsehoods about immunisation.

“I’ve got the virus alive, so I am immunised,” he told supporters in March about being previously infected by Covid-19. “I will let other people get the injection in my place, and later on, if I decide to get the vaccine – because, depending on me, this is voluntary, you cannot force anyone to take it – I will take it.”

In the meantime, local authorities struggle to keep people engaged in vaccination. The north-eastern state of Maranhão recently released a campaign offering up to US$2,000 for those who get the second dose.

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