SOS Brazil: science under attack.

As of Jan 21, 2021, Brazil ranks second in number of deaths from COVID-19 and third in number of cases seen in any single country. As a scientist, I tend not to believe in coincidence. In March, 2020, President Jair Bolsonaro referred to COVID-19 as a “gripezinha”, a little flu. In April, 2020, he declared there were signs the pandemic was coming to an end. A month later, when asked by journalists about the increasing numbers of COVID-19 cases, Bolsonaro responded “So what? What do you want me to do?” In response, the Editors suggested that “perhaps the biggest threat to Brazil's COVID-19 response is its president, Jair Bolsonaro”. More recently, Bolsonaro was, to the best of my knowledge, the only head of state worldwide to say he would not get vaccinated. He even discouraged the population from taking the vaccine by saying: “If you turn into a crocodile, it's your problem”.

Although these statements are outrageous, Brazil's response to the pandemic is much worse. Testing rates are far below the world average. No national policy on contact tracing has been implemented. Social distancing has been discredited. In 4 weeks, Brazil had three ministers of health. Despite Brazilian scientists and research institutes, such as Butantan and Fiocruz, being heavily involved in the global vaccine run, supplies of syringes and needles were insufficient to start the immunisation campaign.

Since the beginning of Bolsonaro's presidency in 2019, science has been attacked with budget cuts and negationism. Ricardo Galvão, director of the National Spatial Research Institute, was fired after presenting and commenting on data on deforestation. Former ministers of health, Luiz Henrique Mandetta and Nelson Teich, publicly disagreed with Bolsonaro by defending scientific recommendations to fight COVID-19. I never thought I would be next.

I am the principal investigator of EPICOVID-19, the largest epidemiological study of COVID-19 in Brazil. In its first three rounds of this countrywide study, we found marked regional, ethnic, and socioeconomic disparities in the COVID-19 pandemic in Brazil, as well as a six-fold difference between official statistics and estimates on the real number of infected people. These findings were not well received by the ministry of health, and funding for the study was discontinued in July, 2020. Fortunately, EPICOVID-19 has received funding from other institutions and continued to provide information on the burden of COVID-19 in Brazil.

In 2020, I was summoned to Brasília on three separate occasions for meetings with the ministry of health. Four days after my last visit to Brasília, in December, 2020, I started presenting with COVID-19 symptoms. My severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was revealed to the public by the media, and I was accused of hypocrisy and a “do as I say, not as I do” attitude. On Jan 11, 2021, in a radio interview, I was criticised by a congressman and by a journalist: the reason being that if I had been infected with SARS-CoV-2, it meant I did not follow the very advice I disseminate. On Jan 14, 2021, Bolsonaro tweeted the link to the specific segment of the radio interview in which my infection was mentioned.

Coincidentally or not, Bolsonaro's attack occurred exactly when the pandemic reached unprecedented numbers in Brazil. Manaus, in the Amazon region, is experiencing chaos as oxygen supplies are being depleted. The minister of health flew to Manaus and, after a 3-day visit, announced the city would be supplied with chloroquine, ivermectin, and other drugs to fight the situation. At the same time, politicians, businessmen, and other supporters of Bolsonaro were fighting against an announced (and urgently needed) lockdown in Manaus. Unbelievably, on Jan 16, 2021, a publication from the ministry of health was flagged by Twitter as violating its publication rules for disseminating misleading and potentially harmful information related to COVID-19.

Brazil's tragic COVID-19 policy comes with a price. With 211 million people, the Brazilian population represents 2·7% of the world's population. If Brazil accounted for 2·7% of global COVID-19 deaths (ie, performing as the global average in fighting the pandemic), 56 311 people would have died. However, by Jan 21, 2021, 212 893 people have died from COVID-19. In other words, 156 582 lives were lost in the country because of underperformance. Attacking scientists will definitely not help solve the problem.