COVID-19 in Brazil: the catastrophic results of an inappropriate and unequal health policy.

Dear editor,

Currently, Brazil is going through a difficult crisis with its health system, which befall the country and has led to a trail of lives being cut short by COVID-19. Brazil has reached, by April 1st 2021, the mark of 12.748.747 cases and 321.515 lost lives caused by COVID-19 [1] and this numbers keeping on rising, as the situation is turn chaotic [2].

Hospitals are at full capacity, some with even more than 100% occupancy and a crescent line of patients waiting for a bed for hospitalization. There is a lack of breathing equipment, oxygen cylinders and the health workers are operating at their physical and mental limits. In Brazil, it was declared on February 3rd, 2020, the Public Health Emergency of National Importance (ESPIN), as a direct result of the human infection by the coronavirus (2019-nCoV), considering it a complex event and the demand for a joint effort of the whole Unified Health System (SUS) is needed, so that the etiology of these occurrences and the adoption of proportional and risk-restricted measures were possible [3]. After a year of the ESPIN declaration, the country goes through its worst moment in this health crisis, since the imposed actions for this pandemic scenery were left at the mercy of the political and economic issues of governments at the federal, state and municipal levels. At the federal level, the country underwent the replacement of four health ministers in the middle of the pandemic and recently the minister of foreign affairs and defence was also replaced. At the state and municipal level, governors and mayors argue about the intensity of the restrictive measures, since many of them end up restricting local business, bringing economic losses to certain regions and in return, these measures can displease potential voters and such actions will have an impact on future elections.

The vaccination process is very slow and Brazil has only about 8.32% [4] of the Brazilian population vaccinated and it faces a variety of logistical challenges to make it possible for the vaccine to arrive in different places in order to serve the population, as country has more than 8.5 million square kilometres. At the beginning of the vaccination process, only the health professionals from the front line, indigenous population and elderly people with restrictions were being vaccinated [5], but currently, each municipality is doing its own management of the priority groups that will receive the vaccine and organizes the form of distribution among the different health units. The delay in commercial agreements for the purchase of vaccines in the country and the absence of a national vaccination plan under the coordination of the federal government, contributed to the collapse scenario in which the health system is today. As if all the wear and tear due to the wait and the delay in vaccination were not enough, the country still faces the position of many doctors and other health professionals who are in favour of using untested cocktails and drugs without any scientific basis for combat of the coronavirus, drugs in which the side effects are still unknown [6].

Brazil has completed more than twelve months of its first case of COVID-19 and it is observed an atonic government, when facing the severity and lethality of the virus. In the economic and social sphere, the unemployment rate in Brazil may reach 16.9% in the first half of 2021, affected by the end of income transfer and the pandemic worsening [7]. This situation tends to increase the income inequality in the country.

And what is the legacy left by COVID-19 in Brazil? It is still not possible to answer this question in a definitive form, as the pandemic is far to be over in Brazil, but it is possible to recognize the devastating effects caused by the virus, claiming more than 300.000 lives and imposing new rules of coexistence on the population. On this pandemic scenery it is necessary to adapt to a new way of conviviality and living. It has been searched new ways of working, having celebrations, studying and many others activities, as there was the necessity of implementation and utilization of new technological tools in order to face the imposed challenges and circulation restrictions. Besides having to deal with the COVID-19 pandemic, which is generating devastating consequences, the Brazilian population is also facing turbulence in the political scenery. It is desirable for the country to be able to overcome these challenges and for governments to be aware that the population's “right to life” is non-negotiable, non-partisan and its preservation is a state priority.

Disclosure of interest

The author declares that he has no competing interest.