Brazilian President Jair Bolsonaro goes back to his car after talking to supporters on May 20, 2020, in Brasilia. | Andressa Anholete/Getty Images

And the president is touting an unproven drug.

Brazil recorded its highest single-day coronavirus death toll on Tuesday: 1,179 fatalities.

It was another bleak statistic for the country, which has seen its coronavirus outbreak explode in the past few weeks. As of May 21, Brazil has confirmed more than 291,000 positive cases, the third-highest in the world, and more than 18,800 Brazilians have died of the virus. Inadequate testing means both the case count and the real death toll are likely higher.

It’s devastating — but it’s also what many predicted might happen in the Latin American country. Brazil’s public health system was already strained before the pandemic, and hospital systems in some of its major cities are now on the verge of being completely overwhelmed. Lack of adequate supplies and health care equipment has put front-line workers at risk; more than 116 nurses have died in Brazil so far.

The virus is now spreading rapidly among more vulnerable communities, especially in favelas on the outskirts of cities, where social distancing is near impossible because of cramped or unsanitary conditions and because many people must work every day just to survive. It has also reached remote indigenous communities, who have far from adequate health care.

And then there is the president, Jair Bolsonaro, who has mishandled the outbreak from the start. He’s consistently downplayed the seriousness of the virus, vocally opposed state governors’ decisions to impose lockdown measures, personally attended anti-lockdown protests, and pushed for businesses to reopen despite the growing outbreak.

Asked by reporters on April 28 for a response to the then-record death toll that day of 474 deaths, Bolsonaro replied: “So what?”

“I’m sorry. What do you want me to do?” he continued.

His stance hasn’t changed as the coronavirus pandemic in the country has intensified.

In his battle to reopen the economy, he has tried to designate gyms and salons as essential businesses. He fired his health minister in April; then last week, the man who’d replaced the fired health minister quit. And now Bolsonaro is endorsing the use of hydroxychloroquine, the controversial antimalarial drug that President Donald Trump claims he’s taking to prevent the coronavirus (though there’s scant evidence it actually works).

Meanwhile, the number of cases and deaths continues to rise — and the crisis has not yet reached its peak.

“We’re in a state of calamity,” Carlos Fortaleza, an epidemiologist at São Paulo State University, told the Wall Street Journal earlier this month.

Brazil’s coronavirus crisis is accelerating. Bolsonaro hasn’t budged.

Bolsonaro’s dismissive attitude has undercut attempts to control the virus and stymied any chance at a coordinated federal response.

State governors have defied him and implemented strict lockdowns. São Paulo and Rio de Janeiro, two of the hardest-hit states, have tightened restrictions in recent weeks, including extending stay-at-home orders and mandating masks.

Brazil’s Supreme Court has previously backed up the power of state governments to implement stay-at-home measures, but Bolsonaro has started to push back even more aggressively.

Last week — just as Brazil saw what was then its highest single-day death toll — he signed an order that would designate some businesses, like gyms and nail salons, as “essential” — an attempt to get around state lockdowns. “Governors who do not agree with the decree can file lawsuits in court,” Bolsonaro tweeted.

At least 10 governors said they would ignore Bolsonaro’s orders, according to Reuters, but the president’s cavalier attitude has likely undercut widespread compliance even in areas that have adopted strict rules.

“The fact that governors and mayors who want to do the right thing have to go pretty much against what the president is saying is an issue,” Marcia Castro, a professor at the Harvard T.H. Chan School of Public Health, told me, “because that brings major challenges for adherence of the population to the measures. Because once you have a polarized society, and you have conflicting messages, people decide to follow whoever they want.”

The president has a fervent base of support, and his fans tend to fully buy into his rhetoric and are distrustful of the mainstream media. As Bolsonaro agitates against these lockdown measures, so do they.

Bolsonaro has even joined anti-lockdown protests, taking photos with demonstrators and frequently defying social distancing guidelines. Last weekend, he did pushups with supporters. “We hope to be free of this question soon, for the good of all of us,” Bolsonaro said in Brasilia over the weekend. “Brazil will come back stronger.”

Bolsonaro’s attitude has also precluded a real, coherent response from his administration, largely leaving states and cities on their own to find resources and medical supplies. The country continues to lag in testing and is facing equipment shortages. According to Bloomberg, the federal government purchased 15,000 ventilators, but logistical problems have meant only 800 have been doled out so far.

Bolsonaro has embraced hydroxychloroquine

Bolsonaro has been referred to as the “Trump of the Tropics” because of his populist rhetoric, his attacks on “fake news,” and his frequent tweets and the controversies they create, to name just a few reasons.

Now add a troubling fixation with the drug hydroxychloroquine to the list of similarities between the two leaders.

Hydroxychloroquine and chloroquine are antimalarial drugs that were seen early on in the pandemic as a possible treatment for the coronavirus, following small but widely criticized studies from China and France. Newer studies have shown no benefits from the use of hydroxychloroquine, and at least one has shown potential negative effects from giving the drug to severely ill coronavirus patients, though that study has not been peer-reviewed.

Public health officials in the US and Brazil have warned against the widespread use of chloroquine and hydroxychloroquine outside hospital and clinical settings and cautioned against touting them as a “miracle cure,” especially in the absence of robust clinical trials of the drug.

Yet Trump has been doing exactly that. And now Bolsonaro has taken a similar tack, pushing the drug over the advice of public health officials.

In late March, Bolsonaro posted a video in which he hyped the drug, falsely claiming that it “is working in every place.” Facebook, Instagram, and Twitter later had the video taken down, saying it had violated their policies on spreading misinformation related to the coronavirus.

Last week, Bolsonaro ordered his health minister, Nelson Teich, to issue new federal guidelines to allow for the wider use of the antimalarial drugs to treat Covid-19.

But Teich had publicly diverged with Bolsonaro over the use of hydroxychloroquine, and on Friday, he quit his job — which he had held for just about a month.

“Life is made up of choices, and today I chose to leave,” Teich said, avoiding details on his departure. “I didn’t accept the job for the position itself. I accepted it because I thought I could help the country and its people.”

Teich had taken over the health ministry in April, after Bolsonaro fired the previous health minister, Luiz Henrique Mandetta. Mandetta had publicly contradicted Bolsonaro, advocating for social distancing measures and backing the state governors’ shutdown orders.

Many Brazilians and political leaders denounced Mandetta’s firing: Brazilians protested from lockdown, banging pots and pans from windows and calling for Bolsonaro’s ouster. When Teich stepped down, they protested again.

Gen. Eduardo Pazuello, who came to the agency in April and had no real public health experience prior to taking the job, is now interim health minister. And he seems willing to go along with Bolsonaro’s orders.

On Wednesday, the health ministry issued new federal guidelines allowing chloroquine and hydroxychloroquine to be used to treat mild cases of coronavirus.

As Reuters reports, “Brazil’s federal guidelines had previously cited the drug only as an unproven treatment for severe cases of the COVID-19 respiratory illness caused by the novel coronavirus.”

Now, “The new guidelines suggest dosage for the antimalarials along with the antibiotic azithromycin at the onset of symptoms. Patients or family members will have to sign a waiver recognizing potential side effects.”

On Twitter, Bolsonaro said Wednesday that though chloroquine wasn’t scientifically proven as a treatment, “it is being monitored and used in Brazil and around the world.”

“Yet we are at War: ‘Worse than being defeated is the shame of not having fought,’ he wrote.

Bolsonaro has also trumpeted the (unproven) wonders of chloroquine to his supporters, and that faith has taken hold among his base.

Over the weekend, Bolsonaro fans, while definitely not social distancing, greeted the president outside his residence and praised chloroquine. “I know that you cure me in the name of Jesus,” they sang. (SUS is the acronym for Brazil’s health system.)

This is where Brazil is: saddled with a leader who defies public health advice, advocates for the use of an unproven treatment, refuses to follow or promote social distancing, and actively tries to thwart state governors’ efforts to impose lockdown measures.

But those lockdown measures involve shutting down the economy, and fear of the (very real) impact lockdown measures are having on the country’s already struggling economy seems to be what’s driving much of Bolsonaro’s resistance.

“I think he wants to be able to say, at the next election, ‘Those governors stopped you from working; it would have been a lot better if I had been able to prevail,’” Anthony Pereira, professor of Brazilian studies at King’s College in London, told me last month.

So better to tout a miracle cure. “If they prioritize the economy, if the goal is to have everything open, then it’s nice to have a discourse that, you know, ‘I have the solution, let’s just have everyone take it, and then we can open the city,’” Castro, the professor at Harvard’s T.H. Chan School of Public Health, said of both Bolsonaro and Trump. “I think it fits the narrative that they have. It just happens to be chloroquine. It could be something else.”

None of this bodes well for Brazil’s coronavirus response. Bolsonaro is also facing a serious political scandal, after he ousted the chief of federal police and his justice minister resigned, accusing Bolsonaro of trying to interfere in law enforcement. Bolsonaro’s sons are under investigation, and now Bolsonaro is as well, and the calls for impeachment are growing.

Bolsonaro may survive it all, and the coronavirus is currently overshadowing the political turmoil. But more than 18,000 Brazilians dead is hardly a distraction.


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