World's worst Covid crisis is unfolding in Brazil, where no fix seems to work

More than a year after a spiked virus launched a murderous campaign across the globe, most countries have put the worst behind them, aided by aggressive government policies and vaccines.

Not Brazil.

The continent-sized nation of 212 million is facing more Covid deaths and cases than ever, its hospitals overflowing, its policy in disarray, its vaccine supply severely limited. In addition to a president who scoffs at the disease, rejects masks and leaves each state on its own, the country plays host to a variant that’s more contagious and possibly deadlier.

Nothing better illustrates the bizarrely fractured nature of Brazil’s Covid policies — and how they’ve sowed confusion and anger and suffering — than three cities along a 140-mile roadway in the state of Sao Paulo, where three distinct approaches to the pandemic coexist. In one, practically anything goes; in another, it’s full lockdown; and in a third, mass vaccination is underway. Each is a mess, overrun by rampant illness and mired in a deep economic funk that shows no signs of ending anytime soon.

“What we’re living through now is much worse than what we had before,” said Denise Garrett, an infectious disease expert and vice president of the Sabin Vaccine Institute in Washington. “I see a huge storm forming in Brazil.”

Sao Paulo, the country’s financial hub and center of wealth, is where the virus first made landfall one year ago in Brazil, transported unwittingly by returning skiers and holiday-makers from Spain, Italy and the US From them, it spread to household help and employees.

Araraquara sits almost in the middle of the state, a four-hour drive from the capital, and has long basked in its access to wealth. Its 240,000 residents make three times the nation’s minimum wage.

These days, work is scarce. In fact, everything is scarce. Araraquara has been hermetically sealed — even supermarkets and gas stations are shut — for the past week or two to push back against a viral attack like no other.

In the first two months of 2021, more people have died of the virus in the city than in all of 2020. Most Covid tests are coming back not only positive but positive for the highly contagious Brazil variant that emerged in the Amazonian city of Manaus. The strain, which preliminary studies suggest is at least twice as transmissible, showed up in more than 80% of samples collected at a clinic in the city from mid-January to mid-February.

So Mayor Edinho Silva has imposed a lockdown of unprecedented severity.

“I opted for a lockdown like what they had in China,” he said. While effects will take time to show up in the numbers, it was the only way to keep the situation from getting even worse. “If we don’t close, we’ll have people dying without having the right to fight for their lives.”

Eighty miles away, the city of Bauru, with 380,000 residents, is facing a similarly devastating rate of infection. Its ICU beds are, like those of its neighbors, 100% occupied. The patients, once elderly, are now in their 20s and 30s and arriving even sicker than previously.

And yet, Bauru is not shutting down. Not by a long shot. Mayor Suellen Rosim has been following the lead of President Jair Bolsonaro, even joining street protests against the state’s governor for ordering lockdowns.

“People are taking risks, but not because they’re irresponsible,” said the city’s health secretary, Orlando Dias. “They just can’t take it anymore.” He denies the pandemic is at its worst moment, and says a municipality that has 70% of its gross domestic product tied to commerce can’t just halt activities because the governor ordered it to.

So Fernando Christian’s small clothing shop in the city is not only open, clients are trying on clothes. City Hall knows about it, he says. What he and other vendors fear is state inspection. When state representatives come, stores rush to close.

Eighty miles in the other direction from Araraquara, Serrana has risen to virus fame in a very different way. The small town of 46,000, where the virus has been twice as deadly as in its neighbors, was chosen for a study researchers say is the first of its kind in the world: mass vaccination.

Henrique and Viviane Ferreira were happily standing in line to become part of the very small group of 30- and 40-year-olds in Brazil to get the vaccine. Elsewhere in the country, shots are available only to health-care professionals and those 75 or older, plus priority groups including the indigenous population. The plan in Serrana is to vaccinate 30,000 people, essentially everyone in the city over 18.

The plan, which was kept secret for months, caused a stir when it was announced in February. More than 90% of the residents signed up. Outsiders tried to buy or rent properties, but a census avoided what mayor Léo Capitelli called “an opportunistic mass migration.”

The results of the experiment, which are expected in May, could give a glimpse into what life for Brazilians may be like once vaccinations gain scale. Health experts like Isabella Ballalai, the vice president of the Brazilian society of immunization, had hoped that would come sooner. Brazil’s centralized vaccination program, she says, used to set the country apart even from rich nations, ensuring fast and equal access.

“We could be vaccinating so much more,” she said. “It’s really sad to see the situation where we’ve arrived at.”

The three cities exemplify the wildly diverse experience that has been Covid in Brazil. Restrictions have varied from city to city and are often eased, only to be reimposed weeks later — a mishmash of policies that have little to no enforcement, lowering their efficacy and prolonging the situation. Politicians setting the rules have been caught evading their own orders and often publicly bicker over who’s to blame for the crisis.

The glimmer of hope offered by vaccination remains elusive. The country has only a few doses at hand, not enough to cover even the priority groups. Jonas Donizette, a former mayor who heads a grouping of 400 municipal chiefs, blames the federal government for not acquiring vaccines. Cities, he says, are going off on their own to try and buy them, something that has never happened before.

And then there’s the economy. The government’s cash handouts, which helped tie over 66 million Brazilians last year and even reduced poverty levels, ran out in December. While lawmakers debated a new round of aid, which was approved just this week, data from retail sales have tumbled, showing the effect of phasing out the so-called coronavouchers.

Christian, the clothing shop owner in Bauru, is among the millions who lost jobs during the pandemic’s first wave. After being fired from a sports apparel shop, he opened a food truck with his father-in-law, only to have to sell off the van, along with everything else, as the crisis worsened.

Today he earns about half of what he did before the virus hit. Even with his wife bringing in money from baking cakes and selling used clothes, it’s not unusual for their refrigerator to be empty, especially now that government aid has run out. It’s a day-to-day worry: “If there’s a lockdown, I’ll earn nothing,” he says.

The Ferreiras, in Serrana, have seen business slow down, too — especially in their part-time work as wedding photographers. The mass vaccination has yet to materialize into a rebound, though the knowledge that they and their families are safer eases part of the blow.

The sense of policy drift and rising deaths — Brazil has lost more than 260,000 to the virus, second only to the US — is producing political anxiety.

This week, state governors criticized the federal government for spreading false information and “prioritizing conflict, creating images of good-versus-evil and undermining cooperation.” States from Sao Paulo to Pernambuco and Rio Grande do Sul have tightened restrictions in the past few days to try to halt contagion.

State health secretaries issued a statement calling on the government to recognize the seriousness of the pandemic, which is causing the collapse of several public and private health-care systems. It lamented the lack of a national, coherent policy and asked for more stringent rules for non-essential businesses, including forbidding sports and religious activities and all in-person classes and closing bars and beaches. It also called for authorities to consider shutting airports and suspending interstate travel, as well as imposing a national curfew from 8 p.m. to 6 a.m. during the week and all day on weekends.

While some at the health ministry are open to discussing nationwide measures with governors, the concern is that Bolsonaro himself will bar any such initiative, a person familiar with the matter said.'We're going to continue to see a high number of infections and deaths for at least three months, because there's nothing to stop it from happening,' said Antonio Carlos Bandeira, a director at Brazil's infectious disease society. 'It's not lockdowns being done in one place or the other that will avoid it. You would have had to have coordinated this long ago.'

This week, as Brazil reported back-to-back record deaths from the virus, Bolsonaro welcomed allies for a lunch in Brasilia. The largely maskless group feasted on typical dishes, including beans with sausage and collard greens, plus a whole roast pig. The following day, the president raged against governors for creating panic in the population.

'You didn't stay home, you didn't cower,' Bolsonaro told a crowd of supporters on Thursday. 'We have to face our fears. No more fussiness, no more whining. Are people going to cry forever?'