Still far from the peak of the coronavirus and on the verge of the southern winter, Brazil is walking towards a perfect storm with the curve of the Covid-19 on the rise, the beginning of the influenza season, the end of the dengue fever and active outbreaks of other viruses that believed to be outdated, like measles.
As the intensive care units of the hospitals fill up, President Jair Bolsonaro continues to be engaged in a “political war” against the isolation measures of the regional governments and in favor of a return to normality.
In that crusade, two health ministers have already fallen in less than a month: Luiz Henrique Mandetta, staunch defender of quarantines, and Nelson Teich, who refused to recommend chloroquine for all types of patients with coronavirus, as the far-right leader wishes. .
Both were doctors and now, with the curve in full exponential escalation, the portfolio of Health is in the hands, on an interim basis, of Eduardo Pazuello, an Army general with no experience in the area.
Until this Saturday, Brazil registered 233,142 confirmed cases of Covid-19, already surpassing Italy and Spain, and 15,633 deaths, reinforcing itself as one of the global outbreaks of the pandemic.
The peak is expected to be reached in the coming weeks, although the coronavirus will not be the only health emergency that the precarious Brazilian public health system will have to face.
An “explosive” combination
The expansion of the coronavirus, which arrived in Brazil in February, occurs amid other infectious outbreaks that have been worrying health authorities.
The country is now overcoming the dengue peak, transmitted by the Aedes Aegypti mosquito, which is also a carrier of the Zika virus, yellow fever, and chikungunya, which is usually in April and May.
According to the last bulletin of the Ministry of Health, so far this year 676,928 probable cases of dengue have been reported, with an incidence rate of 322 cases per 100,000 inhabitants, and 265 deaths.
As of June, with the arrival of the southern winter, dengue cases decrease, but those of common flu and other respiratory diseases rise.
In 2019, Brazil, which has a population of 210 million inhabitants, recorded 1,122 deaths from the three types of influenza, according to official data.
This year, influenza and dengue are added to the Covid-19 and with it the difficulty of differentiating each case, since the three viruses cause similar symptoms in the first days of the disease.
“That combination is quite explosive,” explains Dr. Adriano Massuda, professor of collective health at the Getulio Vargas Foundation (FGV) private study center.
Mauricio Lacerda, a researcher at the São Paulo State Research Amparo Foundation (FAPESP), works at the São José do Rio Preto hospital and assures that “the prospects are very bad” in the face of winter.
“Here in the hospital we already have influenza, Covid-19 and dengue patients, and we had deaths from all three. It is a very complicated situation” and that it “overloads” the public network, he told Efe.
To all this we must add measles outbreaks that are still active in the five regions of Brazil: north, northeast, center-west, southeast and south.
So far this year, 2,910 measles cases have been reported, almost half of them in the state of Pará, also one of the most affected by the coronavirus, and three deaths.
“Measles is coming back to Brazil, it has low immunization coverage and it may be just another problem,” says Massuda.
In 2019, there were 18,200 measles cases and 15 deaths across the country, 14 of which in Sao Paulo, today the Brazilian epicenter of Covid-19.
They denounce lack of investment in the health area
The challenge for the Unified Health System (SUS), which encompasses the entire network of public hospitals and on which 75% of Brazilians depend, will be enormous and even more so with the chronic financing problem it suffers.
For Massuda, the fiscal austerity policy, which began with the Michel Temer government (2016-2018) and continued with Bolsonaro, has aggravated that situation.
According to reports from human rights organizations, since a controversial budget spending ceiling was approved in late 2016, Brazil has stopped investing around R $ 30 billion in the health sector (today about R $ 5.17 billion).
Although the problem has dragged on from before, since, according to these calculations, between 2007 and 2019, the lack of resources has led to a reduction of 49,000 intensive care beds in the country.
“The laboratories of the public health system are dismantled and that is not six months ago, it is ten, fifteen years. That delayed the detection and diagnosis of the coronavirus and now the hospitals are going to pay a huge price,” says Lacerda.