Brazil's COVID-19 response
Authors: Cecilia Siliansky de Andreazzi, Martha Lima Brandão, Marina Galvão Bueno, Gisele R Winck, Fabiana Lopes Rocha, Rafael L G Raimundo, Jean Paul Metzger, Marcia Chame, José Luis Passos Cordeiro, Paulo Sérgio D'Andrea
Journal: The Lancet (2020)

We read with interest the Editorial1The LancetCOVID-19 in Brazil: "So what?".Lancet. 2020; 3951461Summary Full Text Full Text PDF PubMed Scopus (339) Google Scholar about Brazil's response to COVID-19. As Brazilian scientists, we would like to express major concerns about the multiple crises that our country is facing. Unprecedented rates of biodiversity loss caused by the expansion of anthropogenic activities are major drivers of infectious disease outbreaks (eg, Ebola virus, Nipah virus, arboviruses).2Díaz S Settele SJ Brondízio E et al.Summary for policymakers of the global assessment report on biodiversity and ecosystem services. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, Bonn2019Google Scholar The ongoing COVID-19 pandemic has come as a harsh lesson of the social and economic costs of neglecting the interface between biodiversity conservation and public health. Megadiverse countries with high social vulnerability and growing environmental degradation are prone to pathogen spillover from wildlife to humans, and they require policies aimed at avoiding the emergence of zoonoses. In Brazil, clear warnings are the recent emergence of Oropouche virus, hantaviruses, Sabiá virus, and the re-emergence of Chagas disease and sylvatic yellow fever. The ongoing flexibilisation of Brazilian environmental laws, the dismantling of environmental institutions, the disregard for scientific evidence, and the attacks on conservation organisations have fuelled further deforestation, uncontrolled expansion of agriculture, pesticide misuse, illegal wildlife trade, and poaching. All such actions represent a major setback in socioenvironmental policies, which opens new fronts for zoonotic emergence and negatively impacts biodiversity and public health, putting millions of people at risk. By threatening wildlife health and compromising the provision of ecosystem services, these actions further aggravate the effects of climate change and outbreaks of zoonotic diseases. To prevent, control, and mitigate the emergence of zoonoses,3Allen T Murray KA Zambrana-Torrelio C et al.Global hotspots and correlates of emerging zoonotic diseases.Nat Commun. 2017; 81124Crossref PubMed Scopus (607) Google Scholar Brazil needs to strengthen its public health system, including the One Health framework. We urge for an integrated system for wildlife disease surveillance and monitoring, with strong intersectoral collaboration and coordination between animal, human, and environmental health sectors. Multilateral coordinated support and cross-boundary collaboration are key to building institutional capacity for wildlife management and surveillance. COVID-19 is an irrefutable argument of the necessity to integrate biodiversity conservation, social inclusion, and economic resilience via innovative and sustainable socioproductive chains. Science and social justice need to be enforced as instruments for transformation of environmental and health policy making. We declare no competing interests. We thank Luis Alberto Martinez-Vaquero, Sandra Hacon, Paulo Artaxo, Pedro Cordeiro-Estrela, Diogo Loretto, Rodrigo Silva Pinto Jorge, Ronaldo Gonçalves Morato, Paulo Eduardo Brandão, Helder Lima de Queiroz, Luiz Flamarion Barbosa de Oliveira, José Luiz Catão-Dias, Carlos Fonseca, Cibele Rodrigues Bonvicino, Maria Ogrzewalska, and Marcelo Alves Pinto for supporting this Correspondence. Brazil's COVID-19 responseAs physicians and scientists, the COVID-19 pandemic has been disheartening; first and foremost, for the lives lost to the disease and, second, because of the mistreatment of science and evidence-based medicine.1 In the lay media, which is the right environment to discuss and understand politics, we have observed pseudoscience. Full-Text PDF COVID-19 in Brazil: "So what?"The coronavirus disease 2019 (COVID-19) pandemic reached Latin America later than other continents. The first case recorded in Brazil was on Feb 25, 2020. But now, Brazil has the most cases and deaths in Latin America (105 222 cases and 7288 deaths as of May 4), and these are probably substantial underestimates. Even more worryingly, the doubling of the rate of deaths is estimated at only 5 days and a recent study by Imperial College (London, UK), which analysed the active transmission rate of COVID-19 in 48 countries, showed that Brazil is the country with the highest rate of transmission (R0 of 2·81). Full-Text PDF Brazil's COVID-19 responsePartisan politics during the COVID-19 pandemic has hindered any efforts of working together with science for the greater good of Brazil. As a Brazilian who values life, I do not know what scares me more: contracting COVID-19, or Bolsonaro's Government trying to belittle the disease, forcing us out of the door to confront it, even when they know that we have not done enough as a country to make it safe for us to do so. Although COVID-19 is showing us all that we still have a long way to go to overcome this crisis, which, at the time of writing, has killed approximately 1000 people a day over the past 3 months, the more disheartening thought is that this government does not seem to care one way or another whether people are dying or not. Full-Text PDF Brazil's COVID-19 responseThe Editorial1 about Brazil's response to COVID-19 has caused heated debate among physicians working on the Brazilian health-care frontline against COVID-19 about whether or not there is a place for politics in a high-impact medical journal. Full-Text PDF Brazil's COVID-19 responseIt was disappointing to read the Editorial1 about Brazil's response to COVID-19, criticising the Brazilian president who "discourag[ed] the sensible measures of physical distancing and lockdown". Yes, he insisted that lockdown is ineffective and terrible for the economy. Full-Text PDF The Brazilian Government's mistakes in responding to the COVID-19 pandemicIt is unfortunate to read the unsubstantiated and misguided opinion of a few physicians about the role of the current administration during the COVID-19 crisis in Brazil.1 For those of the international scientific community who base their understanding on reliable data, the conclusion that Brazil has shown one of the worst responses to the pandemic is unequivocal.2 The gravity of the pandemic in Brazil is evidenced by the current epidemiological facts: Brazil is among the three countries with the largest number of confirmed cases (more than 5 million as of Oct 15, 2020, according to WHO ), with high mortality,3 evidence of underreporting,3 and a high number of deaths among health professionals, pregnant women,4 and the indigenous population . Full-Text PDF