Brazil and a Tragedy Foretold

By Marcela Almeida



Almeida M. Brazil and a tragedy foretold. HPHR. 2021;48.  


Brazil and a Tragedy Foretold

The way Brazil handled their pandemic crisis has been an active matter of discussion worldwide. Researchers across the country, as well as the international press, have highlighted that the grim outcomes the country is experiencing are largely a consequence of the current administration’s approach to minimize the impact of the pandemic, undermining science and neglecting basic public health needs.


Fifteen months into the pandemic, while many parts of the world are starting to see a return to normalcy, in Brazil, an unjustifiable delay in vaccine availability and refusal to implement or advocate for mitigating strategies has led to a continuous surge in the number of cases and deaths. 


The country comprises numerous areas of highly vulnerable populations, marginally protected by a fragile healthcare and social system. Behind the mantra of “The economy must come first”, individuals were discouraged from staying home, avoiding crowds, or even wearing masks (1).


As a consequence, Brazil’s healthcare system is on the verge of collapse, with a peak daily incidence of over four thousand deaths this past April, leading to a cumulative number of half a million perished citizens. Notably, these numbers are likely underreported in light of difficult access to testing, massive delays in releasing results, and sub-notification. At the beginning of June, 2020, the Brazilian government announced the suspension of shared pandemic numbers on their official website (2-4).  According to one study, Brazil’s numbers are likely 12 times higher than the official count (5).


Essential supplies, including masks, oxygen, respirators, and medications necessary for intubation are lacking even in large metropolitan areas due to President Bolsonaro’s failure to negotiate with distributors. In a country with one of the largest public health and vaccination programs on the planet, hospitals have been at capacity, ICU beds are constantly filled, and access to vaccines remains an arduous and helpless battle.


According to the former president of Pfizer in Brazil, Mr. Bolsonaro declined multiple offers the company has made to sell its vaccine, at times for half the price paid by other countries. Brazil’s former health secretary reportedly said he saw “no need for Pfizer vaccine” (6). Still according to the drug company, Pfizer made its first proposal to sell vaccines to the Brazilian government in mid-August, 2020, with a plan to deliver 70 million doses by December of that year (7). Those initial attempts were unfruitful, as were another fourteen offers by the company, all dismissed by the Brazilian leader, who maintained the discourse that he wouldn’t get vaccinated himself, adding that “it [the shot] might actually turn people into crocodiles” (8).


Facing international pressure, the country has purchased a cheaper and, according to its own manufacturer, less efficacious alternative (9).


The first doses of the Pfizer vaccine arrived in Brazil on April 29th, 2021, more than eight months and 400,000 deaths after the company’s first offer. The distribution efforts remain precarious and inequitable and, as of this writing, just over 11% of Brazil’s 210 million people have been immunized, largely with the less effective vaccine.


Even the new, highly transmissible variants to which Brazil is now hostage couldn’t deter the country’s superspreader events, such as Carnival or countrywide public demonstrations in defense of the current administration. These recent events have resulted in yet another wave, one that, at a personal level, affected me the most as it took the life of my father-in-law.


This poem is dedicated to him.

“The Voiceless”


Thirteen months of lockdown and isolation


You still died


(or were you killed?)


Your fears and safeguard 


Prudence and sacrifice


All infertile attempts


Impotent gestures in the face of the unthoughtful vote


Of a people brewed for years in a kakistocracy


From where yeasts of neglect and death sprout




Five hundred thousand bodies pile up


Silenced in their futile wait


Screams and sobs that would never be heard


Inaudible like the countless pleas for science


The many offers of vaccines


[Fourteen offers of millions of doses, all inaudible]


None of them would ever get to you


Or to your fellow countrymen


Myriad supplications, all muffled — like your lungs




From the loneliness of your bedroom, no one heard you


No one saw you weep or suffocate in the


Patient trust you kept in your torturing homeland


To where you insisted to always return


Now a valley of tears




Murderer, it offered you nothing but a hecatomb


A doomed destiny —


Without hope


Without a voice


Without hugs


Without leisure


Without cuddling


Without air


Without a shot.


  1. Ponce, D. The impact of coronavirus in Brazil: politics and the pandemic. Nat Rev Nephrol 16, 483 (2020).
  4. Idrovo AJ, Manrique-Hernández EF, Fernández Niño JA. Report From Bolsonaro’s Brazil: The Consequences of Ignoring Science. Int J Health Serv. 2021;51(1):31-36. doi:10.1177/0020731420968446
  9. (BMJ2021;373:n969)

About the Author

Marcela Almeida

Marcela Almeida is a psychiatrist specialized in Women’s Mental Health; a Medical Educator; and a Latina. Her research interests include diversity and inclusion, healthcare disparities, immigration, medical education, and women’s mental health.