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[upbeat music] Before I get started today, I'd like to talk about our new Buy Me a Coffee memberships.

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[upbeat music] Exactly a month ago, almost to the day, a World Health Organization spokesperson said the end of the COVID pandemic was a long way off. Well, tell that to the Brazilian government.

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On Sunday, Health Minister Marcelo Queiroga announced that Brazil would lift its coronavirus public health emergency declared back in February 2020.

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However, experts are skeptical about the implications of such a decision. My name is Gustavo Ribeiro. I'm the editor-in-chief of The Brazilian Report.

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This is Explaining Brazil.

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[upbeat music] Ewan Marshall, hello and welcome back from vacation.

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Hi, Gustavo. Glad to be back. So Ewan, you spent some time in Mexico. And how was it to come back in terms of COVID-related procedures at the airport? Yeah, it was totally laid back, actually.

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Uh, Mexico has no restrictions on visiting tourists, and the only hoop that we had to jump through was showing our vaccine certificates when we checked in to fly back to Brazil. You know, no tests, nothing.

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Uh, and actually, if we'd come back a week earlier, we'd have had to get an antigen test at the airport in Mexico City.

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But by the time we were traveling, the Brazilian government had already changed the COVID restrictions on travelers.

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I mean, that is much [laughs] better than my experience, because I went to visit my wife's family in France last year, and I mean, we had to show PCR test results as well as vaccination certificates, not to mention a week in quarantine with the police knocking on our door to check if we were staying inside.

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And then when we were coming back to Brazil, that was another debacle, more PCR tests, forms to fill in. I mean, the whole nine yards. But things are much, much more laid back now, aren't they?

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Yeah, since the scare around the Omicron variant in Brazil, uh, and around the whole world for that matter, uh, the COVID situation has improved quite a lot. The case and death numbers have consistently fallen.

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Uh, mask mandates in outdoor spaces are also a thing of the past, and most states have even lifted them for indoor spaces, too. You know, stores are open normally.

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Traffic in São Paulo is back to its congested best, and not even the Carnival holiday led to a spike in COVID deaths.

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So, you know, life is mostly back to normal or at least the closest to normal we've been in, you know, over two years, right?

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And apparently, the government wants to officially make it normal, at least regulation-wise, too. Yeah, that's right.

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Uh, Health Minister Marcelo Queiroga, he issued a televised address at the weekend announcing that the government would declare the end of the COVID health emergency.

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And in practical terms, what exactly is or was the state of emergency?

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Well, in February 2020, before Brazil had even confirmed a single case, uh, the government had declared an emergency in public health about COVID-19.

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Uh, there were only 14 suspected cases at that point, mostly in people who had been to China or Northern Italy, where the disease was really spreading fast at that point.

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And the last time that Brazil had such an emergency was in 2015, which was during the Zika virus outbreak.

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And Zika, uh, if you don't remember, it's transmitted by the Aedes aegypti mosquito, who is an old foe in Brazil, because it's also known for transmitting dengue fever. Uh, but 2015 was chaos.

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The Zika virus appeared in Brazil for the first time in 2015, and more than a million people have been infected since then.

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Just to put that into perspective, the last largest outbreak happened in French Polynesia, and it really only spread around to a couple hundred people.

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And mosquito season brought with it not only dengue, but also Zika, chikungunya, and yellow fever.

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Um, and this explosive Zika outbreak created panic once Brazilian researchers discovered a link between the virus and cases of microcephaly in babies whose mothers had been infected during pregnancy.

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Brazil is advising pregnant women to avoid this summer's Olympic Games over the risk of birth defects from the Zika virus.

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The World Health Organization took the rare step yesterday of declaring an international public health emergency.

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And by December of 2017, the Brazilian government confirmed 1,400 cases of babies with microcephaly linked to Zika.

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And, you know, as the disease scared the population, many women opted to prevent or interrupt pregnancies, which lowered the number of births in the country, which, you know, that affects the final infant mortality rate, which was up in that year for the first time in decades.

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And the emergency Zika warning lasted for 18 months, uh, was only lifted after cases had dropped by 90%. But why declare a state of emergency if Brazil had yet to confirm any COVID cases?

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Because I remember that just weeks prior to that move, some renowned experts were saying that the coronavirus would probably have a minor impact on Brazil because of our warm climate, just like SARS or MERS in years prior.

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We even did an episode of our podcast with experts suggesting that the economic downturn would probably be the real impact for Brazil. I mean, an episode that aged very, very poorly, by the way [laughs].

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Yeah, that's right. I took part in that one, too. And, uh, um, well, if you remember well, the COVID scenario was changing at a very fast pace.

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In the space of just a week or so, it became clear that things would be much, much more serious than any previous outbreaks.

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Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, he said that the coronavirus would almost certainly become a pandemic, and the World Health Organization had just classified the outbreak as a public health emergency of international concern, and a month later they went all the way and called a pandemic.

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Basically, what Brazil was trying to do was, you know, trying to get ahead of the curve, preparing itself for a scenario in which health networks would be under stress, and the government would have to make smart and quick decisions.

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And, you know, that's what the state of emergency really is.

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Uh, it's a tool that governments use to bypass certain bureaucratic controls which are in place in normal times to avoid abuse, but which can slow down the turning of the government's gears, as it were.

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So the government, the Bolsonaro government, was acting in a prescient way towards the coronavirus. Is that right? [laughs] I mean, the first and last time that ever happened, right? Yeah, pretty much.

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Uh, Brazil caught a few breaks at the beginning of the pandemic, uh, because the country isn't that integrated with global production chains, so the inflow of people from abroad is less pronounced here than it is in Europe or the US.

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So the country was a few weeks behind Asia, Europe, and North America pandemic-wise. So that meant they could observe what other countries were doing, copy what was working, and fix what wasn't.

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But of course, there was a big obstacle in the way in the shape of Jair Bolsonaro, who went against scientific consensus at every turn during the pandemic.

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[upbeat music] And can you remind us about Bolsonaro's playbook of denialism? Well, at the beginning of the pandemic, Bolsonaro was adamant in his opposition to any restrictions.

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[laughs] In March 2020, as the world was descending into chaos, Bolsonaro complained that the country needed to return to normality immediately. And

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one of his justifications for that was that he said a COVID-induced recession would create its own health problems for the population. Now, there is some scientific backing to this.

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Uh, a study published in November 2019 in online scientific journal Lancet Global Health, that traced a link between economic recession and all-cause mortality rate during Brazil's financial crisis of 2014 to 2016.

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But the government quickly discovered that this time would be different. Social distancing and mask use could help Brazil lower infection and death curves, and allow it to regain control of the economy sooner.

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And minutes from meetings at the health ministry show that the government knew this but insisted on preaching to the contrary. God knows why. Right, and what else did the Bolsonaro administration do wrong?

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Yeah, the president stalled purchases of Pfizer vaccines, he shunned jabs from Sinovac from China, and he only purchased half of the vaccines available to Brazil through the UN-backed COVAX facility.

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Bolsonaro also pushed for anti-malarial drug chloroquine to be used on infected patients or as a prophylactic, despite it being ineffective in treating the virus.

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And researchers found that chloroquine was dangerous for patients with heart issues, and multiple people died using the government's so-called COVID kit.

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And when researchers tried to measure the impact of the government's mistakes, what did they say?

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So Brazil's death toll is the second highest in the world, uh, with over 660,000 people killed by COVID, and that doesn't even factor in Brazil's massive problems with COVID data collection, which means that the real numbers might be much higher.

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But, you know, if we base ourselves on official data, researchers believe that over 100,000 lives could have been spared if Brazil had followed scientific consensus right from the start.

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And a Senate inquiry from last year proposed 81 indictments connected to the pandemic, even accusing President Bolsonaro of nine offenses, including crimes against humanity. Yeah, that was something.

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And despite all of this, the government is still claiming victory over the coronavirus. Yeah, don't forget that we have an election coming.

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Uh, by declaring the end of the public health emergency, the Bolsonaro administration is trying to hammer home this idea that Brazil has won its battle against the coronavirus.

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However, you know, while COVID death and infection curves have remained low since February, calling Brazil's pandemic response a success is a huge stretch.

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Because Brazil's vaccination campaign, for example, which could allow the country to go on and, you know, battle any localized spreads without major hiccups in the future, that campaign was only successful despite the government, not because of it.

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But Bolsonaro hopes that the lasting image of the pandemic will be a triumphant one for him, um, and not the accusations of allowing Brazilians to die of COVID.

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And you were saying that the state of emergency formally gives the government certain powers to go about public procurements and health regulations. So what happens when the state of emergency is lifted?

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Yes, some 2,000 special regulations came into force under the state of emergency's umbrella, and they should now be gradually voided over the next 30 to 90 days.

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If nothing else, the government's decision actually creates uncertainty about the future of the vaccination program. And why is that?

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Well, a month and a half ago, President Bolsonaro said that he wanted to declare COVID an endemic disease. Now, that wouldn't change much. It simply suggests that the virus would be here to stay.

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But neither the president nor Health Minister Quiroga have made it clear if Brazilians will now go on to receive yearly COVID vaccinations, as is the case with other endemic diseases.

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And the government also failed to mention what it plans to do with its stockpiled vaccine doses and how or if the country will continue its vaccine production efforts.

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And there's another question mark hanging over the Sinovac vaccine, which still only has approval for emergency use in Brazil. So that means if there's no state of emergency, you can't use that vaccine.

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Now, the Health Ministry wants to ask health regulator Anvisa to extend this permission for another year so that it can use the immunizer on minors or adults who aren't yet completely vaccinated.

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And at the same time, the end of the emergency state could see the beginning of private sector vaccine rollouts in Brazil.

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And that could see the government focusing its efforts on immunizing at-risk groups while encouraging the rest of the population to use their health insurance to get their own jabs.

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And what about telemedicine, which saw a boom during the pandemic? Yeah, that will stay. Quiroga said that telemedicine has now become a feature of public health and that tests during the pandemic were all positive.

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And the government should also expand permissions for telemedicine to some other medical fields. But the end of the state of emergency will have other impacts, right?

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I mean, not just related to the health sector, I mean.

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Yeah, so as an example, the end of the state of emergency will mean the end for a law that forces delivery platforms to provide health insurance and financial assistance to their drivers.

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Now, this legislation is strictly tied to the duration of the coronavirus crisis, even though it provides support that goes beyond the pandemic, such as medical care in the event of traffic accidents.

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And how did the health community react to the news? Health councils at the state and municipal level, they were pretty critical.

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The head of state health department council Conas questioned why would the government want to lift the emergency status while a person dies of COVID in Brazil every 14 minutes. And, you know, perhaps he has a point.

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We're not quite in such a drastic situation anymore, but people are still dying every day.

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We're seeing other countries like Sweden and Norway also declaring the end of the pandemic, but some nations in Europe are seeing cases spike and China is placing Shanghai on a very strict lockdown to contain a new outbreak.

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Where does Brazil sit in all this? Many health experts err on the side of caution. There are still subvariants spreading in multiple areas.

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And I mean, two years in, we've learned not to make many predictions regarding the spread of the coronavirus, right? And I mean, that's why the decision by the Bolsonaro administration seems so ill-advised.

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Well, thanks for sure, Ewan. We'll definitely not be saying that the risks for Brazil are now mainly just economic. Ewan, thank you very much. Thanks, Gustavo.

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And if you like Explaining Brazil, please drop us a five-star rating wherever you get your podcasts. Takes only a second and it will help more people find out about this show.

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We offer a seven-day free trial, no strings attached, which gives you access to the website for a week without the need to insert any credit card details whatsoever. I'm Gustavo Ribeiro. Thanks for listening.

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See you next week.