The novel coronavirus is on the retreat across much of the world. New cases, hospitalizations and deaths are dropping on every continent but one. A year and a half after the Chinese government registered the first cases of COVID-19, and six months after vaccinations began in earnest, only South America is still getting worse.
Experts say there’s one major reason: Brazil. Under the leadership of a conspiracy-peddling COVID-denier, the continent’s most-populous country has become a major exporter of SARS-CoV-2 and even gave rise to its own extra-dangerous variant of the pathogen. Now countries bordering Brazil—Uruguay and Paraguay, in particular—are buckling under the weight of multiplying infections.
There’s a lot the rest of the world can do to help. But as long as Brazil continues to incubate and spread COVID, global assistance is like fighting a fire while the arsonist is still at large. “Brazil is one of the few countries in the world pushing the trend in the wrong direction,” Pedro Hallal, an epidemiologist at Universidade Federal de Pelotas in Brazil, told The Daily Beast.
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The statistics tell a startling story. After weeks of steady declines, five of the six heavily populated continents—North America, Europe, Asia, Africa and Australia—are all registering a weekly average of fewer than 100 new COVID cases per million people per day. South America, on the other hand, is counting more than 300 new cases per million people per day—and the rate is increasing.
Brazil and countries that border Brazil stand out. Brazil’s daily new-case rate is 300 per million. The COVID death rate in the country of 211 million is nine per million per day. Argentina’s rates are 690 new cases and 11 deaths per million.
Uruguay is tallying a staggering 1,100 new cases per million people per day. Paraguay is doing slightly better with 430 new cases per million people per day. But the COVID death rate in both countries has swelled to a devastating 16 people per million per day.
The numbers are likely to get a lot worse before they get better. Vaccines alone won’t turn things around in most of South America. Uruguay is vaccinating its 3.4 million people at a healthy clip. The country has administered 2.7 million doses of vaccine—enough to begin inoculating 77 percent of its population.
But Brazil and Argentina are lagging the standard set by Uruguay and richer countries in North America and Europe. Argentina has given out enough shots to begin inoculating a quarter of its 45 million people. Brazil has administered enough doses for 31 percent of its people. Paraguay is virtually unvaccinated, having handed out sufficient jabs for just four percent of its seven million people.
And winter is coming to the southern hemisphere. That means more people crowding indoors, which in turn tends to spread COVID faster than during the summer. “We are expecting that it will get worse,” Ester Sabino, an immunologist at the University of São Paulo, told The Daily Beast.
This crisis began in Brazil, Hallal explained. “Last year, numbers rose steadily until stabilizing at 1,000 deaths per day. As soon as they stabilized, instead of continuing with restrictions to make them go down, the country started to reopen. What happened? They started to go up again, and reached 2,000 deaths early this year.”
“And again, as soon as they got stable, the country started to reopen before numbers went down. What is happening? They are going up again.”
Hallal blames Bolsonaro. “There is absolutely no national leadership fighting against the virus. In fact, our president plays on the same team of the virus. He continues not to wear masks and promote [conspiracies], for example.”
The divisive Bolsonaro, who many observers have likened to ex-U.S. President Donald Trump, actually came down with a minor case of COVID last summer and, instead of seeking proven treatment and urging mask-wearing and social distancing, he went on TV and gobbled hydroxychloroquine, a false cure that Trump himself once pushed. “It is a monumental failure,” Hallal said.
Big and populous, with teeming cities and close ties to its neighbors, Brazil is the last place you want to let a dangerous virus run rampant. It not only exports the pathogen to its smaller, more vulnerable neighbors—it also functions as a sort of laboratory in which the virus can mutate freely. It’s no accident that arguably the most dangerous new form of SARS-CoV-2—the so-called P.1 lineage—apparently originated in Brazil.
Both Uruguay and Paraguay actually had been making progress toward containing the virus before P.1 first appeared in Brazil in January. But P.1 is more transmissible than baseline SARS-CoV-2 owing to mutations on its spike protein, the part of the virus that grabs onto our cells. “This has facilitated the transmission even in countries that were able to better manage the epidemic, [such] as Paraguay and Uruguay,” Sabino said.
Last month, P.1 accounted for around a third of cases in Uruguay. In Paraguay’s communities bordering Brazil, half of infections were from P.1. The growing predominance of the lineage amid an overall increase in cases points to an even greater surge in infections in coming weeks, even before taking into account the effects of the winter season on case rates.
The pandemic is ending in much of the world. The United States for one is counting the fewest average daily cases and deaths since March 2020. But in South America, it’s possible—likely, even—that the worst is yet to come.
It falls to countries that are beating the virus to do what they can to help countries that are losing to it. But Beijing is late delivering to Sao Paulo’s Butantan Institute the ingredients for millions of doses of vaccine. “China should not delay the delivery,” Sabino said.
Meanwhile, the United States has only recently begun exporting its huge, and growing, stockpile of surplus doses. “It seems obscene to me to stockpile them in the U.S. while the world suffers so badly,” Lawrence Gostin, a Georgetown University global health expert, told The Daily Beast.
The administration of President Joe Biden has pledged to speed up vaccine exports. India, which is finally beginning to bend the curve on its own recent surge in cases, has been a major recipient. South America should be next, Hallal said.
But foreign aid isn’t enough, Hallal added. Brazilian authorities, starting with Bolsonaro, need to help the world help Brazil and its neighbors. Hallal called for “international pressure for Brazil to do its first lockdown. Over 15 months, Brazil has never done a lockdown, and therefore, numbers never go down.”