What Went Wrong in Brazil

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, a new iOS app available for news subscribers. transcript From The New York Times, Im Michael Barbaro. This is The Daily. Today: Brazil has a long and distinguished history of navigating public health crises, until now. Ernesto Londono on what went wrong with the coronavirus. Its Thursday, July 2. OK, Ernesto, as were talking, Brazil is second only to the U.S. in cases of Covid-19. Where do we need to start to understand how we got here? Well, Michael, while were seeing kind of the first concerns about coronavirus rippling beyond China, it was the farthest thing from Brazilians minds. You know, its the peak of summer in the southern hemisphere and especially in February [CARNIVAL MUSIC] People are in party mode. [CARNIVAL MUSIC] You know, all across Brazil in the big cities, people are celebrating Carnival, which turns into this weeks-long celebration. You know, the beaches are thronged. Theres block parties on the street where everybody is dancing, and theres a lot of people kissing strangers. Everybody is sort of a sweaty mess. Theres a lot of heavy drinking. And just about the time when people are starting to sort of nurse their post-Carnival hangover in late February, the first case is diagnosed in Sao Paolo, in Brazils largest city. And the first case involves a man who had traveled home from Italy. And I dont think there were panic alarms that went off initially, but that quickly changed in early March. And it changed as a result of an extraordinary trip. The Brazilian president, Jair Bolsonaro, traveled with a large entourage to Florida, where he dined in Mar-a-Lago with President Trump. Hes doing a fantastic job, great job. Brazil loves him, and the U.S.A. loves him. And as they come back from that trip, a number of people who have been part of that delegation start testing positive. The latest sign of the spread of the virus is it is reaching and threatening the most powerful offices in the world. There are new virus concerns stemming from the meeting President Trump had with a delegation from Brazil in Florida. This video shows Mr. Trump last weekend at Mar-a-Lago next to a man who has since tested positive for the virus. He is the press secretary for Brazils president. We now know that a dozen Brazilians who were there have tested positive for the virus. So Brazil really becomes sort of consumed because their leadership, the people running the country all of a sudden started falling sick. But even as the virus is clearly within the halls of power, the president is not expressing any alarm. Quite the contrary. [IN PORTUGUESE] My obligation as head of state is to anticipate problems, to bring the truth to the Brazilian people. But this truth should not incite panic. President Bolsonaro starts calling this virus something that the media was obsessed with in order to bring down his popularity numbers. [IN PORTUGUESE] He called it a fantasy. He said, this is a measly cold. He said, even if I were to get this virus, because I have an athletes background, I would shake it off within days. Huh. [IN PORTUGUESE] (PARAPHRASING PRESIDENT JAIR BOLSONARO) This is nothing to worry about, and this is not something that justifies shutting the country down for. And on the other hand, you had mayors and governors saying, actually, we have to listen to the scientists. We have to shut down businesses. We have to keep people home. We have to act now if we want to save lives. But it was really hard to enforce when you had the president trying to persuade Brazilians that this was all a mistake and that they shouldnt be listening to these local leaders. So what this did was it really polarized Brazilian society. You had people who are very loyal to the president, essentially taking his side and sort of feeling empowered not to be quarantined, not to have to stay at home, not to have to give up their jobs. But on the other hand, you had a lot of people who despise the president and who became very worried. So by late March, something really striking started happening across the country in big cities. [PROTESTORS BANGING ON POTS] People protesting by banging pots from their windows. It was the only way that people who were actually taking this virus seriously and were worried about it could make their voices viewed. So every night like clockwork at about 8:30 p.m., I would hear from my window people banging pots and screaming, out with Bolsonaro, out with Bolsonaro! And it was a really striking sounded. It almost sounded primal. It was like these voices piercing through the night, and voices that kind of conveyed a degree of despair and anguish. [PROTESTORS BANGING ON POTS] So thats when we start seeing that much of the country was not feeling safe in Bolsonaros hands at a moment of crisis. And did this approach from the president, from Bolsonaro, did it surprise you? Well, I think weve learned not to be terribly surprised by anything that Bolsonaro does. As you might remember, hes a far-right populist leader who has been very divisive ever since he was elected in 2018. But it was very surprising that Brazil would be caught flat-footed in a health care crisis of this magnitude. And the reason for that is that the country has, in the past, risen to the challenge of very serious health care challenges, and deployed its pretty robust and very sophisticated public health care service to go after really complicated problems with very innovative solutions. Ill give you a couple of examples. Back in the 90s when the first H.I.V. medicines were on the market and were allowing people to live healthy and productive lives, these drugs were very expensive for people in poor countries. And Brazil took a pretty maverick approach to this. Brazil essentially challenged to the drug companies and said, we think that this is a matter of human rights, and people should have access to lifesaving medicine without having to fill your pockets for years on end. So that argument was so powerful. It led to drug manufacturers making concessions, and that led to these drugs becoming cheaper and more widely available. And Brazil scored a pretty significant victory on the world stage by taking what was a pretty bold stance at the time. More recently, Brazil had to contend with the Zika crisis, which led to babies being born with deformities that were very, very difficult to manage. And once again, it threw everything it had in the way of scientific expertise. And one of the most interesting solutions that Brazil came up with was genetically modified mosquitoes. And the plan was that by creating a genetically altered breed of mosquitoes, they would be preventing the dangerous types of mosquitoes from reproducing, and in doing so, sort of gradually stamp out Zika from areas where people were catching it. So in recent decades, Brazil has been regarded as a really top-tier player when it came to standing up to really complicated health care challenges and to rising to the challenge, even for a country that has enormous problems. You know, lots of people live in poverty. Lots of people dont have access to clean water. But when it came to saving lives, Brazil has a proven track record of acting in a bold and decisive way. But this year, weve seen something very different. Well be right back. So Ernesto, what explains why Brazils leader would take this essentially denialist approach to the pandemic, especially in light of Brazils very long history of so aggressively confronting public health crises? Bolsonaro was elected as a typical populist, who took the reins of a country that had been reeling from a really brutal economic recession and was only starting to sort of sputter back to life on his watch. So I think for him and his followers, the idea of an economic unraveling on his watch, considering how polarizing a figure he is, was just ruinous. I think he felt that if businesses shut down and jobs disappeared in very significant numbers, his base of support would crumble. And I think another element that might inform Bolsonaros behavior is hes somebody who has always looked up to President Trump for cues on how he should respond to things. Interesting. And President Trump was also taking the approach that this virus was not that big a deal, that this was going to disappear by itself. So you know, theres a striking similarity in how these two embattled leaders are selling this crisis to their bases and to the broader audience that listens to them. Right. And in both cases, and it sounds like especially for Bolsonaro, a strong economy is the basis for his staying in office, for being a leader. And a strong economy and a very strong reaction to this pandemic are almost, by definition, incompatible. So in his mind, the greatest threat to his power is an economy that starts to sputter and stop, not a virus that may infect and start to kill the people of Brazil? Thats right, but theres another element at play here. President Bolsonaro has been consumed by political scandals, pretty much from the beginning of his administration. And in recent months, hes begun to face some legislative and criminal investigations that have called into question his ability to serve out his term. One of these involves an investigation into a money laundering scheme that one of his sons is a target for. And the president is also now being investigated by the Supreme Court over his efforts to switch a police chief, in what his former justice minister thought was an abuse of power and an effort to shield his family members and allies from corruption investigations. So as the virus really starts taking hold of the country, youre left with a president who is also in a really politically precarious situation, and who is clinging onto his hopes for a strong economy an economy that wont go off the rails because he sees that as the key to his political survival. So given all that, Ernesto, how does Bolsonaros approach here play out inside Brazils public health system? What does it look like? Well, you have this extraordinary split-screen reality. On the one hand, you have the health minister going on television every night during press conferences (IN PORTUGUESE) There is nothing that will influence this response more than how the Brazilian society will behave in the next month or in a few days. preaching the merits of social distancing, saying quarantines are the only tried-and-tested tool we can throw at this virus right now, people who can stay at home should stay at home, business shutdowns make perfect sense. (IN PORTUGUESE) We need to have focus, discipline and science. So you essentially had a health minister who was adhering to the conventional wisdom and the scientific consensus on what countries should be doing. (IN PORTUGUESE) So that we can get out of this situation together. On the other hand, you had the president leaving the palace and joining pro-government demonstrations. [CHEERING] You had him shaking hands. He certainly wasnt wearing a mask at that point. And the only thing hes really expressing interest in as sort of a cure for the virus is the anti-malaria drug hydroxychloroquine, which he goes as far as ordering the armed forces to mass produce, even though theres really no scientific consensus that this is a good idea. And theres some signals that it could actually be dangerous for coronavirus patients. So it became this unsustainable rift where people were asking the health minister, how on earth should we expect Brazilians to listen to what youre asking them to do when theyre seeing their president take the exact opposite approach? And it reaches a breaking point in mid-April. The health minister, in the midst of a rising epidemic that is starting to spiral out of control, gets fired. Huh. [IN PORTUGUESE] You know, and on his way out, he delivered a pretty blistering indictment of the presidents handling of this. And he essentially said, I stayed in as long as I could to try to keep Brazil on a responsible path, to try to work within the margins of my authorities, but I can no longer serve under this president because we are too far apart when it comes to our vision and our values on this. Thank you very much, and thank you very much to the ministry of health. So with the first health minister getting tossed out, the president appoints a new minister whos a physician, who had very little name recognition and had never sort of run a large bureaucracy. He often looks like he has a deer-in-the-headlights look. Brazilians started making fun of him in memes online. It just never felt like he was getting any traction or laying out a vision. And just short of completing a month on the job, he convenes a press conference and says (IN PORTUGUESE) Life is made of choices, and today I chose to leave. So you tell me if I didnt do my best during this phase, during this period. (PARAPHRASING NELSON TEICH) This is as far as I can go. (IN PORTUGUESE) Its not easy to be heading a secretariat like this in such a difficult period. Doesnt really give a clear explanation for why hes leaving, but its pretty clear that he, too, just couldnt live with being the face of this response that was being led by the president. It was an honor for me to have been part of this. Thank you. So this is definitively not going well. Youre churning through two health ministers in the middle of a deadly pandemic. Yeah, and the numbers are just spiraling. Brazil now has the most cases of coronavirus in South America with more than 5,800 confirmed Covid-19 cases and growing. A new study out over the last couple of days showing that Brazil might have eight times more cases that have so far been recorded. Brazil has officially reported about 4,500 deaths. The true number are believed to be much higher, due to the lack of testing. Topping 90,000 confirmed cases and with more than 6,000 deaths. 100,000 with more than 7,000 deaths. Brazil now has more confirmed cases of coronavirus deaths than China. You know, at this point Well, as the number of coronavirus cases goes up in Brazil, so does the threat to communities in the Amazon region. you start seeing real strain in some states. Already, the biggest city, Manaus, has seen its health system collapse. Up in the Amazon, for example, grave diggers started digging mass graves because people were dying so quickly that officials were completely overwhelmed at hospitals and funeral homes. In Rio de Janeiro, hundreds of men, women, and children stood on a line to get food and water. So Health systems across the country are struggling. you know, across the country in some cities, panic really starts setting in. But experts dont expect Brazil to reach the peak for a few weeks yet. And at the national level, the health ministry is without a minister. And instead of appointing another expert in the field, the president leaves the ministry in the hands of an active duty army general who was an expert in logistics but had no real track record when it came to medicine. And one of the first things the ministry does when it is essentially run by this army general is endorse this anti-malaria pill, hydroxychloroquine, and say that health care professionals in the country should give it to all coronavirus patients who want it at any stage of contagion. So on his third try, he finally found a health minister willing to take that position. Absolutely. And he had a general on the job, and the general had to take orders from the president. And has Bolsonaro backtracked at all as these infection numbers have surged, as the death toll has risen? Or has he stayed with this same approach as he started with? There have been times when he has acknowledged that this is a very significant problem and this is a crisis, but he has been very consistent in saying that it is crucial to save the economy and to put economic recovery ahead of fighting the virus. At one point, when there had been sort of a milestone in the death toll, somebody asked him outside the palace what he thought, and he said, so what? What do you want me to do? My name might be Messiah, which was a reference to his middle name, but Im not here to perform miracles. Earlier this month, Bolsonaro said, I regret the loss of life. But at the end of the day, this is everybodys destiny. Everybody eventually dies is what hes saying. Yes. So he hasnt really backtracked. And I think in the long run, what some political experts think is that he is betting on the possibility that when the real economic pain is felt six months, a year down the road, when it becomes clear just how big of a beating Brazilians took that Brazilians may take out their wrath on the governors and the mayors who imposed these quarantines, and that the president may be able to sort of carve out a role for himself as the person who consistently wanted to save jobs, wanted to keep the economy on track. And I think its too early to tell. As a political strategy, that may pay dividends down the road. Ernesto, Im curious if you think that given Brazils history of beating back public health crises, that under different leadership not a president like Bolsonaro who is skeptical of the science and who explicitly puts economics over public health that Brazil would be in a very different place right now? Well, I think it bears watching what other countries in the region have done. And theres cases where governments had very decisive and well-thought-out responses that are wrestling with very high numbers. So theres something kind of mystifying about where this virus strikes with wrath, even in the face of a decisive and sophisticated response. I think one common theme were seeing that certainly applies to Brazil is countries with very stark inequality have had a harder time reigning the virus in. You have to think about kind of the way Brazilian cities are laid out. You have many Brazilians living in impoverished, teeming communities where people are sort of stacked up together, where they live numerous families to a small dwelling. And this virus has underscored the privilege some Brazilians have in adhering to conventional social distancing norms and the extent to which, for many Brazilians, for millions of them, its just not a possibility. But theres no question that Brazil had the expertise, had a track record of responding to health care challenges in a really decisive way. And it never really mounted a response that was coherent or sophisticated. Its been mired in this political fight that has prevented it from having a plan that makes sense to people, a plan it can explain to its population. At the end of the day, without a clear national policy, without a political consensus, and without effective enforcement mechanisms for some of these quarantines and lockdowns, there was no reining in the virus. But pretty much everybody I spoke to who has spent years working in health care policy in Brazil said, we were equipped and ready and trained to rise to the challenge. There was so much we could have done in the precious early days of the epidemic to strike back, to prepare and to save lives. Ernesto, thank you very much. We appreciate it. My pleasure, Michael. As of Wednesday, the number of infections in Brazil has risen to 1.4 million, and the number of deaths has surpassed 60,000, confirming Brazils outbreak as the second worst in the world, after the United States. Well be right back. Heres what else you need to know today. So I want to make very clear, we cannot go ahead at this point in time with indoor dining in New York City. Look, even a week ago, honestly, I was hopeful we could. But the news we have gotten from around the country gets worse and worse all the time. As U.S. infections continue to break records, New York City delayed a plan to resume indoor dining, Miami Beach reinstated a curfew to keep residents from congregating at night, and California shut down bars and indoor dining in 19 counties. During a news conference on Wednesday, Californias governor Gavin Newsom said that he knew the decision would be disappointing. And I deeply respect peoples liberty, their desire to go back to the way things once were. But I cannot impress upon you more, our actions have an impact on other people. As of Wednesday night, the U.S. death toll from the virus neared 128,000. [PROTESTORS IN HONG KONG] A new national security law, imposed on Hong Kong by China, was put to the test on Wednesday as thousands of protesters took to the streets there, demanding greater freedom and independence from China. The law, which went into effect on Tuesday, forbids a wide variety of activities, including chanting slogans and carrying banners that China considers seditious. At times, citing the new law, police arrested about 370 people, including a 15-year-old girl waving a flag, calling for Hong Kongs independence. The Daily is made by Theo Balcomb, Andy Mills, Lisa Tobin, Rachel Quester, Lynsea Garrison, Annie Brown, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Larissa Anderson, Wendy Dorr, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Jonathan Wolfe, Lisa Chow, Eric Krupke, Mark George, Luke Vander Ploeg, Adizah Eghan, Kelly Prime, Julia Longoria, Sindhu Gnanasambandan, M.K. Davis Lin, Austin Mitchell, Sayre Quevedo, Neena Pathak, Dan Powell, Dave Shaw, Sydney Harper, Daniel Guillemette, Hans Buetow, Robert Jimison, Mike Benoist, Bianca Giaever, Asthaa Chaturvedi and Rachelle Bonja. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Mikayla Bouchard, Lauren Jackson, Julia Simon, Mahima Chablani, Nora Keller and Lis Moriconi. Thats it for The Daily. Im Michael Barbaro. See you on Monday after the holiday. transcript From The New York Times, Im Michael Barbaro. This is The Daily. Today: Brazil has a long and distinguished history of navigating public health crises, until now. Ernesto Londono on what went wrong with the coronavirus. Its Thursday, July 2. OK, Ernesto, as were talking, Brazil is second only to the U.S. in cases of Covid-19. Where do we need to start to understand how we got here? Well, Michael, while were seeing kind of the first concerns about coronavirus rippling beyond China, it was the farthest thing from Brazilians minds. You know, its the peak of summer in the southern hemisphere and especially in February [CARNIVAL MUSIC] People are in party mode. [CARNIVAL MUSIC] You know, all across Brazil in the big cities, people are celebrating Carnival, which turns into this weeks-long celebration. You know, the beaches are thronged. Theres block parties on the street where everybody is dancing, and theres a lot of people kissing strangers. Everybody is sort of a sweaty mess. Theres a lot of heavy drinking. And just about the time when people are starting to sort of nurse their post-Carnival hangover in late February, the first case is diagnosed in Sao Paolo, in Brazils largest city. And the first case involves a man who had traveled home from Italy. And I dont think there were panic alarms that went off initially, but that quickly changed in early March. And it changed as a result of an extraordinary trip. The Brazilian president, Jair Bolsonaro, traveled with a large entourage to Florida, where he dined in Mar-a-Lago with President Trump. Hes doing a fantastic job, great job. Brazil loves him, and the U.S.A. loves him. And as they come back from that trip, a number of people who have been part of that delegation start testing positive. The latest sign of the spread of the virus is it is reaching and threatening the most powerful offices in the world. There are new virus concerns stemming from the meeting President Trump had with a delegation from Brazil in Florida. This video shows Mr. Trump last weekend at Mar-a-Lago next to a man who has since tested positive for the virus. He is the press secretary for Brazils president. We now know that a dozen Brazilians who were there have tested positive for the virus. So Brazil really becomes sort of consumed because their leadership, the people running the country all of a sudden started falling sick. But even as the virus is clearly within the halls of power, the president is not expressing any alarm. Quite the contrary. [IN PORTUGUESE] My obligation as head of state is to anticipate problems, to bring the truth to the Brazilian people. But this truth should not incite panic. President Bolsonaro starts calling this virus something that the media was obsessed with in order to bring down his popularity numbers. [IN PORTUGUESE] He called it a fantasy. He said, this is a measly cold. He said, even if I were to get this virus, because I have an athletes background, I would shake it off within days. Huh. [IN PORTUGUESE] (PARAPHRASING PRESIDENT JAIR BOLSONARO) This is nothing to worry about, and this is not something that justifies shutting the country down for. And on the other hand, you had mayors and governors saying, actually, we have to listen to the scientists. We have to shut down businesses. We have to keep people home. We have to act now if we want to save lives. But it was really hard to enforce when you had the president trying to persuade Brazilians that this was all a mistake and that they shouldnt be listening to these local leaders. So what this did was it really polarized Brazilian society. You had people who are very loyal to the president, essentially taking his side and sort of feeling empowered not to be quarantined, not to have to stay at home, not to have to give up their jobs. But on the other hand, you had a lot of people who despise the president and who became very worried. So by late March, something really striking started happening across the country in big cities. [PROTESTORS BANGING ON POTS] People protesting by banging pots from their windows. It was the only way that people who were actually taking this virus seriously and were worried about it could make their voices viewed. So every night like clockwork at about 8:30 p.m., I would hear from my window people banging pots and screaming, out with Bolsonaro, out with Bolsonaro! And it was a really striking sounded. It almost sounded primal. It was like these voices piercing through the night, and voices that kind of conveyed a degree of despair and anguish. [PROTESTORS BANGING ON POTS] So thats when we start seeing that much of the country was not feeling safe in Bolsonaros hands at a moment of crisis. And did this approach from the president, from Bolsonaro, did it surprise you? Well, I think weve learned not to be terribly surprised by anything that Bolsonaro does. As you might remember, hes a far-right populist leader who has been very divisive ever since he was elected in 2018. But it was very surprising that Brazil would be caught flat-footed in a health care crisis of this magnitude. And the reason for that is that the country has, in the past, risen to the challenge of very serious health care challenges, and deployed its pretty robust and very sophisticated public health care service to go after really complicated problems with very innovative solutions. Ill give you a couple of examples. Back in the 90s when the first H.I.V. medicines were on the market and were allowing people to live healthy and productive lives, these drugs were very expensive for people in poor countries. And Brazil took a pretty maverick approach to this. Brazil essentially challenged to the drug companies and said, we think that this is a matter of human rights, and people should have access to lifesaving medicine without having to fill your pockets for years on end. So that argument was so powerful. It led to drug manufacturers making concessions, and that led to these drugs becoming cheaper and more widely available. And Brazil scored a pretty significant victory on the world stage by taking what was a pretty bold stance at the time. More recently, Brazil had to contend with the Zika crisis, which led to babies being born with deformities that were very, very difficult to manage. And once again, it threw everything it had in the way of scientific expertise. And one of the most interesting solutions that Brazil came up with was genetically modified mosquitoes. And the plan was that by creating a genetically altered breed of mosquitoes, they would be preventing the dangerous types of mosquitoes from reproducing, and in doing so, sort of gradually stamp out Zika from areas where people were catching it. So in recent decades, Brazil has been regarded as a really top-tier player when it came to standing up to really complicated health care challenges and to rising to the challenge, even for a country that has enormous problems. You know, lots of people live in poverty. Lots of people dont have access to clean water. But when it came to saving lives, Brazil has a proven track record of acting in a bold and decisive way. But this year, weve seen something very different. Well be right back. So Ernesto, what explains why Brazils leader would take this essentially denialist approach to the pandemic, especially in light of Brazils very long history of so aggressively confronting public health crises? Bolsonaro was elected as a typical populist, who took the reins of a country that had been reeling from a really brutal economic recession and was only starting to sort of sputter back to life on his watch. So I think for him and his followers, the idea of an economic unraveling on his watch, considering how polarizing a figure he is, was just ruinous. I think he felt that if businesses shut down and jobs disappeared in very significant numbers, his base of support would crumble. And I think another element that might inform Bolsonaros behavior is hes somebody who has always looked up to President Trump for cues on how he should respond to things. Interesting. And President Trump was also taking the approach that this virus was not that big a deal, that this was going to disappear by itself. So you know, theres a striking similarity in how these two embattled leaders are selling this crisis to their bases and to the broader audience that listens to them. Right. And in both cases, and it sounds like especially for Bolsonaro, a strong economy is the basis for his staying in office, for being a leader. And a strong economy and a very strong reaction to this pandemic are almost, by definition, incompatible. So in his mind, the greatest threat to his power is an economy that starts to sputter and stop, not a virus that may infect and start to kill the people of Brazil? Thats right, but theres another element at play here. President Bolsonaro has been consumed by political scandals, pretty much from the beginning of his administration. And in recent months, hes begun to face some legislative and criminal investigations that have called into question his ability to serve out his term. One of these involves an investigation into a money laundering scheme that one of his sons is a target for. And the president is also now being investigated by the Supreme Court over his efforts to switch a police chief, in what his former justice minister thought was an abuse of power and an effort to shield his family members and allies from corruption investigations. So as the virus really starts taking hold of the country, youre left with a president who is also in a really politically precarious situation, and who is clinging onto his hopes for a strong economy an economy that wont go off the rails because he sees that as the key to his political survival. So given all that, Ernesto, how does Bolsonaros approach here play out inside Brazils public health system? What does it look like? Well, you have this extraordinary split-screen reality. On the one hand, you have the health minister going on television every night during press conferences (IN PORTUGUESE) There is nothing that will influence this response more than how the Brazilian society will behave in the next month or in a few days. preaching the merits of social distancing, saying quarantines are the only tried-and-tested tool we can throw at this virus right now, people who can stay at home should stay at home, business shutdowns make perfect sense. (IN PORTUGUESE) We need to have focus, discipline and science. So you essentially had a health minister who was adhering to the conventional wisdom and the scientific consensus on what countries should be doing. (IN PORTUGUESE) So that we can get out of this situation together. On the other hand, you had the president leaving the palace and joining pro-government demonstrations. [CHEERING] You had him shaking hands. He certainly wasnt wearing a mask at that point. And the only thing hes really expressing interest in as sort of a cure for the virus is the anti-malaria drug hydroxychloroquine, which he goes as far as ordering the armed forces to mass produce, even though theres really no scientific consensus that this is a good idea. And theres some signals that it could actually be dangerous for coronavirus patients. So it became this unsustainable rift where people were asking the health minister, how on earth should we expect Brazilians to listen to what youre asking them to do when theyre seeing their president take the exact opposite approach? And it reaches a breaking point in mid-April. The health minister, in the midst of a rising epidemic that is starting to spiral out of control, gets fired. Huh. [IN PORTUGUESE] You know, and on his way out, he delivered a pretty blistering indictment of the presidents handling of this. And he essentially said, I stayed in as long as I could to try to keep Brazil on a responsible path, to try to work within the margins of my authorities, but I can no longer serve under this president because we are too far apart when it comes to our vision and our values on this. Thank you very much, and thank you very much to the ministry of health. So with the first health minister getting tossed out, the president appoints a new minister whos a physician, who had very little name recognition and had never sort of run a large bureaucracy. He often looks like he has a deer-in-the-headlights look. Brazilians started making fun of him in memes online. It just never felt like he was getting any traction or laying out a vision. And just short of completing a month on the job, he convenes a press conference and says (IN PORTUGUESE) Life is made of choices, and today I chose to leave. So you tell me if I didnt do my best during this phase, during this period. (PARAPHRASING NELSON TEICH) This is as far as I can go. (IN PORTUGUESE) Its not easy to be heading a secretariat like this in such a difficult period. Doesnt really give a clear explanation for why hes leaving, but its pretty clear that he, too, just couldnt live with being the face of this response that was being led by the president. It was an honor for me to have been part of this. Thank you. So this is definitively not going well. Youre churning through two health ministers in the middle of a deadly pandemic. Yeah, and the numbers are just spiraling. Brazil now has the most cases of coronavirus in South America with more than 5,800 confirmed Covid-19 cases and growing. A new study out over the last couple of days showing that Brazil might have eight times more cases that have so far been recorded. Brazil has officially reported about 4,500 deaths. The true number are believed to be much higher, due to the lack of testing. Topping 90,000 confirmed cases and with more than 6,000 deaths. 100,000 with more than 7,000 deaths. Brazil now has more confirmed cases of coronavirus deaths than China. You know, at this point Well, as the number of coronavirus cases goes up in Brazil, so does the threat to communities in the Amazon region. you start seeing real strain in some states. Already, the biggest city, Manaus, has seen its health system collapse. Up in the Amazon, for example, grave diggers started digging mass graves because people were dying so quickly that officials were completely overwhelmed at hospitals and funeral homes. In Rio de Janeiro, hundreds of men, women, and children stood on a line to get food and water. So Health systems across the country are struggling. you know, across the country in some cities, panic really starts setting in. But experts dont expect Brazil to reach the peak for a few weeks yet. And at the national level, the health ministry is without a minister. And instead of appointing another expert in the field, the president leaves the ministry in the hands of an active duty army general who was an expert in logistics but had no real track record when it came to medicine. And one of the first things the ministry does when it is essentially run by this army general is endorse this anti-malaria pill, hydroxychloroquine, and say that health care professionals in the country should give it to all coronavirus patients who want it at any stage of contagion. So on his third try, he finally found a health minister willing to take that position. Absolutely. And he had a general on the job, and the general had to take orders from the president. And has Bolsonaro backtracked at all as these infection numbers have surged, as the death toll has risen? Or has he stayed with this same approach as he started with? There have been times when he has acknowledged that this is a very significant problem and this is a crisis, but he has been very consistent in saying that it is crucial to save the economy and to put economic recovery ahead of fighting the virus. At one point, when there had been sort of a milestone in the death toll, somebody asked him outside the palace what he thought, and he said, so what? What do you want me to do? My name might be Messiah, which was a reference to his middle name, but Im not here to perform miracles. Earlier this month, Bolsonaro said, I regret the loss of life. But at the end of the day, this is everybodys destiny. Everybody eventually dies is what hes saying. Yes. So he hasnt really backtracked. And I think in the long run, what some political experts think is that he is betting on the possibility that when the real economic pain is felt six months, a year down the road, when it becomes clear just how big of a beating Brazilians took that Brazilians may take out their wrath on the governors and the mayors who imposed these quarantines, and that the president may be able to sort of carve out a role for himself as the person who consistently wanted to save jobs, wanted to keep the economy on track. And I think its too early to tell. As a political strategy, that may pay dividends down the road. Ernesto, Im curious if you think that given Brazils history of beating back public health crises, that under different leadership not a president like Bolsonaro who is skeptical of the science and who explicitly puts economics over public health that Brazil would be in a very different place right now? Well, I think it bears watching what other countries in the region have done. And theres cases where governments had very decisive and well-thought-out responses that are wrestling with very high numbers. So theres something kind of mystifying about where this virus strikes with wrath, even in the face of a decisive and sophisticated response. I think one common theme were seeing that certainly applies to Brazil is countries with very stark inequality have had a harder time reigning the virus in. You have to think about kind of the way Brazilian cities are laid out. You have many Brazilians living in impoverished, teeming communities where people are sort of stacked up together, where they live numerous families to a small dwelling. And this virus has underscored the privilege some Brazilians have in adhering to conventional social distancing norms and the extent to which, for many Brazilians, for millions of them, its just not a possibility. But theres no question that Brazil had the expertise, had a track record of responding to health care challenges in a really decisive way. And it never really mounted a response that was coherent or sophisticated. Its been mired in this political fight that has prevented it from having a plan that makes sense to people, a plan it can explain to its population. At the end of the day, without a clear national policy, without a political consensus, and without effective enforcement mechanisms for some of these quarantines and lockdowns, there was no reining in the virus. But pretty much everybody I spoke to who has spent years working in health care policy in Brazil said, we were equipped and ready and trained to rise to the challenge. There was so much we could have done in the precious early days of the epidemic to strike back, to prepare and to save lives. Ernesto, thank you very much. We appreciate it. My pleasure, Michael. As of Wednesday, the number of infections in Brazil has risen to 1.4 million, and the number of deaths has surpassed 60,000, confirming Brazils outbreak as the second worst in the world, after the United States. Well be right back. Heres what else you need to know today. So I want to make very clear, we cannot go ahead at this point in time with indoor dining in New York City. Look, even a week ago, honestly, I was hopeful we could. But the news we have gotten from around the country gets worse and worse all the time. As U.S. infections continue to break records, New York City delayed a plan to resume indoor dining, Miami Beach reinstated a curfew to keep residents from congregating at night, and California shut down bars and indoor dining in 19 counties. During a news conference on Wednesday, Californias governor Gavin Newsom said that he knew the decision would be disappointing. And I deeply respect peoples liberty, their desire to go back to the way things once were. But I cannot impress upon you more, our actions have an impact on other people. As of Wednesday night, the U.S. death toll from the virus neared 128,000. [PROTESTORS IN HONG KONG] A new national security law, imposed on Hong Kong by China, was put to the test on Wednesday as thousands of protesters took to the streets there, demanding greater freedom and independence from China. The law, which went into effect on Tuesday, forbids a wide variety of activities, including chanting slogans and carrying banners that China considers seditious. At times, citing the new law, police arrested about 370 people, including a 15-year-old girl waving a flag, calling for Hong Kongs independence. The Daily is made by Theo Balcomb, Andy Mills, Lisa Tobin, Rachel Quester, Lynsea Garrison, Annie Brown, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Larissa Anderson, Wendy Dorr, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Jonathan Wolfe, Lisa Chow, Eric Krupke, Mark George, Luke Vander Ploeg, Adizah Eghan, Kelly Prime, Julia Longoria, Sindhu Gnanasambandan, M.K. Davis Lin, Austin Mitchell, Sayre Quevedo, Neena Pathak, Dan Powell, Dave Shaw, Sydney Harper, Daniel Guillemette, Hans Buetow, Robert Jimison, Mike Benoist, Bianca Giaever, Asthaa Chaturvedi and Rachelle Bonja. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Mikayla Bouchard, Lauren Jackson, Julia Simon, Mahima Chablani, Nora Keller and Lis Moriconi. Thats it for The Daily. Im Michael Barbaro. See you on Monday after the holiday. Brazil has a long, distinguished history of successfully navigating public health crises. But in recent weeks, it has emerged as one of the worlds most severe coronavirus hot spots, second only to the United States. What went wrong? , the Brazil bureau chief for The New York Times. Heres an overview of what you need to know about . The countrys , including AIDS and Zika, won global praise. Ernesto Londono contributed reporting. The Daily is made by Theo Balcomb, Andy Mills, Lisa Tobin, Rachel Quester, Lynsea Garrison, Annie Brown, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Larissa Anderson, Wendy Dorr, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Jonathan Wolfe, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, Adizah Eghan, Kelly Prime, Julia Longoria, Sindhu Gnanasambandan, M.J. Davis Lin, Austin Mitchell, Sayre Quevedo, Neena Pathak, Dan Powell, Dave Shaw, Sydney Harper, Daniel Guillemette, Hans Buetow, Robert Jimison, Mike Benoist, Bianca Giaever and Asthaa Chaturvedi. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Mikayla Bouchard, Lauren Jackson, Julia Simon, Mahima Chablani and Nora Keller.