The cars ring and ring, the nurses and doctors fade as they rush into the room of an elderly man panting for an air that will not come. The intubation decision is made quickly. It is his only chance at a survival far from guaranteed.
Among half a dozen in the room, nurse Monica Aparecida Calazans says she has already seen too many dead. “I have already lost eight of my colleagues to Covid,” she said. “It’s such a cruel disease.”
As of Sunday, only 0.5% of the country had received a first dose of either AstraZeneca or Sinovac vaccines. No person in Brazil has been completely vaccinated, except for some who have participated in vaccine clinical trials.
Moreover, the supply of vaccines is extremely limited and there remains an astonishing lack of detail in government plans to provide more.
“I would have said that Brazil will be the first”
In June 2020, few believed that Brazil would fight so badly with its launch.
The country’s massive national healthcare system, with medical staff present in almost every thousand municipalities in Brazil, through a number of hospitals and clinics, has a long history of successfully vaccinating its people.
But several experts say the federal government’s ineptitude, led by skeptical Covid President Jair Bolsonaro, has sabotaged its coronavirus response. They indicate a distinct lack of urgency on the part of the federal government to ensure supply and a lack of diversification of the vaccine supply.
“At the beginning of the pandemic, I would have told you that Brazil will be the first country in Latin America to vaccinate its population, because we know how to do it,” said Natalia Pasternak, a Brazilian microbiologist and health care lawyer. “We have all the infrastructure we need. Now we just need a better president.”
Brazilian health officials initially announced a launch plan similar to that of many other major countries. It will produce the AstraZeneca vaccine in the country, producing approximately 30 million doses by the end of January 2021.
Approximately 200 million more will be produced by the end of the year, administered first to health workers and the elderly and then on the line in order of vulnerability.
The Brazilian government has clearly placed its initial hopes on the AstraZeneca vaccine. But his studies with the vaccine lasted longer than others, a perfectly normal and predictable possibility, given the unprecedented nature of the development of the Covid-19 vaccine.
The Brazilian Vaccine Regulatory Agency finally granted emergency use of the AstraZeneca vaccine on January 17, but the lack of the active ingredient needed to make the vaccine means that Brazilian laboratories have not yet begun producing hundreds of millions of doses of needs.
Supplies are expected to arrive this week, but the delay has almost all canceled the government’s timetable. There is no set date for when completed doses will be shipped.
As large countries with similar purchasing power negotiated agreements last year to buy other vaccines from Moderna and Sinovac, Brazil remained standing.
Brazil’s health minister has even rejected an August offer from Pfizer to buy up to 70 million doses of his vaccine. The ministry defended the decision, saying in part it was concerned about the payment guarantee and the agreement that the contractual issues should be resolved by a US court.
“That’s why you don’t put all your eggs in one basket,” Pasternak said. “There is no reasonable explanation for not planning in advance on how you will vaccinate the population.”
However, Bolsonaro recently said that no government “would do better than my government does.”
Bolsonaro’s China flip-flop
Brazil’s best hope for short-term vaccine supply is probably CoronaVac, developed by Chinese firm Sinovac. Regulators approved its emergency use on Jan. 17, and the Bolsonaro administration approved the purchase of 100 million doses.
He leaned toward discrediting the vaccine, while São Paulo Governor João Doria, a key political rival and likely contender in the 2022 presidential race, embraced him.
Doria bypassed the Bolsonaro administration and negotiated the Sinovac vaccine directly with China, eventually securing millions of doses. Doria says the president’s inaction on securing supplies has forced his hand. “In Brazil, we have to fight two viruses, the coronavirus and the Bolsonaro virus,” Doria said in an interview.
Doria was forced to hand over the state-supplied vaccine made in China to the federal government. “We have to [vaccinate] faster than we go now, “he said.” We need more vaccines, but that is the responsibility of the federal government. “
Both men could now be blocked with a vaccine that appears to be less effective than others. Recent data show that the CoronaVac vaccine has an efficacy of 50.4 percent, eliminating the WHO guideline of 50 percent with the thinnest margin.
Bolsonaro said that in addition to the purchase agreements already in place, his administration will buy vaccines as they become available. It is a vague statement, given that vaccines are among the most sought after goods in the world.
Angry, frustrated and helpless
The confusion and frustration over the launch of the vaccine in Brazil comes at a time when Brazil’s outbreak has never been more severe.
In addition to the total daily increase in cases and deaths, which is among the largest pandemics to date, a new variant of Covid-19 has emerged that epidemiologists say is probably more easily transmitted and could be more lethal.
Vaccines are needed more than ever, but today, this supply simply does not exist. Júlio César Barbosa, a nurse who works at a public hospital in São Paulo, volunteered to vaccinate people, but says he feels helpless in his absence. “I am worried and angry with our government because they have trivialized this virus from the very beginning.”
Natalie Gallón of CNN contributed to this report.