(Bloomberg Opinion) -- Fittingly for a region where maladies flourish, everyone in Latin America seems to have a remedy for the spread of the coronavirus. A Venezuelan lawmaker recommends pepper and honey with a twist of lemon. Other sois disant healers swear by avocado tea with mint. For the Global Cathedral of the Holy Spirit, an evangelical order in southern Brazil, there’s no prophylactic like “the power of God.”
All the better for coronavirus, which thrives amid crowd-sourced misinformation. The Brazilian health ministry, encouragingly, launched a website to dispel such charlatanism, while the Chilean fact-checking outfit El Poligrafo has taken aim at the fast spreading fakery.
Since Covid-19 surfaced in Latin America in January, the effects have so far been mild. As of March 4, there were three confirmed cases in Brazil, five in Mexico, 10 in Ecuador and a handful elsewhere in the region, none of them fatal. Several hundred other suspected cases are under investigation. “It’s a cold. We’ll get past this,” Brazilian health minister Luiz Henrique Mandetta said recently, presumably to steady public nerves.
Yet underplaying the menace to a region known for precarious health care, a rash of red tape and markets tied umbilically to the wobbling global economy is also misguided. Signs of economic setback already abound. Analysts reckon the virus and its knock-on effects will weigh on already wan regional prospects. The International Monetary Fund forecasts the seventh straight year of torpid growth for Latin America and the Caribbean. Goldman Sachs just downgraded its projections for Brazilian growth this year from 2.2% to 1.5% and from 1% to 0.6% in Mexico.
The fallout for public health is likely to be worse. Coronavirus is just the latest arrival among a host of pathogens against which most regional officials are already overmatched. As Carissa Etienne, director of the Pan American Health Organization, recently warned. “[T]he impact on health services may be significant with the possibility that health services may become overwhelmed, including high demand for specialized hospital services such as intensive care.”
Latin America’s biggest country is a test case. Brazil is no stranger to debilitating diseases. Its highly trained researchers and clinicians are accustomed to identifying and treating emerging contagions, including devastating mosquito-borne viruses such as Zika*, chikungunya and four strains of dengue, plus resurgent yellow fever. Within 48 hours of the first confirmed coronavirus infection, Brazilian scientists had sequenced the genome of the strain carried by the stricken patient.
Yet even as officials scramble to respond to a possible new outbreak, old scourges rage and many of them, sadly, no longer seem to galvanize public attention. “Brazil has a pile-up of health problems, from dengue fever to resurgent measles. Now comes coronavirus, and we are obliged to redirect resources, which are already thinly spread,” says Ligia Bahia, a physician who teaches public health at the Federal University of Rio de Janeiro.
Brazil led a spike in dengue infections across the region last year, reporting more than 2.2 million reported cases (70% of the Latin American total), 789 of them fatal. More than 94,000 cases new cases were reported in just the first five weeks of 2020. What’s worse, this year’s offending serotype has been out of circulation since the mid- to late-2000s, leaving a generation of Brazilians with no prior exposure suddenly vulnerable.
HIV has also made a comeback, led by youths who – thanks ironically to past medical advances – no longer fear dying and can’t be bothered with condoms. After pioneering treatment with antiretroviral medications through the 2000s, Brazil saw the number of new infections surge 21% from 2010 to 2018, even as the disease retreated across Latin America. Add to those miseries the federal government’s faith-based health dictums which preach that the best prophylaxis is chastity – a doctrine the managing obscurantists drove home last December by firing the health ministry’s foremost expert on sexually transmitted diseases lest her initiatives “offend families.”
Brazil eradicated endemic measles in 2015. Now it’s back, imported by desperate refugees trying to escape the imploding Venezuelan economy, but also enhanced by a new anti-vaccine movement which has weakened protection. Measles killed 14 people last year and claimed its first victim in 2020 in Sao Paulo last month.
Urban disarray further weakens Brazil’s defenses. About 100 million Brazilians (48% of the national population) live in homes with no sewage collection, the Rio de Janeiro consultancy Inter.B found. Unsurprisingly, from 2016 to 2017, more than a third (34.7%) of the country’s 5,570 townships were afflicted by sanitation-related epidemics or preventable illnesses such as intestinal worms and chronic diarrhea, the study reported.
“Brazil is regressing in public health,” said Inter.B president Claudio Frischtak, a former World Bank economist and specialist in public policy. “We have approximately seven million substandard homes, 28% of the total, jumbled in cramped, high-density urban areas with a lack of basic public services, a perfect ecosystem for transmittable disease.”
By rights, Brazil ought to be well placed to manage even the most daunting health emergency. The sick and injured may be whisked to public hospitals and treated free of charge under the vaunted universal health care system, called the Unified Health System (SUS). In practice, it’s a logistical and managerial nightmare, plagued by scarce resources and epic queues. Patients frequently languish and sometimes die of treatable ailments while awaiting care in the emergency room.
“SUS is a brilliant system that Brazilians should be proud of, but it’s overburdened,” said Denise Garrett, a Brazilian physician and vice president of the Sabin Vaccine Institute. People cannot rely only on public health infrastructure, she said, but must know how to protect themselves, avoid unnecessary exposure (so much for the famous Brazilian double-kiss greeting), and work from home when ill, which is not a custom in the Brazilian labor market.
“When the system is overloaded, everything becomes more difficult. Especially when all the science points to the probability that this disease is not a one-off, but will likely continue to circulate,” Garrett said. “We are going to see this problem come and go.”
Nothing could be more inviting for a new contagion. “We are dealing with a lot of unknowns all at once,” said Frischtak. “In theory, our health system is equipped to deal with an outbreak, but how it would unfold is still very abstract. What is our real capacity to deal with a great number of patients all at once, and how will the population react in an emergency? We need to count on a lot of luck.”
Luck and a steady supply of hand sanitizer, which thanks to rippling panic is as scarce these days as miracle elixirs and prayers are abundant.
To contact the editor responsible for this story: James Gibney at jgibney5@bloomberg.net
This column does not necessarily reflect the opinion of Bloomberg LP and its owners.
Mac Margolis is a Bloomberg Opinion columnist covering Latin and South America. He was a reporter for Newsweek and is the author of “The Last New World: The Conquest of the Amazon Frontier.”
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