The machines ring and ring, the nurses and doctors blur as they enter the room of an old man who aspires to seek air that will not come. The decision to intubate is made quickly. It is their only chance of survival far from being guaranteed.
Among the dozen or so in the room, nurse Monica Aparecida Calazans says she has already seen too many dead. “I’ve already lost eight of my teammates against Covid,” he said. “It’s such a cruel disease.”
As of Sunday, only 0.5% of the country had received a first dose of AstraZeneca or Sinovac vaccines. Not a single person in Brazil has been completely vaccinated, apart from a few who participated in clinical trials on vaccines.
In addition, the supply of vaccines is extremely limited and there is still a surprising lack of detail in government plans to achieve more.
“I would have said that Brazil would be the first”
In June 2020, few thought Brazil would be fighting so badly with its launch.
The country’s massive national health system, with health workers present in nearly every thousand municipalities in Brazil through a number of hospitals and clinics, has a long history of successful vaccination of its people.
But several experts say the federal government’s ineptitude, led by skeptical Covid president Jair Bolsonaro, has sabotaged its response to the coronavirus. They point to a clear lack of urgency on the part of the federal government to secure supplies and a lack of diversification in vaccine supply.
“At the beginning of the pandemic, I would have told you that Brazil would be the first Latin American country to vaccinate its population because we know how to do it,” said Natalia Pasternak, a Brazilian microbiologist and health advocate. “We have all the infrastructure we need. Now we just need a better president.”
Brazilian federal health officials initially announced a deployment plan similar to that of many other major countries. It would manufacture the AstraZeneca vaccine in the country, producing about 30 million doses by the end of January 2021.
By the end of the year there would be about 200 million more, administered first to health workers and the elderly and then in order of vulnerability.
The Brazilian government clearly put its initial hopes on the AstraZeneca vaccine. But their vaccine trials took longer than a few others, a perfectly normal and predictable possibility given the unprecedented nature of Covid-19 vaccine development.
The Brazilian vaccine regulatory agency finally granted emergency use authorization for AstraZeneca vaccines on January 17, but the lack of the active ingredient needed to make the vaccine means that Brazilian laboratories have not yet begun to produce the hundreds of millions of doses you need.
Supplies are due to start arriving this week, but the delay has nullified the government’s timeline. There is no set date for when the finished doses will begin to be shipped.
While large countries with similar purchasing power negotiated agreements last year to buy other vaccines from Moderna and Sinovac, Brazil suffered.
Brazil’s health minister even turned down an August offer from Pfizer to buy up to 70 million doses of its vaccine. The ministry defended the decision, saying in part that it was concerned about a payment guarantee and an agreement that contractual issues be dealt with in a U.S. court.
“That’s why you don’t put all the eggs in one basket,” Pasternak said. “There is no reasonable explanation for not planning ahead on how you will vaccinate your population.”
Still, Bolsonaro said recently that no government “would do better than my government does.”
Bolsonaro’s China flip flop
Brazil’s best hope for a short-term supply of vaccines 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 was inclined to discredit the vaccine while São Paulo Governor João Doria, a key political rival and likely competitor in the 2022 presidential race, adopted it.
Doria toured the Bolsonaro administration and negotiated the Sinovac vaccine directly with China, eventually reaching millions of doses. Doria says the president’s inaction in securing supplies 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 supply of the China-made vaccine to the federal government. “We have to [vaccinate] “We need more vaccines, but that responsibility lies with the federal government,” he said.
The two men could now get stuck with a vaccine that appears to be less effective than others. Recent data show that the CoronaVac vaccine has an effectiveness of 50.4 percent, which clears the WHO guideline of 50 percent by the thinnest margin.
Bolsonaro said that in addition to the purchase agreements already established, his administration would buy vaccines as they became available. It is a vague statement, as vaccines are among the most sought after products in the world.
Angry, frustrated and helpless
The confusion and frustration over the deployment of vaccines in Brazil comes at a time when Brazil’s outbreak has never been worse.
In addition to the total increases in daily cases and deaths, among the highest in the pandemic to date, a new variant of Covid -19 has emerged that epidemiologists say is more easily transmitted and can be more lethal.
Vaccines are needed more than ever, but right now that supply simply doesn’t exist. Júlio César Barbosa, a nurse who works at a public hospital in São Paulo, has volunteered to vaccinate people, but says he feels powerless in scarcity. “I am worried and angry with our government because they have trivialized this virus from the beginning.”
CNN’s Natalie Gallón contributed to this report.