Brazil’s COVID-19 inquiry puts pseudoscience on trial,Natália Pasternak,The Skeptic

The Brazilian Senate has recently implemented a Parliamentary Inquiry Committee (CPI in the Portuguese Acronym), to assess the responsibility of the Federal Government on how the pandemic was – or wasn’t – handled in Brazil.

So far, we have heard from the men who commanded the Ministry of Health since 2019 – all four of them, including the present Minister, cardiologist Marcelo Queiroga, the former Minister of International Affairs, the President of Anvisa (Brazil’s Health regulatory agency), and Pfizer’s CEO in Brazil.

Apart from the vaccination issue, where it became clear that Brazil snubbed several attempts made by Pfizer to negotiate, the CPI has become known as the “chloroquine trials”. The use of this medication for COVID-19 still dominates Brazilian media and public debate, so much so that it became the main topic in an initiative that should be geared towards naming and shaming the ones responsible for the disastrous situation of the country. According to Folha de São Paulo, one of the most important Brazilian newspapers, the word “chloroquine” was said 140 times during the CPI so far.

The use of this medication was forcefully promoted under Health Minister Eduardo Pazuello, beginning May 2020. During his tenure, an app called TrateCov was launched. With it any doctor could check patient’s symptoms in an online form, and a “prescription suggestion” would be generated. Simulations showed that any symptom, even if just a simple cough, in any age, even newborn babies, produced very slight variations of the same base prescription: hydroxychloroquine, together with other unproven miracle drugs, such as ivermectin, azithromycin and Vitamin D, in what the Ministry called “early treatment”.

The CPI had some interesting effects, even before it began. Suddenly, all references to the “early treatment” were removed from the official Ministry website. Some very vocal pro-government pundits removed chloroquine-loving videos from their YouTube channels, trying to destroy the records of ever having defended the use of this drug for COVID-19.

Curiously, by the time former Minister Pazuello appeared before the inquiry, no record of “early treatment” remained, either on the Ministry website or in his memory. He did not recall having received direct orders from the President, neither for the use of chloroquine, nor for anything related to vaccines… which is weird, because Bolsonaro was very clear in his statement, broadcast nationally, saying that he would not authorise Pazuello to buy the “Chinese vaccine”, and even went as far as to say “I’m the President, here’s how it works, one gives the command, and the other obeys”.

The chloroquine debate went on, and Pazuello again defended the use of the drug, saying that it was a widely known antiviral – or so he believes because he is not a doctor. He added that the “antiviral” (it isn’t) was widely used during the Zika crisis (it wasn’t), and during Chikungunya outbreaks (also not true). If Pazuello were the least familiar with medical literature on these endemic Brazilian diseases, he would know that chloroquine was tried, and failed, for both Zika and Chikungunya, and many other viral diseases. In fact, for Chikungunya, in animal models, it actually made the disease worse. The former Minister cannot even claim ignorance of these facts: they were published in Portuguese at Revista Questão de Ciência April last year, and revised and republished recently in May.

Most shocking, probably, was Pazuello’s reply when asked why he was fired from his position. He replied that his “mission had been accomplished”. It is hard to imagine to what mission he was referring to, considering that when he was appointed Minister, the number of Brazilian deaths caused by COVID-19 was around 15 thousand, and when he left his position ten months later, 280 thousand lives had been lost to the disease. Is this his accomplishment? Nearly 300 thousand Brazilians dead? Or was his true mission to obey and protect the President at all costs?

Difficult days lie ahead for Brazilian politics, but worse so for the population. While the Senate tries to hold the Executive accountable for Brazil’s death toll, we keep burying our friends and relatives. Vaccines seem like a distant dream, and what used to be one of the world’s leading public immunization programs is now lost in bureaucracy and inefficiency. Half of the population seems confused, and half behaves in an “every man for himself” manner; the very wealthy can go to Miami to get vaccinated, and those who can’t procure a doctor’s statement – not always legitimate – for specific health conditions that allow them to jump the vaccine queue.

Professional categories that should not be prioritised are also getting access to the vaccine early. My own professional category, Biologists, are being contemplated for vaccination now, while someone who is pregnant, in real risk of dying if they get COVID-19 (Brazil has the highest pregnant mortality in the world), has to present a doctor’s statement showing they have accompanying health conditions. Being pregnant is not enough; being a Biologist, even if you work from home, is.

Let’s see what the future of the CPI brings. The following days show promise, with the summons of the Secretary of the Health Ministry, also known as “Captain Chloroquine”, one of the fiercest defenders of the “early treatment”. Mayra Pinheiro even went to Manaus during the oxygen supply crisis, not to solve the problem, but to make sure that Manaus’ doctors were prescribing chloroquine. Some scientists should be summoned as well, including yours truly, hopefully, bringing the chloroquine nonsense to an end. Time alone will tell, though, if the pandemic can also be brought to an end during the present government.

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The COVID-19 inquiry in Brazil is an opportunity to understand what went wrong and what can be learned – it is one we can’t afford to pass up
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