Covid-19 in Brazil: A 21st Century 'Reenactment' of the 19th Century Yellow Fever?
PAULO HENRIQUE RODRIGUES PEREIRA & CAIO HENRIQUE DIAS DUARTE
SAO PAULO/ CAMBRIDGE: As the death toll in
Brazil nears 30,000 people and is likely to remain on a steady and fast
escalade over the next few days, many believe the arrival of the pandemic
during a political and economic crisis has turned to looming disaster.
Nonetheless, Brazilian president Jair Bolsonaro - who called the
virus "just a little flu" - and his supporters are still dedicating their time
to organising protests against isolation measures to contain the spread of the
disease.
But Brazil's history tells us it is not an unpredictable scenario: such
reactions owe a lot to the nation's slave-owning past, and the way its elites
came to handle economic pressures.
58% of Brazilians still live within 200km of the ocean - a heritage from
colonial times. As the exploitation of fertile lands for agriculture grew with
demand for its commodities (sugarcane then coffee in the 19th century) Brazil
became the biggest importer of enslaved labour in the continent, accounting for
46% of the traffic in slaves from Africa to the Americas.
In 1849, with Britain pressuring the Imperial Government to abolish the slave
trade, ships rushed to the Brazilian coast filled with enslaved captives from
Africa, meant to fuel the booming coffee and sugar farms, the demand for house
servants, and urban commerce.
It is still possible to feel this heritage. Brazil has the most significant
African diaspora population in the world, and the social indices still show
they hold precarious jobs, in inadequate housing, education and health
conditions.
In 1849 one of those slave ships, inbound from Havana after a stop in New
Orleans, docked in the old colonial capital of Salvador and let loose some
mosquitoes from Africa. Today, Aedes aegypti with its
black-and-white stripes is well known to Brazilians as a carrier of dengue
fever, zika and chikungunya. On 30 September 1849 however, it brought something
unknown to them: the yellow fever.
Six weeks later, on 15 December 1849, the local authorities sent word of the
problem to the Imperial Government in Rio, and the nation's best doctors at the
Academy of Medicine got together to discuss the matter. They considered that
Brazil had a "proverbial healthiness", as one doctor called it, while yellow fever was believed to be something that only
prospered in much warmer climates. Such a plague would not flourish in our
pleasant weather.
On 23 March 2020, Mr Bolsonaro said the virus would not survive in Brazil's
weather as it had in Italy, with "a climate rather different from ours." The
virus had been first reported in the country just 26 days earlier.
History and
description of the Yellow Fever Epidemic that raged in Rio de Janeiro in 1850
As the ship from Havana followed the coastline down to Rio de Janeiro and the
epidemic spread, with hundreds of sick people reported in the capital and other
coastal cities, British diplomats were lobbying the Imperial Government. They
suggested that quarantine procedures such as closing off ports would be
senseless in the fight against yellow fever, arguing that adverse sanitary
conditions were to blame for the outbreak.
Meanwhile Yellow Jack, as the disease was nicknamed by the British, was
spreading rapidly through the capital's urban tenements.
With doctors suggesting artillery shots and fires to cleanse the air, the next
step would be the destruction of these tenements. The freed and runaway blacks
who lived there would move to the hills of Rio de Janeiro and build the first
favelas (slums). From 1855 onward these places, unsuited to accommodate a large
population, would become a recurring epicentre of cholera outbreaks due to a
lack of basic sanitation provision.
On 26 March 2020, Mr Bolsonaro stated that the spread of the epidemic wouldn't
cause many deaths, considering that the average Brazilian was used to diving
into sewage water during floods, a proof of "innate resistance" that should be
studied.
With the epidemic ravaging the imperial capital, those who could afford not to
work fled into self-isolation in Petrópolis, a tropical and mountainous
Versailles just a few hours away from Rio. They kept their slaves working in
Rio - noblesse oblige.
Although Africans and Afro-descendants were more resistant to the disease, most
likely by accumulated immunities, in truth the rhetoric of the time needed to
find ways to defend the continuity of trade and wage-work.
The statistics in Rio did not consider that slaves and free Africans were, as
their descendants still are, a population with less access to quality health
services. Underreported cases, the denial of information and poor living
conditions defined their reality, and define the reality of those who live in
Brazil's favelas today, who are having to deal with the Covid-19 crisis on
their own, in scenarios where they are about ten times more likely to die from
the infection than their counterparts living in better conditions.
Protecting trade became a priority, and in 1850 the ports were kept open and
the death toll kept rising, with around eighty people dying per day in January,
February and March. Just a few weeks ago, the city of Blumenau in the southern
state of Santa Catarina became a global symbol of denial when it decided to
reopen commerce against the recommendations of the World Health Organization,
with Covid-19 cases spiking 173% after the measure.
In Rio as the fever death toll kept rising, and even the Emperor's son died,
the Hygiene Junta discussed a possible cure. Drawing on reports by a French
doctor who had treated the fever with quinine sulfate years earlier during an
outbreak on board the steamship Gomer, the Imperial experts believed they had
found an answer.
Without proper studies and testing, the treatment was implemented and instantly
began to fail. People with comorbidities, and there were many given the lack of
basic sanitation provision to poorer communities, were undoubtedly the ones
most affected by the fever.
Last month Mr Bolsonaro, having ordered the army to produce chloroquine pills,
went on to say in a public address that this medication should be used to treat
Covid-19, although there isn't to this day a consensus on its effects.
Even after studies of its efficacy were cancelled - after the death of a test
subject in Manaus - Bolsonaro's supporters have pressured for its extensive use
as a "cure" that would allow isolation measures to be ended, basing themselves
on the success a few French doctors obtained in an isolated scenario in
Marseille. As a consequence chloroquine has disappeared from the pharmacies,
and those actually in need of the medicine have difficulty finding it.
In 1850 as Yellow Jack seemed to be easing its grip, the official death toll
was of 4,160 people in a city of 166,000. But the real figures were believed to
be much higher, motivating the creation of South America's first service of
health statistics the following year.
As an answer to the epidemic - and to British pressure - Parliament abolished
the slave trade that year and deemed the measure sufficient.
Epidemics have since become a focus of studies in Brazil, from 19th-century
doctors' researches to panoramic works such as Sidney Chalhoub's Feverish
City. The constant struggles with such diseases have been the result of
political decisions in the field of health, and an absolute disregard for the
most impoverished communities.
In the following decades, as no vaccine was discovered and no extensive public
policy plan was laid, yellow fever would return in wave after wave with
devastating results, until a vaccine was found. Countrywide campaigns would
succeed in eradicating it only in 1942, almost a hundred years later.
Although today scientific advancements allow for faster vaccine development, in
today's Brazil the authorities continue to ignore the warnings of 1850, while
following its mistakes with diligence.
With the government's continued failure to organise a broader system of
financial aid, food supplies and improved sanitation provision, especially for
those in the favelas, we are led to ask ourselves, will the Covid-19 crisis in
Brazil become the biggest historical reenactment on the planet?
Paulo Henrique Rodrigues Pereira is visiting researcher at the African-Latin
American Research Institute and the Department of History at Harvard University
and Caio Henrique Dias Duarte is researcher at the Law School of the University
of Sao Paulo