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COVID-19 in brazil: exacerbating factors, scenarios and risks
April 24, 2020
by Hervé Théry, Senior Researcher in Geography at the University of Paris Sorbonne Nouvelle and Professor at the Universidade de São Paulo
After hitting Europe, the Covid-19 epidemic is currently spreading all over the American continent.
The actual number of known cases is already worrisome and we can fear that the worst is yet to come. There are already 45 757 confirmed cases in Brazil and 2 906 deaths as of April 22 according to the official numbers (table 1). These numbers are probably underestimated since a large part of the population lives informally and only patronizes the healthcare system as a last resort, often in institutions that are also badly equiped to deal with the crisis. So, a large number of cases and deaths can "slip under the radar" of official statistics. But, seeing as contagious factors and mortality linked to SARS-Cov-2 are largely influenced by socio-demographic features for which we have more solid data, it is possible to fill in the blanks, notably by using maps to estimate factors likely to increase the Covid-19 contamination.
Table 1 Confirmed cases in main states on April 22, 2020 (Source: covid.saude.gov.br)
An anamorphosis is a map where territories are shaped according to a statistical feature. Figure 1 uses this process to represent Brazilian States according to their population, showing a territorial image in which the Southeast and Northeast regions are largely predominant (as opposed to the geographic surface distribution where the Amazon is much greater). This map presents the number of confirmed cases and deaths. It shows three critical zones, the Northeast, the Southeast (mainly Rio de Janeiro and São Paulo) and the Amazonas State. The first two are also the most populated regions, so there's a certain logic to them being the most affected. The significant contamination in the Amazonas State, especially in Manaus, could be due to the presence of a foreign-trade zone where many asian businesses are established, the comings and goings of their expatriates could have imported the virus.
Figure 2 looks for similarities with other anamorphoses that would give us explanations and causal relationships - which would then need to be confirmed by systematic analysis. Shown here is a clear link between the anamorphosis based on deaths and the one on the distribution of pentecostal protestants (in Brazil called evangélicos). Another similarity, a little less clear-cut globally but very strong in the Northeast region, is with the distribution of the poor map (earning less than 1/2 the minimum salary).
A third map confirms this clearly marked differentiation. The background color given to each State is calibrated (from light yellow to dark brown) according to the number of people who earn less than half a minimum salary, i.e. less than 80 Euros per month ($86): it's clearly in the Northeast that this percentage is the biggest.
The size of the circles on each State indicates the number of people who have declared themselves of the evangélica religion (pentecostal protestant) on the last census (in 2010) and the color of the circle, calibrated from light yellow to dark green, the percentage in the population: it's in the Southeast, especially São Paulo, that there are the most, but it's in the Amazon that the percentage is highest, which would explain the high rate in this sparsely populated region, notably in the State of Amazonas.
So, the map analysis seems to provide the following conclusion: aside from the Amazonas' cluster, most likely due to the economic relationships with Asia, two factors seem to strongly correlate in the distribution of cases and deaths in Brazil, one being the social conditions and poverty, and the other the importance of the evangelical churches.
Poverty as an aggravating component of the crisis is evident, especially since it is a factor in most countries, whether in Latin America or in North America. But why would the high percentage of evangélicos be an aggravating factor of the infection? Because lots of them deny the seriousness of the epidemic and continue to hold their worship services thinking that divine protection will keep them from getting sick. They are encouraged by the President of the Republic, an evangelical himself and victim to a sort of "back from the dead" syndrome, consistently minimizing the pandemic and its victims, giving the impression that "God will recognize His children".
Needless to say, it is rather reckless if one can believe the scenarios the Imperial College did for Brazil, even if they should be viewed with caution, as in all forecasts.
Imperial College scenarios (Source: The global impact of Covid-19 and strategies for mitigation and suppression, Walker P.G.T. et al., Imperial College Covid-19 Response Team. by Jean-Yves Carfantan, "The President plays russian roulette"" Blog Brésil : politique, économie, société,
The handling of the pandemic crisis is Brazil is anything but a show of political unity in its management. The President of the Republic and the governors of the States have serious disagreements on what to do and especially on the use and length of the confinement. Faced with this carelessness, many Brazilians (already used to not being able to depend on public services for many years) decided to take action themselves. This is particularly the case for the Santa Marta favela's residents who took charge of disinfecting their neighborhood and published the following:
"We have decided ourselves to proceed with cleaning the favela! We've obtained the first donations and have already voluntarily started, with appropriate security equipment, this preventative measure, desinfecting the roads, streets and mournful Santa Marta funicular".
So the residents decided to desinfect themselves the walkways used by the workers who have to leave their home day to day to provide for their family. An incredible example that should be encouraged, and proof that in Brazil, as in a large part of the Americas, the current crisis shows the importance of the people who are "invisible" in normal times.
Hervé Théry is an emeritus Senior Researcher at the University of Paris Sorbonne Nouvelle (CREDA) and Professor at the Universidade de São Paulo (USP-PPGH). A geographer, he has been studying Brazilian territorial disparities and dynamics since 1974, using thematic mapping and field work. He has been a member of the scientific committee of the Institut des Amériques.