AMY GOODMAN: World Health Organization officials warned Wednesday COVID-19 cases are increasing worldwide after falling for more than a month. We begin today’s show in Brazil, which set a daily record for COVID-19 deaths Wednesday for the second day in a row. Brazil’s death toll has now topped nearly 260,000, the world’s second worst after the United States. Brazil’s most populous state, São Paulo, announced new lockdown measures Wednesday. This is the governor, João Doria.

GOV. JOÃO DORIA: [translated] We will now face the worst two weeks of the pandemic since the first case of COVID-19 was confirmed in Brazil. This is a sad reality. For these sad reasons, we will comply with the recommendation of the contingency center, and the entire state of São Paulo will go to red phase, starting at zero o’clock next Saturday.

AMY GOODMAN: Brazil’s far-right President Jair Bolsonaro opposes lockdowns and responded Wednesday that because of the stay-at-home policy, quote, “People are going to die of hunger and depression,” Bolsonaro said. But more states and cities are expected to follow São Paulo’s direction as hospitals report being overwhelmed.

International concern is also growing about the new, highly infectious coronavirus variant P1, which overwhelmed the Amazonian city of Manaus, causing its hospitals to run out of oxygen. Less than 4% of Brazil’s population has been vaccinated. And a health minister Bolsonaro fired last year has warned the failure to launch a rapid vaccination drive means, quote, “The country is running the risk of becoming one big Manaus.”

This comes as the Brazilian government has just announced it reached an agreement to buy 100 million doses of Pfizer’s COVID-19 vaccine after negotiations over liability clauses.

For more, we’re joined by Dr. Marcia Castro, professor of demography and chair of the Department of Global Health and Population at the Harvard School of Public Health. She also chairs the Brazil Studies Program at Harvard’s Center for Latin American Studies.

Welcome back to Democracy Now! We want to start, Professor, by asking about this two days of the highest death rate in this past year in Brazil, second only to the United States. Can you talk about why this is happening and what you feel needs to be done?

MARCIA CASTRO: Sure. Thanks for having me.

So, Brazil has been second in number of deaths since June 7, second to the U.S. So, we had the first wave last year around April, May. And when things started to calm down — so, it was never like a comfortable situation, but when the cases started going down and the deaths started going down, that was the time to try to do something that was not done in the beginning.

But again, what we saw is this combination of inaction but also wrongdoing. It’s the president saying that masks gives you headaches, uncomfortable, and other crazy things. It’s promoting the use of medicine that is not effective, chloroquine. So, it’s the combination of both, of not doing what you have to do, but doing wrong things that end up creating behaviors in the population. For example, I mean, they had Carnival, and there were all kinds of clandestine parties happening, people gathering without masks.

So, people following — so, all the scientists following the data on COVID, we did expect the beginning of 2021 to be very difficult, because things were relaxing. It was almost like “We are done. We can go back to normal,” and no action.

And last year, in July, Pfizer offered vaccines to Brazil. Brazil denied buying vaccines three times. So, by the time other countries are vaccinating, Brazil has only two options, is not trying to acquire more vaccines. So now that the house is on fire, that’s when they decide to buy, but we don’t know when those doses will come.

So, Brazil should be really vaccinating the largest number of people in the shortest time possible in order to contain what’s happening. It’s not doing this. So, the scenario we see now, unfortunately, it’s going to get worse before it gets better. And we are going to lose an unnecessary number of lives, which, unfortunately, for the government, the loss of lives has been normalized. So, that’s a very frustrating, uncomfortable and dramatic situation we are seeing in Brazil.

NERMEEN SHAIKH: And, Maria, could you talk about this new variant that’s emerged — it emerged in December — the P1 variant? It emerged from the Amazon. What’s known about this variant and what vaccines — the effect of vaccines might be against it?

MARCIA CASTRO: Right. So, the first time it was detected was in Manaus. And we have no evidence it was circulating in November. In December, it was found in about 51% of the samples that were tested. And in January, it was already 91%. So, very fast takeover. And now other cities are starting to see the same.

There is an analysis that was done and released last Friday showing that this particular variant is much more transmissible. So, it’s about 1.4 to 2.2 times more transmissible, so it really spreads very fast. The amount of the viral load of people infected with it, it’s also very high. And we have documented cases of reinfection with this variant. We don’t know if the vaccines we have in Brazil are fully effective against it. There is some analysis in vitro; we don’t have analysis in vivo yet. So, we have to wait. But what we know is that this P1 variant is now pretty much spread across Brazil. There are some cities that are testing the samples. And one of them, in the interior of São Paulo, just this month — in February, also 91% of the samples was P1. Rio de Janeiro is also making a lockdown. It’s starting this weekend.

So, what we know is that it’s highly transmissible. It allows reinfections. So it’s kind of a bad scenario, because we have people that can be infected again. People that was never infected can get infected with this one because of the high transmissibility. And we are not vaccinating people enough to try to create a barrier and contain the spread of this variant.

NERMEEN SHAIKH: Well, you mentioned earlier that Brazil, three times, denied the possibility of purchasing vaccines, which is especially striking because Brazil has, of course, universal healthcare and a very good record of vaccinating people. So, if you could say a little about the vaccines that Brazil is now administering, the CoronaVac vaccine from China, which is reportedly only just over 50% effective, as well as AstraZeneca, the Oxford-AstraZeneca vaccine?

MARCIA CASTRO: Yeah. So, what I would say is, I wouldn’t focus too much on those numbers, 50-something, 60-something. I mean, both of those vaccines were extremely effective in preventing serious cases, in preventing hospitalizations and in preventing deaths. And that’s what we need. So, you know, I usually say, “Which one is the best vaccine? It’s the one available. Put it in your arm and go ahead.”

Now, I think one thing we have to highlight is that Brazil is the only country in the world with more than 100 million people that has a universal health system and has a beautiful history of vaccination. In 2010, when we had the threat of H1N1, Brazil vaccinated 80 million people in three months. Brazil do campaigns in a weekend to vaccinate against polio, and it’s able to vaccinate 10 million children in two days. So, Brazil has the knowledge, has the network, has the community health agents, has the network of health units and the expertise to do mass vaccination.

But what we need is, one, the vaccines. And, two, we need campaigns. We need communication campaigns. We usually have, if we look historically, those mask campaigns on TV. You inform. You educate. And that contributes for people to comply to the interventions. We don’t have that. So, we have a lot of people in Brazil that took the first shot, and now they are not sure what they can do, if they can have gatherings, if they can party, before they take the second shot, after they take the second shot. So, we are also missing a campaign to make people aware.

But the main point is, all of those vaccines are good, because they are phenomenal in preventing hospitalization and death. And that’s what people should focus, not so much on the 50, 60, 70, 90. What we wanted to prevent are hospitalizations, so the health system is not overloaded, and, above all, to prevent death.

AMY GOODMAN: Professor Castro, speaking earlier this week in Rio, President Bolsonaro’s son, Flávio, who is also a senator, condemned Brazil’s lockdown strategy as a, quote, “dictatorial measure.”

SEN. FLÁVIO BOLSONARO: [translated] Lockdown is bad management. We all knew Carnival was coming. We all knew crowds were practically inevitable. And it’s obvious that there will be an increase in cases. … But here in the city and the state of Rio, we have the capacity to provide treatment in intensive care units, showing that there’s been planning and preparation, because it is now much easier with a dictatorial measure to close a city, to close a state, to say that lockdown is doing something, to give their satisfaction to the people. Managing like a dictator is easy.

AMY GOODMAN: So, that’s the son of the COVID-denying, but a man who had COVID, the president of Brazil, Jair Bolsonaro. Of course, it sounds very similar to President Trump. He followed in his footsteps, as you said, used a lot of hydroxychloroquine. In the United States, hospitals are trying to give back hydroxychloroquine, because President Trump pushed it baselessly, and many bought many doses. But if you can talk about what this denial means and also Brazil being a site of testing? Johnson & Johnson was just approved, and it goes to that issue of, you know, exactly how effective it was, but it was approved later than the other two vaccines, so it means that it was tested against variants in places like Brazil and South Africa. And what it means to be a site of those tests, yet not to have the vaccines to treat their own people? And then, what it means to get vaccines from places like — and people aren’t, outside of the United States, so familiar with — COVAX and Gavi, and how important they are in the developing world?

MARCIA CASTRO: That’s a great question. I mean, the Janssen vaccine would be the ideal vaccine in Brazil right now. It’s one shot. You don’t need the special freezers. You can go to the Amazon forest, to the semi-arid, to any corner of the country, and deploy the vaccine. One shot, fast, done. Right?

We didn’t buy it. It was tested in Brazil, and we didn’t buy it. So, how can we understand this discourse from the president and his sons? I wish I knew. I don’t even know if a psychologist can understand. But the thing is, we can have our opinions, but they make their opinions the facts. And that’s misleading. That’s misinformation, right?

So, the hospitals in Rio are overloaded. There are barely any ICU beds left. Right? So, the lockdown is needed because nothing was done before. Lockdown is the last resort, right? If we do something right, if we plan ahead, we don’t have to do lockdowns, right? But we never did anything.

So, I think the bad management is all the lack of action. The bad management is promoting drugs that are not effective. So, there’s a long list of what bad management is. Certainly, bad management is not trying to do the right thing to save lives. But again, this government normalized the loss of lives. And it’s not just the lives lost. It’s all the dreams that were interrupted, the families that was disrupted. None of that seems to touch or make the government make the right decision. So, these are not the facts. These are just a way of trying to change the public opinion, people that still believe that this is a good leader. So, it’s misinformation being done over and over and over again.

AMY GOODMAN: When I referred to the two vaccines, I meant the two that were being used in the United States, Pfizer and Moderna.

MARCIA CASTRO: Oh, yes.

AMY GOODMAN: And STAT has an interesting article saying, “Pfizer plays hardball in Covid-19 vaccine negotiations,” insisting some governments “cover the potential costs of civil cases” that result from its “own acts of negligence, fraud, or malice,” Pfizer being “accused of 'bullying' Latin American governments during negotiations to acquire” the vaccine, and the company asking some countries “to put up sovereign assets, such as embassy buildings and military bases, as a guarantee against the cost of any future legal cases.” This was according to an investigation by the U.K.-based Bureau of Investigative Journalism. Can you talk about that negotiation that went on in Brazil — ultimately, Brazil, apparently, going to buy 100 million doses — but what this means? And are you following this accusation of Pfizer bullying Latin American countries?

MARCIA CASTRO: So, the announcement of the accusation of the doses was just made yesterday. It’s actually 100 million from Pfizer and, I believe, 38 [million] from Janssen. But there is no timeline, no expectation. All that there was said is hopefully those doses will come in the second semester. So I don’t know when.

I am not aware of the bullying. I don’t know what kind of negotiation was made with Brazil or if the government had to give any guarantees. I find this a little bit disturbing, actually, because especially in a moment of a public health emergency, what we should see is the opposite, is, like, for example, getting two competitors, like Merck and Johnson & Johnson, to pair to produce more doses. Collaboration is what we should see, not bullying. So, I’m going to investigate that. I wasn’t aware about that. So thank you for bringing that up.

NERMEEN SHAIKH: And, very quickly, before we conclude, Maria, you have emphasized the importance of genomic sequencing. Could you explain what that is and why you think it’s necessary for fighting the pandemic?

MARCIA CASTRO: Right. Yeah. So, ideally, what we should have is a network that brings countries together, actually. And who should oversee this, if it’s going to be WHO or another entity, I don’t know. But it has to be a collaborative network, that actually there are a sentinel surveillance of samples, and we can try to identify new pathogens when they come. Now, what we see now with COVID, not a single country did more genomic sequencing than the U.K. So, the advantage of this, you can identify when new pathogens are circulating. And in the case of an emergency, you can identify when a new variant has emerged.

So, in Brazil, we have something. It’s a network that was set up for influenza. And Brazil is one of the centers that contribute genetic information, so WHO knows what should be the composition of the flu vaccine each year. But it’s very small. It’s not representative of the country. It’s not designed to identify new things that are circulating.

Right now one of the things the government could have done is to bring together university labs that have the potential to do genomic sequencing, private laboratories that are doing a lot of COVID tests, bring everybody together in an effort to sequence those samples that people are having access to, to try to identify those variants. We didn’t have that. We had no support, no incentive from the federal government to really strengthen this network so we could do real genomic sequencing and then anticipate the introduction of those variants and try to contain people that — you know, the first cases that appear, so we prevent that from spreading.

If you have no surveillance like this, the moment you know things are there, it’s already too late. And that’s the situation we see in Brazil now. The house is already on fire. And what we have to do is to save people that are inside those houses. But the house is going to come down.

AMY GOODMAN: Professor Marcia Castro, we want to thank you so much for being with us. And by the way, condolences on the death of your dad.

MARCIA CASTRO: Thank you.

AMY GOODMAN: Professor Castro teaches demography and is chair of the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health, also co-chairs the Brazil Studies Program at Harvard’s Center for Latin American Studies.