SAO PAULO 鈥 A thousand deaths a day.
Since late May, three months after Brazil鈥檚 first reported case of the coronavirus, it has recorded more than 1,000 daily deaths on average in a gruesome plateau that has yet to tilt downward.
The country hit at least 75,000 confirmed deaths Wednesday and is expected to report 2 million confirmed cases of COVID-19 by Thursday evening.
Even as cases wane somewhat in the biggest and hardest-hit Brazilian cities, the virus is peaking in new locations across the largest country in Latin America.
Experts blame denial of the virus鈥 deadly potential by President Jair Bolsonaro and lack of national coordination combined with scattershot responses by city and state governments, with some reopening earlier than health experts recommended.
An interim health minister untrained in the field is presiding over pandemic response. Bolsonaro himself is sick with COVID-19 after repeatedly flouting social distance recommendations and undermining local leaders鈥 restrictions on activity.
Brazil鈥檚 roughly 7,000 COVID-19 deaths in each of the last seven weeks is equal to several airplanes packed with Brazilians crashing every day, former health minister Luiz Henrique Mandetta told The Associated Press.
鈥淧eople have become callous,鈥 Mandetta said. 鈥淲hen you say, 鈥榊esterday there were 1,300 deaths,鈥 people say, 鈥極K, then it didn鈥檛 go up. It was 1,300 people the day before, too.'鈥
Brazil鈥檚 nearly 2 million cases is second only to the United States and experts believe the number to be an under count due to widespread lack of testing. A model created by professors from several Brazilian academic institutions, based on the number of confirmed deaths, estimates Brazil has had 10 million infections.
鈥淭he virus would have been difficult to stop anyway. But this milestone of 2 million cases, which is very underestimated, shows this could have been different,鈥 said Dr. Adriano Massuda, a health care administration specialist and professor at the Getulio Vargas Foundation, a Sao Paulo university. 鈥淭here鈥檚 no national strategy for testing, no measures from the top, 鈥 too little effort to improve basic care so we find serious cases before they become too serious, no tracking.鈥
The virus has begun reaching cities and states previously spared, offsetting declines elsewhere. The number of deaths has been ebbing in states including Rio de Janeiro and Amazonas, where people were buried in mass graves in the capital, Manaus. In the last two weeks, 10 of Brazil鈥檚 26 states and its Federal District saw increases, with two southern states鈥 average daily death tolls doubling.
Bolsonaro has consistently downplayed COVID-19鈥檚 severity, saying strict social distancing measures that sacrifice jobs and income will ultimately be more harmful than the virus itself, and calling on supporters to encourage their local leaders to lift restrictions on activity. Many mayors and governors have struggled to hold the line.
In Ribeirao Preto, a city in Sao Paulo state, protesting shopkeepers on Wednesday demanded they be allowed to reopen. They surrounded the mayor鈥檚 car as he left City Hall, punching his windows and cursing at him.
Campinas, a city of 1.2 million people closer to the state鈥檚 capital, adopted quarantine measures early, but succumbed to political pressure and reopened commerce on June 8, said Pedro de Siqueira, a Campinas city councilman. The city center swarmed with shoppers like an overturned anthill, he said in an interview.
Two weeks later, the number of COVID-19 deaths had roughly tripled to 253, as did the number of confirmed cases, to 6,324. Intensive-care beds refilled with patients, prompting the mayor to reinstate restrictions on commerce on June 22, but allowing offices and churches to continue operating.
鈥淐ampinas reopened prematurely and erroneously, supported by the state government,鈥 Siqueira, who is also a public health physician, said at the time. 鈥淭his reopening was so catastrophic that Campinas had to step back, but did so only partially.鈥
Since then, Campinas鈥 number of cases and deaths has doubled once more. On Wednesday, the city extended restrictions until July 30.
Daniel Soranz, a researcher at state-run biology institute Fiocruz鈥檚 national health school, said Brazil鈥檚 center-west that includes the agricultural heartland will be the last region slammed by the virus. And, looking at deaths from severe respiratory insufficiency, it appears Brazil as a whole has begun turning the corner, he said.
鈥淏y the end of August, we should be at a much better place than today,鈥 Soranz said.
In Sao Paulo, Brazil鈥檚 most populous state with 46 million residents, the number of deaths has stabilized at a level slightly below its peak. At one of the capital鈥檚 cemeteries on Wednesday, Michelle Caverni buried her 88-year-old aunt, who died of COVID-19 and also suffered from pulmonary emphysema. The same day a friend of Caverni鈥檚 buried her 57-year-old mother. She also died of COVID-19.
鈥淯ntil it knocks at your door, people are indifferent,鈥 said Caverni, 40, a restaurant cook. 鈥淵esterday there were 1,300 deaths from COVID-19. Is that supposed to be few? People are saying that鈥檚 just the media. I hear that every day at work.鈥
Most people show only moderate symptoms from COVID-19 and recover. Some, including the elderly or those with longstanding health problems, are more susceptible to severe illness, including pneumonia, or death.
Modeling by the University of Washington鈥檚 Institute for Health Metrics and Evaluation projects that Brazil鈥檚 death toll will reach almost 200,000 by November, nearly closing the gap with that of the U.S. The forecast has a wide margin of error.
鈥淲e will see how this patient known as Brazil will behave until the end of this epidemic,鈥 said Mandetta, who Bolsonaro fired as health minister in April for backing state governors鈥 quarantine measures.