RIO DE JANEIRO – Brazil’s COVID-19 death toll, which surpassed 250,000 on Thursday, is the second highest in the world for the same reason, the second wave has not faded: Prevention has never been a priority, experts say.

Since the start of the pandemic, Brazilian President Jair Bolsonaro has scoffed at the “little flu” and criticized local leaders for imposing restrictions on activity; He said the economy had to keep going to prevent worse hardships.

Even when he approved pandemic welfare payments for the poor, it wasn’t announced as a way to keep people at home. And Brazilians stay out and about vaccinations have started – but launches are proving to be much slower than anticipated.

“Brazil has absolutely no response plan. We have been through this for the past year and we still don’t have a clear plan, a national plan, ”Miguel Lago, executive director of the Brazilian Institute of Health Policy Studies, advising public health officials, told the Associated Press. “There are no plans at all. And the same is true for vaccinations. “

While other countries’ daily cases and deaths have declined, Latin America’s largest country is parked on the plateau – a grim repeat in mid-2020. In the past five weeks, Brazil has averaged more than 1,000 deaths every day. Official data showed the total death toll was 251,498 as of Thursday.

At least 12 Brazilian states are in the midst of a second wave that is even worse than the one faced in 2020, said Domingos Alves, an epidemiologist who has been tracking COVID-19 data.

“This scenario is going to get worse,” Alves told AP, adding that the virus is spreading more rapidly among populations. In Amazonas state, where the capital, Manaus, saw hospitals run out of oxygen last month, there have been more than 5,000 deaths in the first two months of this year, nearly as many as in 2020.

“This is the most difficult time we have experienced since the confirmation of the first case,” Carlos Lula, chairman of the National Council of Health Secretaries, was quoted as saying by the newspaper O Globo, Thursday. “We’ve never had so many states.” with so many difficulties at the same time. “

Alves and other public health experts said the spread was exacerbated by authorities’ reluctance to follow recommendations from international health organizations to impose stricter restrictions.

It’s up to governors and mayors to impose lockdowns or other restrictions to contain the virus. The states of Sao Paulo and Bahia have recently imposed curfews, but experts say the move is too late and insufficient.

“Those are not containment measures; it is palliative action, always taken after the fact, ”said Alves, who is also a professor of social medicine at the University of Sao Paulo. “‘Lockdown’ has become a curse word in Brazil.”

Miguel Nicolelis, a leading Brazilian neurologist, warned in January that Brazil had to go into lockdown or “we will not be able to bury the dead in 2021.” He has been advising the northeastern states on how to fight COVID-19, but has recently left his position, dissatisfied with their refusal to be isolated, reports the newspaper Folha de S. Paulo.

“Currently, Brazil is the largest open laboratory, which allows to observe its natural dynamics corona virus without effective containment measures, “he wrote on Twitter Tuesday. “Everyone will witness the devastating destruction.”

There were a few exceptions, but they remained marginal and failed to inspire a wider movement.

Sao Luis, the capital of the northeastern state of Maranhao, was the first Brazilian city to go into total lockdown last May. It worked, despite Bolsonaro’s attempts to break the restrictions and sow doubts about its efficacy, according to the state’s governor, Flávio Dino.

“It is very difficult to set distances and preventive measures,” said Dino, adding that the first hurdles were economic and social, especially after the federal government’s emergency pandemic assistance program ended last year.

Lago noted that Bolsonaro rarely even comments on the pandemic anymore, and has effectively shifted to other priorities, including gaining support in Congress to relax arms control laws and pass economic reforms. His administration is trying to recover some of the COVID-19 welfare payments, but for a small group of needy Brazilians.

The only preventive measure Bolsonaro has consistently supported is the use of treatments such as hydroxychloroquine, which have shown no benefit in rigorous studies.

The Bolsonaro administration has also adopted a hands-off approach to the vaccination campaign. That depends in large part on a deal to buy one vaccine, AstraZeneca, which is arriving late. National immunization efforts to date have relied mostly on Chinese-made CoronaVac injections secured by the state of Sao Paulo, even though the federal government is now trying to buy another.

Brazil’s decades of experience with successful vaccination programs and its large national public health care network lead many experts to believe immunization – even if it starts with a delay – will be a relatively fast-paced affair. In the previous campaign, the country of 210 million people was able to vaccinate as many as 10 million people in one day, health experts said.

Five weeks after the first injection, Brazil vaccinated only 3.6% of its population. That’s more than double that of Argentina and Mexico, but less than a quarter of Chile, according to Our World in Data, an online research site that compares official government statistics.

“There’s no way to fast with a vaccine shortage; That’s a crucial point, “said Carla Domingues, who for eight years coordinated Brazil’s national vaccination program, until leaving her position in 2019.” Until there is more supply, the pace will be slower, because you have to keep choosing who gets vaccinated. “

Meanwhile, the virus continues to run rampant across Brazil, and takes its toll.

In the city of São Paulo state, Araraquara, there have been more deaths so far this year than last year and the number of intensive care units is exceeding full capacity, with people on a waiting list to enter ICU and get treatment. Local authorities responded on Sunday by declaring a complete lockdown – making Araraquara only the second city to impose the restrictions.

“We never imagined we would reach this point,” said Fabiana Araújo, a nurse and coordinator of the city committee to fight COVID-19. “It’s the only option.”

—— AP author David Biller contributed from Rio and Mauricio Savarese from Sao Paulo.