It’s easy for me to lose sight of the full scale of COVID-19’s effect on the world. Having personally experienced it in Germany and EU as well as the US, I frequently forget that COVID has affected all nations around the world. One event, hosted by Dr. Charles Kenney and featuring guest speakers Gilberto Hochman and Rossana Castiglioni, highlighted the worldwide effects of COVID-19 for me by describing the situations in Brazil and Chile.
Essential to understanding the full effects of COVID-19 in South America in general is the political unrest and corruption that characterizes much of the political discussion in these countries. Having grown-up in America – the longest-lasting (and arguably most stable) democracy currently in existence – it’s difficult for me to fully appreciate the uncertain political situation of these nations. As Dr. Hochman and Dr. Castiglioni note, this political instability has only been exacerbated by the pandemic.
Dr. Gilberto Hochman, author of “The Sanitation of Brazil: Nation, State, and Public Health, 1889-1930,” discussed the history of vaccinations in Brazil and related this history to the public’s current opinion regarding the COVID-19 vaccines. Brazil, when under a military dictatorship in the early 1970s, was one of the last strongholds of smallpox in the world. However, Brazil, assisted by the WHO, actually eradicated smallpox through mandatory vaccinations, despite being under despotic rule. Support for vaccines in Brazil has been fairly consistent, being guaranteed by the government by the “United Health System,” established in 1988.
Unfortunately, under President Bolsonaro, immunization coverage rates, along with public trust in the government, have plummeted in recent years. This drop in coverage has occurred despite widespread support for the public health system in Brazil. However, popular support for a COVID-19 vaccine appears tenuous given President Bolsonaro’s mixed messaging on vaccine distribution, distrust in government, and a vocal anti-vaxxer minority. Further, given the decrease in vaccine coverage, the government’s ability to effectively distribute the vaccine is far from certain.
The situation in Chile shares several similarities with circumstances in Brazil, but has led to rather more dramatic results. Where public trust in government has declined in Brazil, the COVID-19 pandemic and inadequate government response has destroyed popular support for the existing government. Surprisingly, Chile is among the most prosperous (in GDP per capita) countries in South America, yet its people are among the most dissatisfied. This dissatisfaction has prompted calls for a constitutional convention to completely rewrite their constitution. Dr. Castiglioni notes that any new government formed during this time (and a new government is needed) will lack long-lasting legitimacy. She discussed how the gap between Chilean expectations from government and the realistic realities will make the creation of an enduring, legitimate government virtually impossible during the COVID-19 pandemic.
The examples of Chile and Brazil highlight in stark terms the critical role of trust in the government as it relates to pandemic mitigation. While this lesson can still be seen in the United States (where states with greater adherence to social distancing and masking ordinances generally fared better), the true consequences of distrust in the government (or illegitimate, corrupt, political processes) are much more clearly seen in Brazil and Chile.