By CESAR LOCATELLI*
The conclusions of the CPI, before voting on the final report, for the tragedy that was the management of health during the pandemic under the Bolsonaro government
1. The CPI suggests 68 indictments
The CPI held 66 meetings and heard 61 witnesses, from May to October 2021. It produced 72 overt documents and more than 4 million files with confidential documents. Its conclusion, still pending a vote on the final report, was:
“In view of all the above, this CPI, given the limits of the parliamentary investigation and the evidence collected, suggests the following indictments, which include both crimes and civil and administrative offenses, all based on the existence of sufficient evidence of authorship and materiality, as can be seen from the documentary, testimonial and expert evidence exhaustively presented at the end of this report.” (p. 1.058)
The term indictment is customarily used in its legal concept of submitting to a criminal or administrative inquiry. However, the CPI uses the term in the sense of revealing a fault or error, accusation, denouncement. In this sense, the evidence collected will be forwarded to the public ministries, the courts of accounts and other authorities that will decide on the opening of criminal, civil or administrative proceedings.
The relationship begins with Jair Bolsonaro, ministers, former ministers and other Ministry of Health officials. It includes representatives, employees and owners of Davati, Precise, FIB Bank, VTCLog and Prevent Senior companies. Among the occupants of elected positions are a senator, federal deputies and a councilor, including the president's three children. The list brings doctors, and even the president of the Federal Council of Medicine, as well as suspects of spreading fake news.
2. Crimes attributed to Jair Bolsonaro
“By reading this Report, there is no way to remove the responsibility of the President of the Republic, Jair Messias Bolsonaro, with regard to actions and omissions related to facing the pandemic of the new coronavirus. In fact, the set of evidence revealed that the Chief of the Federal Executive had numerous conducts that increased the harmful consequences of covid-19 in our population, which cannot pass without due supervision by this CPI.” (p. 1043)
The President of the Republic is denounced for the following crimes: epidemic resulting in death, breach of preventive health measure, charlatanism, incitement to crime, forgery of private document, irregular use of public funds, prevarication, crimes against humanity, in the modalities of extermination, persecution and other inhuman acts, violation of social rights, incompatibility with dignity, honor and decorum of the office and, finally, crimes of responsibility provided for in Law No. 1.079, of April 10, 1950.
3. Presidential Decree to amend the chloroquine leaflet
“The former minister [Luiz Henrique Mandetta] also mentioned a meeting that took place at the Planalto Palace, at which other ministers and doctors were present, when a draft of a presidential decree was presented in which it was suggested to change the package leaflet for the drug chloroquine, providing for its indication for the early treatment of covid-19.” (p. 36)
The Report does not reveal the origin of the draft decree, nor who was in favor of issuing it. Just that the president of Anvisa, Antonio Barra Torres, was against the idea and that at the meeting in which the decree was discussed there were at least Luiz Henrique Mandetta, Antonio Barra Torres, general Braga Netto, chief minister of the Civil House, and the doctor Nise Yamaguchi.
“Dr. Nise delivered a copy of the draft of the decree for the change of the chloroquine leaflet to the CPI, received on her telephone machine from Dr. Luciano Dias Azevedo, which confirms the story of the other deponents.” (p. 36)
4. The parallel cabinet
The deponents did not explicitly confirm the existence of a parallel office that guided the president contrary to the guidelines of the Ministry of Health. However, several of those interviewed confirmed their participation in meetings where strategies for managing the pandemic were discussed.
“From everything that has been ascertained, therefore, this Commission remains convinced of the existence of a parallel cabinet, made up of technicians who are not part of the Ministry of Health, with great influence on the opinions of the President of the Republic and consequently on the conduct of the federal government during the pandemic.” (p. 45)
“Combining all the evidence collected in this Report, we conclude that the epidemic would not have taken the causal course it did without the parallel advice to the President of the Republic, who directly influenced his decisions and his speech from the beginning. The President's actions and speech have influenced the behavior of millions of Brazilians since March 2020.
The members of the parallel cabinet were aware of the use that the President was making of the information provided and, even so, the advice continued throughout 2020 and early 2021. The requirement of different conduct (culpability) seems clear. As a result, Nise Yamaguchi, Osmar Terra, Arthur Weintraub, Carlos Wizard and Paolo Zanotto must be held accountable for the crime of epidemic [causing an epidemic through the spread of pathogenic germs].” (p. 46)
5. Herd immunity
Several videos show the spread of the idea of herd immunity. One of the biggest advocates, according to the CPI report, was deputy Osmar Terra, who, in one of the videos, from May 2021, states that “it is not the vaccine that will end the pandemic, which will end the pandemic It's herd immunity.
“Dr. [Natalia} Pasternak [microbiologist and researcher at USP] clarified that herd immunity is a vaccine term, only achieved with vaccination campaigns, and not by the transmissibility of the disease. She cited smallpox as an example, which for many years was present in humanity and only disappeared with a vaccination process organized by the WHO, which lasted ten years. (…) She affirmed, finally, that no disease in the world has been eradicated or controlled in this way, but always with vaccines.” (p. 50 and 51)
The Doctor. Claudio Maierovitch, public health doctor at the Oswaldo Cruz Foundation and former president of Anvisa, “explained, initially, that the expression herd immunity originated in the veterinary area, since the vaccination of a part of the livestock prevents the circulation of the infectious agent , providing protection even for animals that have not been vaccinated. In the scenario of covid-19, the theory of herd immunity due to the transmissibility of the disease implies such a large number of sick and dead people that it would not even be ethically acceptable to consider it. (…) He affirmed, finally, that the Brazilian government remained in the position of producing herd immunity in the population, at the expense of human lives, instead of adopting the measures recognized by science to face the crisis ”. (p. 51 and 52)
6. Early treatment
The Report explains that early treatment is “the use of one or more drugs for the treatment of covid-19 after a suspected or confirmed diagnosis. Among the drugs that are part of this so-called kit-covid, the best known are chloroquine, hydroxychloroquine, ivermectin and azithromycin. This is not a closed list because, depending on who expresses it, flutamide, proxalutamide, colchicine, nasal spray, as well as various vitamins and food supplements may be included”. P. 54)
When answering about the effectiveness of these drugs in coronavirus infection, Dr. Natalia Pasternak emphasized: “These drugs are not suitable for covid-19, according to the scientific evidence accumulated so far. But the evidence we have accumulated so far and accumulated in a way that is actually robust or sufficient is strong enough to tell us that these drugs are not indicated for Covid-19. They don't reduce viral load, they don't reduce inflammation, they don't reduce length of stay, they don't increase survival. Unfortunately, we don't have specific drugs, as we don't have for so many other diseases caused by viruses”. (p. 61)
This scientific evidence did not deter Jair Bolsonaro: “If herd immunity was the end to be pursued, chloroquine was the method. These actions, added to the delay of vaccines, would very likely result in the spread of covid-19. The propaganda made by the President of the Republic could be seen, for example, in the interview he gave to Blog do Mano, in which he declared that 'whoever is on the right takes chloroquine, whoever is on the left takes tubaína'.” (p. 129)
7. Opposition to non-pharmacological measures
The Report explains that non-pharmacological measures “are strategies that aim to prevent the new coronavirus from physically reaching the respiratory tract of more individuals, either by reducing contact between people or by asepsis of environments or the body”. (p. 147)
The President of the Republic, on a national radio and television channel on 24/3/2020, criticized the confinement and preached a return to normality:
“The virus has arrived, it is being faced by us and will soon pass. Our life must go on. Jobs must be maintained. The sustenance of families must be preserved. Yes, we must return to normality. A few state and municipal authorities must abandon the concept of scorched earth, the ban on transport, the closure of businesses and mass confinement.
What is happening in the world has shown that the risk group is people over 60 years old. Why close schools? Fatal cases of healthy people under 40 years of age are rare. Ninety percent of us will not have any symptoms if we get infected.
We must be extremely concerned about not transmitting the virus to others, especially to our dear parents and grandparents, respecting the guidelines of the Ministry of Health. In my particular case, due to my athletic history, if I were infected with the virus, I wouldn't have to worry. I would feel nothing or be, at most, affected by a little flu or a cold, as that famous doctor on that famous television said.” (p 150 and 151)
8. Refusal and delay in acquiring vaccines
“As already stated throughout this Report, the purchase of vaccines, alongside non-pharmacological measures, such as social distancing and encouraging the use of masks and alcohol gel, should have taken precedence in the definition of public policy adopted by the Brazilian government to face the pandemic, which, however, did not happen and ended up favoring the spread of the new coronavirus and contributing to the deaths of hundreds of thousands of Brazilians.” (p. 195)
Negotiations with the Butantan Institute fully demonstrate that vaccination could have started much earlier than what actually happened. The Report describes it like this:
“In July 2020, the Butantan Institute requested the participation of the Ministry of Health in the initiative to seek a vaccine against covid-19 and, later that month, made the first offer of vaccines. On that occasion, any contract would be for 60 million doses, which could be delivered in the last quarter of 2020.” (p. 227) There was no response from the federal government.
After 4 months, the Institute would no longer be able to deliver 60 million doses in 2020, but 15 million doses less: “in October 2020 there was a sign that the vaccine could be incorporated into the National Immunization Plan - PNI, as well as how there could be any support for factory reform. Thus, a new offer of 100 million doses was made; of which, 45 million would be produced at the Butantan Institute by December 2020, 15 million by the end of February this year and 40 million by May”. (p. 227)
The President barred negotiations: “There were several reports that reported the President's refusal to acquire the immunizer. The words of the Chief Executive were as follows: 'I already ordered the cancellation, I am the president, I will not relinquish my authority'.” (p. 228)
Only in January 2021 was the commitment fulfilled. Mr. Dimas Tadeu Covas told the Commission: “And I, many times, publicly declared that Brazil could be the first country in the world to start vaccination, were it not for the mishaps we had to face during this period, both from the point of view of the contract, as well as from the regulatory point of view”.
9. Preventable deaths
Several studies have already been and will still be prepared in an attempt to assess how many deaths could have been avoided if the federal government had behaved differently. One of them comes from Ipea, which states: “Brazil recorded, in 2020, in proportion to its total population, more deaths from covid-1 than 89,3% of the other 178 countries, according to data compiled by the WHO. When the comparison is adjusted to the population distribution by age group and sex with each country, the Brazilian result becomes worse than those of 94,9% of the same 178 countries. All these data point to reckless management by the federal government in combating the pandemic.” (p. 970)
CEPEDISA – Center for Studies and Research on Sanitary Law, of the Faculty of Public Health at USP, carried out, together with Conectas Human Rights, a study that reveals that 3.049 norms related to covid-19 were edited in 2020 by the federal government. In general, the norms point to a strategy for the spread of the virus systematically conducted by the federal government, followed by resistance attempts by the other Powers and federative entities. (p. 970)
“The conclusion of the research center was emphatic: [The Brazilian government provoked the] constant incitement to expose the population to the virus and to non-compliance with preventive health measures, based on the denial of the seriousness of the disease, on the apology for courage and on the supposed existence of an 'early treatment' for covid-19, converted into public policy.” (p. 72)
10. Typification of the crime of extermination
The report proposes a bill that typifies the crime of extermination
“Finally, still within the scope of the mentioned need to criminalize conduct, it appears that, in Brazil, covid-19 has killed hundreds of thousands of people, and a good part of the deaths would be preventable if measures recommended by medical science – and already tested in other countries – had been followed.
Public and private agents who acted to promote contagion, or who failed to protect and promote health, or both, contributed to this indiscriminate killing, in which the victims were discarded as collateral damage of a political struggle.
In view of the magnitude of this collective tragedy, which makes the accusations already provided for in the legislation sound timid, we are facing a very serious crime and still without a name in Brazilian law, which affronts the humanitarian conscience and cannot go unpunished.
It is proposed, therefore, to bring to the national legislation the typification of the crime of extermination, already foreseen in the Rome Statute of the International Criminal Court, with the necessary adjustments of legislative technique.” (p. 1092)
The bill reads: “The crime of extermination is committed by anyone who, by action or omission, with the intention or assuming the risk of destroying a non-specific part of the civilian population, practices the following conduct:
I – generalized, indiscriminate or systematic attack directed at the civilian population or without due care for it, which results in death;
II – cause serious harm to the physical or mental integrity of members of the civilian population, without the intention of harming specific persons or groups;
III – subjecting all or a non-specific part of the population to conditions of existence capable of causing death, serious suffering or serious harm to their physical integrity, such as deprivation of food, medicine or other goods and services essential to life.”
* Cesar Locatelli holds a master's degree in economics from PUC-SP.
Originally published on the portal Major Card.