6 years of Covid-19: the scars of inequality and denialism

The virus that laid bare the class divide, state barbarity, and the resilience of the SUS

Six years have passed since the World Health Organization (WHO) declared, in March 2020, that the world was facing a Covid-19 pandemic. What followed was the greatest health, economic, and social crisis of the 21st century. Looking back through the rearview mirror of history, the global numbers are still frightening: according to the WHO, there were more than 7 million officially recorded deaths worldwide — with estimates of excess mortality exceeding 20 million people.

The pandemic was not just a biological event; it was a cruel mirror of our social fractures. In Brazil, the virus found fertile ground not only in historical inequality but also in the disastrous and denialist handling by the previous government, turning the country into one of the global epicenters of the tragedy.

“A color defect”

The narrative that “the virus was democratic” in Brazil fell apart in the very first weeks. Covid-19 laid bare the class gap. While the middle and upper classes were able to isolate themselves at home, informal and essential workers continued to be exposed on the streets and in crowded public transportation.

The hallmark of this inequality in Brazil has a face, class, and color. It is both symbolic and tragic that one of the first recorded fatal victims in the country was Cleonice Gonçalves, a 63-year-old Black woman and domestic worker in Rio de Janeiro. She contracted the virus from her employers, who had returned from a trip to Italy and did not excuse her from work, even though they were showing symptoms. Cleonice’s death was the harbinger of how the pandemic would affect the most vulnerable.

The pulmonologist of the Pulmonology Division of the Heart Institute (InCor) of the Hospital das Clínicas of FMUSP, Dr. Ubiratan de Paula Santos, pointed out that Covid affected the poorest and with greater severity.

In 2024, the specialist conducted a study with cleaning staff and administrative employees at the HC. A total of 420 workers from each sector were interviewed. “The cleaning staff got Covid much more because they earn less, have worse living conditions, their houses have poorer ventilation, and the severity of Covid depended greatly on the amount of virus inhaled. If you have an environment with lower ventilation, with the same number of people, but fewer windows, smaller size, and less airy, the concentration of the virus remains longer in the air,” he explained.

Data from the World Bank and the Economic Commission for Latin America and the Caribbean (ECLAC) confirm this social tragedy: the pandemic pushed millions of Latin Americans back into extreme poverty. Loss of income, food inflation, and unemployment hit the outskirts hard, where social distancing was an unattainable privilege and access to basic sanitation, a mirage.

At the other end were the risk groups, people with the so-called ‘comorbidities’ – the simultaneous occurrence of two or more diseases or disorders, chronic or acute – a word that the pandemic popularized. In the state of Piauí, Antônio Nonato Lima Gomes, mayor of the city of São José do Divino from the PT party, was the first fatal victim of the disease. He was 57 years old and belonged to the risk group because he was diabetic.

Dr. Paula Santos points out that currently, Covid has a greater impact on much older people and those with comorbidities, more severe lung or cardiovascular disease.

Denialism as a state policy and international solidarity

From a medical and administrative point of view, Brazil experienced a particular nightmare. With more than 700,000 lives lost, the country accounted for about 10% of global deaths, having only 2.7% of the world’s population. This outcome was not a matter of chance, but rather a direct result of the management of Jair Bolsonaro’s government.

The previous administration turned denialism into state policy. The world watched, stunned, as a president who refused to wear masks, promoted gatherings, and boycotted the isolation measures adopted by governors and mayors. Even more serious was the sabotage in the purchase of vaccines: emails from the pharmaceutical company Pfizer went unanswered for months, delaying immunization that could have saved tens of thousands of lives. As if the omission were not enough, there was cruelty: in live broadcasts, the then head of the executive even mocked patients choking to death.

The peak of the collapse occurred in Manaus, at the beginning of 2021, when patients died of asphyxiation in hospitals due to a lack of oxygen cylinders. Faced with the inertia of the Brazilian federal government, the salvation came from abroad: the government of Venezuela, even facing its own embargoes and crises, sent convoys of trucks loaded with oxygen to help the Amazonian capital, a historic gesture of Latin American solidarity amid the barbarism.

Remote work: a “positive” legacy?

If one can extract anything positive from such a dark period, the changes in work dynamics stand out as the main legacy. The need for isolation forced an abrupt digitalization that, six years later, has been consolidated in the market.

Remote work and hybrid models have ceased to be an exception and have become a quality of life requirement for millions of professionals. According to recent reports from the International Labour Organization (ILO), teleworking has proven capable of maintaining or even increasing productivity, as well as reducing commuting time in large metropolises, decreasing greenhouse gas emissions, and allowing for a better balance between personal and professional life.

However, the ILO itself warns that this “positive side” also requires regulation to prevent digital exhaustion (burnout) and ensure the right to disconnect. Furthermore, it is important to remember that telework remains a reality mostly limited to white-collar workers, reinforcing the need for public policies that protect those whose functions require physical presence.

Memory and Justice

Six years after the beginning of the nightmare, Brazil and the world are still dealing with the aftermath of Covid-19 — from ‘long Covid,’ which affects the health of millions, to the economic scars. Remembering this date is not just an exercise in mourning for the victims, but also a political act.

The pandemic proved the vital importance of a strong state, adequate funding for science, and the unconditional defense of the Unified Health System (SUS). Dr. Ubriratan states that the tragedy highlighted the vital importance of the country having the system. He reiterates that it was this public structure that prevented an even more catastrophic mortality rate, bravely resisting a denialist federal government at the time. The reach of a care network spread throughout the national territory, with hospitals and reference centers, was something that “made the difference”.

The pulmonologist recalls an emblematic example “when HC managed to set up 800 beds exclusively for Covid-19 patients in just 30 days. More than saving lives, this terrible experience left a fundamental legacy: it reinforced, in an incontestable way for the medical category and for all professionals in the field, the irreplaceable role of SUS in managing and resolving the major public health problems in Brazil,” he concludes.

Above all, the six years of the pandemic remind us that public health can never be at the mercy of denialism and necropolitics. May the memory of Cleonice, Antônio de Felícia, and hundreds of thousands of Brazilians serve as a permanent reminder that life must always come above profit and barbarity.