RIO DE JANEIRO — In the country with the most Covid-19 deaths a day and over 100,000 new daily cases, alarm and anger is growing over the lack of access and the slow pace of vaccinations amid a health care system nearing collapse.
Linda, 75, was scheduled to get her first vaccine dosage in the first days of March, after traveling for three hours from a small town and managing to stay at a friend's house to be there on time. But the city changed its calendar and canceled the appointment amid an ongoing shortage of vaccines and distribution problems.
"I took a bus trip that was dangerous, and in the end I had to return,” Linda told NBC News. She had to repeat the costly and difficult trip once her vaccination date was rescheduled.
“I was apprehensive, but finally I managed to get the shot," Linda said, asking that her last name be withheld because she's been criticized for traveling to Rio and "taking" a vaccine from someone in the city — even though she fully qualifies because of her age.
The bitterness and frustration around vaccine access and delays have become part of the country’s routine. Last week, officials in Macapá, the capital of the northern state of Amapá, announced a temporary suspension in their vaccination schedule due to a vaccine shortage.
“The vaccination pace is 10 times under the nation's capacity," said Miguel Nicolelis, a Brazilian neuroscientist and researcher at Duke University.
Only 2.1 percent of Brazilians have received two vaccine shots, and only a third of the 77 million Brazilians who qualify for shots — the elderly, health care workers and Indigenous communities —are being vaccinated. Fewer than 7 percent of Brazilians have received at least one shot since January.
The low numbers are a stark reversal for a country that has long been regarded as one of the world's best on vaccinations. In a recent poll, 76 percent of Brazilians think the vaccination is slower than it should be.
Steep rise in deaths among younger Brazilians
Deaths among younger Brazilians, those 30 to 59, have increased by 317 percent from the beginning of the year to mid-March, and new cases in that age group have grown by almost 600 percent.
The rising cases are overwhelming hospitals' resources since younger adults resist longer than the elderly in intubation, which requires even more supplies.
Renan Cardoso, 22, was the first to die in São Paulo in the recent Covid-19 wave while waiting for a space in an ICU. His family is now watching over Renan's father, who tested positive for Covid-19.
“A few doctors already disagreed on what to do with him,” Paulo Lobato, his cousin, told NBC News, fearing that the family nightmare might happen again. Renan's father is isolated in a room at home, waiting to get better, hoping he doesn't have to go to a hospital. If he does, he will join a line of 6,300 people nationwide waiting for a bed.
Caroline Lins, a photographer, has seen the early stages of this latest surge in her home city, Manaus. What is now being felt nationwide, with crowded hospitals and lack of ICU beds, hit the city first, in January.
“The same patterns are repeating,” she told NBC, remembering the emergency campaign she and others did to gather supplies, and oxygen cylinders, for the city's hospitals.
A global threat, lack of leadership, misinformation
Brazil's growing coronavirus cases and deaths and the slow vaccination pace is a threat to global health, Nicolelis said, warning that the pandemic cannot be suppressed if Brazil's crisis lingers. He and other medical specialists worry about the spread of more dangerous coronavirus mutations.
"This was caused by incompetence at the federal level,” Nicolelis said.
The country's lack of leadership and coordination around Covid-19 is widely blamed on President Jair Bolsonaro. The right-wing populist has repeatedly denied the benefit of wearing masks, questioned the efficacy of vaccines and repeatedly encourages gatherings, contradicting health experts. The country has had four health ministers since the pandemic began, slowing the country's planning and coordination.
Amid political infighting, there's also scandal: To get around the slow vaccination, some politicians and businessmen allegedly bought Pfizer vaccines and sold them to friends and family. The act is illegal and under investigation. Other Brazilians are choosing to go to other countries like Uruguay to get vaccinated.
Bolsonaro's behavior as well as the broad dissemination of fake news has led to more lasting misinformation about unproven Covid-19 treatments compared to other countries, according to a recent international report. This misinformation is circulating widely alongside antivaccine rhetoric.
Juliana Nunes, 37, an engineer, does not intend to get the vaccine. She says she's been using her mask and has treated herself with certain drugs, even though they have proven to be ineffective against Covid-19, such as chloroquine and ivermectin. The fact that her mother was infected with Covid-19 but did not develop serious symptoms ended up reinforcing the myth.
"I do not trust the Chinese vaccine that is being distributed, and I know that AstraZeneca's has serious side effects,” she said. Nunes thinks that people are exaggerating the effects of Covid-19 on purpose to make the economy worse, leading to the removal of Bolsonaro, who has called the disease “a little flu."
Monica Mariano, 60, a retired architect from Rio, is somewhere in the middle. While she believes in some of the unproven early treatments, she is looking forward to getting the vaccine. "I do everything not to catch it, and if they tell me that these drugs prevent it, I will try them. But I stay at home and wear a mask while waiting for my turn. As the speed is still very slow, I prevent (getting Covid) the way I can," she said.
Brazil's leading economists and business leaders recently urged the government in an open letter to speed up mass vaccinations and prepare for emergency lockdowns, contradicting Bolsonaro's assertions that closings would impose too much hardship.
Amid government inaction, managing the pandemic has largely rested on the country's health care workers, and that has taken a heavy toll on them, said José Gallucci-Neto, a psychiatrist and a researcher at the University of São Paulo. Gallucci-Neto is among the doctors and science journalists who have been tackling the spread of Covid-related misinformation.
"Many are developing symptoms of PTSD,” he said of the country's doctors and nurses.