By Lorena Moraes*
Last weekend, the largest Brazilian national survey on Covid-19 suffered resistance in a number of cities, most of them located in the country’s hinterland. The cities selected for the survey are described as “sentinel cities” – i.e., the main urban centers of various sub-regions of the country, according to criteria defined by the National Census Bureau (Brazilian Institute of Geography and Statistics – IBGE). They are, therefore, key in the overall scope of the survey sample.
National mainstream media vehicles reported that researchers had been arrested and assaulted in the course of data collection. The research, financed by the Ministry of Health, is coordinated by Professor Pedro Hallal of the Federal University of Pelotas (UFPel). It uses the services of the main opinion poll company – the National Institute of Public Opinion and Statistics (IBOPE) – which hired local poll companies to perform the survey in the selected municipalities. According to UFPel’s official statement, municipal health departments had been previously notified about the research and the staff compliance to Covid-19 safety regulations by the Ministry of Health.. They carried personal protective equipment and only researchers who tested negative for the coronavirus were included in the study crew.
However, this information had not reach some municipal health departments and regional health offices before their arrival. According to Márcia Conrado, Serra Talhada’s Secretary of Health, in the state of Pernambuco, her staff only learned about the research after the local population called the police denouncing the presence of unknown people collecting blood samples, leading to the arrest of the research professionals. Only after their arrest that the Municipal Secretary of Health authorized the research to carry on. In Picos (in the state of Piauí) — another city that did not receive the communication from the Ministry of Health in time — the Health Secretariat claimed that, because it was unaware of the survey and its objectives, it required the 17 members crew to comply with quarantine rules before starting the field work. In a release, the Pico’s Secretary denounced the research team had no institutional identification, neither from UFPel nor from Ibope. In addition, according to Sayonara Moura, president of the Council of Municipal Health Secretariats of the State of Ceará (COSEMS), the study crews were not health professionals, which is unusual in this type of research. It should not come as a surprise that the slowness or total absence of dialogue between the Ministry of Health and municipal levels has decidedly hindered the progress of the survey in 75 of the 133 municipalities it was intended to cover.
Epidemiologist Pedro Hallal, in charge of the survey, argued in an interview to newspaper O Globo that while the country was “at war” against Covid-19, some municipal governments were behaving as “sheriffs” and impeding the work of research crews. However, his statement seems to disregard Brazil’s current policy scenario which, in addition to the pandemic, involves a wide gamut of complex factors, aggravated by high levels of social vulnerability. I am referring here to the perennial political crisis provoked by president Bolsonaro and his efforts to discredit science, unleash attacks on public universities, create major instabilities in the Ministry of Health and fuel the intense dissemination of fake news of all kinds. I am also referring to conditions of collective panic, brought by the thousands of deaths that grow day by day and what this means in terms of deep reconfigurations of sociability and interpersonal relations.
Researchers from any area of knowledge production, even in the face of the urgent need to obtain data in an epidemic situation, cannot disregard the context of deep crisis which people are experiencing in their daily lives. The research “Evolution of Infection Prevalence by Covid-19: A Population-Based Study” is indeed urgent to identify how the virus is spreading across the country and to create more solid bases to better ground efficient responses to Covid-19. However, not even this relevance and urgency should be used as a pretext to disregard the insecurity, misinformation, anxiety and collective panic that is right now governing people’s lives.
Let us go by parts. Communication with municipal agencies about the research was under the responsibility of the Ministry of Health, but, as is well known, communication between the Ministry and the local levels is not usually quickly established or effectively enough. Right now, to make it further difficult, the public health sector is undergoing major instabilities caused by the political divergences and obscure economic interests promoted by Bolsonaro that puts the physical and mental health of the Brazilian population at risk. Moreover, as it is well known, the federal administration has been systematically contradicting World Health Organization (WHO) guidelines and scientific premises.
A second point to be noted is that, contrary to what newspaper Folha de São Paulo suggested, the survey is not exactly similar to an opinion poll, even when it is being carried out by IBOPE. It is an epidemiological investigation which, in addition to conducting a sociodemographic survey, applies rapid serology test for SARS-CoV-2. It should not come as a surprise the fear and uproar triggered by the research, as the survey implies a blood test performed by unknown professionals who are not even from health, exactly when what prevails are quite draconian rules of social distancing. The survey implies more than a conversation, it means body contact.
In that regard, I want to call attention to Social Sciences qualitative research protocols, guided by the recognition that, as noted by professor Jean Segata, data is not devoid from faces, trajectories, biographies and feelings. Persons, who are transformed into data, numbers, and statistics, “share experiences and compose unique environments”. In other words, as the same author suggests, a “pandemic must (also) be considered as an experience lived within bodies and collective sensibilities” , which requires that the political, social, and cultural context of each site is fully taken into account. The Brazilian COVID survey is not an opinion poll, but rather an investigation on the politics of life and death.
Therefore, its design should not be just about informing and requesting permission from each municipality or Municipal Health Secretary. It is neither the case of fueling disputes across the various spheres and levels of health policy management. What was at stake in this regrettable episode was a firm requirement of establishing and adopting clear methodological procedures for mediation and communication with the municipal health secretaries, as well as with the population that would be researched. If such a guideline had been adopted, the research would have been made public at local levels and this would have avoided (or minimized) the fear and panic of the population and the related spread of fake news about the presence of strangers roaming the territories.
Such caution would have guaranteed the field research’s safety and prevented violence against the survey crew, as it happened in Santarém (state of Pará), where the local Health Surveillance officer had an unacceptable conduct when the population denounces reached them. Induced by fake news claiming that the test kits were contaminated, health surveillance officials and military police officers broke into sociologist Zenilda Bentes home, who was the coordinator of the local research. In this operation, the officers seized testing material and the PPEs, constrained the researchers, and subjected Ms. Bentes’s elderly parents, who were in strict isolation, to the risks of contagion. This action exposed the family to public embarrassment, since the local press gave great visibility to the episode and has certainly aggravated the atmosphere of fear surrounding the research.
It does not seem, therefore, excessive to say that the Ministry of Health conduct was authoritarian or, at least, omissive. In the same manner, the research national coordination failed to establish partnerships and solid channels of communication with local authorities. On the other hand, it is unacceptable that local state actors restrict the circulation of people/researchers, apprehend materials, contest the veracity of the investigation and put the lives of vulnerable people at risk. Does it not the Santarém episode sharply illustrates the logic of hierarchization and social control that sustains the “right to cause death or let live“? (Foucault, 1988).
Following Michel Foucault’s concept of biopolitics (2008), the disarray and side effects of the Brazilian Covid-19 study are to be read as symptoms of technologies of control that, justified by the biomedical emergency, maintain and amplify varied forms of discipline of social bodies. Paul Preciado, writing about the biopolitical effects of Covid-19, draws attention to their paradoxes. Preciado stresses that each act that promotes protection during an epidemic implies a definition of community immunity. That is to say that not everyone is legitimate to have immunity and, therefore, for the sake of protecting some lives, others must be sacrificed: “The state of exception is the normalization of this unbearable paradox“. The police interventions and state violence that took place in Santarem can be read as a micropolitical expression of this “state of exception”. It is not trivial that such exceptionality was motivated by unfounded, pernicious and criminal news, known in popular language as fake news.
A final aspect to consider is that, under different conditions, this research could have been an excellent opportunity for the Ministry of Health to show an effective response to Covid-19. It could have also facilitated the reconstruction of virtuous links between academia and society to compensate for the virulent attacks on public university and academic and scientific knowledge now prevailing. But, unfortunately, this was not the case. In several of the municipalities selected, due to the misconduct of institutional actors involved (Ministry of Health, university, IBOPE, and health surveillance), the Covid-19 research has mainly triggered disinformation, institutional and popular distrust, violence, arbitrary interventions and undue criminalization.
These conditions reflect the mismanagement and disarray to which Brazilian society is now subjected. Returning to Preciado:
the virus actually reproduces, materializes, widens, and intensifies (from the individual body to the population as a whole) the dominant forms of biopolitical and necropolitical management that were already operating over sexual, racial, or migrant minorities before the state of exception.
On the other hand, it also seems valid to bring to this discussion the frame developed by Javier Lifschitz (2020) when he states that “biopolitics is not a one blade weapon”. This imply that we should not totally devalue or disqualify what he names as the “biopolitics of life protection” as, for example, a well-designed policy of mass testing. As we know, the resource to positive biopolitics had clear effects in the containment of Covid-19 in a number of countries. Brazil is far away from applying such a policy frame, not because of its continental extension or lack of public acceptance, but rather because of blunt state omission.
As previously noted, the country is subject to high levels of political insecurity and does not count with the necessary coordination across the various levels of public health management. There is no national plan for containing the coronavirus pandemic and the scientific evidence on the pandemic is disregarded by a wide range of state actors, especially the president. It is not, therefore, surprising that the first and largest national official research on the prevalence of SARS-CoV-2 could not count with the required credibility on the part of the Brazilian population and, in many places, has mostly caused panic.
*Lorena Moraes has a PhD in Social Sciences and is a faculty member at the Federal Rural University of Pernambuco – Academic Unit of Serra Talhadaanvi.
Acknowledgements
I am grateful to Zenilda Bentes, an indigenous woman, teacher, sociologist and local research supervisor, who told me about the violent episode in Santarém (state of Amazonas); to Andrea Oliveira, sociopolitical director of the Women’s Executive Secretariat, who informed me about the case in Serra Talhada (Pernambuco); to Professor Letícia Carolina (UFPI), who sent me news about Picos (Piauí) and reviewed my writings, and to Professor Daniel Valença (UFERSA), who gave me information about Mossoró (state of Rio Grande de Norte), to Nicole Pontes, Joana Emmerick and Avelino Neto for the dialogue.
Image: Anna Dumitriu
References
FOUCAULT, Michel. História da sexualidade I: a vontade de saber. Rio de Janeiro, Edições Graal, 1988.
FOUCAULT, Michel. Segurança, território e população. São Paulo: Martins Fontes, 2008.
LIFSCHITZ, Javier Alejandro. Pandemia: qual biopolítica? In: AUGUSTO, Cristiane Brandão; SANTOS, Rogerio Dultra dos. Pandemias e pandemônio no Brasil. 1. ed. São Paulo: Tirant lo Blanch, 2020. p. 77-89.