Outside of the United States, Brazil has the largest number of confirmed SARS-CoV-2 infections; it’s behind only the US and UK in terms of confirmed COVID-caused deaths. Meanwhile, its leader, President Jair Bolsonaro, has frequently minimized the risks posed by the pandemic and has frequently been photographed taking minimal precautions—going without a face mask and hugging supporters.
Complicating his country’s policy response, Bolsonaro has also fired his health minister in the midst of the pandemic, only to see his replacement quit after a month on the job.
All of that took place, however, against a backdrop of detailed data about the known extent of the COVID-19 pandemic within the country, allowing Bolsonaro’s public proclamations to be tested against the facts. Over the weekend, however, all of that data was taken down from government websites. After a brief hiatus, it was replaced by a simple tally of cases and deaths—only to see that replaced by a different set of numbers shortly afterwards.
Previously, the government website provided access to data that tracked the progress of the pandemic over time and broke it down by state. Information on larger municipalities was also present. This data could be useful for tracking the spread of the disease over time and designing policies to limit its spread from areas where it’s highly prevalent to those with a lower case burden.
Instead, the website has been replaced by a page that simply lists new cases, deaths, and recoveries, with new being defined as within the last day. A separate report of the total cases and deaths, however, listed numbers that were inconsistent with the ones found at the daily update site. By Monday, the numbers had been brought into alignment, but the reason for the discrepancy hadn’t been disclosed.
As in the US, the government’s response to the pandemic has been heavily politicized, which has led to accusations that the decision to limit data availability was meant to obscure the extent of the pandemic in Brazil. On the opposite side of the political spectrum, a government minister accused state and local governments of inflating their figures in order to receive more funding. On Sunday, that same minister announced he was stepping down after threats of a boycott of his businesses.
Math is hard
Even in countries where there’s no indication that reporting of basic medical statistics is being distorted, however, getting accurate numbers can be a challenge. On Monday, The Washington Post released a state-by-state analysis of pandemic figures submitted to the Centers for Disease Control. It finds that fewer than half the states are following the CDC guidelines for the data they submit.
Due to the frequent problems the US has had with providing sufficient testing capacity, many people with COVID-19 symptoms—including some who ultimately died—were never tested. As a result, the CDC was advised to include suspected cases in with its figures. But, even months after this guidance was issued, many states haven’t submitted the data on suspected cases. Their submission of any data is voluntary, and states contacted listed a variety of reasons for not complying with the CDC’s requests. But in at least one case (Illinois), the state indicated it was not submitting data for reasons that echo the accusations in Brazil: “concern from the public that the number of deaths is being inflated.”
Many countries that have strong national health systems made testing available shortly after the outbreak reached them. These likely have accurate counts of the total cases. But for many countries, we’ll probably have to wait for a detailed analysis of nationwide mortality figures to get a complete picture of the scope of the pandemic. That’s a process that could take years—assuming it occurs without political interference.