With an admittedly grossly underestimated death toll of more than half a million, Brazil is one of the countries hardest hit by the Covid-19 pandemic. It is also one in which the catastrophic effects of the SARS-CoV-2 virus can be attributed, with little space for controversy, to the adoption of public policies based on pseudoscience and disregard of sound scientific advice.
President Jair Bolsonaro, elected to office in 2018 and in power since 2019, not only strong-armed the Ministry of Health into promoting false “cures” and “preventives” for the disease—including hydroxychloroquine, ivermectin, and vitamin D—but used the prestige of his office and the visibility of his public persona to deride the use of masks and the need for social distancing and even to smear vaccines (in one of his speeches he joked that “unproven” vaccines could “turn you into an alligator”). He even threatened to mobilize the army against state governors who tried to impose strict lockdowns.
Finally, in April 2021, after a lot of backstage compromising and negotiation, the opposition to the president in the Brazilian Senate got around to establishing a Parliamentary Inquest Committee (“CPI” is the acronym in Portuguese) on the handling of the pandemic by the federal government. The senators in the Inquest Committee will underwrite a final report that might offer grounds for criminal prosecution and/or impeachment of the president.
Recent developments in the CPI include the arrest of a former officer of the Ministry of Health for lying under oath in testimony before the Senate and the revelation that some of Bolsonaro’s supporters were trying to extract bribes from vaccine manufactures, including AstraZeneca.
Be that as it may, science denial and a fierce disposition to attack science and scientists and to promote unproved and unplausible “cures” for Covid-19 still make up much of the federal government’s (and Bolsonaro’s) response to the pandemic. Because of that, one of us, CSI Fellow and President of Instituto Questão de Ciência Natalia Pasternak, was called to testify at the CPI.
Due to her background in microbiology and long experience communicating science to large audiences—be it online, in books, or in lectures—Pasternak saw herself in high demand by the Brazilian news media as soon as the pandemic hit. But due to the government’s actions and words, she saw herself talking less and less on the specifics of the virus and the disease and more and more on the value of science in general, on the need for skepticism when faced with “miracle” cures, and on the irresponsibility and foolishness of adopting public health policies that ignore scientific evidence. It was as a skeptic and science communicator—much more than as a specialist in microscopic critters—that she appeared before the Senate on June 11.
Bringing skepticism and scientific thinking to Brazil’s Senate, during an investigation followed by millions of people on YouTube, was a lifetime opportunity. Our major goal as leaders of the skeptic movement in Brazil has always been to bring science and rationality to the public debate. Speaking at the Senate, and explaining science to policy makers, was not only a recognition of our work but our chance to help the members of parliament understand the dangers of promoting pseudoscience as public policies.
Pasternak spoke of how science works, the difference between correlation and causation, how clinical trials are run, what conclusions can be inferred from “in vitro” studies and animal models, the fallacies most commonly used by pseudoscience promoters—so well known by skeptics all over the world—such as anecdotal evidence and confounding factors, cherry picking of data, and, of course, the “garbage in-garbage out” method of meta-analyses. Also supporting science in front of the Senate was Claudio Maierovitch, former president of Brazil’s drug regulatory agency Anvisa, who was also heard as an expert witness.
Among the many miracle cures promoted by the federal government during the pandemic, hydroxychloroquine (HCQ) was certainly the most potentially harmful and infamous, because it was the president’s pet treatment. Bolsonaro claimed he was cured by HCQ. A picture of Bolsonaro with a box of the medication in hand, chasing after an emu at the presidential palace in Brasilia, became an online hit. Pasternak even took advantage of this vaudeville moment to explain how animal models showed that HCQ had no effect on COVID-19 prevention or treatment, even when used as “early treatment,” which was encouraged by its defenders.
Using a slide presentation, she showed how “in vitro” assays can be misleading and must be confirmed by animal models and, if those bring positive results, by human clinical trials. HCQ was tried in mouse and nonhuman primate models against Covid-19 and didn’t work. Pasternak explained that it could even have been tested in emus, but they were smart and kept running away!
Next came the explanation of how human clinical trials were conducted for HCQ and COVID-19 and how the best available evidence makes it very clear that this treatment should not be recommended. Finally, she showed why personal stories and confounding factors can lead to the impression that it works, but we can weed out such misconceptions with skepticism and scientific thinking.
For the most part, the deposition was well received. Senator Marcos Rogerio anti-Semitically demanded why Pasternak dared to sign a manifesto of Jewish intellectuals against Bolsonaro, and Senator Luis Carlos Heinze asked her what her “H-index” was (compared to HCQ promoter Didier Raoult). Other than that, there was hardly any scientific argument—or any argument at all—during her presentation.
Pasternak replied to both senators firmly, stating that it was her right as a citizen and a member of the Brazilian Jewish community to sign whatever she deemed right in a democratic country. She also explained that the H-index is an imperfect metric used to evaluate academic achievement, and although she has a strong background as a lab scientist, she no longer works as an academic. Therefore, most of her work can be found in books and newspapers, communicating science directly to the public.
Four days later, the attacks began. Senator Luis Carlos Heinze accused Pasternak of using irony to debunk his claims that HCQ works—yes, it took him ninety-six hours to realize it—and he blatantly lied, saying that she had never published academic papers in her entire career. Other congresspeople who support the government joined in. Our favorite accusation was: “Natalia Pasternak is not a medical doctor; she never treated a single patient.” It’s not clear what could be wrong with this statement: Because she is not a medical doctor, and never claimed to be, isn’t it a good thing that she doesn’t treat patients? Whenever purely medical questions were asked, she would defer to her colleague Dr. Maierovitch, who is in fact a medical doctor.
It comes as no surprise to us that the attacks on Pasternak’s participation at the CPI were personal and offensive. When it is impossible to argue with the facts, the messenger becomes the target. After two years running the only Brazilian NGO for the promotion of skepticism and critical thinking, we are used to this approach. And the senators and other congresspeople should have learned already that we are not easily intimidated. The investigation continues, and, hopefully, by the end of the CPI Brazilians will have realized what happens when a denialist is voted into office—and will get rid of him.
The pandemic in Brazil has killed more than a half million people mainly because the federal government has denied and disregarded scientific evidence. We hope it serves as an example, for our country and the world, never to be repeated.