A correspondence letter from Professors Lorena Barbeira, Silvia Costa and Ester Sabino details the need for a coordinated and cooperative approach to tackle COVID-19 in Brazil. After more than 14 months under siege, Brazilians continue to suffer as they see thousands of people dying every day, killed by the fast-moving respiratory pathogen SARS-CoV-2. Families are struggling to secure their livelihoods, quell hunger and, in some cases, adjust to the long-term toll of having survived infection with SARS-CoV-2. With the surge in cases, overcrowding of hospitals and high lethality, those on the front lines understand that Brazil is at war with COVID-19. The assault has been brutal1. A quarter of all deaths from COVID-19 in Brazil were officially recorded in April 2021. Meanwhile, a SARS-CoV-2 variant of concern, lineage P.1 (B.1.1.28.1), continues to be detected in an ever-increasing share of infections, on the basis of the small number of genomes sequenced across the country. This Commentary discusses the many factors that explain why the toll of the pandemic on Brazil has been so extraordinary, including its close transport connectivity with world markets, the marked socioeconomic vulnerabilities of its many populations, and persistent inequities.
