Brazil represents a tragic example of how lack of appropriate policies and pandemic denial impact public health. The country of 212 million inhabitants (3% of the world population) recorded around 1/3 of all daily COVID-19 deaths worldwide in late March 2021 [1]. Brazil's brutal surge in COVID-19 deaths in the first months of 2021 has been climbing steadily, reaching over 4000 fatalities/day in early April, as a consequence of the widespread of the new variants overwhelming hospitals. In spite of the alarming scenario, the federal government is not yet adopting evidence-based and reliable public health measures, such as use of masks and social distancing. Brazil's public health system provides healthcare for 78% of the population. Its free, publicly funded national vaccination program has an excellent track record: 96% of the population is vaccinated against TB, diphtheria, polio and hepatitis [2]. However the country is struggling with a slow COVID-19 vaccine rollout, pushing the country's healthcare system to the brink. The lack of federal government leadership is leading state governors to negotiate and purchase COVID-19 vaccines within a consortium of governors, facing several delays and difficulties.

Brazil's president, Jair Bolsonaro, first downplayed the thread of COVID-19 and later embraced herd immunity as an effective strategy. The country never adopted a national lockdown, even in hardest hit cities such as Manaus [3]. Brazil's capital declared a 24-hour lockdown in February 2021, while larger cities such as Sao Paulo and Rio de Janeiro adopted nightly curfews and nonessential business