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The covid-19 pandemic in vulnerable communities: the responses of Rio de Janeiro’s favelas

La pandémie de covid-19 dans les communautés vulnérables : les réponses des favelas de Rio de Janeiro
La pandemia de Covid-19 en las comunidades vulnerables: las repuestas de las favelas de Rio de Janeiro
Dalia Maimon Schiray

Résumés

Cet article analyse l’efficacité des réponses du gouvernement brésilien en matière de santé publique et de politique économique à la pandémie durant l’année 2020. Nous montrons que la prévention, qui suit les directives de l’OMS, est plus facilement adoptée par la classe moyenne. Dans les groupes à faible revenu, les conditions de logement, le manque d’installations sanitaires et l’informalité limitent l’efficacité de la prévention. Les problèmes de gouvernance dans les relations entre le gouvernement fédéral et les États et municipalités ont réduit l’efficacité de ces mesures. Le Brésil continue de lutter contre le deuxième plus grand nombre de décès au monde, après les États-Unis. Dans ce contexte, nous centrons le propos de l’article sur les réponses des favelas de Rio de Janeiro à la pandémie pendant et après le confinement. Sans politique spécifique de la part du gouvernement brésilien, la population vulnérable de ces quartiers, soutenue par l’organisation sociale présente dans les communautés, a adopté des mesures préventives en matière de santé et a bénéficié de dons de nourriture et de produits d’hygiène qui ont minimisé la tragédie annoncée.

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Introduction

1During 2020, governments around the world responded to the pandemic with unprecedented policies designed to slow the growth rate of the infection. Many actions, such as closing schools and confining populations to their homes, impose large and visible costs on society, but their benefits cannot be directly observed and still today are not well understood by a significant portion of the population. Despite scientific studies and investments to find a way to fight this global threat, until the end of 2020, no vaccine or medicine proven effective have been available. Prevention was, therefore, fundamental, and for it to be effective, an emergency communication plan for a change in behaviour was necessary.

Most people infected will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical conditions – such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer – are more likely to develop serious illness (WHO, 2020a).

  • 1 Humanitarian logistics (HL) is a set of plans and actions aimed at saving lives, displacing people (...)

2World Health Organization (WHO) is supporting countries in their containment and mitigation efforts with actions, such as providing technical guidance, strengthening laboratory capacity for testing and equipment for hospitals and healthcare workers. Following WHO recommendations, the simultaneous social isolation measures on a global scale have been unprecedented. The crisis has transformed the priorities of public action from an economic logic to a humanitarian logic and established a humanitarian logistics effort1 (Matz, 2020). Social inequality complexifies the fight against dissemination since it implies sanitary and housing conditions that hinder physical and social distancing measures, low access to basic supplies for hygiene and protection and restrictions of access to health services in the public network.

3However, what is relevant in terms of health and economy is that the impact on the population will depend on socioeconomic factors, ceteris paribus age and co-morbidity. The rate of transmission depends on the structure of social contacts in a community. The rate of mortality depends on the hospital capacities of the countries, as well as on the quantity of screening tests performed, that is, whether only patients who have symptoms are tested or they are conducted in a big sample of the population. The mortality rate also depends on access to care, which is obviously affected by social inequalities within a workforce in precarious and often informal work: 1.7 billion people work in this type of activity (ILO, 2020). There is an inequality among formal workers as well, between those whose professions allow remote work and those who need to be present to exercise their activity.

The paper is organized into two sections, in addition to this introduction and the conclusion. In section 1, we analyse the first responses by the Brazilian government to the pandemic. In section 2, we point out the main prevention responses of favela communities to the covid-19, based on the case studies, lived experience in events in which we have participated and according to several websites of Rio’s favelas.

1. Brazilian first responses to the pandemic

4In Brazil, in the end of 2020, the number of covid-19 infections had exceeded 5.5 million cases, with a death toll of more than 160 thousand people. The country continues to fight the world’s second-highest number of deaths after the United States. This part presents an exploratory analysis of the main measures of emergency health and economic policy adopted by the federal government of Brazil within the scope of the strategy to face the economic, social and public health crisis resulting from the covid-19 pandemic. The objective is to identify the main axes of actions instituted at the federal, state and municipality levels in the initial phase of the crisis.

1.1. Health Responses

  • 2 There was earlier advice that wearing masks was not necessary for the general public.

5The first case occurred at the end of February 2020. That led the federal government, states and municipalities to start adopting humanitarian logistics (Matz, 2020) in prevention, such as evaluation of health infrastructure, import of protective equipment and ventilators, construction of field hospitals. WHO reacted late to the declaration of the pandemic, delaying airport blockages, but gradually indicated preventive measures, such as washing hands, cleaning the environment, social isolation and, later, wearing masks2 and testing (WHO, 2020b).

  • 3 Decision-making in environmental health policy is a complex procedure, even in well-known condition (...)

6The Brazilian Ministry of Health under the administration of Luiz Henrique Mandetta implemented an integration of policies and actions together with the federation states. They were based on the assumption that scientific knowledge and expertise were at the core of the decision-making process for all governmental regulatory bodies that had to address environmental health3 (Reis & Spencer, 2019). The Minister was a doctor and demonstrated communication and leadership skills, gaining the confidence of professionals in the field as well as the population’s (Maimon Schiray, 2020).

  • 4 “Communication is at the heart of who we are as human beings. It is our way of exchanging informati (...)

7The so-called instrumental communication4 (Rimal & Lapinsky, 2009) was implemented by the Ministry of Health and the governors. Every day, an account of the situation was broadcast on the main television channels and on social media, indicating the evolution of hospital capacity, prevention equipment availability and the evolution of cases of morbidity and mortality, often with tables and figures presentations. The TV news channels were great allies in the fight against the pandemic, reporting the Brazilian situation vis a vis the international. This communication, which has been relatively effective on the middle class or those with some level of education, has not reached low-income communities, where morbidity and mortality has intensified (Maimon Schiray, 2020).

8However, in the presidency, an economic logic prevailed, with a position against social isolation, which ended up in the resignation of Luiz Henrique Mandetta. The new health minister, Nelson Teich, also a doctor, took over when the mortality rates were already high. More discreet, he was in charge of a gradual plan to return to economic activities, but what he proposed was considered inadequate by the President, who ended up asking for his resignation.

9Finally, after the resignation of the second pandemic period health minister, President Bolsonaro replaced doctors with the military at the head of the Ministry of Health and determined the use of hydroxychloroquine as a protocol for covid-19 treatment, contrary to medical and scientific recommendations. At the beginning of June, due to the high number of deaths, the Ministry of Health decided to delay the announcement of cases and death counts in the media and recommended a change in the methodologies of notification.

10Brazil signed separate agreements with four pharmaceutical companies to produce a covid-19 vaccine and financed the construction of a factory with the help of private investments. The construction of a US$ 18 million covid vaccine factory was financed by the Brazilian billionaire Jorge Lemann’s Foundation (OECD, 2020). Rio de Janeiro and São Paulo accepted testing vaccines. Vaccines were also partially manufactured in the laboratories of Fiocruz – AstraZeneca – and Butantan – Sinovac – (Fiocruz, 2021, Instituto Butantan, 2021).

  • 5 Opinion Box (2020), Impacto nos hábitos de compra e consumo, Belo Horizonte, Covid-19, 27th ed., p. (...)

11Opinion Box5 weekly survey suggests that mask use was relatively well accepted. From Mars to November 2020, almost seventy seven percent of the population always wore a mask and only 1% admitted that they did not use it. The lack of masks and the difficulty of importing them were solved with the manufacture of homemade masks. In terms of social isolation, the difficulty has been greater. Figure 1 shows that from April 2020 onwards, there was a decrease in isolation in all the states, although the lockdown only ended around June in all states. The isolation rate was around 40% by September and fell in October to an average of 25% all over the country.

Figure 1. Participation of population in social isolation by state, 16 November 2020 (%)

Figure 1. Participation of population in social isolation by state, 16 November 2020 (%)

Source: Dalia Maimon Schiray, based on Inloco, (2020), Mapa brasileiro da COVID-19. Índice de Isolamento Social. URL : https://mapabrasileirodacovid.inloco.com.br/​pt/​ [accessed on 16/08/2020]

1.2. Economic Responses

12Regarding the economic responses due to the state of public calamity, the government established a “war budget” allowing the expansion of public expenditure. The strategy of extraordinary economic policy is organized into two large sets of measures: first, a fiscal policy aimed at guaranteeing family income, supporting companies and providing financial assistance to states and municipalities; secondly, a policy consisting of providing liquidity and releasing regulatory capital, aimed at the stability of the financial system and the expansion of the credit supply (Santos Silva, 2020). The main directives are (Ministry of Economy, 2020):

  • Support to families, informal and unemployed workers, with the transfer of R$ 600 (US$ 120) for 8 months, an unprecedented support to those most in need, which reached up to 58.6 million people. This aid of R$ 321.8 billion (almost US$ 60 billion), 4% of gross domestic product (GDP), is largely due to the increase in the primary deficit (Salama, 2020; 2021). In the beginning, poor people had difficulties applying to the Program: many of them have no income to subscribe to an Internet service to download the application, others don’t have an identity card or the CPF (cadastro de pessoas físicas, the individual fiscal registration number).

  • Protection measures for formal jobs, including remote work; anticipation of individual paid vacations; mandatory vacation leave; intensification of the compensatory time off; paying aid for the proportional reduction of wages and working hours in return for the maintenance of jobs. These measures reached R$ 51.6 billion (almost US$ 10 billion) and saved 8.1 million jobs, about a third of the total number of formal employees (Ministry of Economy, 2020).

  • Grant of credit lines by public banks to small and medium-sized firms, interruption of outstanding loan payments and suspension of amortizations for some sectors (oil and gas, airports, ports, energy, transportation, urban mobility, health, industry and commerce and services). Firms complain that banks didn’t want to lend, due to the economic risk of the pandemic.

  • Aid to states and municipalities: in September 2020, in the amount of R$ 60 billion (US$ 12 billion) and debt payment waivers concerning loan to the states and municipalities by the Federal Government.

1.3. Governance problems

The 1988 Constitution provides for a decentralized health policy, implemented in the great majority of times by states and municipalities. The Union, states and municipalities finance the SUS (Sistema Único de Saúde), the Brazilian Health Service, but only governors and mayors have by law the right to make decisions on implementation and prevention.

13Until April, everything seemed to be on track with the adoption of the social isolation measures decreed by the state and municipal governments. There was, however, a politicization of covid-19. The background was the conflict between prevention by social isolation and its repercussion on the economy. The visibility of governors and the health minister in the media was felt as a threat to the re-election of President Bolsonaro, who questioned the effects of social isolation on employment and income and the cost of the Emergency Aid on the budget. The same applies to aid to states and municipalities that could favour the governors, who are potential presidential candidates for the 2022 election.

14In this context, the president takes on a “negationist” (contagion-denying) and anti-scientific stance, either via his decisions or his image in the media without a mask, visiting merchants and participating in public demonstrations. These conflicting messages have compromised the planning and execution of humanitarian logistics in the organized fight against the disease. In contrast, state and municipal governments have been working with the assistance of health professionals, epidemiologists and specialists in management and planning, currently at the forefront of this fight.

15We resume here the Brazilian federal and states responses according to OxCGRT (The Oxford covid-19 Government Response Tracker). The OxCGRT collects publicly available information on 20 indicators of government responses. Eight of the policy indicators record information on containment and closure policies, such as school closures and restrictions in movement. Four of the indicators record economic policies, such as income support to citizens or provision of foreign aid. Eight of the indicators record health system policies, such as the covid-19 testing regime, emergency investments into healthcare and most recently, vaccination policies (Table 1).

Table 1. Brazilian federal and states responses

Federal

States (i)

School closure

x

x

Workplace closure (some sectors)

x

x

Cancellation of public events

x

x

Restrictions on gatherings size

Closure of public transport

Stay at home requirements

x

x

Restrictions on internal movement

x

x

Restrictions on international travel

x

x

Economic Response

Income aid

x

x

Debt/contract relief for households

Fiscal measures

x

x

Giving international support

Health systems

Public information campaign

x (ii)

x

Testing policy

Contact tracing

Emergency investment in healthcare

x

x

Investment in covid-19 vaccines

x

x

Notes: i. Conass (2020); ii. During two months, there was daily TV broadcast with all the Ministry of Health team, followed by one month daily TV broadcast with some ministers, including the health minister. In June, due to high numbers of deaths and notified cases, no TV emission was aired and major problems with diffusion occurred, including data manipulation.

Source: Dalia Maimon Schiray, based on Hale T., Webster S., Petherick A., Phillips T. & B. Kira (2020), Oxford COVID-19 Government Response Tracker, Blavatnik School of Government Working Paper, version 6.0. URL : http://www.bsg.ox.ac.uk/​covidtracker [accessed on 16/08/2020]

16Restrictive measures, such as national lockdowns and strict social distancing measures did not have the same effect in Brazil. Instead of a rapid decline in the number of cases and deaths, contagion plateaued at a high level for several weeks, with no marked decline until the month of September. Governance problems in the relationship between the federal government and states and municipalities have reduced the effectiveness of these measures, they can probably explain part of this lag.

17Nevertheless, the main explication is that the population at risk of exposure to covid-19 does not have the means to follow the WHO’s and Brazilian recommendations, given the healthcare inequities or the great social and economic inequality. The housing situation is precarious, due to lack of basic sanitation and the high number of people living in the same household, often in the same room. In 2016, 35 million (16.7%) people had no treated water, of which 7.2% corresponds to the urban population, and today 100 million Brazilians (48.1%) still lack basic sanitation, of which 39.1% in the urban population (IBGE, 2018).

18The economic condition is also fragile for the majority of informal employees. According to ILO (2020), “To die from hunger or from the virus” is the all-too-real dilemma faced by many informal economy workers. Dalia Maimon Schiray (AFP, 2020) quoted that for people who have to survive from their work, “to starve to death is certain, so I’m going to work and I’ll try not to get contaminated”.

2. Prevention in Rio’s favelas

  • 6 Designation of places such as slums, invasions and communities with at least 51 households, where m (...)

19In 2019, the estimated Brazilian population living in subnormal agglomerations6 (SA) was 13.6 million (6% of the total), which corresponds to 5.271 thousand households (IBGE, 2020). Estimated household data reveal that, although the proliferation of precarious housing is commonly associated with SA in large cities such as Rio de Janeiro (19.27%) and São Paulo (12.91%), the phenomenon occurs in large proportion in smaller capitals of the North region such as Belém (55.5%) and Manaus (53.37%) and the Northeast, such as Salvador (41.83%) (IBGE, 2020).

20The progression of covid-19 in the municipality of Rio de Janeiro gained rapid geographical expansion. After the moment of the virus “importing” by the higher income classes (in Copacabana, Ipanema and Barra da Tijuca), it multiplied within the city itself, spreading through urban mobility equipment and infrastructure to other, low income, territories (Campo Grande, Bangu, Santa Cruz). It is precisely here that the greatest impacts of social inequality are felt on the dynamics of contagion. As we have pointed out, housing conditions, basic infrastructure and circulation in the city, among others, in addition to the unequal distribution of income that push the populations of suburbs and peripheral slums toward workplaces – making isolation impossible –, aggravate the already accelerated speed of contagion towards popular territories (Barbosa, Teixeira & Braga, 2020).

21At the beginning of June, both the state and municipal administrations in Rio began to target the gradual reopening of social and economic activities. For the city of Rio, they proposed a model with six phases. It seems to be a health risk, since, on the one hand, the percentage of people adhering to isolation has been falling (Figure 3) and, on the other, the notified cases and deaths were still growing. It is important to recall that in Rio, people are not systematically tested. This has an impact on the notification of confirmed cases and consequently on lethality’s rate.

22In the municipality of Rio de Janeiro, the population living in slums is estimated at 1.36 million (19.2% of the total), living in 453,6 thousand households considered as sub-standard (IBGE, 2020). This municipality is composed of 163 neighbourhoods and about 86% of the area in these neighbourhoods is made up of favelas. Some neighbourhoods are entirely occupied by favelas (Rocinha, Jacarezinho, Complexo do Maré and Vila Kenedy). However, most favelas are smaller and are located within a neighborhood.

23According to Jorge Barbosa, Lino Teixeira and Aruan Braga (2020), it is an announced tragedy, since the trend, in the very short term, is the worsening of transmission to more vulnerable groups and territories and, as a result, the high probability of deaths – mainly due to the limited number of beds for specialized care in hospitals, especially in terms of beds available in intensive care units.

Figure 2 shows morbidity and mortality data in Rio de Janeiro’s favelas published by the Frente da Mobilização da Maré. It is an example of community self-organization. It is updated every day with information from the official data of the city of Rio de Janeiro, the health clinics (clínicas da família) located near or within the favelas and local leaders.

Figure 2. Deaths and confirmed cases in Rio de Janeiro favelas, 16 November 2020

Figure 2. Deaths and confirmed cases in Rio de Janeiro favelas, 16 November 2020

Source: Dalia Maimon Schiray, based on Frente de Mobilização da Maré (2020), Painel #CoronaNasFavelas COVID-19 Maré, 2020. URL : https://datastudio.google.com/​u/​0/​reporting/​ceb26582-afc7-4357-b65f-3727c18b3d5a/​page/​rYxKB [accessed on 09 /08/2020]

24There are two studies that analyse the impact of covid on the population of the municipality of Rio de Janeiro: that of covid-19 observatory of Fiocruz (2020a, 2020b), a major centre of epidemiological research, and that of Pedro Miranda, Priscila Koeller, Graziela Zucoloto, Weverthon Machado and Fernanda de Negri (2020) from Ipea (Institute of Applied Research), which has a tradition in econometric studies of public policies.

  • 7 The IDS takes in account eight social indicators of 2010 Census: housing, education and income cond (...)
  • 8 Mortality rate is a measure of the frequency of occurrence of death in a defined population during (...)

25Miranda and his collegues (id.) disaggregate Rio’s neighbourhoods by quintiles of IDS7 (Social Development Indicators). This analysis has three restrictions: first, it uses the population data of 2010, supposing all neighbourhoods have had the same population growth trend in the last 10 years. Second, it disregards the existence of poorer communities within more developed areas of the city, an urban characteristic that biases the averaged data. The third restriction is that, in Brazil, there is no systematic testing, so morbidity data are underestimated. In this sense, mortality data are the best indicators and therefore those of lethality8 are not significant. The authors conclude that:

it is clear that the lethality indicators are much larger in the neighbourhoods with less social development within the municipality of Rio de Janeiro. At the same time when deaths are observed as a proportion of the population, it is noted that this indicator has rates closer to those among almost all neighbourhood groups, except for those with very high income (group 5), which stand out from the rest with lower mortality in practically all age groups. (ibid., p. 13)

26The covid-19 observatory of Fiocruz (2020a, 2020b) has developed a specific study for Rio’s favelas, for two periods: during the lockdown (Mars to 22 of June 2020) and after that (until October 2020), considering the geographical concentration of favelas in each neighbourhood. This analysis has two restrictions: the classification concerns the surface of the favelas and not its population. The second restriction is the same as the third one on Pedro Miranda study.

27As we can observe in Figure 3, there is an inverse relationship between morbidity and the presence of slums: in neighbourhoods with low concentration, there is a higher morbidity and inversely, in high concentration neighbourhoods, there is a low morbidity. This trend did not change during the lockdown period. In the post lockdown period, there was a decrease in cases in the municipality of Rio de Janeiro, but with an increase in neighbourhoods with no slums, probably due to the greater possibility of testing paid in these high-income areas.

Figure 3. Incidence rate of covid-19 per 10,000 inhabitants according to the neighbourhoods of Rio de Janeiro distributed by concentration of slum areas

Figure 3. Incidence rate of covid-19 per 10,000 inhabitants according to the neighbourhoods of Rio de Janeiro distributed by concentration of slum areas

Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 20. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 20. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]

Figure 4. Incidence rate of covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)

Figure 4. Incidence rate of covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)

Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 21. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 42. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]

28This trend is also confirmed in the deaths data (Figure 5). There was a decrease in the municipality and in all the neighbourhoods. Those with no favelas and low concentration had a higher mortality rate. On the contrary, the neighbourhoods with high and very high concentration of slums had a lower mortality rate. In the slumps located in the neighbourhoods with a very high concentration (Figure 6): the mortality is, also, lower in those favelas than the average of Rio de Janeiro municipality.

Figure 5. Mortality rate of covid-19 per 10,000 inhabitants according to neighbourhoods in the municipality of Rio de Janeiro distributed by concentration of slum areas

Figure 5. Mortality rate of covid-19 per 10,000 inhabitants according to neighbourhoods in the municipality of Rio de Janeiro distributed by concentration of slum areas

Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 22. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 24. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]

Figure 6. Mortality rate per covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)

Figure 6. Mortality rate per covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)

Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 23. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 44. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]

29For our study, Fiocruz’s data seems to be more appropriate because it is targeted on favelas. Ipea’s work indicates that the literature already points out that there is an inverse correlation between morbidity and mortality and income. However, the data from Fiocruz and specific information about the population of the favelas indicates that this population is more resilient. At least, it can resist in this first year of the pandemic.

30Our hypothesis is that both morbidity and mortality are minor in the Rio favelas because these communities are more empowered, with the help of associations, many of them being internationally recognized. The favelas established crisis offices that raised funds, organized the distribution of food baskets and hygiene kits. This initiative has been complemented by the Federal Government’s Emergency Aid. In this respect, the solidarity of the population of Rio de Janeiro, who donated financial and material resources, should be highlighted. To compared only two organizations donated funds: Rio Contra Corona raised U$ 4.6 million and Viva Rio raised about U$ 1.0 million, in addition to important individual and company donations (Frente de Mobilização da Maré, 2020 and Viva Rio, 2020).

31Communication in the favelas adopted “Fique dentro de casa” (stay inside the house) posters, easier to understand than the “Fique em casa” (stay at home). Prevention manuals and leaflets, guiding access to health services for residents with confirmation or suspicion of contamination were distributed (Observatório das Favelas, 2020). Plastic bottles with water and soap at the main intersections, special controls over motorcycle taxis, prevention in community radio and clarification on fake news were other measures that were implemented. Some favelas even introduced the immunization of the alleys (Table 2).

Table 2. Favela’s responses to covid-19

 

Prevention in community radio and guidelines

Clarificarion of fake news

Networking

Residents and leaders reports

Donation

Own statistics morbidity and mortality

Immunization of the alleys

Rocinha

x

x

x

x

x

x

x

Maré

x

x

x

x

x

x

x

Mangueira

x

x

x

x

x

x

x

Babilônia

x

x

x

x

x

x

Dona Marta

x

x

x

x

x

x

Jacaré

x

x

x

x

x

x

Borel

x

x

x

x

x

x

Alemão

x

x

x

x

x

x

Manguinhos

x

x

x

x

x

Vigário Geral

x

x

x

x

x

Jacarezinho

x

x

x

x

x

Cidade de Deus

x

x

x

x

x

Acari

x

x

x

x

x

Morro da

Providência

x

x

x

x

x

Vidigal

x

x

x

x

x

Vila Kennedy

x

x

x

x

x

Pavão – Pavãozinho e Cantagalo

x

x

x

x

x

Caju

x

x

x

x

x

Parada de Lucas

x

x

x

x

x

Source: Dalia Maimon Schiray, based on Dicionário de Favelas Marielle Franco (2020), « Painel Covid-19 nas favelas do Rio de Janeiro », last modified July 5. URL : https://wikifavelas.com.br/​index.php?title=Painel_Covid-19_nas_favelas_do_Rio_de_Janeiro [accessed on 24/08/2020]

32This was the response of an empowered population, that is used to survive without the help of the state, autonomously and with a lot of creativity. They realized that, once again, there was no specific measure from the government that took into account their specific condition. Despite this performance, the favelas continue to stress the need for the state to be present. However, the state is slow to respond. On May 26, 2020, about 100 organizations signed a document that holds the federal government responsible for lack of protection and the consequent mortality and morbidity in the favelas (Observatório das Favelas, 2020).

3. Conclusion

33The socio-economic impact of the covid-19 crisis has been greater in Brazil than in any other emerging or developed region (IMF, 2020). In the second quarter of 2021, Brazil continues to be at the second place in terms of mortality rate, with strong economic and social consequences. It went from 9th world GDP in 2019 to 12th in 2020, despite the magnitude of the economic measures implemented by the Ministry of Economy.

34This article allows us to conclude that the prevention policy adopted in Brazil, following the guidance of WHO, was aimed at the middle class, who could wash their hands and adopt the “stay at home” recommendation of social isolation. The communication of these prevention measures on television channels and social networks also reached the majority of this same income group. The political crisis between the federal government and the governors was very harmful to the effectiveness of the adopted prevention. A prevention policy and its communication must be differentiated, taking into account the socioeconomic and geographical characteristics of these areas, such as the lack or limited access to sanitation, the cost of personal hygiene products, the type of employment (informal work, underemployment), jobs that are impossible to carry out from home and weaker employment ties, etc., among other vulnerabilities.

35The favelas of Rio de Janeiro have managed to mitigate the negative impacts of the pandemic, both in terms of health and in terms of income. They performed better than many other more privileged neighbourhoods of Rio. However, false optimism should not relax government action since the pandemic is taking root where civil society is less organized and less visible. In areas with strong community empowerment, like the favelas, a positive response could be expected for an emergency period but would lose its energy over very long periods. An emergency response cannot be expected to be lasting. Our recent research in the favela of Mangueira (Maimon Schiray, 2021) observed a decrease in donations, the use of masks, the mobilization of the population and even the return of the collective funky dancing.

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Notes

1 Humanitarian logistics (HL) is a set of plans and actions aimed at saving lives, displacing people and materials, promoting the flow of information and managing the acquisition, storage, transport and distribution of supplies to serve people affected by disasters, unpredictable events or complex situations.

Humanitarian Logistics has a different view than business logistics, which has a predictable demand. In HL, the demand occurs in an unpredictable way, generated by random events, unreliable information systems, prioritizing care for victims, leaving aside the lowest cost item and emphasizing the urgency to act in the shortest time (Matz, 2020).

2 There was earlier advice that wearing masks was not necessary for the general public.

3 Decision-making in environmental health policy is a complex procedure, even in well-known conditions. Thus, in the case of uncertainty, decision-making becomes a hurdle race as it combines both qualitative and quantitative uncertainty.

4 “Communication is at the heart of who we are as human beings. It is our way of exchanging information; it also signifies our symbolic capability… These two functions that communication serves an instrumental role (e.g. it helps one acquire knowledge) but it also fulfils a ritualistic function, one that reflects humans as members of a social community.” (Rimal & Lapiinsky, 2009, p. 247).

5 Opinion Box (2020), Impacto nos hábitos de compra e consumo, Belo Horizonte, Covid-19, 27th ed., p. 8. URL : http://materiais.opinionbox.com/pesquisa-coronavirus [accessed on 16/11/2020]

6 Designation of places such as slums, invasions and communities with at least 51 households, where most suffer from the lack or inadequacy of quality public services, in addition to being, in general, dense and disorderly (IBGE, 2010).

7 The IDS takes in account eight social indicators of 2010 Census: housing, education and income conditions.

8 Mortality rate is a measure of the frequency of occurrence of death in a defined population during a specified interval. It is calculated in relation to the total population. The lethality rate is the number of deaths in relation to the number of confirmed cases (Miranda et al., 2020). Lethality statistical measure may in certain cases not be entirely representative because of asymptomatic cases.

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Table des illustrations

Titre Figure 1. Participation of population in social isolation by state, 16 November 2020 (%)
Crédits Source: Dalia Maimon Schiray, based on Inloco, (2020), Mapa brasileiro da COVID-19. Índice de Isolamento Social. URL : https://mapabrasileirodacovid.inloco.com.br/​pt/​ [accessed on 16/08/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-1.png
Fichier image/png, 61k
Titre Figure 2. Deaths and confirmed cases in Rio de Janeiro favelas, 16 November 2020
Crédits Source: Dalia Maimon Schiray, based on Frente de Mobilização da Maré (2020), Painel #CoronaNasFavelas COVID-19 Maré, 2020. URL : https://datastudio.google.com/​u/​0/​reporting/​ceb26582-afc7-4357-b65f-3727c18b3d5a/​page/​rYxKB [accessed on 09 /08/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-2.png
Fichier image/png, 34k
Titre Figure 3. Incidence rate of covid-19 per 10,000 inhabitants according to the neighbourhoods of Rio de Janeiro distributed by concentration of slum areas
Crédits Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 20. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 20. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-3.png
Fichier image/png, 60k
Titre Figure 4. Incidence rate of covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)
Crédits Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 21. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 42. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-4.png
Fichier image/png, 62k
Titre Figure 5. Mortality rate of covid-19 per 10,000 inhabitants according to neighbourhoods in the municipality of Rio de Janeiro distributed by concentration of slum areas
Crédits Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 22. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 24. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-5.png
Fichier image/png, 48k
Titre Figure 6. Mortality rate per covid-19 per 10,000 inhabitants in neighbourhoods with a very high concentration of slums (i.e. slums covering more than 50% of the territory)
Crédits Source: Dalia Maimon Schiray, based on Fiocruz (2020a), Boletim socioepidemiológico da Covid-19 nas Favelas, no 1, p. 23. URL : http://www.ensp.fiocruz.br/​portal-ensp/​informe/​site/​arquivos/​anexos/​36c528bb42327a6fd1e4f53f98aa716524db35e9.PDF [accessed on 10/08/2020]; Fiocruz (2020b), Boletim socioepidemiológico da Covid-19 nas Favelas, no 2, p. 44. URL : https://portal.fiocruz.br/​sites/​portal.fiocruz.br/​files/​documentos/​boletim2_covid19_favelas.pdf [accessed on 16/11/2020]
URL http://journals.openedition.org/regulation/docannexe/image/19809/img-6.png
Fichier image/png, 86k
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Référence électronique

Dalia Maimon Schiray, « The covid-19 pandemic in vulnerable communities: the responses of Rio de Janeiro’s favelas », Revue de la régulation [En ligne], 29 | 2021, mis en ligne le 21 juillet 2021, consulté le 24 juillet 2021. URL : http://journals.openedition.org/regulation/19809 ; DOI : 10.4000/regulation.19809

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Auteur

Dalia Maimon Schiray

Full professor, Economic Institute of the Federal University of Rio de Janeiro, head of the Laboratory of social and environmental responsibility, Avenida Pasteur 250 – Urca, Rio de Janeiro – RJ 22290-250, Brazil; dalia@ie.ufrj.br

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