A woman is seen after receiving a dose of the COVID-19 vaccine at a vaccination center on Cangulo square, Saracuruna neighbourhood, in Duque de Caxias, Rio de Janeiro state, Brazil, on March 30, 2021. (PHOTO / AFP)

A sharp surge in COVID-19 cases brings the prospect that Brazil will have the most infections and deaths in the pandemic worldwide, deepening the challenges for the country's reshuffled government.

A particular concern is the P.1 strain of the novel coronavirus, which is spreading rapidly in the largest and most populous country in Latin America, experts said.

Against this backdrop, Brazil has had four health ministers since the pandemic started, and on Monday, the ministers of foreign relations and defense resigned.

Since the beginning of the year, cases among people aged 30 to 59 have gone up more than 600 percent and the number of deaths tripled. As of March 29, Brazil was recording more than 100,000 new cases per day and the seven-day average of deaths had risen to 2,595.

The total death toll was set to top 314,000 with the P.1 strain, already linked to 3,650 deaths, spreading rapidly. Hospitals are overflowing.

Since the beginning of the year, cases among people aged 30 to 59 have gone up more than 600 percent and the number of deaths tripled. As of March 29, Brazil was recording more than 100,000 new cases per day and the seven-day average of deaths had risen to 2,595

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 “Unfortunately, people have become immune to the numbers. Hundreds dying per day was terrible, a thousand dying per day was of great concern, but several thousand dying per day has become old news,” said William Magnusson, a researcher based in Manaus.

Manaus, some 2,000 kilometers away from the federal capital city Brasilia, is in the heart of the Amazon jungle. The P.1 strain was first identified there on Jan 12.

The strain spread rapidly throughout cities and towns in the rainforest, prompting Brazil’s neighbors to close their borders.

“The P.1 strain was identified in at least 70 percent of the cases in Sao Paulo and in Rio Grande do Sul, the state (that borders) Uruguay,” said Jorge Kalil, a professor of clinical immunology and allergy at the University of Sao Paulo.

With restrictions widely flaunted, it will be difficult for the country to slow down the virus.

With case numbers rising daily, Brazil has topped 12.5 million infections and pressure is mounting on the government to take more effective measures to curb the pandemic.

Marcelo Brisolla, a Rio de Janeiro-based lawyer and a consultant for the life sciences sector, said Brazil is passing through “the worst moment of the pandemic”.

Hugo Nogueira, an international relations analyst based in the city of Belo Horizonte, noted that Brazil’s president, Jair Bolsonaro, has moved away from his long-standing denial and has begun acknowledging the pandemic.

Bolsonaro, who was once himself infected by the SARS-Cov-2 virus, said in mid-January that he would refuse a COVID-19 vaccine shot, but has seemingly changed his stance recently, approving measures aimed at speeding up purchases of vaccines.

“It is a change of posture, but we still need him to change his posture even more to get the country out of this crisis,” Nogueira said.

Protesters were out in full force on March 24, banging pots and pans throughout Brazil, in protest of the federal government’s approach to the pandemic and the slow progress in the nation’s vaccination campaign.

Some, like Eugenio Aragao, a former minister of justice, are not sure how far the change of posture will go.

“Brazil is perhaps the only country where you do not have any central governmental action in regard to the pandemic. Even vaccines have to be purchased by local governments, which complicates things enormously,” he explained.

Brazil has had four different health ministers since the pandemic started and, on March 29, the ministers of foreign relations and defense resigned.

The resignations prompted a sweeping cabinet reshuffle that saw Bolsonaro replace six of his ministers.

Following the reshuffle of the cabinet, the chiefs of the armed forces also resigned on March 30, landing Bolsonaro into a big political crisis.

Complicating the country’s response have been shortages of various medical supplies, including ventilators and drugs to keep patients intubated, and even bottles of oxygen.

Brazil started its vaccination campaign against SARS-CoV-2 on Jan 17, with a batch of more than 10 million vaccine doses sourced by Sao Paulo state from China’s Sinovac Biotech. The vaccines are being finished and packaged in the state by the Butantan Institute, a Sao Paulo-based biologic research center that has a partnership with Sinovac.

Brazil's healthcare regulator, Anvisa, has also approved the emergency use of Comirnaty, developed by Pfizer and BioNtech, but that vaccine is yet to arrive in the country

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“Together with the Butantan Institute, the state of Sao Paulo entered into an unprecedented partnership with the Chinese pharmaceutical company Sinovac Biotech for the production and testing of the coronavirus vaccine,” said Brisolla.

While the state of Sao Paulo is counting on Sinovac’s CoronaVac jabs, the federal government has also sourced and is distributing the AZD-1222 vaccine developed by AstraZeneca and the University of Oxford.

Brazil's healthcare regulator, Anvisa, has also approved the emergency use of Comirnaty, developed by Pfizer and BioNtech, but that vaccine is yet to arrive in the country.

As of now, just 2.1 percent of Brazilians have received two vaccine shots, and just over 20 million people — out of a population of 209 million — have received one shot.

“We are starting to get closer to vaccinating 1 million Brazilians per day. We are (now) close to 750,000 per day. Ideally, we would need 1.5 million people vaccinated each day, which (could help) Brazil to curb the pandemic within five to six months,” said Benny Spiewak, a lawyer and life sciences consultant based in Sao Paulo.

The writer is a freelance journalist for China Daily.