Welcome to hardtalk. Im stephen sackur. The global covid 19 pandemic has put a spotlight on the relationship between scientists and policy makers. Leaders across the world have responded to the science with everything from respect to scepticism, foremost amongst the sceptics president Jair Bolsonaro of brazil, one of the countries hit hardest by the virus. My guest, brazilian microbiologist natalia pasternak, has launched a crusade against her president in the name of science. Is she winning the argument . Natalia pasternak in sao paulo, welcome to hardtalk. Thank you, stephen, for having me. Its a pleasure to have you on the programme. Lets start with the claim from your president , Jair Bolsonaro, that the worst of the coronavirus epidemic in brazil is now over. Would you agree . Of course not. Were still in the middle of it. If were lucky. And the president seems to be completely disconnected from reality, really. Thats the way hes been behaving from the start. So, he has no real measure of the dangers and the gravity of this pandemic. You talk of the numbers. The numbers are horrible more than 116,000 brazilians dead as a result of coronavirus, well over 3. 5 million cases already. But if one looks across the region, across latin america, brazil is by no means alone here. Countries from peru to mexico have suffered very badly. And of course, brazils numbers are worse because its a bigger country. But this is a regional problem, not a brazil problem. I think it is a regional problem but brazil sets a terrible role model for its neighbouring countries, being the largest country in latin america. And of course, with a large population, the numbers can be masqueraded, too. So, weve got over 200 million people. If you look at the relative numbers, you may be under the impression that the numbers are not as grave as they really are. But if you have a look at the curve, you see that brazils numbers have been rising, and then they stabilised at about 1,000 people dead a day. Thats not a good number to be stabilised. You are a scientist, arent you, dr pasternak . Youre not a politician. And science knows no politics. Would you agree with that . Yes, science is usually very kept apart from politics, especially here in brazil, the Scientific Community has not. Doesnt have a habit of interfering in politics. We usually keep to ourselves and its not a very good attitude, really. We should be more involved in politics. Politics needs us. May i come back to the point that surely the power of science, that it doesnt wear political colours . And yet im just looking at things youve said in the last few weeks. As president , you say, bolsonaro bears personal responsibility. His behaviour is deplorable. He disgusts me. To have the worst possible leadership at this worst possible time as a scientist and citizen, ifind it so sad that the government has wrecked my country. Theres not a lot of science in there, but theres an awful lot of politics. There is, because im a scientist, but im also a citizen, and i see what the current government is doing to my country, especially because the federal government ignores science and ignores the Scientific Community. And it doesnt look to science for advice, as it should during a sanitary crisis, a health crisis. So, as a citizen, im disgusted, and im very sad to see what happens to my country. And as a scientist, ifeel ignored. And explain to me why you pin all of this all of your disgust, your anger onJair Bolsonaro when it is quite obvious brazil is a federal political system. Many of the key decisions on the nature of lockdown, social distancing rules, face masks, etc, theyre not taken in the president ial palace, theyre taken by the federal state. So, why pin all the blame on mr bolsonaro . Of course, the president is not to blame for everything thats happening. He didnt create the virus. He didnt spread the virus. Hes not to blame for the existence of the pandemic, but he is to blame for the lack of guidance and National Guidelines that could put us in a better place during this pandemic. We are lucky were a federation and the states have autonomy to make their own decisions. Thats what saved us. But the federal government has been ignoring science and Scientific Evidence and has not issued federal and National Guidelines to help the states get through this pandemic. In this sense, the federal government is to blame and president bolsonaro himself sets a terrible role model for the country, and confuses the population. But you have to be realistic, dont you . I notice you comparing brazil unfavourably with germany and new zealand. You said, if wed implemented a proper quarantine, as those countries did, we would have saved at least half of the 100,000 deaths. Wed be in the same place as them, with a near normal life. Are you seriously suggesting that brazil, with its population of more than 210 million, many of them living in poverty, can be directly compared with germany and new zealand . Of course not. And thats not what i meant. What i meant is that if we followed their role model, wed be in a much better place. But the point is, you couldnt. Its not possible in brazil. Its not possible to be exactly in the same place as more developed countries with better economies, thats for sure. But its possible to do a much better job than whats been actually done. Let me quote to you words from the Vice President just a week or so ago. He said, you have to understand the nature of brazilian people. They are not so very disciplined. Its impossible to tell them what to do, and this made it very much more difficult for us to fight the pandemic as they did in europe. Would you agree with that characterisation . I wouldnt put it that way. Of course, brazilians are not as organised. But to pin it down at the brazilian population and culture would be a mistake. We had a lot of misinformation coming directly from the federal government. The population is confused. Dont you agree that the population would be confused when it sees their president going out on the streets and shaking peoples hands and not wearing a mask and taking selfies with people, and saying that its just a minor flu and they have nothing to worry about . And, lets focus on the economy. It gets people confused. They dont know where to look, they dont know who to follow, they dont know who to listen to. Well, lets focus on the economy isnt necessarily an unreasonable thing to say, is it . Let me quote you a very strong bolsonaro supporter, congressman osmar terra, who said this. He happens to be a doctor, by the way. He said, lockdowns, as discussed in the strict sense, are only good for the middle class those who have fridges full of food and live with a regular income. But for those who are poor, who need to work in the morning to eat in the afternoon, well, they end up starving. They are much more concerned with their hunger than they are with the virus. Now, hes a politician. Hes not a scientist. But in that sense, theres a lot of wisdom in those words, isnt there . Theres a lot that we can take from those words. And thats. The part that is really true, its that, of course, the poor population has to be protected. It should be protected by the government. So, we should have pensions so that they can stay at home when its necessary. The other thing is that the wealthy population of brazil who could stay at home is currently going out to bars, restaurants and shopping malls. So, if the wealthy did stay at home so that the poor, the ones who had to go out on the streets and get Public Transportation and expose themselves to risk they would be more protected if the other part of the population, the ones who can stay at home, did stay at home, and they would be more protected if they had protection and pensions from the federal government so they can afford to stay at home when its really necessary. But you know, dr pasternak, that the governments made a great focus on its economic assistance policy for the poor. The poor in brazil are receiving at the moment roughly 110 or more us dollars a month in economic support to keep them going during this crisis. And it is quite obvious from all of the opinion poll evidence that the majority of people in brazil feel grateful for that economic assistance. And its notjust for their economic wellbeing, its also for their health wellbeing. Dont you, even as a doctor and a scientist, recognise the importance of that . I recognise the importance of that, but it doesnt get to all people as it should. We have a lot of bureaucracy. Its difficult to get the pension. And about the Health Care System yes, we are very proud in brazil to have a national Health Care System that caters to 200 million people, but its overwhelmed, with long lines. It didnt collapse, and thats a good thing, but still its overwhelmed and crowded. So, its been difficult to really cater and bring Health Service to all these people. But i guess theres a deeper question here of exactly where you focus your attentions as a scientist. I note that long before coronavirus hit brazil, youd established an institute, the question of science institute, to make science more central to the public debate in brazil, particularly to policymaking decisions. It seems to me that if youre going to make that work, you have to consider, as a scientist, the impact of economic damage done by coronavirus. Rather than just sticking to your assessment of how many lives could have been saved if lockdown and quarantine had been organised more efficiently, in your view, surely you need to analyse the data which says if people cant go to work, many of them are going to suffer Massive Health and wellbeing problems in the longer term . Of course, stephen. It has to be taken into account as well. But as far as i know, dead people pay no taxes and dont go to work. So, its a balance, and this balance has to be very well studied. And we have to. We have to get this balance to be. To give ourfederal government. With respect, i dont see any balance. I dont see any balance in your analysis, because you do all these media interviews across brazil. Youve become a very famous name in brazil in the course of the pandemic. But i dont see any analysis where youre putting any sort of data together on how many lives might have been lost had the economy gone into a much deeper freefall than its already in. Bolsonaros point is that he wanted to ease the restrictions early, to save lives. But you havent run any numbers on whether there may be some merit to that argument. Well, because for me, health and lives come first, and the economy is going to be. The economys going to suffer anyway. The economy is suffering because of the pandemic, not because of the lockdowns. So this is what has to be ta ken into account. We have to protect Peoples Health and peoples lives. And the economy, of course, is going to suffer anyway. And that is. This is why we need a Multidisciplinary Team to handle the situation. And this is what i have been actually saying in all my interviews, that this has to be taken in to a Multidisciplinary Team, with both Health Workers and doctors and economists, so that we can tackle the situation together. It doesnt have to be one extreme or the other. Do you think scientists who present a united front on some of the core issues, for example, you personally have expressed your displeasure with Jair Bolsonaro pushing the claims of hydroxychloroquine as an effective treatment for coronavirus. But im looking at quotes here from other leading doctors in brazil who are claiming that there is some evidence that hydroxychloroquine can play an effective role. The science in your country doesnt seem united or coherent on this. Theres a small part of scientists, and especially doctors in brazil, who support hydroxychloroquine. I think this comes from a failure in our medical education, in our medical schools, that dont really teach scientific method. So there are lots of doctors who rely on what we call anecdotal evidence. So its case reports and people that think that chloroquine works because they see it working and they dont really rely on randomised clinical trials, which are the best medical evidence that we should rely on. But i think theres enough Scientific Consensus in the world right now that hydroxychloroquine is not an effective treatment for covid 19. And this is what we should be following here in brazil. But isnt that one of the features of brazilian public life, that a lot of brazilians dont like to be lectured to from the outside . They want things to be handled by their own people inside the country. Theyre very proud. So when doctors like ricardo azevedo, a rheumatologist and professor at the federal university of rio, says that, quite simply, i think hydroxychloroquine can play an important therapeutic role, we have evidence the medication decreases the entry of the virus into cells. Brazilians are inclined to listen to that. Well, in a way, yes. On the other way, if brazilians look to their scientific, medical, scientific and medical societies, they will see that the virology society, the brazilian virology society, brazil infectology society, brazilian epidemiology society. Most brazilian scientific and medical societies have already issued statements saying that Scientific Consensus says that hydroxychloroquine doesnt work for covid 19 and it shouldnt be used as a treatment. So we have a national Scientific Consensus here in brazil that agrees with the international Scientific Consensus that hydroxychloroquine shouldnt be a treatment for covid 19. If there are isolated doctors that disagree, they are isolated, they are not part of this national Scientific Consensus. Well, you talk a lot about consensus. And i want to bring it back to brazils collective mood at the moment. It seems to me, given what we discussed earlier about your expressions of anger and disgust at mr bolsonaro, that you would like the brazilian public to bejust as angry and disgusted as you. But the truth is, if one looks at the latest opinion polls in your country, quite the reverse is true. In the last few weeks, weve seen bolsonaros popularity rising. How do you explain that . Unfortunately, people are fed up with being at home. And of course, people dont like being told what to do. And i think part of it is our failure as communicators and as science communicators to really communicate to the brazilian population about the reality, about whats actually happening in brazil, about the gravity of the situation. And when you mentioned, stephen, that im angry, yes, i am angry because lots of people are dying. And most of the stats, at least half of them, probably could have been prevented by more effective measures. So i have reason to be angry. And, yes, i would like the population of brazil not to be angry or disgusted, but at least to be well informed. Well, whos to say theyre not well informed, but maybe they re making decisions and using a perspective that isnt your own . And actually, this is almost a philosophical question about the interface between science, culture and politics. And im very mindful of something that was said to me on this show by a compatriot of yours, the former Health Minister luiz mandetta, who, of course, was famously fired by mr bolsonaro because they disagreed over lockdown measures. But mr mandetta came on this show and he said, you know, in the end, bolsonaro made his choice. He decided that he was going to prioritise the economy. Yes, it brought him into collision with me as minister of health. But it is, ultimately, his right, because hes in charge. He was elected. We have more elections, in a couple of years, for the presidency. And people will then get their chance to judge whether he got it right or not. Thats democracy. And for right now, your president is legitimate. He has a mandate, and he is doing what he is elected to do, lead the country. I agree he was democratically elected and i agree that he has the privilege, including firing ministers that dont agree with him, but firing people for not agreeing with him and for ignoring, and ignoring Scientific Evidence in the midst of a health crisis, doesnt seem as democratic, to me, as it should. So the president was elected, yes, but that doesnt mean that he behaves in a democratic way during his mandate. And of course, its the privilege of the resident population to. To challenge that, if they feel its warranted. Right now, he still has the support of 37 of the population. But that means that more than half of brazilian population doesnt support him. So i think he. He. Well, hes protected, of course, by the democratic regime. He has been elected. And we as a population have also the right to ask that he does the right thing, that he leads the country in an effective measure, with effective measures during the pandemic. Right. Seems to me, one huge challenge is looming for you in brazil, and particularly for you as a leading scientist arguing for the power and importance of science in the policymaking debate. And that challenge is the vaccine. If one looks at the polling evidence inside brazil, a survey from the association of immunisation in your country reported 60 of the population currently believe that vaccines, of many different kinds, are totally unsafe. So the implication of that is that even if the International Community comes up with what appears to be an effective vaccine, many in brazil will choose not to take it. I disagree, stephen, i dont know where you get that data from. But the data that i have from the National Polling service here, which is a very reliable polling service, says that 89 of brazilian population would agree to get a covid 19 shot as soon as its ready. So. The 59 figure i was referring to, about people doubting vaccines, actually comes from the Brazilian Association of immunisation, in a survey last year. Well, its news to me. The data that i have is very encouraging, really, from this polling service here in brazil, and it says that 89 of the interviewees would agree to get a covid 19 shot as soon as its ready. So people in brazil are usually very favourable to vaccines. We have very strong vaccination programmes here in brazil. So the anti vax movement is not very strong here yet. Not that we shouldnt worry about it. But usually brazilian population is very favourable to vaccines. Before we close, ijust want this big thought from you. You campaign against all sorts of things, the prevalence of alternative medicines and therapies, which you say are damaging and counterproductive to Overall Health care in brazil. Youre clearly worried about the way in which the current government handles data, scientific advice and expertise across a range of subjects. We could go even as far as Climate Change and deforestation. But ultimately, you said to me, the problem is we have a communications challenge. We are not reaching the brazilian public, or at least many of them. So how do you tackle that . How do you improve your communication . Well, i have been trying to, thats why i launched the institute, question of science, last year. And so one of the aims, one of the goals of my institute is to communicate better with the public, and bring science into their daily lives, so that they realise that science is important for Decision Making in their own daily lives, or for policy making. And i think its improving slowly in brazil. But people are becoming aware that science communication plays a major role in building these bridges among the academy, and society and government. So i think, in time, well be able to build a bridge, really, and be able to communicate science to the people and to the government. Really . So that they realise that science is an ally. Well, i think it probably is fair to say that right now in brazil, youre living through an age of populism. You think you can get that message across, you can have science in the ascendant in this age of populism . Its a challenge and its going to be difficult. But i think we must try, especially because science is being so politicised, not only in brazil, but across the world, during the pandemic. So i think now is the time that we really have to strive for science to be understood, and to be taken into account both by the population and by governments. All right. Well, natalia pasternak, i thank you very much indeed forjoining me on hardtalk from sao paulo. Thank you very much. Thank you, stephen. Hello. So, wednesday was a pretty decent day for many parts, but that was wednesday. And now thursday has a different look to it because low pressure is increasingly dominant. After a bright enough start in the east, the cloud piles in from the atlantic. And before too long, i think it will be thick enough for some rain to get in through the north of wales, the north of england, into central and southern scotland, through Northern Ireland, too, in places. And later in the day, will bring some really quite heavy showers and some longer spells of rain through wales and the south west of england on a day where we might make 20 in the drier spots in east anglia. I say drier until later in the day when you, too, mayjust pick up on some heavy bursts of rain there. And all the while, the rain just fizzles away across the heart of scotland. Now, having brought that area of low pressure in on thursday, its still around on friday, and the isobars quite tightly packed on its western flank. So, its a spell of pretty wet and windy weather. Less so perhaps again for the far north of scotland, Northern Ireland drier, too. But the rain in the north of england quite persistent, the showers in the south really quite heavy, quite a lot of them and they may have a rumble of thunder about them. And again, really disappointing temperatures for the time of year. And surprisingly, as i talk about the weekend, im talking about quite a lot of dry weather. It will be on the cool side both by day and by night, and the winds will eventually ease. What winds, you say . Well, the low pressures not a million miles away and the High Pressures trying to build in, so the squeeze comes on, the isobars pack together and they re coming from a cool direction. The wind running along them from north to south, never a warm direction, even at this time of year. And youve got the overhang of cloud to contend with through east anglia and the south east with a wee bit of rain for the first part of the day. And thats the gustiness and the nature of the wind from the north, so you can imagine its not going to be the warmest of the day despite the fact that many areas will be dry and really quite bright. But look at that, a max of only 18. Thats below par for sure. And having reached those lofty heights, itll be quite a cool night because the High Pressure topples in, the skies begin to clear, the winds fall lighter and we end up with temperatures well down into single figures well across the country. And then sunday is a really decent day if you want to get out and about because theres a lot of dry weather. There wont be much in the way of breeze, so youll feel every bit of 16, 17 or 18. This is bbc news im mike embley. 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