Brazil has lost two health ministers in the past six weeks – one was fired, the other resigned – after they disagreed publicly with Bolsonaro over how best to combat the virus.

They described a response that began promisingly, but which was soon hobbled by the president’s clashes with Health Ministry and cabinet officials who could not persuade him that Brazil’s economic fortunes ultimately hinged on how effectively it tackled its public health emergency.

But the people who spoke with Reuters said things began to unravel along two main fronts: Bolsonaro’s opposition to shutdown measures favoured by the Health Ministry and the government’s inability to scale up testing quickly.

A Guedes ally, Solange Vieira, who was involved in the government’s landmark pension reform last year, likewise showed little urgency when presented with forecasts in mid-March from the Health Ministry, according to epidemiologist Croda.

Shortly after the new guidelines were issued on March 13, Croda said he got a call from his former boss, Health Surveillance Secretary Wanderson Oliveira, who said he was “under lots of pressure from Casa Civil and had to change the communique” published by the ministry outlining the measures.