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Less than a month after Health Minister Luiz Henrique Mandetta was sacked by President Jair Bolsonaro, his successor, Nelson Teich, resigned from his post, citing an “incompatibility” with Bolsonaro’s approach to combatting the coronavirus outbreak that has made Brazil a new epicenter for the virus.

Bolsonaro repeatedly disagreed with the now-former Health Minister Luiz Henrique Mandetta over the need for social distancing and said that only at-risk individuals, such as the elderly and those with pre-existing health problems, should be quarantined, while the rest should be “put to work”. These disagreements led to Bolsonaro sacking Mandetta, saying, “Mandetta’s vision was that of health, of life. Mine is more than life, it includes the economy and jobs.”

Teich, a 62-year-old oncologist, came on board on April 17, one day after Mandetta was fired. When he took over Mandetta’s position, Teich promised “total alignment” with the President. However, the same issues that plagued Mandetta’s tenure as Health Minister soon led to Teich’s downfall as well.

It soon became apparent that under Bolsonaro, the tag of Health Minister is simply symbolic. For example, Teich was not consulted and was surprised when Bolsonaro deemed salons beauty salons and gyms “essential services” last week.

In addition, Teich also disagreed with Bolsonaro’s affinity for chloroquine as a treatment for the coronavirus, despite concerns over its safety and efficacy. In April, both Facebook and Twitter removed a video in which Bolsonaro endorsed an unproven antiviral drug, chloroquine phosphate, which can have dire health consequences, including death. In the video, he also spoke of the efficacy of hydroxychloroquine sulfate, an anti-malarial drug, which has not yet been significantly tested. Despite the deletion of the videos, Bolsonaro has continued to endorse the unproven drugs.

This is akin to US President Donald Trump, who has repeatedly extolled the potential benefits of chloroquine during televised briefings. In April, taking Trump’s advice to heart, an Arizona man died after ingesting it. His wife, too, fell extremely ill. It was revealed that they had not bought the pharmaceutical version of chloroquine phosphate; rather, they ingested an additive used to kill parasites in fish tanks and treat fish diseases. This week, Trump confirmed that he has been taking hydroxychloroquine for over a week, even though it still hasn’t been confirmed as an effective treatment for the coronavirus. In the past, he has also questioned whether injecting disinfectant into the body could guard against the virus.

The repeated efforts of Bolsonaro and Trump to undermine the work and advice of medical experts pose potentially disastrous consequences at a time when anxious and fearful populations may look to their leader for advice, support, and guidance. To compound these problems further, Bolsonaro has also participated in three anti-lockdown protests.

In the past, Bolsonaro has called the coronavirus a “little flu”, said that media and politicians are blowing the issue out of proportion, and that strict quarantine and lockdown measures threaten the safety of Brazil’s economy and democracy. His flippant disregard for both the virus and Brazilian citizens was most apparent when he said “So what?” after a reporter presented him with statistics about the soaring number of coronavirus deaths.

Aside from his prioritization of economic concerns over medical needs, he has also openly flouted medical advice. For example, in March, he refused his medical team’s advice to self-isolate after several members of his delegation to Florida, who met with Trump, tested positive for the coronavirus. Rather, he was seen at a rally, “shaking hands, bumping fists, and slapping […] backs”.

Hence, Brazil’s governors and mayors have had to take matters into their own hands and implement states of emergency and lockdowns by themselves. In return, Bolsonaro has called them “job killers” and ‘criminals’.

However, unlike governors and mayors, Mandetta and Teich did not have the authority to act independently of Bolsonaro. Consequently, they were left with just two choices: speak out and risk being sacked like Mandetta, or refuse to be seen as complicit in the administration’s failures and resign like Teich. With over 254,220 confirmed COVID-19 cases, Brazil now has the third most infections across the globe, second only to the US and Russia. It has recorded over 17,000 deaths. Given that Brazil is conducting less than 3,500 tests per million people, medical experts suggest that the true case count and the death toll could be twelve to fifteen times higher than what is being reported.