The Brazilian health minister, Eduardo Pazuello, is set to be sacked after an inglorious 10-month tenure during which more than 260,000 Brazilians have been killed by a coronavirus outbreak that his government stands accused of catastrophically mismanaging.

When the far-right president, Jair Bolsonaro, named the army general his interim health minister on 16 May last year, nearly 15,000 Brazilians had died of Covid-19. Ten months later, the death toll has risen to almost 280,000 and South America’s largest nation has been thrust into the most deadly chapter of its epidemic.

Pazuello, whose dismal performance earned him the nickname Pesadello (Nightmare), was Bolsonaro’s third health minister of the crisis, after two predecessors walked out over disagreements about the president’s stance towards Covid-19. From the outset, Bolsonaro has trivialized the disease, which both he and Pazuello caught, as a “little flu” and torpedoed efforts to contain it through social distancing, lockdowns or mass vaccination.

Pazuello, a 58-year-old with no public health background, had made clear that the person calling the shots in the health ministry was Bolsonaro, not him. “It’s simple: one gives the orders and the other obeys,” he said of his relationship with the president last October after Bolsonaro after overruled his attempt to buy 46m shots of the Chinese-produced vaccine CoronaVac.

Even so, it is Pazuello who now faces the most immediate risk of sanctions over his response to the health emergency. Earlier this year he was placed under investigation over his possible role in failing to prevent a calamitous health service collapse in the Amazon city of Manaus where hospitals ran out of oxygen for patients.

Few believe Pazuello’s departure will herald a dramatic shift in the government’s behaviour towards what is widely considered the worst pubic health crisis in Brazilian history. Ludhmila Hajjar, a respected cardiologist who was reportedly offered the job by Bolsonaro, claimed she had turned the opportunity down because she believed in science.

“The outlook looks really bleak. [If nothing changes] Brazil is going to hit 500,000 or 600,000 deaths,” Hajjar warned in a television interview after rejecting Bolsonaro’s offer. During a meeting the previous day, Bolsonaro was reported to have asked Hajjar: “You’re not going to fuck me by locking down the north-east and losing me the [presidential] election, are you?”

Reports on Monday night claimed Bolsonaro would appoint another cardiologist called Marcelo Queiroga the following day.

Bolsonaro told supporters outside the presidential residence on Tuesday: “The way I see things, he’s got all you need to do a good job, giving continuity to everything Pazuello has done so far.”

He claimed the new minister would signal a new “aggressive” stance towards the epidemic.

Writing in the Folha de São Paulo newspaper on Monday, the political columnist Ricardo Melo said: “Clearly, Doctor Nightmare … is good for nothing but filling up cemeteries … [But] the only way to avoid more Covid deaths … is to remove Bolsonaro from power.”

Brazil’s former health minister José Gomes Temporão said: “The problem isn’t the health minister – the big problem right now is the president himself.”

“The truth is that the president is the health minister … he’s the one who chose to do battle with science and with World Health Organization guidelines … So for anything to change the president would need to change his view of the disease, of science, of this false dichotomy between the economy and public health,” Temporão added.

Temporão said he believed political pressure was now the only thing that might force Bolsonaro to change tack, particularly from former president Luiz Inácio Lula da Silva. Lula roared back onto the political scene last week after his political rights were restored by a supreme court judge and used his comeback speech to berate Bolsonaro’s “moronic” and inept response to the tragedy.

“Lula showed that the emperor had no clothes,” Temporão said.

This content first appear on the guardian

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