Reports from the frontline: health workers describe COVID-19 risks and fears in five cities in Brazil

Background: Health providers are under unprecedented pressures to perform in the COVID-19 health crisis and under unprecedented risks. We initiated a large survey of health professionals in five large metropolitan areas in Brazil to document the needs of health professionals. To initiate that study, we conducted formative research. Methods: : We conducted 77 rapid ethnographic assessment interviews on-line in a convenience sample of physicians, nurses, nurse technicians, and physiotherapists in Belem, Fortaleza, Porto Alegre, Recife and São Paulo, Brazil. Results: : Responses are organized into three themes: the lack of preparation for the pandemic and effects on staffing and training; the overlap of personal, family, and professional risk and consequences; and inadequately addressed anxiety and suffering among health staff. Conclusions: : Our respondents were unprepared for the epidemic, especially the institutional sequelae and psychological cost. These consequences were exacerbated by the ongoing failure of political and health leadership that is undercutting the Brazilian health system.