The death toll from COVID-19 in Brazil has surpassed 250,000, making the country the second-largest coronavirus-related death toll in the world, AP reported.

From the start of the pandemic, Brazilian President Jair Bolsonaro called the virus a flu and criticized local leaders for imposing restrictions.

“Brazil simply didn’t have a response plan. We’ve been through this for the last year and still we don’t have a clear plan, a national plan,” Miguel Lago, executive director of Brazil’s Institute for Health Policy Studies, which advises public health officials, told the Associated Press. “There’s no plan, at all. And the same applies to vaccination.”

At least 12 Brazilian states are in the midst of a second wave, even more serious than the one they faced in 2020, said epidemiologist Domingos Alves, who tracks COVID-19 data.

“This scenario is going to get worse,” Alves told the AP.

Alves and other public health experts said the spread of the disease was exacerbated by the authorities' reluctance to follow the recommendations of international health organizations to impose stricter restrictions.