INTRODUCTION – We analysed the 2014–16 Brazilian recession and found that recession-related increases in unemployment were associated with increases in mortality. This statement is often cited to argue against stay-at-home orders in Brazil. However, our findings are not that informative in the COVID-19 context because pandemic recessions are substantially different in impact and duration than traditional recessions. Whereas we examined the effects of recession on health, the causality is reversed during the pandemic where health is determining economic productivity. Indeed, evidence from the USA suggest health concerns, rather than official stay-at-home policies, drove reductions in consumer spending and economic contraction. Furthermore, in our study, we found that unemployment-associated mortality only increased where local health and welfare systems were weak and underfunded—a statement less frequently reported but in line with evidence from Europe. If strong health and welfare systems are key in protecting individuals from negative recession health impacts, then the argument should focus on promoting these services instead.

The solutions to addressing the COVID-19 pandemic are complex and multifaceted requiring careful and informed policy decisions to balance economic, social, and health priorities. We do not doubt that economic recessions will have profound health consequences, but distilling arguments into simple trade-offs is unhelpful. Evidence points to the importance in investing in health and welfare systems to protect both health and the economy, yet further polarising debates with misuse of evidence will only hamper effective pandemic responses in a desperate Brazil.

Leia o artigo, na íntegra, em inglês, no site da revista acadêmica The Lancet