By MAURICIO SAVARESE (Associated Press)

SAO PAULO (AP) — Brazil’s Federal Police have accused former President Jair Bolsonaro of criminal association and falsifying his own COVID-19 vaccination data, marking the first indictment for the embattled far-right leader with others potentially in store.

The Supreme Court released the police’s indictment on Tuesday that alleges Bolsonaro and 16 others inserted false information into the public health database to make it appear as though the then-president, his 12-year-old daughter and several others in his circle had received the COVID-19 vaccine.

During the pandemic, Bolsonaro was one of the few world leaders railing against the vaccine, openly flouting health restrictions and encouraging society to follow his example. His administration ignored several emails from pharmaceutical company Pfizer offering to sell Brazil tens of millions of shots in 2020 and openly criticized a move by Sao Paulo state’s then-Gov. João Doria to buy vaccines from Chinese company Sinovac when no jabs were otherwise available.

Brazil’s prosecutor-general’s office will have the final say on whether to use the police indictment to file charges against Bolsonaro at the Supreme Court. It stems from one of several investigations targeting Bolsonaro, who governed between 2019 and 2022.

Bolsonaro’s lawyer did not immediately respond to a request for comment from The Associated Press. The former president denied any wrongdoing during questioning in May 2023.

Police accuse Bolsonaro and his aides of tampering with the health ministry’s database shortly before he traveled to the U.S. in December 2022, two months after he lost his reelection bid to Luiz Inácio Lula da Silva.

Bolsonaro needed a certificate of vaccination to enter the U.S., where he remained for the final days of his term and the first months of Lula’s term.

If convicted for falsifying health data, the 68-year-old politician could spend up to 12 years behind bars, and as little as two years, according to legal analyst Zilan Costa. The maximum jail time for a charge of criminal association is four years, he said.

Bolsonaro retains staunch allegiance among his base, as shown by an outpouring of support last month with an estimated 185,000 people clogging Sao Paulo’s main boulevard to decry what they — and the former president — characterize as political persecution.

Brazil’s top electoral court has already ruled Bolsonaro ineligible until 2030, on the grounds that he abused his power during the 2022 campaign and cast unfounded doubts on the country’s electronic voting system.

Other investigations include one seeking to determine whether Bolsonaro tried to sneak two sets of expensive diamond jewelry into Brazil and prevent them from being incorporated into the presidency’s public collection. Another relates to his alleged involvement in the Jan. 8, 2023 uprising in capital Brasilia, soon after Lula took power, that resembled the Capitol riot in Washington two years prior. He has denied wrongdoing in both cases.

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The Flores siblings were supposed to leave their small Texas border town and make films together.

Robie Flores, a self-described “awkward Tejana” teen who just wanted to “get the fuck out” of Eagle Pass to reinvent herself, had dreams of making movies with her brothers, Paco, Alex, and Marcelo. 

But their dreams were crushed when Marcelo, who went by Mars, died in 2015 during a family trip in Acapulco, Mexico. He had recently graduated from the University of Texas at Austin’s Radio-Television-Film program and was only 23.

In the wake of her brother’s death, Flores returned home and reexamined her hometown through new eyes. This reappraisal is the basis of her new film, The In Between, an 82-minute feature documentary that premiered at South by Southwest (SXSW) in Austin on March 9. Using a combination of old footage recovered from Mars’ hard drives along with fresh film recorded by siblings in the wake of his death, The In Between serves as an homage to Mars’ memory, the culture of South Texas, and the Mexican-American youth who grow up there.

The film begins with a man and child on a hike-and-bike trail in Piedras Negras, across the Rio Grande from Eagle Pass, looking across the river at Shelby Park on the U.S. side, where Eagle Pass is hosting a festival. The camera pans to the international bridge, connecting the sister cities, and Flores introduces herself and her relationship to la frontera. 

“I must have crossed this bridge a million times,” she recalled. “But the first time I remember was when I was five. That was when my brothers, the twins Mars and Alex, were born.”

Her parents had crossed to the Mexican side of the bridge the day before the twins were born, Flores continued, because the hospitals were better.

The In Between explores both the magical and the mundane aspects of border life: kayaking on the Rio Grande, Texas football and Friday Night Lights with team chants in Spanish, young girls dancing and dressed up in Selena’s iconic sparkly purple jumpsuit, teenagers dancing at quinceañeras, stands of nopales, and coyotes crossing the street. The kids on the border code-switch mid-conversation, and language serves as a tool for exploring identity and culture in Flores’ depiction of Eagle Pass. “¡Ya estás todo gringo!”, one young woman tells a little boy, who responded in English when spoken to in Spanish. In Flores’ version of the border, being too Americanized was considered embarrassing. When they were kids, her brothers “didn’t get the memo that it was way cooler to be Mexican,” Flores recalls.

The movie is also an exploration of universal human experiences, like grief and gratitude. Scenes from Flores’ late brother’s hard drives are interwoven with moments captured on film after his death, stitching together elements of the coming-of-age of Eagle Pass’ youth, then and now. In this film, there is no grandiose plot ending to spoil. Bearing witness to the cyclical journey itself is one of the points of watching the film. 

In grief, Flores grasps for lessons. “APPRECIATE everything. Welcome the good. Welcome the ‘bad’,” her late brother Mars had scribbled out in a diary, which she held onto for years after his death before reading it. As she films her hometown and explores Mars’ old footage, Flores shares both her profound sense of loss and, at other times, gratitude. She learns something new with Mars again by studying moments he had previously captured. After Mars’ death, Flores began to document everything compulsively with her camera—which she contrasts with her brother’s approach.

In Flores’ Eagle Pass, the river (and the border) is not a geographical divide.

“Maybe it was never about memory for Mars,” Flores wonders out loud. “Maybe it was about being present and helping look at life more intently. I’ll never know.”

As the film nears its closing scene, we see intimate familial moments before Mars’ death: the twins’ birthday and old footage of Mars and Alex at a football stadium, donning burnt-orange letterman jackets with “Flores twins” emblazoned on the backs.

The In Between paints a portrait of Eagle Pass and Piedras Negras through the eyes of those who have loved and lost there. It is a love letter to la frontera—to the people of these sister cities straddling the U.S.-Mexico divide. The movie’s depiction of the border offers a real look at the community that calls the place their home.

Last month, I visited Eagle Pass for a story. When I was in town, vigilantes and nativists roamed the streets and dined in the town café, jeering at local activists. Shelby Park was closed off to the general public, and the U.S. side of the border was lined with shipping containers, concertina wire, and a nearly hundred person show-of-force shield of National Guard soldiers, ready for Governor Greg Abbott’s photo op. The town had been flooded with militarization, law enforcement personnel, border theater politics, and anti-immigrant narratives. 

Two Eagle Pass teenagers after their high school graduation Courtesy/The In Between

Flores’ film takes its audience to the real Eagle Pass—not the one with concertina wire but the unimpeded, publicly accessible Shelby Park. Flores and her brother Alex giggle and capture their community verité-style, with families singing during backyard cookouts and fishing in the Rio Grande. In Flores’ Eagle Pass, the river (and the border) is not a geographical divide that signals danger but a “magical portal”—and a character unto itself that brings communities on both sides together. 

In these times of manufactured paranoia about border security, we need fewer right-wing pundits who don’t know anything about life on the border, and more art like Flores’ film. 

A few years ago, researchers made the unnerving discovery that in the brains of people with Alzheimer’s disease, disordered clumps of abnormal proteins had been growing for 15 or even 20 years before their diagnosis. That means these pathological-looking deposits are silently accumulating in the brains of millions of seemingly healthy individuals in their 50s and 60s.

Recently, scientists have found that a blood test can detect that silent damage with surprising accuracy. About 13% of people ages 75-84 have Alzheimer’s disease, which means a substantial fraction of younger people ought to test positive. But are we better off knowing?

There are few Alzheimer’s drugs for people with symptoms — and nothing for presymptomatic people. The leading drugs are expensive antibody infusions that clear out most of the visible deposits, called amyloid, but don’t slow the degeneration of neurons. These have shown only a modest ability to stall the disease’s progression. Nothing can reverse its course.

The blood test that’s causing all the excitement measures levels of a protein called p-Tau 217. A study published this month in Nature Medicine and another published in January in the Journal of the American Medical Association showed that this test works as well as other Alzheimer’s diagnostics — PET scans and cerebrospinal fluid sampling following a lumbar puncture. That means it’s likely not just a predictor of risk, but an indicator that something is already wrong in your brain.

Some doctors envision Alzheimer’s tests becoming as routine as a cholesterol workup — though of course, the results are likely to be far more terrifying and, for now, dramatically less actionable.

The test works so well because “It really reflects the core pathology of Alzheimer’s disease,” said Henrik Zetterberg, a professor of neurochemistry at the University of Gothenburg in Sweden. The disease can start when a protein called beta amyloid collects outside of neurons, but that alone won’t necessarily cause impairment — so tests for beta amyloid are not very predictive.

The progression to true Alzheimer’s begins when changes happen within the neurons, including another protein buildup called tau tangles. At that stage, neurons start to shrink back, and in the process, produce a modified protein — p-tau 217.

But it’s not clear what people can do with the knowledge that they have elevated p-tau 217. Scott Small, a neurologist at Columbia University, said that the question recently came up in a conversation with his colleagues, and most of them said they’d take one of the available antibody drugs.

Those drugs do an extraordinary job of cleaning out those amyloid plaques. These are the most visible sign of the disease upon autopsy — like “wiry nests” contaminating the brain, Small said. But scientists still don’t agree on the connection between the amyloid plaques and the cognitive effects of the disease. The drugs don’t clear out the tau tangles or stop neurons from dying, he said. At best, they slow the progression of the disease by about 30%.

The first of these antibody drugs to win approval from the Food and Drug Administration was Biogen’s aducanumab, hailed as a blockbuster with an individual price tag of $56,000 a year. But ultimately, Biogen abandoned it due to concerns about inconsistent clinical trials and serious side effects. Last year, the FDA approved a similar drug, lecanemab, which showed more consistent evidence for a modest slowing of symptoms, but also a risk of brain swelling and bleeding.

Some doctors worry that the pharmaceutical industry will take advantage of the fear surrounding Alzheimer’s to sell more of these expensive drugs to people unlikely to benefit.

Last year, the Alzheimer’s Association, working with a panel of scientists, floated a proposal to label cognitively normal people as having “Stage 1 Alzheimer’s Disease” if they test positive for blood biomarkers such as p-tau 217. Eric Widera, a professor of medicine and geriatrician at the University of California San Francisco, said many of the panelists had ties to the pharmaceutical industry. Some stand to make money if they can redefine the disease to include asymptomatic people, and the relabeling offered no clear-cut benefit to patients, who might face emotional distress, stigma and discrimination if the information got out.

No test is perfect, so there would inevitably be some false positives or people whose degeneration was so slow they were likely to die of something else before they noticed symptoms. Widera worried that the tests might quietly find their way into standard blood panels, after which millions of people would be horrified to be told they have Alzheimer’s.

Despite these concerns, researchers are elated at the power of this blood test for accelerating their progress toward better treatments.

No antibody drugs are approved for asymptomatic people, but there’s a gray area since most of us have occasional mental lapses. And doctors may prescribe the drugs off-label. It will take time and good epidemiological studies to establish how to interpret the p-tau 217 test. How high a reading should be considered abnormal or warrant treatment?

It’s also possible that the existing antibody drugs will prevent disease if given early enough. Reisa Sperling, a Harvard researcher, is conducting clinical trials in people without symptoms, using the p-tau 217 test to screen volunteers.

Others are taking a different approach — one that they hope gets closer to the root cause of the disease. Small, of Columbia, said he’s examining changes in the way proteins are transported within cells. He made an analogy with cholesterol deposits in arteries. You can aim drugs at breaking down the deposits, but it’s more effective to use drugs that prevent the liver from making excessive cholesterol in the first place.

In the researchers’ wildest hopes, preventive drugs will get so good that a positive test for Alzheimer’s proteins would be no more frightening than a high cholesterol reading. They have a long way to go.

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