Covid-19: explosion in the number of deaths, saturated hospitals, variants … Why the situation in Brazil is worrying

“Chaos”, “genocide”, “collapse”… In Brazil, editorial writers do not mince their words to describe the catastrophic health situation linked to the Covid-19 epidemic. If it remains the second most bereaved country in the world behind the United States, the Latin American giant became, a few weeks ago, the state with the highest number of daily deaths on the planet. On average, more than 2,200 deaths are recorded there every day, according to the data of Our World in Data through Sunday March 21. A figure that continues to increase.

To date, nearly one in four deaths from Covid-19 recorded worldwide is Brazilian. And statistics are not the only cause for concern for Brazil, unable to massively vaccinate its population and affected by a more deadly variant.

More than 3,000 patients are waiting for a place in intensive care

Since January, in Brazil, hospitals in 27 states and federal districts have seen their number of patients explode. The occupancy rate of intensive care beds across the country has now reached a level “critical”, writes the public health research institute Fiocruz (article in Portuguese). Over 90% of intensive care beds are occupied in the vast majority of territories. As of March 20, only two states had an occupancy rate below 80%.

The worsening of the situation is such that more than 3,000 patients are waiting for a place to become available in the intensive care unit in twelve federated states, the newspaper reported O Globo (article in Portuguese). To date, 20,000 people occupy intensive care beds in public hospitals across the country. Fiocruz speaks of a “ehealth and hospital foundation unprecedented in the history of Brazil “. In the state of Sao Paulo, two young people aged 22 and 25 succumbed to the disease one day apart. They were waiting for a bed in intensive care.

The Brazilian variant, more contagious and more deadly

This second epidemic wave was born in January in Manaus, a city of 2.1 million inhabitants, capital of the state of Amazonas, in the north of the country. Scientists imagined that the region, hard hit during the first wave in spring 2020, would benefit from herd immunity. But the emergence of a new variant has changed that. The new contaminations and recontaminations exploded, plunging the city into a health chaos.

The P1 variant, nicknamed “Brazilian variant”, would be more contagious and lethal for the youngest, according to caregivers. “The profile of our patients has changed”, Jaques Sztajnbok, head of the intensive care unit at Emilio Ribas hospital in Sao Paulo, told AFP. “Today we have younger people hospitalized in very serious condition, even though they don’t have co-morbidities.“About 29% of those who have died in recent weeks are under 60, compared to 22% in November and December.

According to a study by Massachusetts General Hospital dating from January and relayed by the site Allodocteurs, the vaccines could prove to be less effective against the variant which appeared in Brazil. A fear nuanced but confirmed by a recent preliminary study from the University of Oxford (in English).

A vaccination campaign that slips

Like other countries, Brazil is lacking in doses. The vaccination campaign, which began in mid-January with two vaccines (the Swedish-British AstraZeneca and the Chinese CoronaVac), is far too slow to begin to produce the first effects on the evolution of the epidemic.

To date, less than 6% of the country’s 210 million people have received at least a first dose, according to data from Our World in Data. A figure still far from the goal posted by the Ministry of Health, which hopes to vaccinate the entire population by the end of the year.

In an attempt to accelerate the movement, Brazil on March 21 lifted the obligation for local authorities to reserve vaccine stocks for the second injection.

Bolsonaro’s decried strategy

The authorities’ response to the health crisis is also being slowed down by the political standoff between the federal government and local authorities. Several large cities have declared a state of health emergency. In Sao Paulo, the governor, Joao Doria, who has established himself as the main opponent of the president, on March 15 decreed a new series of restrictions, to the chagrin of Jair Bolsonaro.

For several months, the Brazilian president has publicly criticized the implementation of these restrictions and denied the seriousness of the epidemic.“Enough whining!” Jair Bolsonaro launched on March 4. “Enough, these stories. We have enough problems. How long are you going to stay home? Until when will everything stay closed? Nobody can stand that anymore!A new Minister of Health, the fourth since the start of the pandemic, was appointed in mid-March.

A time bomb for the rest of the world

With a rampant epidemic and a low vaccination rate, the virus may have time to adapt to counter the antibodies, scientists warn. “If these vaccine antibodies appear while the infection is in progress and is spreading through your body, the virus can reproduce itself in a way that escapes the antibodies produced. The mutations most beneficial to the virus will survive and be passed on in a natural selection process “, Julian Tang, a virologist at the University of Leicester in the United Kingdom, told the BBC.

Brazil could therefore expect to see the emergence of other variants, potentially more contagious or more virulent. A threat that theWorld Health Organization (WHO). Michael Ryan, in charge of the organization’s emergency response program, expressed concern on March 12 about the situation in the country and the “global consequences” that this situation might have. “Starting with the government, everyone in Brazil must take the pandemic seriously “, he said, reports O Globo (article in Portuguese).

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