RIO DE JANEIRO – COVID-19 has already left a trail of death and despair in Brazil, one of the worst in the world. Now, a year into the pandemic, the country is setting another bad record.
No other nation that has experienced such a major outbreak is still struggling with the record death rate and a health care system on the verge of collapse. Many other countries that have been hit hard are instead taking preliminary steps towards a semblance of normality.
But Brazil is struggling with a more contagious variant that has trampled on one big city and spread to others, even if Brazilians throw away precautions that can keep them safe.
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On Tuesday, Brazil recorded more than 1,700 COVID-19 deaths, the highest one-day toll of the pandemic.
“The acceleration of the epidemic in various states is leading to the collapse of their public and private hospital systems, which may soon be the case in every region of Brazil,” the national association of health secretaries said in a statement. “Unfortunately, the anemic deployment of vaccines and the slow pace at which they are becoming available still do not indicate that this scenario will reverse in the short term.”
And the news only got worse for Brazil – and possibly for the world as well.
Preliminary studies suggest that the variant swept through the city of Manaus is not only more contagious, but also prevents it from infecting people who have already recovered from other versions of the virus. And the variant slipped the borders of Brazil and showed up in two dozen other countries and in small numbers in the United States.
Although trials with a number of vaccines indicate that they can protect against serious diseases, even if it does not prevent the infection with the variant, most of the world has not yet been vaccinated. This means that even people who have recovered and thought they were safe for the time being can still be in danger and that world leaders can once again lift restrictions too quickly.
“You need vaccines to get rid of these things,” said William Hanage, a public health researcher at the Harvard TH Chan School of Public Health, about variants that can cause re-infections. “The immunity you get when you walk cemeteries out of the room, even that will not be enough to protect you.”
The danger of new variants has not lost scientists around the world. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, pleaded with Americans this week not to let their guards down. “Please hear me clearly,” she said. “At this level of cases with variants spreading, we can completely lose the hard-earned field we have gained.”
Brazilians were hoping to see the worst of the outbreak last year. Manaus, capital of the northern state of Amazonas, was hit so hard in April and May that scientists wondered if the city would not have achieved herd immunity.
But in September, affairs in the state began to increase again, which worried health officials. An attempt by Amazonian governor Wilson Lima to impose a new quarantine before the Christmas holidays has been fiercely opposed by business owners and leading politicians close to President Jair Bolsonaro.
By January, scientists had discovered that a new variant, known as P.1, had become dominant in the state. Within weeks, the danger became apparent when hospitals in the city ran out of oxygen amid a rush of patients, which led to death suffocating.
Dr Antonio Souza was haunted by the terrified faces of his colleagues and relatives of patients when it became clear that the oxygen supply in Manaus Hospital was depleted. He thinks of the patient he anesthetized to spare her a painful death when the oxygen ran out at another clinic.
“No one ever has to make that decision,” he said. “It’s too terrible.”
Maria Glaudimar, a nurse in Manaus, said she felt trapped in a nightmare earlier this year without an end to it. At work, patients and their family members pleaded for oxygen, and all the intensive care beds were full. At home, her son contracted tuberculosis after contracting COVID-19, and her husband shed £ 22 while fighting the virus.
“No one was prepared for this,” Glaudimar said. “It was a horror movie.”
Since then, the coronavirus crisis in the Amazon has eased somewhat, but has worsened in most of Brazil.
Scientists have struggled to learn more about the variant and to track its spread across the country. But limited resources for testing have kept them behind as they try to determine what role it plays.
Anderson Brito, a Brazilian virus expert at Yale University, said his lab alone has half as many coronavirus genomes as the whole of Brazil. While the United States has genetically sequenced about one in every 200 confirmed cases, Brazil follows about one in every 3,000.
The variant spread rapidly. By the end of January, an investigation by government investigators found that it was present in 91% of the samples followed up in the state of Amazonas. By the end of February, health officials had reported cases of the P.1 variant in 21 of 26 Brazilian states, but without testing further, it is difficult to determine its prevalence.
During the pandemic, researchers said the re-infection of COVID-19 appeared to be extremely rare, enabling people recovering to assume they had immunity for at least a while. But that was before P.1 appeared and doctors and nurses began to notice something strange.
João Alho, a doctor in Santarém, a city in Pará, a country bordering the Amazon, said several colleagues who recovered from COVID 19 months ago became ill again and tested positive.
Juliana Cunha, a nurse in Rio de Janeiro who worked at COVID-19 testing centers, said she accepted that she was safe after contracting the virus in June. But in November, after experiencing mild symptoms, she tested positive again.
“I could not believe it,” said Cunha, 23. “It has to be the variants.”
But there is no way to be sure what happens to people who become re-infected unless both their old and new specimens are preserved, genetically sequenced, and compared.
One way to reduce the boom is through vaccinations, but the rollout in Brazil, as in so many countries, has been slow.
Brazil began vaccinating priority groups at the end of January, including health care workers and the elderly. But the government has failed to obtain a large enough number of doses. Richer countries captured most of the available supply, while Bolsonaro was skeptical about the impact of the disease and about the vaccines.
Just over 5.8 million Brazilians – about 2.6% of the population – received at least one dose of COVID-19 vaccine, according to the Ministry of Health. Only about 1.5 million received both doses. The country currently uses the Chinese-made CoronaVac – which according to laboratory tests is less effective against P.1 than against other variants – and the one made by the British-Swedish pharmaceutical company AstraZeneca.
Margareth Dalcolmo, a pulmonologist at Fiocruz, a prominent scientific research center, said Brazil’s failure to conduct a robust vaccination campaign was the scene of the current crisis.
“We have to vaccinate more than a million people a day,” she said. “It’s the truth. We are not, not because we do not know how to do it, but because we do not have enough vaccines. ‘
Other countries should note, said Ester Sabino, a researcher on infectious diseases at the University of São Paulo, who is one of the leading experts on the P.1 variant.
“You can vaccinate your entire population and only control the problem for a short period of time if a new variant appears elsewhere in the world,” she said. “It will come there one day.”
Health Minister Eduardo Pazuello, who called the variant a ‘new stage’ of the pandemic, said last week that the government was stepping up its efforts and hoped to have by June and the rest by the end of the year about half of vaccinate the population.
But many Brazilians have little confidence in a government led by a president who has sabotaged closures, repeatedly underestimated the threat of the virus and promoted untested drugs long after scientists said they were clearly not working.
Just last week, the president spoke disrespectfully about masks, which are one of the best defenses to combat infection, claiming that they are harmful to children, causing headaches and concentration problems.
Pazuello’s vaccine predictions were also met with skepticism. The government last week placed an order for 20 million doses of an Indian vaccine that has not completed clinical trials. It sued a federal prosecutor in a lawsuit that endangers the purchase of $ 286 million.
Even if it is effective, it will be too late for many people.
Tony Maquiné, a 39-year-old marketing specialist in Manaus, has lost a grandmother, an uncle, two aunts and a cousin in the last few cases. He said the time had become a vague number of attempts to get hospitals with free beds for life while arranging funerals for the dead.
“It was a nightmare,” Maquiné said. “I’m afraid of what lies ahead.
This article originally appeared in The New York Times.
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