The guardian
‘Covid takes over’: Brazil plunges into deadliest chapter of its epidemic
Last year, Jair Bolsonaro declared that Brazil had reached ‘the tail end’ of one of the world’s worst outbreaks. Three months later, the country lost nearly 100,000 more lives. Coronavirus patients were erected on March 4 in a field hospital in a sports coliseum in Santo André, on the outskirts of São Paulo, Brazil. Photo: André Penner / AP It was mid-February when André Machado realized that the Coronavirus catastrophe in Brazil had progressed into a staggering and relentless new phase. “The floodgates opened and the water flowed out,” recalled the infectious disease specialist from Our Lady of the Conception Hospital in Porto Alegre, one of the largest cities in southern Brazil. Since then, Machado’s hospital, like health centers in the country, has been engulfed by a flood of tumultuous, gasping patients – many of whom were previously healthy and staggeringly young. Among the recent recordings was a pregnant 37-year-old man who was allegedly brought in for breathing problems and coughing. Doctors performed an emergency in the C-section to give birth to the baby in a desperate attempt to take the pressure off the expectant mother’s Covid-drawn lungs. “We try to help people, but this disease is much faster and more aggressive than the tactics we used,” Machado, 44, said as the team tried to keep up with tripling admissions. “It’s like we’re hitting a dead horse,” he said before adding, “This disease is going to kill a lot more people in Brazil.” Late last year, Brazilian President Jair Bolsonaro – a Donald Trump-worshiping populist who blatantly sabotaged Covid’s control efforts – declared his country ‘the tail end’ of what is already one of the worst outbreaks in the world. wash. Bolsonaro was wrong. Three months later, Latin America’s largest country lost nearly 100,000 more lives – the total death toll to more than 275,000, the second to the US, and plunged into the deadliest chapter of its 13-month epidemic. Jair Bolsonaro speaks to the media on March 10 in Brazil, Brazil. Photo: Ueslei Marcelino / Reuters Former left-wing president Luiz Inácio Lula da Silva hit a record 2,349 daily deaths this week, urging citizens to confront their incompetent ‘blowhard’ leader. “This country is in complete turmoil and confusion because there is no government. I will repeat: this country has no government, ”Lula declared, blaming Bolsonaro’s” uncivilized “leadership and rejecting science for the scale of the disaster in Brazil. “So, so many lives could be saved,” Lula claims, warning, “Covid is taking over the country.” As the emergency intensified this week, health workers on the front line from Porto Alegre to Recife, a coastal town 3,000km further north, described scenes of sadness, despair and exhaustion as intensive care units and cemeteries filled up like never before. Workers bury a person who died with Covid on January 27 in Manaus, Amazonas, Brazil. Photo: Raphael Alves / EPA “It feels like we’re putting a band-aid on a bullet wound,” said Eduarda Santa Rosa Barata, a 31-year-old infectious disease specialist working in three ICUs in the north-eastern capital of Pernambuco. state, everything now stretched to the limit. “We are working on damage reduction … You are opening new beds and they will be filled immediately.” A few days earlier, Barata had admitted a 37-year-old man who had no underlying medical conditions but whose lungs were so badly damaged that he needed intubation. “It looks so random,” she said. “It’s a bizarre disease. This is scary. Machado has seen several explanations for the deluge of cases he and other doctors are now seeing, including political mismanagement and the weakening of social distance measures, especially among young people. In recent months, such restriction efforts have largely collapsed, with schools and businesses reopening, and Bolsonaro’s tourism minister has even encouraged citizens to start holidaying again. But the doctor suspected that a third, more worrying element was also at work: an enigmatic and apparently more contagious variant called P1 that presumably originated in the Amazon region at the end of 2020, but now in Brazil circulating, including in the southern state of Rio Grande do Sul, where Machado works. People walk in a shopping mall in São Paulo, Brazil on March 4th. Photo: Cris Faga / NurPhoto / Rex / Shutterstock “It’s not just theoretical. This is something we see in practice, ”Machado said of the variant, of which at least ten cases were detected in the United Kingdom and 15 in the USA. ‘By the end of 2020, you would have a family and one member would be infected, but not the other three or four members, even if they live in the same area. You do not see it anymore. “If there is one confirmed case, everyone will eventually become infected by the virus,” he said. “It is clear that this new variant is now spreading among us.” This is a matter of intense debate over how much of the current crisis in Brazil is due to the new variant, or other variants being diverted to the United Kingdom and South Africa. Some experts believe the variant provides a convenient smokescreen for political leaders who could not suppress the disease that dismissed President Bolsonaro as a ‘little flu’. When he ordered a two-week emergency strike in Brazil’s populous state on Thursday, São Paulo’s governor João Doria claimed the variant played an important role in pushing hospitals to the brink. “This new strain of the virus is very aggressive and very dangerous,” Doria warned, claiming that Brazil was “collapsing” in some cases. Jesem Orellana, an epidemiologist from the Amazon city of Manaus, where hospitals recently ran out of oxygen due to the explosion of infections, was convinced that mutations were the biggest culprit. “From a political point of view, it is much easier to place the blame on the variant. “We all know that the worst variant of all is the way the epidemic was handled incorrectly,” he said. Orellana suspected that politicians at all levels of government had not stopped the coronavirus with unpopular and economically painful barriers, now ‘using the variant as a crutch to push themselves and justify their mistakes and their negligence over the epidemic’. Patients in the emergency room of a hospital overcrowded in Porto Alegre, Brazil, on March 11th. Photo: Diego Vara / Reuters But Marcos Boulos, a leading specialist in infectious diseases, said he had no doubt that the P1 variant was contributing to the rising effects of Brazil: “There is no way to hide it.” Boulos also said that anecdotal evidence from hospitals in Brazil suggests that the variant also produces serious cases in young people. “We do not yet have the data to confirm this categorically, but it is possible according to doctors,” the University of São Paulo said. ‘Here in the hospital we have a 20-year-old woman in our ICU in a serious condition. Today, you have serious patients in ICUs of all ages. Previously, we would say it was almost 90% elderly. Today they are still the majority, but not in the same way, “Boulos added. “We do not yet know how it works, but that is what we are seeing … There is no other reason why young people would suddenly start suffering from a more serious illness.” São Paulo’s health secretary, Jean Gorinchteyn, told reporters this week that half of the patients in many of the ICUs are now under 50. “I’m talking about 26- and 29- and 30-year-olds – often in a very serious condition,” he said, urging citizens to avoid crowds and stay at home. “We all need to understand that what is happening right now is a different pandemic than the one we saw last year,” Gorinchteyn claimed. Barata said she also had the impression that her Covid patients were getting younger and coming to the hospital in a worse condition. Despite being vaccinated with the Chinese CoronaVac vaccine in February, she admitted that she now felt more fearful than during the previous peak last June. ‘It feels like the virus is getting closer every day … You can say everywhere, there is someone who has symptoms, or is sick, or in the hospital … The mother-in-law of one of my colleagues is in a critical condition. in intensive care, ”she said. Barata said she was not sure what role new variants would play in Brazil’s latest crash, but whatever – or whoever – was responsible, she feared the human tragedy was far from over: ‘It feels as if the disease were besieging us. , locks and infects anyone who has not yet caught it. Machado said the expectant mother and her child were rushed to intensive care after giving birth to her 36-week-old baby, where the former was placed in a ventilator. “We do not know if she’s going to make it,” he acknowledged last week when the Covid 19 ward in hospital reached the brink of collapse, and fears of the global impact of the uncontrolled epidemic in Brazil were mounting. has. Twenty-four hours later, at ten minutes past midnight, the woman was gone, leaving five orphans and a country in disarray.