Brazil’s Covid-19 variant overwhelms local hospitals, hits younger patients

The new variant, known as P.1, is 1.4 to 2.2 times more contagious than previously found versions of the virus in Brazil and 25% to 61% more able to re-infect people who have been infected by an earlier strain, according to a study released Tuesday.

With mass vaccination far from the region, countries such as Brazil risk becoming a breeding ground for new, more potent versions of the virus that could make current Covid-19 vaccines less effective, public health experts have warned.

A longer-term pandemic could also have devastating economic consequences for countries such as Brazil, slowing growth and expanding the country’s already large debt pile as the government expands payments to the poor, economists said.

“We are facing a dramatic situation here – the health systems in many Brazilian states are already collapsing, and more will be in the coming days,” said Eliseu Waldman, an epidemiologist at the University of São Paulo.

Several doctors reported an increase in younger patients in Covid-19 wards, many between the ages of 30 and 40 without health problems. In Peru, some doctors said that patients get seriously ill faster, just three or four days after the onset of the first symptoms, compared to an average of nine to 14 days last year.

“The virus is behaving differently,” said Rosa Lopez, a doctor in the intensive care unit at Guillermo Almenara Irigoyen Hospital in Lima. “It’s really aggressive … the situation is very difficult, really terrible.”

The Amazon strain, P.1, appeared in the Brazilian city of Manaus late last year and quickly caught the attention of Brazilian and international scientists who ran to map its spread. The large number of variants of the spike protein mutations, which help the virus to enter the cells, has caused great concern.

“We are at the worst possible time, I would not be surprised if P.1 is already all over Brazil,” said Felipe Naveca, a researcher at the Oswaldo Cruz Foundation who studied the new strain. He estimated that Brazil is already hosting hundreds of new Covid-19 variants, although P.1. is the most worrying so far, he said.

However, researchers are still at a loss as to why more young people seem to get sick and whether P.1 is more deadly or just more contagious.

“The recent epidemic in Manaus has strained the city’s health system, leading to inadequate access to healthcare,” wrote the authors of the P.1 study launched Tuesday, led by Nuno Faria, a professor of virus evolution at Oxford University and Imperial College. from London. Therefore, we cannot determine whether the estimated increase in the relative risk of mortality is due to P.1 infection, stress on the health system in Manaus or both, ”they wrote.

A study led by Mr Naveca, launched last week, showed that in some cases the P.1 strain had a viral load about 10 times higher than the initial versions of the virus circulating in Brazil for most of the pandemic. But the group of international scientists led by Mr Faria concluded that it was not possible until detailed clinical investigations were carried out to determine whether P.1 infection was associated with an increase in viral loads.

Researchers in South Africa struggled with the same questions when studying another new variant, B.1.351. Doctors there have also reported an increase in hospitalizations and deaths of younger patients, but researchers have concluded that more young people become seriously ill because more people are generally infected. The likelihood of younger death increased, they said, because hospitals were overwhelmed, not because the variant itself was more deadly.

Another possible explanation is that the virus has already made its way through many older hosts, said Francisco Cardoso, an infectious disease specialist at Emílio Ribas Hospital in São Paulo, who also saw an increase in younger patients. .

“Many [older patients] they have already had contact with the virus and obtained some protection through antibodies or they have already died, ”he said.

Latin America has been one of the hot spots in the Covid-19 world since the pandemic began, but in recent days doctors in Brazil have become increasingly desperate, describing horror scenes across the country. While the new strain is to blame, so is the lack of training and prevention from governments in the region, public health experts said.

Hospitals operate at ICU occupancy rates of over 80% in almost two-thirds of Brazil. After dozens of patients were strangled to death in Manaus earlier this year, when hospitals ran out of oxygen, prosecutors are investigating reports from another Amazon city that intubated patients were tied to their beds due to a sedative deficiency.

In Peru, where the government detected strain P.1, hospitals were quickly pushed beyond capacity as infections rose in January after one of the world’s worst outbreaks last year. Doctors now choose from dozens of patients when an intensive care bed will open, while Chile donates life-saving oxygen amid acute shortages.

The scenes come as the US and parts of Europe celebrate declining infection rates amid mass vaccination campaigns, evidence of a growing immunity gap between rich and poorest nations. While more than 15% of people in the United States received a Covid-19 shot, Brazil administered vaccines to only 3% of its population. Peru and Colombia have vaccinated less than 1%.

If Latin America does not find a way to speed up its vaccination campaigns, other countries, such as Colombia and Bolivia, which have seen recent slowdowns in new infections, could also fall victim to the new variant, experts said. in cases of infectious infection.

The more the disease is left in countries such as Brazil, the more likely it is that new variants will appear that reduce the effectiveness of Covid-19 vaccines, thus posing a threat to nations that have already immunized their populations.

“Unless everyone gets the vaccine soon, none of us will be protected,” said Patricia Garcia, a former Peruvian health minister and epidemiologist. “It will never stop.”

Cesar Palacios, a 44-year-old pediatrician from the northern Peruvian town of Piura, lost his parents and younger sister to the disease earlier this year. He spent 10 days on a ventilator after falling ill himself, the disease rapidly advancing as blood oxygen levels fell into dangerous territory, to 86% just one day after his first symptom. A few days later he was in an intensive care unit.

“When you’re put on a mechanical fan, do you think I’ll live?” I will die? Said Dr. Palacios. “I had no choice. I was so scared. “

While Peru has imposed a night stop in Lima and other states with major infections, Brazilian cities such as São Paulo and the capital Brasilia have introduced tougher restrictions in recent days.

But many Brazilians defied the rules, taking a cue from the country’s president. Right-wing leader Jair Bolsonaro downplayed the disease and attacked state governors for imposing blockades, accusing them of destroying local businesses.

São Paulo military police attacked about 50 units over the weekend that refused to comply, including a group of 190 elderly Brazilians organizing a clandestine party.

—Luciana Magalhaes from São Paulo and Gabriele Steinhauser from Johannesburg contributed to this article.

Write to Samantha Pearson at [email protected] and Ryan Dube at [email protected]