RIO DE JANEIRO (AP) – Brazilian hospitals falter because a variant of the highly contagious coronavirus spreads across the country, the president insists on unproven treatments and the only attempt to create a national plan to contain COVID-19 falls short.
Last week, Brazilian governors sought to do something that President Jair Bolsonaro doggedly rejects: patching up a proposal for states to help contain the deadliest COVID-19 outbreak to date. The effort was expected to include a curfew, a ban on overcrowded events and limits on the opening hours of non-essential services.
The final product, presented Wednesday, was a one-page document that included general support for restricting activities, but without any specific measures. Six governors, evidently still cautious about antagonizing Bolsonaro, refused to sign.
Piauí State Governor Wellington Dias told the Associated Press that, unless the pressure on hospitals is relieved, an increasing number of patients will have to endure the disease without a hospital bed or any hope of treatment in a hospital. intensive therapy.
“We have reached the limit throughout Brazil; exceptions are rare, ”said Dias, who heads the governors’ forum. “The chance of dying without assistance is real.”
These deaths have already started. In Brazil’s wealthiest state, São Paulo, at least 30 patients died this month while waiting for ICU beds, according to a count published Wednesday by the news site G1. In the south of the state of Santa Catarina, 419 people are awaiting transfer to ICU beds. In neighboring Rio Grande do Sul, the ICU capacity is 106%.
Alexandre Zavascki, a doctor from Porto Alegre, capital of Rio Grande do Sul, describes the constant arrival of patients in hospitals with difficulty breathing.
“I have many colleagues who sometimes stop crying. This is not a medication that we are used to doing routinely. This is a drug adapted to a war scenario, ”said Zavascki, who oversees the treatment of infectious diseases in a private hospital. “We see a good part of the population refusing to see what is happening, resisting the facts. These people may be the next to enter the hospital and will want beds. But there will not be one. “
The country, he added, needs “stricter measures” from local authorities.
Despite the president’s objections, the Supreme Court last year maintained jurisdiction over cities and states to impose restrictions on activity. Even so, Bolsonaro consistently condemned his moves, saying that the economy needed to continue to stir and that the isolation would cause depression. The measures were relaxed in late 2020, as COVID-19 cases and deaths decreased, municipal election campaigns began and Brazilians at home began to become fatigued by the quarantine.
The most recent increase is driven by the P1 variant, which Brazil’s Minister of Health said last month was three times more transmissible than the original strain. It became dominant in the Amazon city of Manaus and in January it forced the air transport of hundreds of patients to other states.
Brazil’s failure to stop the spread of the virus since then is increasingly seen as a concern not only for Latin American neighbors, but also as a warning to the world, said Tedros Adhanom Ghebreyesus, director of the World Health Organization, at a press conference on March 5. .
“Across the country, the aggressive use of public health measures, social measures, will be very, very crucial,” he said. “Without doing things to impact transmission or suppress the virus, I don’t think we will be able to have a declining trend in Brazil.”
Last week’s count of more than 10,000 deaths was the highest in Brazil since the pandemic began, and this week’s figure is expected to be even higher after the country recorded almost 2,300 deaths on Wednesday – exploding the previous day’s total. , which was also a record.
“Governors, like a large part of the population, are getting fed up with all this inaction,” said Margareth Dalcolmo, a prominent pulmonologist at the state Fiocruz Institute. She added that the proposed pact is vague and will remain symbolic, unless it becomes broader and faces the federal government.
The national council of state health secretaries in Brazil last week called for the establishment of a national curfew and blockade in regions that are approaching the maximum capacity of hospitals. Bolsonaro again objected.
“I am not going to decree this,” Bolsonaro said at an event on Monday. “And you can be sure of one thing: my army does not go out into the street to force the people to stay at home.”
Restrictions can already be found in front of the presidential palace after the governor of the Federal District, Ibaneis Rocha, implemented a curfew and partial blockade. Rocha warned on Tuesday that he can crack down harder, saving only pharmacies and hospitals, if people continue to break the rules. Currently, 213 people in the district are waiting for a place in the ICU.
Bolsonaro told reporters on Monday that the curfew is “an outrage, unacceptable,” and said that even WHO believes the blockages are inadequate because they disproportionately harm the poor. Although WHO recognizes “profound negative effects”, she says that some countries have had no choice but to impose heavy measures to delay transmission and that governments should make the most of the extra time provided to test and track cases while taking care of patients.
That nuance was lost in Bolsonaro. Your government continues its search for silver bullet solutions that have so far only served to raise false hopes. Any idea seems to deserve consideration, except for public health experts.
Bolsonaro’s government has spent millions producing and distributing malaria pills, which have shown no benefit in rigorous studies. Even so, Bolsonaro endorsed the drugs. He also supported treatment with two drugs to fight parasites, none of which proved effective. He again praised his ability to avoid hospitalizations during an event on Wednesday at the presidential palace.
Bolsonaro also sent a committee to Israel this week to evaluate an unproven nasal spray that he called “a miracle product”. Dalcolmo da Fiocruz, whose younger sister is hospitalized in an ICU, called the trip “really pathetic”.
Camila Romano, a researcher at the Institute of Tropical Medicine at the University of São Paulo, hopes that a test developed by her laboratory to identify worrying variants, including P1, will help monitor and control its spread. It also wants stricter government measures and citizens to do their part.
“Each day is a new surprise, a new variant, a city whose health system collapses,” said Romano. “We are now in the worst phase. If this is going to be the worst phase of all, unfortunately we do not know what is yet to come. “
___ Reported Álvares de Brasília. Associated Press videojournalist Tatiana Pollastri contributed from São Paulo.