Covid-19 variant in Brazil runs over local hospitals and reaches younger patients

The new variant, known as P.1, is 1.4 to 2.2 times more contagious than the versions of the virus previously found in Brazil and 25% to 61% more capable of reinfecting people who were infected by a previous strain, according to a study released Tuesday.

With mass vaccination very far in the region, countries like Brazil are at risk of becoming a breeding ground for powerful new versions of the virus that could make current Covid-19 vaccines less effective, public health experts warned.

A more protracted pandemic can also have devastating economic consequences for countries like Brazil, slowing growth and expanding the country’s already large pile of debt as the government extends payments to the poor, economists said.

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

Several doctors reported a sudden increase in younger patients in their Covid-19 wards, many in their 30s and 40s with no underlying health problems. In Peru, some doctors said that patients are getting seriously ill faster, just three or four days after the first symptoms appear, compared with an average of nine to 14 days last year.

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

The Amazonian strain, P.1, appeared in the Brazilian city of Manaus at the end of last year and quickly caught the attention of Brazilian and international scientists who rushed to map its spread. The large number of mutations in the variant in the spike protein, which helps the virus penetrate cells, has caused particular concern.

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

However, researchers still don’t know why more younger people seem to be getting sick and whether P.1 is more deadly or just more contagious.

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

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

Researchers in South Africa struggled with the same questions when studying another new variant, B.1.351. Doctors also reported an increase in hospitalizations and deaths of younger patients, but the researchers concluded that more younger people were becoming seriously ill because more people were being infected. The likelihood of younger people dying, they said, because the hospitals were crowded, not because the variant itself was more deadly.

Another possible explanation is that the virus has already spread to many older hosts, said Francisco Cardoso, an infectious disease specialist at Emílio Ribas hospital in São Paulo, who also noticed an increase in younger patients.

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

Latin America has been one of the hot spots of Covid-19 in the world since the beginning of the pandemic, but in recent days doctors in Brazil have become increasingly desperate, describing scenes of horror across the country. While the new strain is the main culprit, so is the region’s lack of preparedness and prevention, public health experts said.

Hospitals operate with ICU occupancy rates above 80% in almost two thirds of Brazilian states. After many patients suffocated to death in Manaus earlier this year, when hospitals ran out of oxygen, prosecutors are investigating reports from another Amazonian city that intubated patients have been tied to their beds due to a lack of sedatives.

In Peru, where the government detected the P.1 strain, hospitals were quickly pushed beyond capacity as infections increased in January, after one of the worst outbreaks in the world last year. Doctors are now choosing from dozens of patients when a bed in the ICU opens, while Chile donates vital oxygen amid an acute shortage.

The scenes take place as the United States and parts of Europe celebrate the drop in infection rates amid mass vaccination campaigns, evidence of a widening immunity gap between rich and poor nations. While more than 15% of people in the United States received a Covid-19 vaccine, Brazil administered vaccines to only 3% of its population. Peru and Colombia vaccinated less than 1%.

If Latin America does not find a way to speed up its vaccination campaigns, other countries like Colombia and Bolivia, which have recently seen a slowdown in new infections, may also fall victim to the new variant, infectious disease experts said.

The longer the disease is left to rot in countries like Brazil, the greater the chance of new variants that will reduce the effectiveness of Covid-19 vaccines, which also poses a threat to nations that have already immunized their populations.

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

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

“When are you going to be put on the mechanical ventilator, you think, am I going to live? I will die? “said Dr. Palacios.” I had no other option. I was so scared. “

While Peru imposed a night curfew in Lima and other states with high infection, Brazilian cities like São Paulo and the capital Brasília have introduced tougher restrictions in recent days.

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

São Paulo’s military police raided about 50 establishments over the weekend that they refused to obey, including a group of 190 elderly Brazilians at a clandestine party.

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

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