Covid: Hospitals in Brazilian cities 'close to collapse'

Health systems in most of Brazil’s largest cities are close to collapse due to Covid-19 cases, a report by the country’s Fiocruz institute warns.

The Rio de Janeiro-based institute said more than 80% of intensive care unit (ICU) beds are occupied in the capitals of 25 of Brazil’s 27 states.

On Tuesday the country recorded 1,972 Covid deaths, a new daily record.

Brazil has recorded more than 266,000 deaths and 11 million cases since the pandemic began.

It has the second highest number of deaths in the world after the US and the third highest number of confirmed cases.

According to Fiocruz, 15 state capitals have ICUs that are at more than 90% capacity including Rio de Janeiro, Brasilia and São Paulo.

Two cities — Porto Alegre and Campo Grande — have exceeded ICU capacity.

In its report it warned that figures pointed to the “overload and even collapse of health systems”.

“The fight against Covid-19 was lost in 2020 and there is not the slightest chance of reversing this tragic circumstance in the first half of 2021,” Fiocruz epidemiologist Jesem Orellana said, quoted by AFP news agency.

“The best we can do is hope for the miracle of mass vaccination or a radical change in the management of the pandemic.

“Today, Brazil is a threat to humanity and an open-air laboratory where impunity in management seems to be the rule.”

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Will vaccines work against the new variants?
How pandemic turned political in Brazil
Last week experts told Valor Economic newspaper that deaths would soon surpass 2,000 a day. They warned that the only way to avoid this was if the federal government took over national coordination of the fight against the virus, recommending lockdowns, the use of masks and a mass vaccination drive.

More than eight million people have had their first vaccination dose so far, representing just over 4% of the population.

On Tuesday, the country also recorded more than 70,000 cases, a 38% increase on last week, according to local media. The recent rise has been attributed to the spread of a highly contagious variant of the virus thought to have originated in the Amazon city of Manaus.

Despite this, President Jair Bolsonaro has continued to downplay the threat posed by the virus.

Earlier this week he told people to “stop whining”. Speaking at an event, he said: “How long are you going to keep crying about it? How much longer will you stay at home and close everything? No-one can stand it anymore. We regret the deaths, again, but we need a solution.”

A number of quarantine measures have been taken by regional governors, which Mr Bolsonaro has opposed, arguing that the collateral damage to the economy will be worse than the effects of the virus itself.

A Covid variant first identified in Brazil has been found in the UK.

Public health officials have identified and contacted the six people found to be infected and are doing testing to see if it has spread to more people.

Some variants, like this one, appear to be more contagious and there are concerns current vaccines may not work as well.

What are these new variants?
There are many thousands of different versions, or variants, of Covid circulating.

Apart from the Brazil variant (also known as P.1), concerns focus on a few:

A UK or Kent variant (also known as B.1.1.7) now dominant in much of Britain, has spread to more than 50 countries and appears to be mutating again
A South Africa variant (B.1.351) found in at least 20 other countries, including the UK
It’s not unexpected that new variants have developed — all viruses mutate as they make copies of themselves to spread and thrive.

Most of these differences are inconsequential. A few can even be harmful to the virus’s survival. But some can make it more infectious or threatening.

Coronavirus variants: The science explained
Are the new ones more dangerous?
There is no evidence that any of them cause much more serious illness for the vast majority of people who become infected.

As with the original version, the risk is highest for people who are elderly or have significant underlying health conditions.

For the UK variant there is some research suggesting it may be associated with a 30% higher risk of death. The evidence is not strong and the data is still uncertain though.

Measures such as washing your hands, keeping your distance from other people and wearing a face covering will still help prevent infections. Because the new variants appear to spread more easily it is important to be extra vigilant.

What’s happening to the virus?
The UK, South Africa and Brazil variants could be much more contagious or easy to catch.

All three have undergone changes to their spike protein — the part of the virus which attaches to human cells.

As a result, they seem to be better at infecting cells and spreading.

Experts think the UK or “Kent” strain emerged in September and may be up to 70% more transmissible or infectious. The latest research by Public Health England puts it between 30% and 50%.

The South Africa variant emerged in October, and has more potentially important changes in the spike protein. Experts recently found a small number of cases of the UK variant that have one of these more concerning changes too.

It involves a key mutation — called E484K — that may help the virus evade parts of the immune system, called antibodies, that can fight coronavirus based on experience from prior infection or a vaccine.

Where has the South Africa variant been found in the UK?
South Africa coronavirus variant: What’s the risk?
UK variant has mutated again, scientists say
The Brazil variant emerged in July and has this E484K mutation too.

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Will vaccines still work?
Current vaccines were designed around earlier versions of coronavirus, but scientists believe they should still work, although perhaps not quite as well.

A recent study suggests the Brazilian variant may be resisting antibodies in people who should have some immunity because they have caught and recovered from an earlier version of coronavirus.

Early lab results, however, suggest the Pfizer vaccine can protect against the new variants, although slightly less effectively.

Two new coronavirus vaccines that could be approved soon — one from Novavax and another from Janssen — appear to offer some protection too.

Data from the Oxford-AstraZeneca vaccine team suggests it protects just as well against the new UK variant. It offers less protection against the South Africa variant — although it should still protect against severe illness.

Early results from Moderna suggest its vaccine is effective against the South Africa variant, although the immune response may not be as strong or long-lasting.

Variants could emerge in the future that are different again.

Even in the worst case scenario, vaccines could be redesigned and tweaked to be a better match — in a matter of weeks or months, if necessary, say experts.

As with flu, where a new shot is given each year to account for any changes in circulating flu viruses, something similar could happen for coronavirus.

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What is being done about it?
More variants will emerge.

Scientists around the world are on the look-out and any important ones will be closely studied and monitored.

Experts are updating coronavirus vaccines. The UK Government has announced a deal with biopharmaceutical company CureVac to develop vaccines against future variants, with a pre-order of 50 million doses.

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Covid: Hospitals in Brazilian cities ‘close to collapse’

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