Worst may lie ahead for Brazil in coronavirus pandemic with deaths poised to pass US total

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Brazil already accounts for one-quarter of the world’s daily coronavirus deaths, but the nation could be on the verge of a far greater crisis, global health experts warn.

The nation’s seven-day average of 2,400 deaths stands to reach to 3,000 within weeks,  according to six different epidemiologists.

That figure is approaching the worst level seen by the United States, even though Brazil has only two-thirds of its population.

Spikes of daily deaths could soon hit 4,000 after hitting 3,650 last Friday.

Having glimpsed the abyss, there is growing recognition shutdowns are no longer avoidable.

Restrictions on activity implemented last year were half-hearted and consistently sabotaged by President Jair Bolsonaro, who sought to stave off economic doom.

He remains unconvinced of any need for lockdowns, which leaves local leaders pursuing a patchwork of measures to prevent the death toll from spiralling further.

It may be too late, with a more contagious variant rampaging across Brazil.

For the first time, new daily cases topped 100,000 on March 25, with many more uncounted.

A dark-skinned man in white hat and face mask looks away as he is injected by white syringe
Only 2 per cent of Brazilians have been fully vaccinated against COVID-19.(

AP: Silvia Izquierdo

)

Miguel Nicolelis, a professor of neurobiology at Duke University who advised several Brazilian governors and mayors on pandemic control, anticipates the total death toll reaching 500,000 by July and exceeding that of the US by year-end.

“We have surpassed levels never imagined for a country with a public health care system, a history of efficient immunisation campaigns and health workers who are second to none in the world,” Mr Nicolelis said.

The system is already buckling, with almost all states’ intensive care units near or at full capacity.

Dr Jose Antonio Curiati, a supervisor at Sao Paulo’s Hospital das Clinicas, the biggest hospital medical in Latin America, said its beds are full, but patients keep arriving.

The city’s oxygen supply is not guaranteed, and stocks of sedatives required for intubation in intensive care units will soon run out.

The back of an ambulance is opened to reveal a masked patient surrounded by medical staff at dusk.
The spike in coronavirus cases means that Brazil’s health system is struggling to cope.(

AP: Felipe Dana

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On March 17 in the northeastern Piaui state, nurse Polyena Silveira wept beside a COVID-19 patient who died on the floor for lack of beds at her public hospital. 

“When he was gone, I had two minutes to feel sorry before moving to the next patient,” 33-year-old Ms Silveira said.

‘Coordinated action’ needed

Brazil’s state-run science and technology institute, Fiocruz, has called for a 14-day lockdown to reduce transmission by 40 per cent.

Natalia Pasternak, a microbiologist who presides over the Question of Science Institute, pointed to the city of Araraquara as a success story after seeing its cases and deaths drop after imposing a lockdown.

Ms Pasternak declined to estimate Brazil’s looming daily death toll but said the trend is for continued growth if nothing is done.

“We need coordinated action, and that’s probably not going to happen because the federal government has no real interest in pursuing preventative actions,” Ms Pasternak said.

“[Mayors and governors] are trying to implement preventative measures, but separately and in their own ways. This isn’t the best approach, but it’s better than nothing.”

Minas Gerais, Brazil’s second-most populous state, has closed non-essential shops, while Espirito Santo state will enter lockdown this week.

An aerial view of a beautiful beach with buildings beside and mountain in background.
Rio’s Copacabana beach is deserted due to reinstated COVID-19 pandemic restrictions.(

AP: Lucas Dumphreys

)

Brazil’s two biggest cities, Rio De Janeiro and Sao Paulo, have imposed extensive restrictions on non-essential activities.

Their state authorities brought forward holidays to create a 10-day period of repose, which started on Friday.

President undermines health guidelines

Restrictive measures, however, are only as strong as citizens’ compliance.

And Mr Bolsonaro continues to undermine their willingness by painting even partial shutdown as an assault on one’s right to earn an honest day’s wages.

“We need to open our eyes and understand this is no joke,” said Rio’s Mayor Eduardo Paes, stressing that no mayor wants to cause unemployment.

“No one knows this disease’s limit. No one knows how many variants could emerge.”

A middle-aged woman in face mask holds Brazilian flag at front of signs in street rally.
Supporters of President Jair Bolsonaro protested the start of a 10-day period of increased restrictions in Rio.(

AP: Silvia Izquierdo

)

Hundreds of protesters marched along Rio’s Copacabana beach over the weekend, with many sporting the green-and-yellow shirts that are a hallmark of pro-Bolsonaro rallies, while declining to wear masks.

They chanted “We want to work!” and directed vitriol at Mr Paes.

The World Health Organization’s director, Tedros Adhanom Ghebreyesus, has called for everyone in Brazil to muster a serious response “whether it’s the government or the people”.

“It’s a concerted effort of all actors that will really reverse this upward trend,” he said.

“Especially we’re worried about the [weekly] death rate, which doubled in just one month from 7,000 to 15,000.”

Variants add to challenges

The spread of the virus has been turbocharged by more contagious variants which have become cause for concern beyond Brazil’s borders, not just in South America.

Dr Anthony Fauci, the top US infectious disease expert, said his team would be meeting with Brazilian authorities and are “quite concerned” about the situation in Brazil.

The US has seen its death toll plunge since January, amid a massive vaccine rollout, with its seven-day average dipping below 1,000.

By contrast, Brazil’s vaccine rollout has been strained, at best.

The government bet big on a single vaccine provider, AstraZeneca, while for months rejecting offers to purchase others.

Only after delivery delays from AstraZeneca jeopardised the rollout did Brazil’s health ministry begin buying vaccines — but too late for most deliveries to arrive in the first half of this year.

The nation has fully vaccinated fewer than 2 per cent of its citizens, which experts widely consider an embarrassment for a country long regarded as a global model for vaccination programs.

More than 500 of the nation’s most influential economists and executives wrote an open letter last week calling for mass vaccination, while decrying the situation.

They said that controversy regarding the economic impacts of social distancing is a false dilemma and all levels of government should be prepared to implement emergency lockdown.

While Brazil’s economy did not contract as much as regional peers last year, the worsening health crisis casts a shadow over 2021, according to William Jackson, chief emerging markets economist at Capital Economics.

GDP will return to pre-crisis levels late this year, at the earliest, marking a weak recovery relative to other emerging markets.

Monica de Bolle, a Brazilian senior fellow at the Peterson Institute for International Economics in Washington, was more pessimistic, and expects another recession in 2021.

“All in all, it’s a huge disaster,” said Ms de Bolle, who has done postgraduate studies in immunology and genetics.

“Could have been avoided… wasn’t. Very difficult to fix now.



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