Covid-19 variant in Brazil overwhelms local hospitals, affects younger patients

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

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

A longer-lasting pandemic could also have devastating economic consequences for countries like Brazil, slowing growth and expanding the country’s already large debt stack as the government pays off the poor, economists said.

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

Several doctors have reported an 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 become seriously ill more quickly, just three or four days after the first symptoms appeared, compared to an average of nine to 14 days last year.

“The virus behaves differently,” said Rosa Lopez, an intensive care physician at Guillermo Almenara Irigoyen Hospital in Lima. “It’s really aggressive … the situation is very difficult, really awful.”

The Amazon species, P.1, emerged in the Brazilian city of Manaus late last year and quickly caught the attention of Brazilian and international scientists racing to map its distribution. The large number of mutations of the variant in the spike protein, which helps the virus enter cells, is of particular concern.

“We are at the worst, I wouldn’t be surprised if P.1 is now all over Brazil,” said Felipe Naveca, a researcher at the Oswaldo Cruz Foundation who has studied the new species. He estimated that Brazil is already home to hundreds of new Covid-19 variants, although P.1. is most troubling so far, he said.

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

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

A study led by Mr. Naveca released last week found that in some cases the P.1 strain carried a viral load that was about 10 times higher than the original versions of the virus that were produced for most of the pandemic in Brazil. But the group of international scientists led by Mr. Faria concluded that it was only possible to conduct detailed clinical research to determine whether 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 there also reported an increase in hospitalizations and deaths of younger patients, but researchers concluded that more younger people became seriously ill because more people became infected overall. Younger people’s chances of dying 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 much older hosts, said Francisco Cardoso, an infectious disease specialist at Emílio Ribas Hospital in São Paulo, who has also noticed an increase in younger patients.

“A lot of [older patients] have already been in contact with the virus and they have either received some protection through antibodies or have already died, ”he said.

Latin America has been one of the Covid-19 hotspots in the world since the start of the pandemic, but in recent days, doctors in Brazil have become increasingly desperate, describing horrific scenes across the country. While the new species is largely to blame, that’s also a lack of preparation and prevention by the region’s governments, public health specialists said.

Hospitals operate with an ICU occupancy rate of more than 80% in nearly two-thirds of the Brazilian states. After dozens of patients were suffocated 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 lack of sedatives.

In Peru, where the government has discovered the P.1 strain, hospitals were quickly pushed out of capacity as infections increased in January after one of the world’s worst outbreaks last year. Doctors now choose from dozens of patients when an IC bed opens, while Chile provides life-saving oxygen amid acute shortages.

The scenes come as the US and parts of Europe celebrate declining infection rates amid massive vaccination campaigns, testament to a growing immunity gap between rich and poorer countries. While more than 15% of people in the US have received a Covid-19 shot, Brazil has given vaccines to just 3% of the population. Peru and Colombia vaccinated less than 1%.

If Latin America doesn’t find a way to speed up its vaccination campaigns, other countries, such as Colombia and Bolivia, which have recently seen the number of new infections decrease, could also fall victim to the new variant, infectious disease specialists say.

The longer the disease persists in countries like Brazil, the more likely new variants will emerge that reduce the effectiveness of Covid-19 vaccines and thus pose a threat to countries 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 Peruvian health minister and epidemiologist. “It will never stop.”

Cesar Palacios, a 44-year-old pediatrician in the northern city of Piura, Peru, lost his parents and younger sister to the disease earlier this year. He spent 10 days on a ventilator after becoming ill himself, the illness progressed rapidly as his blood oxygen level dropped to dangerous territory, with 86% just a day after his first symptom. A few days later he was in an ICU.

‘If you’re put on a mechanical breathing machine, you think, am I going to live? Am I dying? “said Dr. Palacios.” I had no choice. I was so scared. “

While Peru has imposed curfews in Lima and other high-contagion states, Brazilian cities such as São Paulo and the capital Brasília have introduced tougher restrictions in recent days.

But many Brazilians have defied the rules, following the example of the country’s president. Right-wing leader Jair Bolsonaro has downplayed the disease and attacked governors for imposing lockdowns, accusing them of destroying local businesses.

São Paulo military police raided about 50 institutions over the weekend that refused to comply, including a group of 190 elderly Brazilians holding 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]