A protester places a rose on a blanket during a protest against the government’s pandemic response on March 24 outside Raul Gazzola hospital in Rio de Janeiro.
Photographer: Dado Galdieri / Bloomberg
Photographer: Dado Galdieri / Bloomberg
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Staggering beneath worst period of the pandemic, with daily records of caseloads and deaths, Brazil is facing a daunting development: an increasing number of deaths among young people.
According to the government this month so far data, about 2,030 Brazilians deprecated 30 to 39 died of Covid, more than double the number recorded in January. Among those in their 40s, there were 4,150 fatalities in March, down from 1,823 in January, and for those aged 20 to 29, there were up from 242 deaths to 505.
“In the past, the risk factor of dying from Covid-19 was older, with some co-morbidity,” said Domingos Alves, a professor of medicine who is part of the national control group. “Now the risk is of being Brazilian.”
Fiocruz, a health care nonprofit organization, has one report on Friday showing the same trend with slightly different numbers.
It said among those cases deprecated 30 to 59 had risen from the start of the year to mid-March at a rate nearly double the national average of 316%. Those age groups saw the death rate increase by at least 317%, compared to 223% for Brazil as a whole.
In Sao Paulo, the country’s richest and most populous state, the increase is especially prominent in private hospitals, Secretary of State Jean Gorinchteyn said in an interview. Those aged 60 and over continue to dominate hospital admissions, but the proportion of people under 50 has risen from 10% last year to 15%.
In the state capital, more and more people between the ages of 20 and 54 are becoming infected, says the city’s health secretary, Edson Aparecido, GloboNews told TV on Friday. Younger patients wait longer to seek medical care and are sicker when they arrive.
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The explanation for the rising infection rate among young people – in a country that is largely young – remains unclear, although officials and medical experts suggest several possibilities. First, local and regional restrictions hindered socialization in 2020. That changed with the holidays, the new year and the loosening of lockdowns.
Second, a variant that was first spotted in the Amazon city According to Jaques Sztajnbok, who helps run the ICU at Emílio Ribas Hospital, one of Brazil’s main infectious disease facilities, this is likely partly due to Manaus. Patients largely get sick with that variant or the British variant, which is also more contagious. A study conducted in Sao Paulo found one of the two variants in 71% of the cases.
Health workers hold a meeting while treating patients in a Covid-19 ICU at a field hospital in Sao Paulo’s Heliopolis favela on March 19.
Photographer: Jonne Roriz / Bloomberg
Third, vaccines are limited in Brazil and there is no timeline for vaccinating the young.
Fernando Brum, a director of Santa Casa Hospital in Sorocaba, said the mutation of the virus in a much more contagious version with a viral load that makes people sick more quickly and aggressively has resulted in young people transitioning from mostly asymptomatic cases to seriously affected.
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Brum, whose hospital is a two-hour drive from Sao Paulo, says ICUs are also filled with 30-year-olds. He estimates that the age of patients hospitalized with Covid-19 has decreased by 50% from 2020.
“The intensive care unit is constantly and uninterruptedly occupied,” he said. Patients in their 30s make up at least half of those beds, and their average time in hospital has tripled from last year. It’s recently come down for a grim reason – patients are dying more quickly.
Sztajnbok said it is now not uncommon to see people under 40 or even in their 20s without risk factors requiring intubation and life support. In the past, he said, patients were usually over 65. “The first time that happened, we were shocked,” he said. “We were shocked the second time too. Now we are no more. “
The longer hospital stays are put pressure on healthcare in Brazil, which is struggling with decades of underinvestment. According to the new Fiocruz report, ICU capacity rates were at or above 80% in 25 states, while 17 states had levels above 90%.
A worker wearing protective equipment digs a grave at Vila Formosa Cemetery in Sao Paulo on March 24.
Photographer: Victor Moriyama / Bloomberg
In a March 23 report, Fiocruz also pointed to a “disproportionate increase in the country’s death rate,” which rose from 2% to 3.1% late last year. The jump indicates that patients could die from lack of assistance or from health care failures, he said.
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Brazil has become the epicenter of the pandemic, it recently reported records of more than 100,000 cases and 3,650 deaths per day. Home to 212 million people, the country alone follows the US in the toll of the virus. Although the vaccinations have been picked up in the last week, the 19 million shots deployed to date have only covered 7% of the population with one dose and about 2% fully vaccinated.
The shift to younger victims means pregnant women are becoming infected, says Fatima Marinho, an epidemiologist and senior advisor at Vital Strategies. The virus has also killed more children under 10. They usually have different symptoms, leading to a misdiagnosis, she added.
Marinho estimates a national death toll of 500,000 in June. It passed 300,000 this week, two and a half months after hitting 200,000, half the time it took to go from 100,000 to 200,000.
Even as vaccination coverage accelerates, she has another fear: “Such an intense virus circulation means Brazil may soon have other strains of viruses that become resistant to vaccines.”
– With the help of Isadora Sanches and Rafael Mendes