A rise in deaths among younger people prompts alarm over P.1 variant, present in more than 20 countries
PORTO ALEGRE, Brazil—Brazil is in the throes of a battle against the new Covid-19 variant from the Amazon that threatens to send shock waves across the globe.
Home to less than 3% of the world’s population, Brazil currently accounts for almost a third of the daily global deaths from Covid-19, driven by the new variant. More than 300,000 have died, and daily deaths now top 3,000, a toll suffered only by the far more populous U.S.
“We’re in the trenches here, fighting a war,” said Andréia Cruz, a 42-year-old emergency-ward nurse in the southern Brazilian city of Porto Alegre. In the past three weeks alone, the surrounding state of Rio Grande do Sul has seen nearly 5,000 people die from Covid-19, more than in the final three months of last year.
The spread of the virus in Brazil threatens to turn this country of 213 million into a global public-health hazard. The so-called P.1 strain, present in more than 20 countries and identified in New York last week, is up to 2.2 times more contagious and as much as 61% more able to reinfect people than previous versions of the coronavirus, according to a recent study.
The P.1 is now responsible for the majority of new infections in Brazil, with many doctors here saying they are seeing more young and otherwise healthy patients falling ill. About 30% of people dying from Covid-19 are now under 60, compared with an average of about 26% during Brazil’s previous peak between June and August, according to official figures analyzed by The Wall Street Journal.
Public health researchers warn this isn’t just Brazil’s crisis, pointing to what they say is widespread complacency in the U.S. and elsewhere over the risks stemming from Latin America and other unvaccinated swaths of the globe. Brazil has fully vaccinated only 1.8% of its population.
“There is a rush to declare this pandemic is over, and it’s not,” said William Hanage, a Harvard University epidemiologist. “I dread to think what will happen when P.1 manages to get to [places] that are not likely to get vaccinated for quite some time.”
A t the Moacyr Scliar hospital in Porto Alegre, harried doctors push aside stretchers to tend to the next patient, many of whom are forced to sleep on chairs for days as they struggle for air in the hot ward.
“If I make any movement, sit up or turn around, my heart races and it gets hard to breathe,” said Jeanne Silva, a 30-year-old asthma sufferer. She grimaced with pain as she shifted in the armchair she had been sitting in for 30 hours, oxygen tubes connected to her nose. “I’m scared,” she said.
Brazil has become a global pariah as scores of nations impose restrictions on travelers from the country, including neighboring Colombia as well as others such as the U.K. Peru’s government said 40% of infections in its hard-hit capital are from P.1, while tiny Uruguay, which borders Rio Grande do Sul, has seen infections skyrocket to an all-time high.
Researchers said preliminary studies suggest the existing vaccines being rolled out across the world are effective on P.1, but further studies are needed to check if their efficacy is reduced with the new variant. The longer the virus is left to fester and mutate here, the higher the chance that even more aggressive strains may emerge, threatening vaccination progress made by the U.S. and elsewhere.
Further alarming researchers, the P.1 variant itself has also already started to mutate, showing changes that could make it even more infectious, said Felipe Naveca, who led some of the first research into P.1 and works at the Oswaldo Cruz Foundation, a public health institution.
“If we don’t stop the virus circulating, it won’t stop evolving,” he said.
A lackadaisical approach to masking and social distancing and a slow vaccine rollout all helped turn Brazil into the perfect breeding ground for variants, researchers said. The P.1 emerged in Manaus, a major industrial hub from where truckers likely helped spread it rapidly across the country.
A later arrival than the B.1.1.7 strain in the U.K., P.1. remains somewhat of a mystery—in part because Brazil also tests less than the U.K., meaning data is scarcer. While researchers know P.1 is more contagious and more capable of reinfecting, there is no definitive answer yet on whether it is also more lethal.
B ut from the Brazilian jungle and northeastern coastal cities to the southern farming belt, doctors and hospital directors said in interviews with the Journal that the dangers from P.1 are overwhelming and obvious.
“We’re seeing patients who aren’t obese, who have no comorbidities, who are not old but, even so, the virus just overwhelms them,” said Diego Montarroyos Simões, an intensive-care doctor in the northeast city of Recife.
A thousand miles to the southwest in the mining state of Minas Gerais, many doctors note a rise in younger and more critically ill patients in comparison to the country’s surge of cases in the middle of last year.
“The virus is claiming parents and their children,” said Eduardo Lopes, 47, an assistant nurse at one of the main hospitals treating Covid-19 patients in Belo Horizonte.
In Porto Alegre, where at least 60% of new Covid-19 infections are caused by P.1, the number of patients between 40 and 69 years old dying in the city has risen 125.5% since December, while total fatalities rose only 102.7%, according to official data analyzed by Álvaro Krüger Ramos, a mathematician at the Federal University of Rio Grande do Sul.
Researchers say it could be a reflection that younger people are taking more risks as they tire of social-distancing rules, or because many of the eldest and most vulnerable Brazilians have either died or been vaccinated. Or it could be more lethal, though they say further studies are needed.
The scale of the human tragedy here has been amplified by the breakdown of the Brazilian health system, which is so overtaxed that patients admitted for everything from injuries from car crashes to heart attacks are also more likely to die.
ICU wards in all but two states are now full or struggling to cope at more than 80% capacity, said the Oswaldo Cruz Foundation. The country’s funeral association is urging funeral homes to stock up on urns.
After oxygen shortages caused patients to suffocate to death earlier this year in the Amazonian city of Manaus, hundreds of cities across the country have braced for a similar fate. Even São Paulo’s top private hospitals, which treat billionaires and presidents from across Latin America, have run out of ICU beds in recent weeks.
Brazil also owes its current catastrophe to a fatal combination of what public health experts say was mismanagement of the crisis by the government.
President Jair Bolsonaro, a former army captain, has played down the dangers of the disease, disparaging face masks and recently telling Brazilians to get back to work and “stop whining.”
His health ministry has spent tens of millions of dollars on unproven cures for the disease while dragging its feet on vaccine supply deals.
“Why the hurry to vaccinate,” Mr. Bolsonaro told supporters in December as he declared the pandemic to be “almost over.”
Many Brazilians have adopted the same attitude and refused to bow to a patchwork of curfews and restrictions imposed by cities across the country.
State governments have sought out vaccines, with no federal help. São Paulo, Brazil’s richest state, struck its own deal with the Chinese to test and produce Sinovac’s Covid-19 shot, CoronaVac, at the Butantan Institute, its biomedical research center, and several northern states turned to Russia, signing purchases for the Sputnik V shot.
Brazil’s Health Ministry said it is doing everything possible to speed up vaccinations and has secured 562 million doses to be delivered this year.
But more than two months after it started, Brazil’s vaccination campaign hasn’t been enough, public health experts said.
With 10 mutations on the spike protein that helps the virus attach to human cells, P.1 has been found to be more contagious than previous versions. But P.1 also appears to cause more serious illness, said José Eduardo Levi, a virologist at the lab and hospital group DASA.
With vaccines slow to arrive, some cities have taken drastic measures. Araraquara, home to 240,000 people and one of the first cities to be devastated by P.1, shut down supermarkets for six days and public transport for 10 days last month.
“The greatest humanitarian tragedy in the history of Brazil will be the coronavirus,” said Edinho Silva, Araraquara’s mayor.
He said the president’s argument that Brazil must remain open to save its economy made no sense. “No one is going to invest in the middle of a pandemic—either you deal with the pandemic or the economy doesn’t recover,” Mr. Silva said.
In Araraquara, 19 people under the age of 40 have died from Covid-19 this year, or 8.75% of all fatalities from the disease, compared with only one person in 2020, representing 1.1%.
One of them was Jorge Carbone, a 35-year-old store manager with no previous health problems. Less than two weeks after complaining of a sore throat, he was dead.
“The pain of losing him is unbearable,” said Luzia Abud, his 50-year-old aunt. “People are just disappearing,”
Marcos Oling, 47, an Uber driver in Porto Alegre, became infected and has been hooked up to oxygen for more than a week, most of which he spent on a wheelchair for lack of spare beds. He said he is frustrated by those not taking the virus seriously.
“People think nothing will happen to them,” he said.