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How COVID-19 deaths exploded in Brazil

How COVID-19 deaths exploded in Brazil
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Crosses at the Nossa Senhora Aparecida Cemetery in Manaus, Brazil mark the graves of those who died from COVID-19. Brazil s COVID-19 deaths have exploded and country s ICU capacity is at a breaking point. (Photo: Sandro Pereira/Fotoarena/Sipa USA)(Sipa via AP Images)

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TORONTO -- As vaccines start making their way around the world, many countries have seen their deaths due to COVID-19 decline.

But Brazil is bucking the global trend and has seen an explosion in cases and death, leaving the country s ICU capacity at a breaking point.

Tuesday alone saw 3,251 deaths as well as an average of 2,364 daily deaths in the previous seven days. Several states have also seen ICU capacities at or almost at 100 per cent. Nearly 300,000 Brazilians have died from COVID-19 since the start of the pandemic, a death toll that is second only to the U.S.

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Fiocruz, Brazil s public health research institute, reported last Tuesday that ICU capacity in all but two of its 26 states were above 80 per cent. In 10 states, capacity exceeded 95 per cent and in the state of Rio Grande do Sul, ICU capacity was at 100 per cent.

The high death rate is despite the fact that Brazil has a younger population than Canada and countries in Europe.

"Inherently you would think there would be fewer deaths, but just the situation there just seems to have spiralled totally out of control," said Jean-Paul Soucy, an infectious disease epidemiologist and PhD student at the University of Toronto in a phone interview.

The virus has also disproportionately burdened Brazil s Indigenous population, who have already been facing the deforestation of the Amazon rainforest. Brazil s Indigenous People Articulation says that over 51,000 Indigenous people of Brazil have tested positive while 1,022 have died. The highest number of deaths are centred in the state of Amazonas, where 242 Indigenous people have died.

Experts say crisis has unfolded in large part due to the mishandling of the pandemic from Brazil s federal government, led by far-right President Jair Bolsonaro. Bolsonaro has opposed implementing lockdown restrictions or curfews and has gone to court to fight against lockdown measures imposed by local mayors and state governors, whom he calls "tyrants." He has also promoted misinformation discrediting masks-wearing and the severity of COVID-19.

On top of that, Brazil has been slow to roll out the vaccines, which Bolsonaro has also publicly disparaged.

"The president there, Bolsonaro, has made some unkind comments about the mask wearing and vaccine efficacy. It doesn t seem like his federal government really prioritized acquiring vaccines which is why now they ve had little vaccination in that country," said Soucy.

Anne-Emanuelle Birn, an expert in Latin American public health and a professor at the University of Toronto s Dalla Lana School of Public Health, notes that cracks in Brazil s public health infrastructure date back well before the pandemic.

In December 2016, before Bolsonaro came into power, the Brazilian government imposed a constitutional amendment that would freeze social spending for 20 years, which Birn calls "the world s harshest austerity measure."

"This means that the famed unified health care system, established in 1989 and arguably the worlds most ambitious effort to realize the right to health, has been in shambles for years," said Birn in an email.

"So, the COVID-19 crisis has exploded atop what was already a dire situation. Brazilian president Bolsonaros yearlong denial and mockery of the pandemic and his administrations criminal failure to enact public health measures to protect the population have escalated into the current disaster."

This map from Brazil s public health research institution shows the ICU capacity per state in the country. (Fiocruz)

The other factor is the dominance of the P1 variant of SARS-CoV-2, which was first detected in Japan in travellers who had returned from Brazil.

"The P1 variant seems to be extraordinarily transmissible as well as being more likely to reinfect people who had conventional COVID. So, we do see evidence of quite a number of the infections happening in Brazil," said Soucy.

"Given the situation with rising case numbers given the situation with high ICU numbers, hospitalization numbers. I think we re going to see those go up for some time to come. Even if transmission got turned around tomorrow, I think you re still going to see a big period of suffering, unfortunately."
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