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Brazil exceeds 150,000 deaths from covid-19

Brazil has exceeded 150,000 deaths from coronavirus at a time when it celebrates small victories due to the slowdown of the pandemic, although it remains immersed in a serious scenario and without an effective national policy against the crisis. A third of the deaths from covid-19 in the country have been registered in the last two months. This means that at least 50,000 people died from the disease precisely in the period when official figures for the spread of the virus began to show signs of containment of the health crisis.

Starting in August, just after the country reached 100,000 deaths, the contagion rate began to decrease and was even at times below 1, considered the threshold of uncontrolled. The average of more than 1,000 daily deaths recorded so far has also dropped. The most recent data looks promising: Imperial College reported this week that Brazil has kept the virus transmission rate below 1 for two consecutive weeks for the first time since April. And the daily average of deaths in the week of September 27 to October 3 fell to 654, representing a reduction of 5%. Brazil is the country with the second highest death toll, after the United States. When the deaths proportional to the population are calculated, the country is in third position, with 695 deaths per million inhabitants. Ahead are Peru, with 989, and Belgium, with 867. Spain, facing a second wave, has 686 deaths per million inhabitants.

But these advances are not enough to get the country out of the worrying phase, although they give the population a feeling of greater security to resume some activities. Only 33.8 million Brazilians (16% of the population) follow rigorous isolation, according to data from the National Household Sampling Survey (PNAD) of the Brazilian Institute of Geography and Statistics. This number fell by 1.6 million between the second and third week of September, according to a survey published this Friday.

In any case, the fact that more than 600 deaths from coronavirus are registered daily in Brazil cannot be ignored. “It is a brutal loss,” says Gabriel Erick dos Santos, who lost his sister, Erika Regina Leandro dos Santos, an actress who lived “as if she were never going to die.” With diabetes, hypertension, and being overweight, he used to have health problems, but he always recovered. Until he was infected with coronavirus. Erika passed away at the age of 39 without her brother being able to return the care that she had given him a year ago during a convalescence. “What hurts me the most is that I couldn’t be by his side or say goodbye,” Gabriel laments. The pandemic did not even allow him to pay the tribute Erika deserved, especially for raising him after his parents died when they were young. “She was a very open person, it was very easy to get close to her and have affection for her,” she says. Gabriel remembers that the most terrible thing was the funeral, in which there were only six people (almost the whole family), who could only lead a short prayer while the cemetery workers rushed to the burial. “I couldn’t even hang a tape with his name on it, a family heirloom, on the coffin.”

A country with different contagions and political actions

Each Brazilian state faces the pandemic at different speeds and with different intensity. Some northeastern states that were brutally affected in the first months of the crisis, such as Ceará, seem, in fact, to have slowed transmission. But you cannot lower your guard, as the case of Amazonas reveals: the state reached a violent peak of infections between April and May and, after a period with a minimal transmission rate, cases have increased again. For now, experts avoid talking about a second wave, but ask the attention of political and health authorities.

On the other hand, São Paulo, the city that was the gateway of the virus in the country, has concentrated the highest number of cases and deaths since the beginning of the crisis. It was one of the first capitals to implement partial confinement to have time to prepare its sanitary system. The demand for beds in hospitals fell over the months, and even field hospitals were deactivated. But, currently, the populous megalopolis still registers more than 100 deaths from covid-19 a day. And it is preparing to enter an even less restrictive phase in relation to measures to avoid contagion: starting this Saturday, São Paulo will allow the reopening of cultural spaces, such as cinemas and museums. The impacts of the new measures should be analyzed over the next few weeks.

“The level of contagion in Brazil is still worrying, both nationally and in certain places. We have never implemented measures that prevent contagion itself. What we have done is to take mitigating and costly distancing measures, such as remaining in quarantine ”, considers Rafael Lopes, researcher at the Covid-19 Observatory. Lopes says that Brazilian public managers are focused on managing contagion in order to reactivate the economy, but the country does not have a strategy to really control the pandemic. “Brazil is a continental country, we have diverse realities and epidemics, the evidence deficit is still very large. We cannot use the evidence we have to discover new cases, we use it only to confirm them. It would be very important that we do extensive tests to identify the chains of contagion and break them, “he defends.

Lack of national coordination

After more than seven months of crisis, Brazil does not have a solid national policy to control the pandemic. Important decisions, such as the de-escalation of quarantine, are still made by local administrators – according to the Federal Supreme Court decided – but without any explicit national orientation. In general, local rulers rely on data such as the ICU occupancy rate, the virus transmission rate, and the positivity rate in tests to determine the reopening of economic activity, with their own criteria. All this situation will be subjected to an additional test at the beginning of November, when the municipal elections will be held in person in the more than 5,000 municipalities of the country. In many cities, campaign events have simply ignored security protocols. The Ministry of Health, traditionally responsible for coordinating and transmitting health policies to other states, has focused on distributing materials and taking actions that corroborate the ideas of President Jair Bolsonaro, a denier who contracted the disease but continues to minimize the severity of the pandemic.

Recently, the Ministry suspended an action called D-Day to stimulate early treatment in patients with symptoms of covid-19. There is still no drug or treatment capable of curing the disease and the scientific community interpreted it as an action to stimulate the use of chloroquine, a drug widely defended by Bolsonaro although science has shown that it is ineffective against covid-19. In response to the supposed D-day of chloroquine, researchers and former health ministers even held an event in defense of science.

And it is that a protocol with guidelines on the use of chloroquine to treat covid-19 had been disclosed throughout the country by order of Minister Eduardo Pazuello, a military man who recently admitted having assumed the most delicate position in the fight against the pandemic without even knowing the Brazilian Unified Health System (SUS), the largest public health system in the world. “I didn’t even know what SUS was. All my life I have been treated in public institutions of the Army, I have only known the SUS now and I have understood the magnitude of this tool that Brazil has given us, “he said during an event on breast cancer last week.

The Ministry of Health’s bets to overcome the pandemic seem now to focus on vaccines for the coronavirus, which are in the clinical trial phase. Brazil – which had already signed a contract with Aztrazeneca to buy doses and the rights to produce the drug in the country – recently joined a global consortium to purchase seven other potential vaccines. The executive secretary of the Ministry of Health, Elcio Franco, affirms that the country hopes to start the vaccination campaign in the first quarter of next year and that it has developed a strategy to guarantee 140 million doses of vaccines until mid-2021.

The Brazilian National Health Surveillance Agency (Anvisa) has already adapted the necessary procedures to try to speed up the registration of vaccines as soon as the trials reveal that they are safe and effective, analyzing part of the process before the investigation ends. He also admits that he can reduce the required efficacy rate from 70% to 50%, because he understands that, in a pandemic of this severity, this level of immunization would already have important effects on public health. “Making the criteria for the efficacy of vaccines more flexible does not mean giving up safety. This is the priority we give it, ”said Gustavo Mendes, general director of Medicines and Biological Products of Anvisa. A group of specialists works with the Ministry to design an immunization program. The strategies look promising. We’ll see if science actually succeeds in developing a safe vaccine.

Information about the coronavirus

– Here you can follow the last hour on the evolution of the pandemic

– This is how the coronavirus curve evolves in Spain and in each autonomy

– Download the tracking application for Spain

– Search engine: The new normal by municipalities

– Guide to action against the disease