Brazil - Experts say explosion of deaths from covid requires measures: 'we are not doing anything'
This Thursday (4th), Brazil once again surpassed the mark of a thousand new deaths from covid-19 confirmed in a single day. The 1,041 deaths were the highest number confirmed in a day since August 26, 2021 (920 deaths recorded) and the first time that it exceeds 1,000 deaths since August 18 (1,064), according to data from the Covid-19 panel of the National Health Council. Health Secretaries (Conass).
The infectious disease doctor Alexandre Zavascki, from the Hospital de Clínicas de Porto Alegre (HCPA), says that the growth in deaths was expected to occur weeks after the surge in cases, recorded from the beginning of January in Brazil. In Rio Grande do Sul, the number of patients with covid-19 or suspected patients admitted to the ICU reached 699 this Friday (4). On January 1st, they totaled 243. “The death curve does not come at the first moment. She has a delay that is the evolution of the disease itself”, says Zavascki.
Data scientist Isaac Schrarstzhaupt, coordinator at the Covid-19 Analysis Network, highlights that, in January, 3,139,223 new cases of covid-19 were recorded throughout Brazil. In March 2021, considered one of the worst moments of the pandemic so far, there were 2,197,488 cases, almost a million less. The difference is that, last March, 66,573 deaths were recorded, against 8,033 this January, 58,540 less cases. If the same fatality rate as in March had been maintained, the country would have recorded 96,000 deaths in January. “This point shows us that the vaccine works to reduce deaths”, he says.
Zavascki states that it is indisputable that the proportion of deaths to the number of infected by covid-19 is lower in the current wave of the omicron variant than in previous waves. However, he points out that there are no conclusive data to say that the Ômicron is less severe than the other variants, since the lower mortality can be attributed to vaccination.
“Let's assume that she has a predisposition to have fewer severe cases, one thing is at the individual level, another thing is at the collective level. So, you have a smaller proportion of people who will have pneumonia and have oxygenation problems. But the number of infected people is incomparably greater and that ends up having a greater impact, because a lot of people will end up suffering,” she says.
For him, part of the scientific community and the press was rushed to disclose that the ômicron is less serious than the previous variants. “There were no major conclusions and we were evaluating the cases happening in vaccinated patients, with the vaccine protecting from worsening. So it wasn’t necessarily the variant,” he says.
Infectologist doctor and Master in Medical Sciences from the Federal University of Rio Grande do Sul (UFRGS), Ronaldo Hallal also points out that, although the omicron apparently does not cause serious impairment like the previous variants, it is highly transmissible, which keeps the situation as usual. risk, especially for patients from the so-called risk groups. “And there is a very fertile scenario for its spread, which are unvaccinated people, who have the greatest possibility of transmission and of contracting the disease in the severe form”, he says.
The first case of the omicron variant in Rio Grande do Sul was confirmed on December 3rd. On January 7 this year, the State Health Department (SES) reported that the variant already accounted for 95% of the coronavirus samples sequenced in the state.
For Ronaldo Hallal, governments should have already implemented measures to try to control the current wave. “We have the context that for governments and a good part of the population it is as if the pandemic has already passed and this is fertile territory for the wide circulation of the omicron around here. What is interesting is that there is no longer talk of intensifying isolation and prevention measures, as was said in 2020 and part of 2021. So, it ends up being a territory for the spread of the omicron, since it is very transmissible” , it says.
Hallal says that the best way to control the current variant would be similar to the previous waves, with restrictions on social mobility, agglomerations and face-to-face activities. He recognizes the difficulty of implementing new measures of this type, but argues that governments should have prepared themselves better for the scenario. For example, with increased testing and distribution of prevention supplies, such as masks.
“We've recently seen a lack of testing, a complete loss of access to testing. Isolation measures after a positive test have also not been adopted, on the contrary, the new protocols reduce the isolation time. It is true that transmissibility reduces after the seventh day, but it is not eliminated and there is a biological variation. I think we should opt for prudence and measures to control the pandemic rather than flexibility”, he says.
For Zavascki, a situation that differentiates the current wave of covid-19 from previous ones is the fact that, so far, no health authority in capitals, states or the federal government has taken any action to try to stop the surge in cases. “We used to argue about whether we were doing enough, but this time we're not doing anything. Life is normal, things are happening, there is no concern and no kind of campaign for people to protect themselves,” he says.
The infectologist believes that, in part, this is due to lack of knowledge. Another factor that would be influencing would be the “tiredness” of restrictive measures, which would lead people to accept living with the risks of infection. However, he questions whether this is also the result of a lack of knowledge about the risks of infection, since public awareness and information campaigns about the risks of the omicron variant have also been reduced. “If they were well educated, maybe they wouldn't take the risks, but there's no denying that it's an option for society to live like this”, he evaluates.
Hallal considers that the restrictions are only being adopted when “imposed by the virus”, when services temporarily stop working because workers have been contaminated. “Lockdown seems to be an expression that can no longer be pronounced. We already have strong enough reasons to determine a lockdown”, he says.
Data scientist Isaac Schrarstzhaupt says that in recent days there has been an apparent slowdown in the speed of growth of the current wave, pulled especially by the South and Southeast regions.
However, he considers that the available data do not allow to say if this deceleration means that the wave has reached a peak, which could precede a rapid fall, or if it has reached a plateau. “If we reach the limit of our testing capacity, it will plateau, not peak. It will remain high, but stabilized”, he says.
Schrarstzhaupt considers that any prediction would depend on indicators of positivity – proportion of positive results for each test performed –, but points out that there are no data available that give a dimension of the situation at the national level. “If positivity goes down with it, then it's really going down. If positivity stays high, then it's probably a lack of testing,” he says.
On the other hand, he points out that the research carried out by the University of Maryland based on the report of symptoms on Facebook indicates that the recent peak of posts about covid-19 on the social network was reached on January 18, with a reversal trend being recorded. on the curve ever since.
In South Africa, the country where the omicron variant was identified, the curve of covid-19 cases was marked by an almost vertical growth, followed by a sharp drop after reaching the peak. The behavior of the onomicron in South Africa generates the expectation that the current Brazilian wave may have a similar curve, which would indicate a strong reduction in cases in the coming weeks and months.
Alexandre Zavascki says he would not bet the chips that the curve will go down quickly, because, in previous waves, other countries also recorded sharp drops in infections and this never happened in Brazil. “The fall has always been slower, so it's hard to say it's going to happen again. We hope it drops quickly, but it could happen that we have a different scenario and a slower drop,” he says.
Ronaldo Hallal also recalls that previous projections indicated that the covid-19 pandemic could already have ended in 2021 because collective immunity was achieved, combining vaccination with people who have already been contaminated, which would reduce the portion of the population still susceptible to infection. contaminated by the disease and the virus would have great difficulties to multiply. However, due to the vaccine leak and the immune leak – the possibility of vaccinated people and people who have already contracted coronavirus recontaminating themselves –, he says that it is not possible, at this moment, to make any prediction about the future behavior of the virus. Especially given the fact that new variants may emerge.
Schrarstzhaupt also believes that it is dangerous to try to project the behavior of the disease in Brazil based on the example of other countries. “This speed of decline is multifactorial, depending on the number of susceptible people, the vaccines used, the interval between vaccines, the age pyramid, population mobility, etc. For example, South Africa, which went down super fast in the wave of the omicron, also went down super fast in the other waves. You take the United Kingdom, it dropped super fast, but when you open the data by age group, you notice that it is falling above 20 years old and rising in children from 0 to 17. You add it all up and divide it, it is falling, but it is rising among the most vulnerable”, he says. The UK started vaccinating children aged 5 to 11 with comorbidities just this week.
He also says that, contrary to the South African example, is Austria, which was the first European country to have a big wave of the omicron variant. The country carried out a lockdown for the non-vaccinated and the curve of cases had a rapid drop, but soon rose to an even higher level. “It went up fast, went down fast and days later a wave broke out twice as large as the previous wave of the omni, which was already giant. So, how can we predict?”, asks the data scientist.
Schrarstzhaupt also warns that cases of Severe Acute Respiratory Syndrome (SARS), which includes severe cases of flu and other respiratory illnesses, tend to rise from late February and early March, reaching a peak in the months of June and July. and starting to fall from August. He says that, in 2020, cases of covid-19 followed the SARS curve, but started a high at the end of the year, followed by a new fall in January, which preceded the explosion of cases from February and March of 2020. 2021. At the end of last year, the omicron variant pushed up the curve of covid-19 cases again.
The data scientist says that it is necessary to wait until mid-March to find out if cases of covid-19 will once again follow the trend of other respiratory syndromes. If that happens, we would have a new wave of growth starting in March. “If by then, we don't see a rebound in the trend, then we may have depletion of susceptibles and greater immunity. If not, what has always happened will probably happen (increase in respiratory syndromes)”.
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source newsroom https://sul21.com.br/noticias/saude/coronavirus/2022/02/especialistas-dizem-que-explosao-de-mortes-por-covid-exige-medidas-nao-estamos-fazendo-nada/
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