How a small city in Brazil may reveal how fast vaccines can curb Covid-19

‘The city of Serrana in Brazil is a living experiment. The picturesque place, surrounded by sugarcane fields, is nestled in the southeast of one of the countries hit hardest by COVID-19. By the end of March, daily deaths in Brazil surged to 3,000 on average a day, a high in a pandemic that has claimed more than 405,000 lives there — the second worst death toll of any country in the world behind only the United States. And as vaccines slowly trickle into the country, only about 15 percent of the population has gotten at least one shot.

‘Except in Serrana. There, nearly all the adults have gotten their shots. What happens next in this city could provide a glimpse of what the future of the pandemic could be — not only in Brazil but across the globe as vaccinations pick up.’

Read here (Science News, May 5, 2021)

Brazil after the collapse

‘Health experts warned about it for weeks. In early March, the Brazilian health system entered a state of collapse under the weight of a nationwide spike in COVID-19 infections. Hospitals were not able to attend to all patients who needed treatment. By the end of March, all over Brazil, more than 6000 people were waiting for an ICU bed, most of them in overcrowded health centres and emergency wards without the necessary equipment and personnel for treatment.

‘In parallel, the power bases of the presidency of Jair Bolsonaro eroded in rapid fashion after he seemed to have consolidated his power in early February with the election of his preferred candidates to the powerful positions of speaker of the Parliament and of the Senate.’

Read here (The Bullet, Apr 13, 2021) 

Brazil coronavirus strain: Variant three times more deadly for those aged 18-45, research shows

‘The new coronavirus variant sweeping through Brazil, and spreading to other nations around the world, is proving to be up to three times more deadly for young people, according to research. 

‘It is also spreading more quickly among younger people with cases among Brazilians in their 30s, 40s, and 50s are up by 565 per cent, 626 per cent and 525 per cent respectively since the beginning of January, according to Brazilian public health institute Fiocruz. In comparison, during the same periods the increase in the overall population was much lower at 316 per cent, suggesting the virus infections are making “a shift to younger age groups”. There is also growing evidence shows that young people are not only more likely to get infected with the new strain – dubbed P. 1 – but also to die from it.’

Read here (News.com, Apr 6, 2021)

A city in Brazil’s Amazon rain forest is a stark warning about Covid to the rest of the world

‘Manaus and cities like it will continue to generate dangerous viral variants if vaccination campaigns are not expanded to broadly reach all nations, rich or poor...

‘Manaus was devastated by a first wave of COVID cases beginning last March. Excess deaths—the 3,457 people in the city who died above the expected mortality figures between March 19 and June 24, 2020—represented 0.16 percent of Manaus’s relatively young population. And 7 percent of men older than 75 died at the peak of the spread.

‘Infections were so prevalent that researchers at the University of São Paulo and their colleagues concluded that Manaus was the first city in the world to reach herd immunity—the point at which enough people are immune to a virus that the spread of new infections is hindered. Their preliminary preprint study estimated that 66 percent of the population had been infected with SARS-CoV-2 (they later revised their figure to 76 percent as of October). The threshold for COVID herd immunity is unknown, but projections often cited range from 60 to 90 percent. Similarly high rates of infection have also been found in the Peruvian and Colombian Amazon...

‘In December 2020 a second wave did hit. And by January the city’s health system, which serves communities across the Amazon, had collapsed. ICUs were full to bursting, and oxygen supplies became exhausted. Some patients were airlifted to other regions of Brazil. But many died of asphyxiation on makeshift beds in hospital corridors or their home, doctors say.

‘More severe than the first one, the new wave took Manaus by surprise. Wearing masks and practicing social distancing had been discarded in the belief the city had reached herd immunity. Caseloads surged out of control, and bleak milestones from last year were surpassed. In January alone more than 3,200 excess deaths were logged, Orellana says.’

Read here (Scientific American, Mar 29, 2021)

'Covid is taking over': Brazil plunges into deadliest chapter of its epidemic

‘[André] Machado saw several explanations for the torrent of cases he and other doctors are now seeing, including political mismanagement and the slackening of social distancing measures, principally among the young. In recent months such containment efforts have largely collapsed, with schools and businesses reopening and Bolsonaro’s tourism minister even urging citizens to start holidaying again.

‘But the doctor suspected a third, more troubling element was also at work: an enigmatic and apparently more contagious variant called P1 that is thought to have emerged in the Amazon region in late 2020 but is now circulating across Brazil, including in the southern state of Rio Grande do Sul, where Machado works.’

Read here (The Guardian, Mar 13, 2021)

Why has P1 appeared? Heads it wins, tails we lose?

‘You may already know that viruses mutate, that this is normal and these small changes to the virus’s genetic code are to be expected. Well, that’s true, but that doesn’t mean they’re always harmless. Many mutations will be irrelevant, and some will make a virus weaker and will die out. But others will make it fitter, giving it an advantage over other variants and allowing it to out-compete them.

‘As people socially distance, observe stricter personal hygiene and wear masks, it becomes an advantage for the virus to be more transmissible. Similarly, as more people around the world gain immunity through being infected or vaccinated, another advantage would be for the virus to change so that antibodies can no longer attach to it and prevent it from infecting cells.

‘It’s therefore not surprising to see variants with mutations that provide these advantages now out-competing other forms of the coronavirus. Control measures and rising immunity are pressuring the coronavirus to evolve.’

Read here (The Conversation, Mar 3, 2021)

Resurgence of Covid-19 in Manaus, Brazil, despite high seroprevalence

‘A study published in The Lancet analyzed the increased SARS-CoV-2 transmission in Manaus, Brazil, a region that had previously shown high levels of seroprevalence among its community members. A study conducted in October 2020 detected SARS-CoV-2 antibodies in samples from 76% of blood donors, which suggested that the region may have reached the threshold to provide some level of community immunity (ie, herd immunity). Despite the high seroprevalence, Manaus exhibited a large surge in COVID-19 cases and hospitalizations in January 2021.

‘The researchers present 4 possible explanations for the surprising surge in cases. First, the previous study could have overestimated the seroprevalence, which could have put the community below the herd immunity threshold. Second, immunity to SARS-CoV-2 conferred by earlier infection could have waned, resulting in re-infections. Third, the new infectious could be a result of emerging variants, including the P.1 variant first reported in the area, that are less susceptible to antibodies from prior infections. And finally, new SARS-CoV-2 lineages could simply be exhibiting much higher transmissibility, which could allow widespread community transmission even in areas with high existing seroprevalence. The researchers note that these theories are not mutually exclusive, and further study is needed to better characterize the factors driving the current resurgence. In particular, it is critical to investigate the potential that emerging variants could evade antibodies developed from infection with other strains, which could inform response activities in communities around the world.’ 

Read here (The Lancet, Jan 27, 2021)

A Covid genocide in the Americas?

‘Just as political leaders like Donald Trump and Jair Bolsonaro have forced a reckoning about the historical persistence of fascist politics, so have their disastrous responses to the COVID-19 pandemic renewed the relevance of the concept of genocide. How else are we to come to grips with so many culpably avoidable deaths?’

Read here (Project Syndicate, Jan 18, 2021)

World questions whether China’s Covid jab is safe

‘Although Turkish researchers found that the Sinovac vaccine was 91.25 percent effective in preventing the onset of the coronavirus, trials in the United Arab Emirates found it to be somewhat lesser, at 86 percent effective, while Indonesian trials found the drug was only 61 percent effective. The Turkish trials were conducted on only 29 subjects. Even worse news emerged from Brazil, where the Chinese vaccine was found to be effective in only 50.4 percent of cases in clinical trials numbering13,000 participants. Too many across Asia and elsewhere believe there wasn’t sufficient scientific rigor, the trials were too short and too rushed, and that, in the words of one observer who declined to be named, “poor Asians and others are being given a shoddy vaccine because Beijing wants to score political points with its crappy jab.”

‘Whether that is true or not, those countries going ahead with the Chinese vaccine, however, seem to be proceeding on the basis that, while it may only be 50 percent effective, it’s better than zero percent without a vaccine. Pfizer and Moderna vaccines have been found to be more than 90 percent effective, but it’s a question of availability and price. Although legions of common citizens from the Philippines to Indonesia to Turkey to Brazil are shying away from China’s vaccine, governments are sticking with it. Singapore has announced it will continue with the Chinese products, as will Thailand although authorities have also bought 26 million doses of the UK-based AstraZenica vaccine – which won’t arrive until June. It will still need to be approved by the Thai FDA.’

Read here (Asia Sentinel, Jan 17, 2021)

Brazil trial finds efficacy of Sinovac vaccine at 50.4 percent

‘A coronavirus vaccine developed by China’s Sinovac Biotech was found to be just 50.4 percent effective at preventing symptomatic infections of COVID-19 in a Brazilian trial, researchers said on Tuesday, barely enough for regulatory approval and well below the rate announced last week.

‘The latest results are a substantial disappointment for Brazil, as the Chinese vaccine is one of two that the federal government has lined up to begin immunisation during the second wave of the world’s second-deadliest COVID-19 outbreak.’

Read here (Aljazeera, Jan 13, 2021)

Sinovac releases vaccine data in Brazil: 100% effective in preventing severe cases, could reduce hospitalizations by 80%

‘Sinovac's COVID-19 vaccine is 100 percent effective in preventing severe and moderate infections, 77.96 percent effective in preventing mild cases, and has an overall efficacy of 50.4 percent in Brazil's final-stage trials. Experts say the result is good enough considering almost all participants in Brazil are high-risk medical workers, and the 77.96 efficacy for mild-case protection means the vaccine can reduce 78 percent of people from needing hospitalization. 

‘We have today one of the best vaccines in the world, Dimas Covas, director of the Butantan Institute in Brazil, said during a news conference on Tuesday.’

Read here (Global Times, Jan 13, 2021)

A second Chinese coronavirus vaccine is said to be effective

‘Brazilian officials said Thursday that a coronavirus vaccine made by a Chinese company was effective, bolstering the chances of approval for a second Chinese inoculation that could be rolled out in much of the developing world. Officials in the state of São Paulo, where a prominent medical research institute carried out a large study of the vaccine made by the Beijing-based Sinovac, said the inoculation had an efficacy rate of 78 percent.

‘The vaccine prevented all participants from developing serious and mild complications from the virus, officials said, calling it a highly effective preventive tool. Sinovac Biotech has sold more than 300 million doses to the developing world, filling a gap left by Western countries.’

Read here (New York Times, Jan 7, 2021)

World’s vaccine testing ground deems Chinese Covid candidate ‘the safest, most promising’

‘Brazil is one of the world’s top COVID-19 vaccine testing grounds. Now officials there say that CoronaVac, the experimental COVID-19 vaccine from Chinese developer Sinovac, is the safest of the coronavirus immunizations evaluated in the country so far.

“The first results of the clinical study conducted in Brazil prove that among all the vaccines tested in the country, CoronaVac is the safest, the one with the best and most promising rates,” São Paulo Gov. João Doria told reporters in Brazil on Monday.’

Read here (Fortune, Oct 20, 2020)

Eleven people died in Manaus, in the state of Amazonas, Brazil, during a study conducted with high doses of the drug chloroquine

‘Eighty-one patients participated in the research, 41 of whom received a high dose of chloroquine. After three days of treatment, those who received the highest dose of chloroquine began to have heart arrhythmias. On the sixth day of treatment, 11 of them died, leading the group of researchers to abandon the investigation.

‘The patients in the study were also given the antibiotic azithromycin, a drug that presents the same cardiac risk. The data is still preliminary, not conclusive, which means that more studies are needed on the relationship between the drug, the disease and the deaths.’

Read here (TeleSureTV, April 15, 2020)