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Health experts have warned that Brazil, which currently accounts for a quarter of the world's daily Covid-19 deaths, is on the verge of even greater calamity.
The nation's seven-day average of 2,400 deaths is set to reach 3,000 within weeks, six experts told the Associated Press. That is nearly the worst level seen by the United States, though Brazil has two-thirds of its population.
There are also warnings that spikes of daily deaths could soon hit 4,000, after the country recorded 3,650 Covid-related deaths on Friday.
There is growing recognition that shutdowns are no longer avoidable – not just among experts, but also many mayors and governors.
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Restrictions on activity they implemented last year were half-hearted and consistently sabotaged by president Jair Bolsonaro, who sought to stave off economic doom. He remains unconvinced of any need for a clampdown, which leaves local leaders pursuing a patchwork of measures to prevent the death toll from spiralling further.
It may be too late, with a more contagious variant rampaging across Brazil. For the first time, new daily cases topped 100,000 on Thursday, with many more uncounted.
Miguel Nicolelis, professor of neurobiology at Duke University who advised several Brazilian governors and mayors on pandemic control, anticipates the total death toll reaching 500,000 by July and exceeding that of the US by the end of the year.
“We have surpassed levels never imagined for a country with a public healthcare system, a history of efficient immunisation campaigns and health workers who are second to none in the world,” said Prof Nicolelis, who is also an epidemiologist. “The next stage is the health system collapse.”
Buckling health system
The system is already buckling, with almost all states’ intensive care units near or at capacity.
Dr Jose Antonio Curiati, a supervisor at Sao Paulo's Hospital das Clinicas, the biggest hospital complex in Latin America, said its beds are full, but patients keep arriving. The city's oxygen supply is not guaranteed and stocks of sedatives required for intubation in intensive care units will soon run out.
“Four thousand deaths a day seems to be right around the corner,” Dr Curiati said.
On March 17th in northeastern Piaui state, nurse Polyena Silveira wept beside a Covid-19 patient who died on the floor for lack of beds at her public hospital. A photo capturing the moment went viral and served as a national wake-up call.
“When he was gone, I had two minutes to feel sorry before moving to the next patient,” she said. “In eight years as a nurse, I’d never felt as much pain as that night. I’m near my limit, physically and mentally.”
Brazil’s state-run science and technology institute, Fiocruz, on Tuesday called for a 14-day lockdown to reduce transmission by 40 per cent.
Minas Gerais, Brazil's second most populous state, has closed non-essential shops. Espirito Santo state will enter lockdown on Sunday. Brazil's two biggest cities, Rio and Sao Paulo, have imposed extensive restrictions on non-essential activities. Their state authorities brought forward holidays to create a 10-day period of repose, which started on Friday.
Restrictive measures, however, are only as strong as citizens’ compliance. And Mr Bolsonaro continues to undermine their willingness by painting even partial shutdown as an assault on one’s right to earn an honest day’s wages. He has lashed out at local leaders, particularly governors, who go against him.
The World Health Organisation's director, Tedros Adhanom Ghebreyesus, has called for everyone in Brazil to muster a serious response, "whether it's the government or the people".
P1 variant
The virus's spread has been turbocharged by the more contagious P1 variant that has become cause for concern beyond Brazil's borders, not just in South America. It has already been identified in the US, this week in New York.
Dr Anthony Fauci, the top US infectious disease expert, said on Wednesday that his team will be meeting Brazilian authorities and are "quite concerned" about the situation.
The US has seen its death toll plunge since late January amid a massive vaccine rollout, and its seven-day average has dipped below 1,000. By contrast, Brazil’s vaccine rollout has been strained, at best.
The government bet big on a single vaccine provider, AstraZeneca, while for months rejecting offers to purchase others. Only after delivery delays from AstraZeneca jeopardised the rollout did Brazil's health ministry begin buying, but it was too late for most deliveries to arrive in the first half of this year.
The nation has fully vaccinated less than 2 per cent of its citizens. – Associated Press