Pennsylvania/São Paulo: Staggering under its worst period of the pandemic, with daily records of caseloads and deaths, Brazil is facing a daunting development: a rising number of deaths among the young.
So far this month, according to government data, about 2,030 Brazilians aged 30 to 39 have died from Covid, more than double the number recorded in January. Among those in their 40s, there have been 4,150 fatalities in March, up from 1,823 in January, and for those 20-29, deaths jumped to 505 from 242.
“Before, the risk factor to dying from Covid-19 was being older, having some co-morbidity,” said Domingos Alves, a professor of medicine who’s part of the national monitoring group. “Now, the risk is being Brazilian.”
Fiocruz, a health nonprofit, issued a report on Friday showing the same trend with slightly different numbers.
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It said cases among those aged 30 to 59 had surged from the start of the year until mid-March at a pace nearly double the national average of 316%. Those age groups saw deaths jump by at least 317%, compared with 223% for Brazil as a whole.
In Sao Paulo, the country’s richest and most populous state, the rise is especially prominent in private hospitals, state Health Secretary Jean Gorinchteyn said in an interview. Those 60 and older continue to dominate hospital admissions but the share of those under 50 has risen to 15% from 10% last year.
In the state’s capital, more and more people between 20 and 54 are getting infected, the city’s health secretary, Edson Aparecido, told GloboNews TV on Friday. Younger patients wait longer to seek health care and are sicker when they arrive.
The explanation for the growing infection rate among the young — in a country that is largely young — remains unclear although officials and medical experts suggest several possibilities. First, throughout 2020, local and regional restrictions hampered socializing. That changed with the holidays, the new year and the loosening of lockdowns.
Second, a variant first spotted in the Amazonian city of Manaus is probably partly to blame, according to Jaques Sztajnbok, who helps run the ICU at Emílio Ribas hospital, one of Brazil’s main facilities for infectious diseases. Patients are largely getting sick with that variant or the U.K. one, which is also more contagious. A study carried out in Sao Paulo found one of the two variants in 71% of cases.
Third, vaccines are limited in Brazil and there is no time line for inoculating the young.
Fernando Brum, a director at Sorocaba’s Santa Casa hospital, said the mutation of the virus into a much more contagious version with a viral load that makes people sick in a faster and more aggressive way has meant young people have gone from mostly asymptomatic cases to being gravely affected.
Brum, whose hospital is a two-hour drive from Sao Paulo, says ICUs are also filled with 30-year-olds. He estimates that the age of patients hospitalized with Covid-19 has decreased by 50% compared with 2020.
“The intensive care unit is constantly and uninterruptedly occupied,” he said. Patients in their 30s make up at least half of those beds, and their average time spent in the hospital has tripled from last year. It has come down recently for a a grim reason — patients are dying more quickly.
Sztajnbok said it’s not unusual now to see people under 40 or even in their 20s without any risk factors needing intubation and life support. Before, he said, patients were mostly over 65. “The first time that happened, we were shocked,” he said. “We were also shocked the second time. Now we are not anymore.”
The longer hospital stays are putting a strain on Brazil’s health-care system, struggling after decades of underinvestment. ICU capacity rates were at or above 80% in 25 states, according to the new Fiocruz report, while 17 states had levels higher than 90%.
In a March 23 report, Fiocruz also highlighted a “disproportionate increase in mortality in the country,” which went to 3.1% from 2% at the end of last year. The jump signals patients could be dying due to a lack of assistance or because of failures in health care, it said.
Brazil has become the epicenter of the pandemic, recently reporting records of more than 100,000 cases and 3,650 deaths a day. Home to 212 million people, the country trails only the U.S. in the virus’ toll. While vaccinations have picked up in the last week, the 19 million shots deployed so far have only covered 7% of the population with one dose, and fully vaccinated about 2%.
The shift to younger victims means that pregnant women are getting infected, said Fatima Marinho, an epidemiologist and senior adviser at Vital Strategies. The virus has also killed more children under 10. They tend to have different symptoms, leading to a wrong diagnosis, she added.
Marinho estimates a national death toll of 500,000 by June. It crossed 300,000 this week, two-and-a-half months after hitting 200,000, half the time it took to go from 100,000 to 200,000.
Even if vaccination rates quicken, she has another fear: “Such an intense virus circulation means that Brazil may soon have other strains of the virus that become resistant to vaccines.”- Bloomberg
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