Brazil: Hospitals collapse without a National Virus Plan

Brazil’s hospitals are collapsing as a highly contagious variant of the coronavirus spreads across the country, the president insists on unproven treatments, and the only attempt to create a national plan to contain COVID-19 has fallen short.

Over the past week, Brazilian governors tried to do something that President Jair Bolsonaro stubbornly rejects: put together a proposal for states to help curb the country’s deadliest outbreak of the virus to date. The effort was expected to include a curfew, a ban on mass events and limits on the hours that non-essential services can operate.

The final product, unveiled on Wednesday, was a one-page document that included general support for the activity restriction but without any specific measures. Six governors, still fearful of confronting Bolsonaro, refused to sign him.

The one from Piauí state, Wellington Dias, told The Associated Press that unless the pressure on hospitals is eased, more and more patients will have to go through the disease without a hospital bed or hope of receiving treatment in a hospital. intensive care unit.

“We have reached the limit in all of Brazil; The exceptions are rare,” said Dias, who heads the governors’ forum. “The possibility of dying without help is real.”

Those deaths have already begun. In Brazil’s richest region, Sao Paulo, at least 30 patients died this month waiting for a place in the ICU, according to a count published Wednesday by news website G1.

In Santa Catarina, in the south of the country, 419 people are waiting to be transferred to a bed in an intensive care unit, and in neighboring Rio Grande do Sul, ICUs are at 106% capacity.

Alexandre Zavascki, a doctor in the capital of Rio Grande do Sul, Porto Alegre, described the constant arrival of patients with breathing problems.

“I have many colleagues who sometimes stop crying. This is not the medicine that we are used to practicing. This is a medicine adapted for a war scenario,” said Zavascki, who oversees the treatment of infectious diseases at a private hospital.

“We see that a good part of the population refuses to see what is happening, they resist the facts. These people may be the next to step foot in a hospital and they will want beds. But there won’t be any”.

The country, he added, needs “more rigid measures” from local authorities.

Despite the president’s objections, the Brazilian Federal Supreme Court confirmed the jurisdiction of cities and states to impose restrictions on activity.

Still, Bolsonaro has consistently condemned his moves, claiming that the economy needs to stay active and that isolation would cause depression. The measures were relaxed at the end of 2020, when infections and deaths from COVID-19 declined, the campaign for municipal elections began and the Brazilians who returned home were tired of the quarantine.

The latest rally is driven by the P1 variant, which the country’s Health Minister said last month is three times more transmissible than the original. It first became dominant in the Amazonian city of Manaus, and in January forced hundreds of patients to be airlifted to other regions.

Brazil’s failure to contain the virus since then is increasingly seen as a concern not only for its Latin American neighbors, but also as a warning to the world, said the director general of the World Health Organization (WHO ), Tedros Adhanom Ghebreyesus, at a press conference on March 5.

“In the country as a whole, the aggressive use of public health measures, of social measures, will be very, very crucial,” he said. “Without doing things that have an impact on transmission or suppress the virus, I don’t think there can be a downward trend in Brazil.”

The more than 10,000 deaths reported last week in Brazil were its worst mark since the start of the pandemic, and this week’s count is on track to be even higher after about 2,300 deaths were recorded on Wednesday alone, beating the record from the day before.

“The governors, like a large part of the population, are getting fed up with all this inaction,” said Margareth Dalholm, a prominent pulmonologist at the state-run Fiocruz Institute. The proposed pact is vague and will remain symbolic unless it is far-reaching and confronts the federal government, he added.

Last week, the national council of state ministers of Health called for the establishment of a nationwide curfew and quarantines in regions where hospital capacity is near its maximum. Once again, Bolsonaro objected.

“I will not decree it,” said the politician in a ceremony on Monday. “And you can be sure of one thing: my army will not go out onto the streets to force people to stay home.”

The restrictions could already be noticed outside the presidential palace after the governor of the Federal District, Ibaneis Rocha, implemented a curfew and partial confinement.

Rocha warned Tuesday that he could increase restrictions, excluding only pharmacies and hospitals, if people don’t flout the rules. Currently, the waiting list to occupy a bed in an ICU in the region is 213 people.

Bolsonaro told reporters on Monday that the curfew is “an affront, unacceptable” and that even the WHO believes that the lockdowns are not adequate because they disproportionately affect the poor.

Although the United Nations Health Agency recognizes the “profound negative effects” of this measure, it points out that some nations have no choice but to impose very strict measures to slow down infections, and that governments must make the most of the additional time to do so. testing and tracking cases, as well as caring for patients.

This nuance escaped Bolsonaro. His government continues to search for miracle solutions that for the moment have served nothing more than to feed false hopes. Any idea seems worthy of consideration, except those of public health experts.

The Bolsonaro government spent millions to produce and distribute anti-malaria pills, which in rigorous studies showed no benefit. However, the president endorsed this drug. He also supported treatment with two drugs to fight the parasites, neither of which has been shown to be effective.

On Wednesday he again praised his ability to avoid hospitalizations during a ceremony at the presidential palace.

Bolsonaro also sent a committee to Israel this week to evaluate an untested nasal spray that he has called a “miracle product.” Dalholm, whose sister is in ICU, called the trip “really pathetic.”

Camila Romano, a researcher at the Institute of Tropical Medicine at the University of Sao Paulo, hopes that the test her laboratory is developing to identify worrisome variants, including P1, will help monitor and control their spread. In addition, it calls for stricter measures from the government and that citizens do their part.

“Every day there is a new surprise, a new variant, a city whose health system is collapsing,” said Romano. “Now we are in the worst phase. If this is the worst phase, (because) unfortunately we do not know what is to come”.