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Brazil hospitals 'run out of oxygen' for virus patients in Manaus as hundreds wait for beds - COVID19 epidemic worsening. Because of the new Brazil P1 variant of SARSCoV2? January 15, 2021

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  • sharon sanders
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    bump this

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  • Vibrant62
    replied
    Manaus COVID-19 crisis could strike across Brazil, doctors warn

    The following report contains some hard data and percentages of the current P1 variant outbreak from Brazil. This is not looking good for the S. Americas.

    Health system in Amazonas state capital is overrun by COVID-19 and experts say other regions could face a similar catastrophe.
    https://www.aljazeera.com/news/2021/1/25/doctors-fear-manaus-covid-crisis-could-spread-across-brazil

    COVID-19 infections surged by 125 percent in Manaus between January 7 and January 22, according to the National Council of Health Secretaries and Brazilian media.

    Staviack said doctors have noticed an increase in the number of premature births in Manaus, as pregnant women with COVID-19 had to have caesareans due to their low oxygen levels. The threat of COVID-19 also propelled some pregnant women to take drastic steps, he said.


    snip

    Ferreira said doctors working in the area reported that the variant is spreading and this time more young people aged 30 to 50 are falling sick with more severe symptoms. “The virus will spread to other states such as Rondonia and those in the northeast of Brazil – they could suffer from a lack of oxygen as they are so poor,” Ferreira said.

    He said the virus is already spreading up the Madeira River that runs through Bolivia.

    “We are very, very scared about that,” said Ferreira, adding that Brazilian MP Cassio Espirito Santo recently said people from Peru and Bolivia also were coming to Tabatinga, in western Amazonas state, to be treated.
    snip

    Dr Julio Ponce, an epidemiologist who works in Sao Paulo, said last week that while deaths from the disease are under-reported, the latest data showed a seven-day daily average of 54,000 new cases and 983 deaths countrywide.

    “Manaus serves as a sentinel for the rest of the country,” said Ponce, explaining that in April last year it was the first city in Brazil to experience a peak that led to the collapse of its healthcare system, followed by Para and other states in the country’s northeast.

    “The same pattern will emerge this time, but with far worse outcomes,” said Ponce, who added that the new variant accounts for 42 percent of new cases in Manaus.

    “All of the states and hospitals are fighting for a limited supply of oxygen. Other states besides Amazonas could run out if we don’t have a coordinated effort by the federal government. We are running out, state by state.”

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  • sharon sanders
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  • Shiloh
    replied
    Source: https://www.reuters.com/article/us-h...-idUSKBN29R2GP

    January 22, 20212:45 PM Updated an hour ago
    New Brazil coronavirus variant found in nearly half of Amazon city cases
    By Anthony Boadle
    3 Min Read

    BRASILIA (Reuters) - A variant of the novel coronavirus already accounts for about half of new infections in the Brazilian Amazonian city of Manaus, raising concerns about a greater risk of spread, a researcher warned on Friday.
    FILE PHOTO: Health workers transport a patient at Getulio Vargas hospital, amid the coronavirus disease (COVID-19) outbreak in Manaus, Brazil, January 14, 2021. REUTERS/Bruno Kelly/File Photo

    A team led by immunologist Ester Sabino collected genomic data from COVID-19 tests in Manaus that indicated 42% of the confirmed cases were infected by the new variant, which has mutations similar to the British and South African variants.

    “That was the frequency that appeared in our December data. We are finishing January now and it is increasing,” said Sabino, a University of Sao Paulo professor whose team’s preliminary results have been published on the Virological.org forum.

    She said it was quite likely the new Brazilian variant is more transmissible than the current dominant strain, although it has not been proven definitively, because it has mutations shown to have that effect in other variants...

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  • Shiloh
    replied
    Source: https://nymag.com/intelligencer/arti...ronavirus.html

    7:00 AM
    What We Know About the New P.1 Strain of the Coronavirus
    By Chas Danner

    Last week, researchers announced that a troubling new strain of the coronavirus had been detected in the Amazon city of Manaus, Brazil, amid a horrifying surge of new COVID-19 cases in the area. The onslaught of infections has led to the collapse of the local health-care system for the second time during the pandemic. The city was hit brutally hard by the first wave in March, and some experts believed it had reached a level of herd immunity by the fall. Scientists are now trying to determine what role the newly discovered P.1 coronavirus variant — which has at least two key mutations that may make the strain more transm.M
    Wissible and better able to reinfect COVID survivors as well as render vaccines less effective — may have played in the new wave.

    Below is everything we know about the P.1 variant and why scientists around the world are concerned about it...

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  • Shiloh
    replied
    Source: https://time.com/5931366/brazil-new-covid-19-strain/


    A New Strain of COVID-19 Is Being Blamed for a Surge in Cases in Brazil. Here's What to Know
    Lucas Silva – Picture Alliance/Getty Images
    By Ciara Nugent
    January 20, 2021 1:52 PM EST

    Many hoped the Brazilian city of Manaus had seen the worst of the pandemic, after a first wave of COVID-19 tore through it in spring 2020, forcing authorities to dig mass graves and causing the mayor to break down during television interviews.

    Yet a new wave of infections has once again driven the city’s health services to a state of collapse this month. On Jan. 14, Manaus reported 2,516 new cases of COVID-19 and 254 hospitalizations after a diagnosis, the highest daily numbers since the pandemic began. The city’s hospitals have run out of ICU beds and oxygen supplies, forcing doctors to perform manual ventilation and leading to patients being airlifted out of Amazonas state, of which Manaus is the capital. Dozens are dying in the city every day – 22% more on average than during the peak of the first wave.

    On Jan. 16, in a letter sent to Brazil’s supreme court, the state government blamed the surge in cases on “an unfortunate and absolutely unforeseeable coincidence”: the emergence of a new strain of COVID-19 in the region in late 2020. It was first reported on Jan. 11 by Japanese researchers in from four people who had traveled from the state to Tokyo.

    Based on the mutations that the variant has acquired, scientists say it’s likely to be more infectious, like strains identified in the U.K. and South Africa have proven to be. There’s also a risk it may potentially evade immune responses to COVID-19 — with a large percentage of Manaus residents thought to have already had COVID-19, scientists had hoped their antibodies would slow the virus down, but that does not appear to have happened. Some epidemiologists in Brazil say those characteristics mean new strain is the “most plausible explanation” for the new wave of cases in Manaus.

    After news of the variant emerged, Italy and the U.K. announced bans on flights from Brazil and South America respectively in an attempt to keep it out of their countries (non-U.S. citizens are already barred from travelling to the U.S. after spending time in Brazil, a restriction President Joe Biden has pledged to extend.)

    But it’s too early to say with certainty if the variant is driving greater transmission or reinfection in Manaus, according to Felipe Naveca, a researcher in the Amazonas branch of Fiocruz, Brazil’s national medical research body, who led a study of the new variant. He says a lack of social distancing and a change in the season have helped to spread COVID-19 in recent weeks. “We still can’t confirm what is the role of this new variant in the recent explosion of cases, we need to do more work to confirm how common it is,” Naveca says in recordings sent to TIME by Fiocruz. “But I think it’s one of the factors.”

    Here’s what to know about the new Brazilian variant and the situation in Manaus.
    What is driving the second wave in Manaus?

    The new variant is likely playing a role, but it’s not the only cause of the heavy caseload in Manaus. Doctors have been harshly critical of the state government’s failure to introduce tight enough measures to stop the spread of COVID-19...

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  • sharon sanders
    replied
    snip

    Marcus Venecia Lacerda (ph) is an infectious disease doctor there. He says the second surge appears worse than the first.

    MARCUS VENECIA LACERDA: I'm really afraid. I'm really afraid. I'm seeing lots of people dying, so the situation here now is of panic.

    DOUCLEFF: Because hospitals are turning away people - they've run out of oxygen. Patients on ventilators are suffocating. In many ways, this resurgence doesn't seem to make sense because in Manaus, a large proportion of the population should be immune to the coronavirus. So why is the city seeing such a huge surge? Lacerda says part of the reason could be reinfections.

    VENECIA LACERDA: So apparently, what is happening is that people who had some small exposure to the virus in the past are becoming infected now.

    DOUCLEFF: Since the spring, people's immunity could have waned. On top of that, Manaus, like the U.K., has a new version of the virus that's spreading very quickly. This new variant, called P1, has about 20 mutations, including one that's especially concerning. In laboratory settings, this mutation helps the virus avoid or evade antibodies.

    https://www.npr.org/2021/01/19/95847...ding-in-brazil

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  • Michael Coston
    replied

    Brazil MOH Confirms Reinfection With COVID Variant P.1 In Amazonas



    Amazonas State, Brazil - Credit Wikipedia

    #15,721


    Ten days ago, in PrePrint: Genomic Evidence of a Sars-Cov-2 Reinfection Case With E484K Spike Mutation in Brazil, we looked at the first confirmed reinfection in a 45 y.o. healthcare worker in Bahia state with one of the recently emerged COVID variants in South America carrying the E484K mutation.

    The authors wrote:

    Viral evolution may favor reinfections, and the recently described spike mutations, particularly in the receptor binding domain (RBD) in SARS-CoV-2 lineages circulating in the UK, South Africa, and most recently in Brazil, have raised concern on their potential impact in infectivity and immune escape.

    We report the first case of reinfection from genetically distinct SARS-CoV-2 lineage presenting the E484K spike mutation in Brazil, a variant associated with escape from neutralizing antibodies.


    Of course, we've seen reinfections before - even when the E484K mutation was not involved - in places like India, Hong Kong, the Netherlands & Belgium, and in Nevada. The bar for confirming a reinfection is set pretty high, and so many cases go unconfirmed.

    A study published last week (see UK PHE: Results From the SIREN Study On COVID Reinfection) found post infection immunity appears to provide 83% protection against reinfection for at least 5 months, although they warn that some of those infected during the first wave may be vulnerable to reinfection now.

    Making the relevance of a small number of reinfections with the E484K mutation difficult to ascertain.

    While they could be due to changes to the virus, these patients could simply have reached the limits of their acquired immunity, and might have been reinfected regardless of the variant they were exposed to.

    As more cases are identified, we should get a better idea of what we are dealing with.

    Today we've a new report from Brazil's Ministry of Health (published Friday) on another reinfection, this time in Amazonas state, where the P.1 variant with the E484K mutation is currently wreaking havoc (see Brazil: Amazonas Transfers 235 COVID Cases To Other States Amid Critical Oxygen Shortage).

    (Note: for reasons unknown, the Amazonas government website is unreachable for me this morning, and simply times out).

    An overview of the P.1 variant is available at Virological: Another E484K South American Variant To Ponder. The translated report from the Brazilian MOH follows:

    Health confirms case of reinfection by new strain of Covid-19

    So far, two cases of reinfection due to a new variant of SARS-CoV-2 have been reported. One was confirmed in the state of Amazonas and another in Bahia is still under investigation

    Published on 15/01/2021 09h51 Updated on 15/01/2021 09h54

    The Ministry of Health was notified this Wednesday (01/13), by the state of Amazonas, about a confirmed case of reinfection by a new variant strain of SARS-CoV-2. On January 12, Fiocruz in the state of Amazonas identified a variant of the coronavirus in a 29-year-old woman with mild symptoms of the disease.

    The woman was diagnosed with the infection for the first time on 03/24/2020 and, on 12/30/2020 (nine months later), obtained the second positive diagnosis for Covid-19 by RT-PCR. The second analysis carried out showed a pattern of mutations, compatible with the variant of the SARS-CoV-2 virus, recently identified by the Ministry of Health of Japan, but originating in Amazonas.

    The information was shared, as part of the routine of epidemiological surveillance, with the Pan American Health Organization (PAHO / WHO) and with the entire Network of the Center for Strategic Information and Response in Health Surveillance (Cievs). The Ministry of Health recommended to the states, Federal District and municipalities the continuous strengthening of the control activities of Covid-19, the expansion of the routine sequencing of SARS-CoV-2 viruses, the investigation of outbreaks and the tracking of contacts in every case from Covid-19.

    In Brazil, two cases of reinfection due to a new variant of SARS-CoV-2 have been reported so far, one in the state of Bahia with the mutation originally identified in South Africa that is still under investigation, and the other already confirmed. in the state of Amazonas with Amazonian variant initially identified in Japan. The cases are monitored by teams from the Ministry of Health and PAHO / WHO.

    CONFIRMED REINFECTIONS

    So far, in Brazil, three cases of reinfection with strains already circulating in the country have been confirmed. The first case in the state of Rio Grande do Norte, the second case in the state of São Paulo and a third case in the state of Rio Grande do Sul.

    The portfolio has received several notifications of suspected cases of reinfection by Covid-19, but that do not meet all the criteria necessary for confirmation of new cases, as established in
    a technical note .
    A case of Covid-19 reinfection requires the individual to present two positive results of real-time RT-PCR for the SARS-CoV-2 virus, with an interval equal to or greater than 90 days between the two episodes of respiratory infection, regardless of clinical condition observed in both episodes.

    The Ministry of Health reinforces the need for the adoption of continuous use of masks, constant hand hygiene and the use of gel alcohol.

    Ministry of Health
    (61) 3315-3580 / 2351


    https://afludiary.blogspot.com/2021/...tion-with.html

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  • Mary Wilson
    replied
    Reeling again from COVID-19, Amazonas gets respirators, oxygen from Brazil military and Venezuela

    JANUARY 16, 20219:41 AM UPDATED 8 HOURS AGO
    By Bruno Kelly, Jamie McGeever

    MANAUS/BRASILIA (Reuters) - The Brazilian jungle state of Amazonas received more emergency supplies of oxygen and respirators on Saturday, as the military and neighboring Venezuela scrambled to alleviate an unfolding humanitarian crisis caused by a devastating COVID-19 outbreak.

    The army also said it had evacuated 12 patients from hospitals in the state capital Manaus to the northern city of Sao Luis overnight, with hospitals at breaking point with no oxygen supplies and overflowing intensive care wards.

    ... Brazil’s Air Force said on Saturday a second flight had landed in Manaus with eight tanks of liquid oxygen, following an earlier emergency delivery of five tanks, and the Navy said in a statement that it is sending 40 respirators.

    Venezuela, meanwhile, said it has sent the first batch of oxygen supplies on the 1,500-km (930-mile) road trip to Amazonas, which should arrive in Manaus on Sunday.

    https://www.reuters.com/article/us-h...source=twitter

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  • Vibrant62
    commented on 's reply
    Fourth possibility - virus has evolved away from immune response generated from first exposures, rendering it useless. But I agree with the final sentiment. We need to work out - fast - what is occurring here, as it has implications for the world at large. If this fourth option is correct, it may be that this variant does not have transmission advantage vs e.g. the UK strain and will die out, BUT even if that were true, it shows that when there is sufficient immunity to Type A strain (and any variants that are still neutralised with the same antibody/ T cell responses), then it is possible for a Type B strain to emerge quite rapidly that evades existing immunity, and it will potentially take multiple passages with novel variants to pass through human populations before severity wanes.

    The independent emergence of multiple variants with significant numbers of mutations in (probably) single individuals with some degree of immunocompromise also indicates that whilst SARS-Cov-2 is well adapted to humans, it perhaps hasn't fully adapted to us yet.. so things can and will change as time goes on.

    I would also like to understand the risks of recombination in this virus. i.e what happens if SARS-Cov-2 meets e.g MERS in a single individual - we need to quantify the potential risks and have plans in place to counter such an emergence, if it is a viable possibility. I seem to remember that we are coming up to the time of the year when MERS rears its ugly head, so we do really need to understand the risks here.

  • sharon sanders
    replied



    Kai Kupferschmidt

    @kakape
    ·
    5m
    Replying to
    @kakape
    @DrMikeRyan
    and 2 others
    IF 75% were already infected in Manaus, then 3 ways to explain surge,
    @EvolveDotZoo
    told me: 1. P.1 doesn’t matter. Immunity is waning and people are getting infected again. 2. P.1 is better at reinfecting people. 3. P.1 is more transmissible (threshold for herd immunity higher)
    4
    12
    21
    Kai Kupferschmidt

    @kakape
    ·
    1m
    It could, of course, also be a combination of these three factors. But it should be clear from this why the situation around P.1 is concerning and why figuring out what is going on in Manaus is one of the urgent puzzles of this pandemic.
    1

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  • Emily
    replied
    https://www.mypanhandle.com/health/w...virus-spreads/
    WHO cites human behavior more than variants as virus spreads
    Health

    Posted: Jan 15, 2021 / 02:05 PM CST / Updated: Jan 15, 2021 / 03:16 PM CST

    GENEVA (AP) — The World Health Organization’s emergencies chief said Friday that the impact of new variants of COVID-19 in places like Britain, South Africa and Brazil remains to be seen, citing human behavior for some recent rises in infection counts.
    “It’s just too easy to lay the blame on the variant and say, ‘It’s the virus that did it,’” Dr. Michael Ryan told reporters. “Well unfortunately, it’s also what we didn’t do that did it.”
    That was an allusion to holiday merrymaking and other social contacts plus loosening adherence — in pockets — to calls from public health officials for people to respect measures like physical distancing, regular hand hygiene and mask-wearing...

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  • kiwibird
    replied
    https://www.aljazeera.com/news/2021/...attered-manaus

    Sao Paulo Governor João Doria said some 60 premature babies in incubators needed to be relocated to other parts of Brazil, while officials said hospitals needed three times more oxygen than was available.

    Manaus was one of the first cities to reel from the pandemic in Brazil, which has the world’s second-highest COVID-19 death toll after the United States. Critics of President Jair Bolsonaro said the grim situation there was just the latest example of his poor handling of the crisis.

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  • sharon sanders
    replied
    bump this

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  • kiwibird
    replied
    https://www.independent.co.uk/news/h...-b1787815.html

    WHO says will investigate all possibilities for the origins of Covid-19 in Wuhan
    Coronavirus: One of two Brazil variants is already in UK, expert says
    ‘There are two different types of Brazilian variants and one of them has been detected [in the UK] and one of them has not,’ says Professor Wendy Barclay

    Samuel Lovett
    @samueljlovett

    One of two coronavirus variants that first emerged in Brazil has been identified in the UK, according to a leading virologist — but not the highly-contagious form of the virus that has gripped the South American country.

    Professor Wendy Barclay, head of G2P-UK National Virology Consortium, a new project set up to study the effects of emerging coronavirus mutations, said the Brazilian variant of concern was not in circulation within Britain.

    Called P.1, the variant was first identified in four people who had travelled from Brazil’s Amazonas state to Tokyo earlier this month.

    Japanese scientists are studying the efficacy of the Covid-19 vaccines against P.1, which shares similarities with the highly infectious variants that have already been identified in the UK and South Africa.

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