H5N1

COVID-19 in Brazil: 68,333 new cases, 2,595 deaths today

A screenshot from the CONASS PANEL | COVID-19 dashboard:

Cases and deaths are going down, but the case fatality rate is going up. Until yesterday, it was 2.7%; now it's 2.8%. Earlier this year it was 2.6%.

Brazil backs away from the virus brink, but remains at risk

Via The Associated Press: Brazil backs away from the virus brink, but remains at risk.

RIO DE JANEIRO (AP) — For most of this month, intensive care units across Brazil were at or near capacity amid a crush of COVID-19 patients, and sedatives needed to intubate patients dwindled. The nation’s biggest cemetery had so many corpses to bury that gravediggers worked hours past sundown. 

But Brazil has stepped back from the edge — at least for now — as burial and hospital services no longer face collapse. It has ceased to be the virus’ global epicenter, as its death toll ebbed and was overtaken by India’s surge. Experts warn, however, that the situation remains precarious, and caution is warranted. 

 The number of states with ICU capacity above 90% has slipped to 10, from 17 a month ago, according to data from the state-run Fiocruz medical research institute. And nighttime burials at Vila Formosa and three other cemeteries in Sao Paulo were suspended Thursday, after two weeks of declining deaths.

That comes as cold comfort in a country where some 2,400 people died every day over the past week, more than triple the number in the U.S. Brazil surpassed the grim milestone of 400,000 confirmed deaths on Thursday — a number considered by experts to be a significant undercount, in part because many cases were overlooked, especially early in the pandemic. The seven-day average has retreated from more than 3,100 deaths in mid-April, but Fiocruz warned in a bulletin Wednesday that it may plateau —and at an even higher level than it did last year. 

“Our goal now is to make the numbers keep going down instead of stabilizing. That’s the most crucial thing,” said Pedro Hallal, an epidemiologist and coordinator of Brazil’s largest COVID-19 testing program. “It’s good that they’re going down, but let’s not assume that this will be the last wave. There is hope that it will be the last wave, because of the vaccine, but that needs to be confirmed.” 

Given the slow vaccine rollout, there are millions more Brazilians vulnerable to infection, Hallal added, and the threshold scientists believe is needed to stop uncontrolled spread — 70% or higher of the population with immunity through vaccination or past infection — remains distant. 

Brazil’s death toll of 401,186 is the world’s second-highest, with the majority recorded in just the last four months as a more contagious variant swept the nation. In the thick of the Southern Hemisphere’s summer, crowds gathered and people boarded public transport in droves as mayors and governors relaxed the restrictions on activity that Brazil’s President Jair Bolsonaro fervently opposes.

386,452 cases, 3,498 deaths on Friday: India cases up as scientists appeal to Modi to release data

Via The Associated Press: India cases up as scientists appeal to Modi to release data. Excerpt: 

NEW DELHI (AP) — Indian scientists appealed to Prime Minister Narendra Modi to publicly release virus data that would allow them to save lives as coronavirus cases climbed again Friday, prompting the army to open its hospitals in a desperate bid to control a massive humanitarian crisis. 

With 386,452 new cases, India now has reported more than 18.7 million since the pandemic began, second only to the United States. The Health Ministry on Friday also reported 3,498 deaths in the last 24 hours, bringing the total to 208,330. Experts believe both figures are an undercount, but it’s unclear by how much. 

India’s pandemic response has been marred by insufficient data and the online appeal — signed by over 350 scientists Friday afternoon — asks government to release data about the sequencing of virus variants, testing, recovered patients and how people were responding to vaccines. 

The appeal says that “granular” data on testing was inaccessible to non-government experts and some government experts too. Modeling work to predict future surges was being done by government-appointed experts with insufficient information. Similarly, scientists had failed to get information that would allow them predict how many beds, oxygen or intensive care facilities would be needed, it said.

The appeal urged the government to widen the number of organizations sequencing the virus to study its evolution, and also increase the number of samples being studied. It added that restrictions on importing scientific raw materials — to make India ‘self reliant’ is a key goal for Modi and his government — was an obstacle. “Such restrictions, at this time, only serve to impede our ability to deal with COVID-19,” it said. 

Meanwhile, families continued to flood social media and messaging apps with pleas for help: oxygen, beds, medicines, intensive care units and wood for funeral pyres.

After a year of loss, South America suffers worst Covid-19 death tolls yet

Via The New York Times: After a Year of Loss, South America Suffers Worst Covid-19 Death Tolls Yet. Excerpt:

BOGOTÁ, Colombia — In the capital of Colombia, Bogotá, the mayor is warning residents to brace for “the worst two weeks of our lives.” 

Uruguay, once lauded as a model for keeping the coronavirus under control, now has one of the highest death rates in the world, while the grim daily tallies of the dead have hit records in Argentina, Brazil, Colombia and Peru in recent days. 

Even Venezuela, where the authoritarian government is notorious for hiding health statistics and any suggestion of disarray, says that coronavirus deaths are up 86 percent since January. 

As vaccinations mount in some of the world’s wealthiest countries and people cautiously envision life after the pandemic, the crisis in Latin America — and in South America in particular — is taking an alarming turn for the worse, potentially threatening the progress made well beyond its borders. 

Last week, Latin America accounted for 35 percent of all coronavirus deaths in the world, despite having just 8 percent of the global population, according to data compiled by The New York Times. 

Latin America was already one of the world’s hardest hit regions in 2020, with bodies sometimes abandoned on sidewalks and new burial grounds cut into thick forest. Yet even after a year of incalculable loss, it is still one of the most troubling global hot spots, with a recent surge in many countries that is even more deadly than before.

The crisis stems in part from predictable forces — limited vaccine supplies and slow rollouts, weak health systems and fragile economies that make stay-at-home orders difficult to impose or maintain. 

 But the region has another thorny challenge, health officials say: living side-by-side with Brazil, a country of more than 200 million whose president has consistently dismissed the threat of the virus and denounced measures to control it, helping fuel a dangerous variant that is now stalking the continent. 

The length of Latin America’s epidemic makes it even harder to fight. The region has already endured some of the strictest lockdowns, longest schools closures and largest economic contractions in the world. 

Inequality, a longstanding scourge that had been easing before the pandemic, is widening once again, and millions have been tossed back into the precarious positions they thought they had escaped during a relative boom. Many are venting their anger in the streets, defying official pleas to stay home. 

“They’ve taken so much from us that we’ve even lost our fear,” read a sign held by Brissa Rodríguez, 14, at a protest with thousands of others in Bogotá on Wednesday. 

Experts worry that Latin America is on a path to becoming one of the globe’s longest-haul Covid patients — leaving public health, economic, social and political scars that may run deeper than anywhere else in the world.

COVID-19 in Brazil: 69,389 new cases, 3,001 deaths today

A screenshot from the PAINEL CONASS | COVID-19 dashboard:

Note that Brazil's total case count is now 14,590,678. Deaths now total 401,186.

SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties

Via The Lancet: SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties.

The trade-off between different objectives is at the heart of political decision making. Public health, economic growth, democratic solidarity, and civil liberties are important factors when evaluating pandemic responses. There is mounting evidence that these objectives do not need to be in conflict in the COVID-19 response. Countries that consistently aim for elimination—ie, maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible—have generally fared better than countries that opt for mitigation—ie, action increased in a stepwise, targeted way to reduce cases so as not to overwhelm health-care systems. 

We compared COVID-19 deaths, gross domestic product (GDP) growth, and strictness of lockdown measures during the first 12 months of the pandemic for Organisation for Economic Co-operation and Development (OECD) countries that aim for elimination or mitigation (figure). Although all indicators favour elimination, our analysis does not prove a causal connection between varying pandemic response strategies and the different outcome measures. 

COVID-19 deaths per 1 million population in OECD countries that opted for elimination (Australia, Iceland, Japan, New Zealand, and South Korea) have been about 25 times lower than in other OECD countries that favoured mitigation (figure). Mortality is a proxy for a country's broader disease burden. For example, decision makers should also consider the increasing evidence of long-term morbidities after SARS-CoV-2 infection. 

There is also increasing consensus that elimination is preferable to mitigation in relation to a country's economic performance.6 One study quantified the optimal basic reproduction number so that elimination is achieved at minimal economic cost. To this end, consider weekly GDP growth with respect to 2019 for the OECD countries that opted for elimination or mitigation (figure). Elimination is superior to mitigation for GDP growth on average and at almost all time periods. GDP growth returned to pre-pandemic levels in early 2021 in the five countries that opted for elimination, whereas growth is still negative for the other 32 OECD countries. 

Despite its health and economic advantages, an elimination strategy has been criticised for restricting civil liberties. This claim can be challenged by analysing the stringency index developed by researchers at the University of Oxford. This index measures the strictness of lockdown-style policies that primarily restrict people's behaviour by combining eight indicators of containment and closure policies, eight indicators of health system policies, and one indicator of public information campaigns. 

Among OECD countries, liberties were most severely impacted in those that chose mitigation, whereas swift lockdown measures—in line with elimination—were less strict and of shorter duration (figure). Importantly, elimination has been framed as a civic solidarity approach that will restore civil liberties the soonest; this focus on common purpose is frequently neglected in the political debate. 

Evidence suggests that countries that opt for rapid action to eliminate SARS-CoV-2—with the strong support of their inhabitants—also better protect their economies and minimise restrictions on civil liberties compared with those that strive for mitigation. Looking ahead, mass COVID-19 vaccination is key to returning to usual life, but relying solely on COVID-19 vaccines to control the pandemic is risky due to their uneven roll-out and uptake, time-limited immunity, and the emergence of new SARS-CoV-2 variants. 

History shows that vaccination alone can neither single-handedly nor rapidly control a virus and that a combination of public health measures are needed for containment. The eradication of smallpox required concerted, decades-long efforts, including vaccination; communication and public engagement; and test, trace, and isolate measures. Even at the end of vaccination campaigns, such public health measures must be maintained to some extent or new waves of infections might lead to increased morbidity and mortality. 

With the proliferation of new SARS-CoV-2 variants of concern, many scientists are calling for a coordinated international strategy to eliminate SARS-CoV-2. Moreover, the US Department of State declared in April, 2021, that stopping COVID-19 is the Biden–Harris administration's number one priority and highlighted that “this pandemic won't end at home until it ends worldwide”. 

National action alone is insufficient and a clear global plan to exit the pandemic is necessary. Countries that opt to live with the virus will likely pose a threat to other countries, notably those that have less access to COVID-19 vaccines. The uncertainty of lockdown timing, duration, and severity will stifle economic growth as businesses withhold investments and consumer confidence deteriorates. Global trade and travel will continue to be affected. 

Political indecisiveness and partisan policy decisions reduce trust in government. This does not bode well in those countries that have seen a retraction of democracy. Meanwhile, countries opting for elimination are likely to return to near normal: they can restart their economies, allow travel between green zones, and support other countries in their vaccination campaigns and beyond. 

The consequences of varying government COVID-19 responses will be long-lasting and extend beyond the end of the pandemic. Early economic and political gains made by countries aiming to eliminate SARS-CoV-2 will probably pay off in the long run.

COVID-19 in Brazil: 79,726 new cases, 3,163 deaths today

A screenshot from the CONASS PANEL | COVID-19 dashboard:

While today's cases are only about a quarter of India's, Brazil's deaths are closely comparable to India's 3,293.

India suffers worst day of pandemic with record number of cases and deaths

Via The Guardian: India suffers worst day of pandemic with record number of cases and deaths. Excerpt:

India has suffered its worst day yet of the pandemic, as both new Covid-19 cases and deaths break previous records and crematoriums in Delhi become so overloaded with bodies that they are being forced to build makeshift funeral pyres on spare patches of land. 

On Wednesday morning, India reported 360,960 new cases in the previous 24 hours, the largest single-day increase in the world, taking India’s total to nearly 18 million. A further 3,293 deaths, the deadliest day so far, took the death toll to 201,187. 

Dellhi is under lockdown until at least next week but deaths in the capital continue to climb in record numbers, with another 381 succumbing to Covid-19 on Tuesday. The city’s crematoriums and graveyards struggled to cope with the sheer number of bodies, running out of both space and wood for funeral pyres. Relatives of the dead sat with bodies for up 20 hours outside some crematoriums waiting to perform the last rites on their loved ones. 

Outside some crematoriums, dozens of dead bodies waiting to be cremated were laid out on the pavements, covered with sheets and flowers in Delhi’s baking heat. 

Many believe the real death toll in the capital and across India is far higher than official figures, as authorities have been accused of skewing the data to downplay the tragedy. Many people have also been in home quarantine and so not officially registered as Covid-19 deaths. In Delhi, 3,472 Covid-protocol funerals have taken place over the past week, but officially only 2,127 people died of coronavirus in this period. 

Jayant Malhotra, co-founder of Sant Shiv Sewa foundation, which has been assisting people with cremations in Delhi for free during the pandemic, said the number of bodies his organisation was called to cremate or bury had gone from one every few days to 40 every day in recent weeks.

How Senegal fought Covid-19 with lessons learned from Ebola and HIV/AIDS prevention

Via Vox.com: How Senegal fought Covid-19 with lessons learned from Ebola and HIV/AIDS prevention. Excerpt:

DAKAR, Senegal — Aissatou Diao talked about Covid-19 a lot. How to socially distance, what to do if you have a cough or a fever. But when the first coronavirus case arrived in Yeumbeul, a village outside Dakar where she does health outreach as a community relay, she couldn’t believe it. 

“I almost died when I heard I was on the list of people who were in contact with the Covid patient,” Diao recalls. 

That single contact brought Diao to Novotel, an upscale hotel in Dakar with Atlantic Ocean views. As part of its pandemic response, Senegal sought to provide a bed to everyone with Covid-19 — including mild or asymptomatic cases — and their direct contacts. In the spring of 2020, for about six months, Red Cross volunteers replaced hotel staff at Novotel, and rooms filled with people like Diao, exposed to Covid-19 and sent away to isolate. 

Her fellow community relays, who did Covid-19 outreach with her, kept calling and calling to check her status. They wanted to know if they’d be next. “We all got ready with our luggage, waiting for the results,” one of them said. 

Diao tested negative, twice, and she left quarantine after just four days. A year later, she calls it a funny story: a short stay in quarantine as she tries to make others aware of the seriousness of Covid-19. 

Diao’s experience captures both sides of Senegal’s Covid-19 response. The West African country used aggressive interventions like this isolation policy to slow transmission. At the same time, community and local health actors bolstered the public health response from the bottom up, relying on longstanding relationships and trust to convince people to wear masks, seek out testing, and get treatment.

“We have what we call a ‘chain of solidarity’: The nation joined hands together,” Moussa Seydi, chief of infectious disease service at Dakar’s University of Fann Hospital Center, said. “Religious leaders came to join the political decision-makers, and also, the community involved themselves in giving this response to Covid-19.”

COVID-19 in Brazil: 72,140 new cases, 3,086 deaths today

A screenshot from the CONASS PANEL | COVID-19 dashboard: 

The numbers are not quite as high as they were, but Brazil approaches 400,000 dead, and the case fatality rate has stuck at 2.7% for many weeks. This has been no ordinary catastrophe. This has been catastrophe driven by deliberate policy.