The death rate from the coronavirus in Brazil tripled in February among people in their 20s when the country’s dangerous new strain took over, a study finds.
Researchers examined the ratio of Covid cases to deaths in Brazil last month and found that it was increasing in young people.
While the number of cases declined across the country, the number of people aged 20 to 29 who died of the disease had tripled, they noted.
And the proportion of people who die from the corona virus between the ages of 30 and 60 has doubled.
Academics said the data “indicates a significant increase in the death rate in young and middle adults after identifying a new SARS-Cov-2 strain circulating in Brazil.”
The variant referenced in the paper is known as P1 and has already been spotted in 27 people in the UK. It has mutations that make it appear to spread faster, infect people who have already had other strains of the virus, and it can be more deadly.
Scientists said the discovery should raise “ public health alarms ” about the variant and that vaccines should be rushed to stop the mutated strain.
An important factor that was not taken into account in the study is the fact that Brazilian hospitals were inundated with Covid patients in February, which may have made survival less likely for people with the disease.
The researchers admitted it was ‘hard to discern’ whether the new variant or ‘pressure on hospitals’ was to blame, but didn’t factor it into their numbers.
But they insisted that the data, which came from the state of Parana, “coincided with a steady two-month decline in the total number of cases.”
The study found that the February death rate from Covid rose dramatically in some age groups, most rising from 0.04 percent to 0.13 percent in people in their twenties (yellow) and from 0.43 to 0.9 percent in people in their forties (green).
Hospitals in Brazil were overwhelmed by Covid patients in February as the country struggled to get its second wave under control (photo: a man at the hospital in Baaru, Sao Paulo)
The reasons for the sudden rise in CFR [case fatality ratio] are not entirely clear, ‘wrote the researchers, led by Professor Helena Santos de Oliveira of the Federal University of Paraná. Academics from Cincinnati in the US and Verona in Italy were also involved in the study.
At a peak, even in well-designed clinical trials, it can be difficult to distinguish between truly increased pathogenic virulence versus increased pressure on hospitals, acute care beds and other care resources, resulting in worse clinical outcomes as the leading cause of increased death rates .
While it may be reasonable to believe that the increased transmissibility of a new strain may have resulted in an overload of the hospital system and healthcare system, the increase in CFR actually coincided with a steady two-month decline in the total number of cases in the state of Parana. ‘
The study, published online at medRxiv, said 70 percent of Covid cases in the Brazilian state of Parana were caused by the P1 variant.
It did not link the P1 strain to the patients who died, but the timing of the rise in the death rate and the emergence of the variant suggested an association.
The researchers found that the Covid death rate for people in their 20s was 0.04 percent in January, but rose to 0.13 percent in February.
In people in their thirties, it rose from 0.17 percent to 0.32 percent.
Among people over 40, it rose from 0.43 percent to 0.9 percent, and for people over 50, it was 1.17 percent to 2.1 percent.
The largest increase occurred in the age group of 20, among whom the risk of death increased 3.15-fold, and in the over-40s, who saw it increase by 2.1-fold.
The rising death rate came as Brazil was totally overpowered by critically ill Covid patients in February and early March.
The Covid death rate among older age groups did not increase to the same extent as it did in younger people, the researchers found
The researchers noted that the death rate increased even as the number of people who tested positive decreased
Brazil has had one of the worst Covid outbreaks in the world, with more than 12 million cases and 300,000 deaths (Photo: People lining up for vaccines near Rio de Janeiro in March)
On March 10, the country recorded more than 2,000 deaths on its worst day to date, and regional governors warned the country was tied up by the virus, calling for a lockdown.
Piaui head of state Wellington Dias described hospitals where infected patients could not even get a bed, let alone the intensive care they needed.
‘We have reached the border all over Brazil; rare are the exceptions, ”said Dias, who heads the governors’ Covid forum, earlier this month. “The chance of dying without help is real.”
At the beginning of this month, more than 80 percent of intensive care beds in 25 major cities in the country were full BBC reported.
Entire hospitals are known to have worse survival rates because people cannot receive the same level of attention and medical care as if there were fewer other patients.
The increased mortality rates could therefore have been related to the fact that hospitals were busier than the new variant.
The country is among the countries with the worst Covid outbreaks in the world – it has recorded 12.6 million cases and 314,000 deaths, second only to the US in both counts.
President Jair Bolsonaro has consistently denounced the virus and allowed it to run rampant, comparing Covid to the flu and publicly spreading anti-vaccination myths, hampering the country’s pandemic response.
WHAT DO WE KNOW ABOUT THE BRAZIL VARIANT?
Name: B.1.1.248 or P.1
Date: Discovered in Tokyo, Japan, with four travelers arriving from Manaus, Brazil on January 2.
Why should we care? The variant has the same peak protein mutation as the highly transmittable versions found in Kent and South Africa – called N501Y – which makes the peak more able to bind to receptors in the body.
It has a third, less well-studied mutation called K417T, and the consequences of this are still under investigation.
What do the mutations do?
The N501Y mutation causes the spike protein to bind better to receptors in the human body and therefore makes the virus more contagious.
Just how much more contagious it is remains to be seen, but scientists estimate that the similar-looking variant in the UK is about 56 percent more transmissible than its predecessor.
Even if the virus doesn’t seem more dangerous, its ability to spread faster and cause more infections will inevitably lead to a higher death rate.
Another important mutation in the variant called E484K, is also on the spike protein and is present in the South African variety.
E484K may be associated with its ability to evade parts of the immune system called antibodies, researchers at the Federal University of Rio de Janeiro said in a scientific paper published online.
However, there are multiple immune cells and substances involved in the destruction of coronavirus when it enters the body, so this may not translate into a difference in how people get infected or recover.
Do our vaccines work against it?
There are concerns that vaccines may be less effective against the Brazilian strain, with trials using the Johnson & Johnson found it to be slightly less effective in Latin America at preventing mild or moderate cases.
However, the studies showed that it still prevented hospitalizations and deaths.
No studies have tested the Oxford / AstraZeneca vaccine against the P1 variant, while Moderna and Pfizer say their mRNA coronavirus vaccines should work against variants with the E484K mutation, with early results showing that these vaccines are only slightly less effective are against the P1 variant.