RIO DE JANEIRO, BRAZIL – A survey conducted by Estadão considered countries with over 1,000 deaths per million inhabitants and with at least 20 million inhabitants.
Lorena saw her daughter Maria, 1 year and 5 months old, die in her arms. With a late diagnosis, Lucas, 1 year old, Jéssika’s son, suffered several complications related to Covid and died. Jose Rivera saw his 3-year-old son Bernardo succumb to Covid-19 one week after testing positive.
These are not exceptions. By mid-May, 948 children between the ages of 0 and 9 have died from Covid-19 in Brazil, according to data from the Influenza Surveillance Information System (Sivep-Gripe) compiled by Estadão. Lacking child protection policies, lacking control of the pandemic, and with closed schools, Brazil is in 2nd place in the sad ranking of children victims of Covid, behind only Peru.
For every 1 million children aged between 0 and 9 years of age in Brazil, 32 have lost their lives to Covid-19. In Peru, the country with the highest number of deaths among the 11 analyzed, there were 41 per million. Neighboring Argentina and Colombia had 12 and 13 deaths per million, respectively.
For the analysis, the countries that registered at least 1,000 deaths per million inhabitants and that have over 20 million inhabitants were considered. Poland and Ukraine, which would have been on the list, were excluded due to lack of data. The estimate was prepared by Estadão with the support of Leonardo Bastos, statistician from the Oswaldo Cruz Foundation (Fiocruz).
In European countries, the scenario was completely different. The UK and France recorded only 4 deaths of children aged 0 to 9, which results in a rate of 0.5 deaths per million in each country. On the continent, the highest number was recorded in Spain. There, for every 1 million children, 3 died of Covid – one-tenth of the Brazilian rate.
Fatima Marinho, Senior Epidemiologist at Vital Strategies, a global public health organization, explains that the health system in Peru is much more precarious than in Brazil. Therefore, the Andean country was expected to register worse rates. “Peru’s public health service is much more precarious. It doesn’t treat any expensive diseases, for instance,” she says.
In Latin America, the Brazilian National Health System (SUS) was able to better deal with the pandemic compared to the Mexican and Colombian systems, according to Fatima. However, Brazil’s mortality and uncontrolled rates are much worse.
“Mexico has a popular health plan, but it is very restricted. Anyone who doesn’t at least pay for that plan dies on the sidewalk. These types of health care systems are a challenge. With the exception of Argentina, Chile and Uruguay, we were better prepared than other Latin countries to handle the pandemic,” says the epidemiologist.
The majority of deaths occurred in May of last year, when 131 children aged 0 to 9 lost their lives to Covid-19 in Brazil. Next comes April this year, with 99 deaths. The figures for May 2021 have not yet been compiled. Infants up to 2 years of age were the main victims, accounting for 32.7% of the deaths analyzed.
According to the Sivep-Gripe data, 57% of the children killed by Covid-19 in Brazil were black (the official classification includes black and mixed-race people). White children accounted for 21.5% of victims, Asian children 0.9%, and 16% had no race specified.
Deaths among indigenous people were also quite significant. Despite representing only 0.5% of the Brazilian population, 4.4% of the children who lost their lives to Covid-19 in Brazil were indigenous. In gross numbers, there were 42 deaths, mostly in Mato Grosso (12) and Amazonas (11).
Fatima Marinho says that, due to social inequality, the mortality rate among black children was already higher before the pandemic. Covid came to exacerbate this inequality. “Many of the black children live in overcrowded housing, with adults who need to go out to work, who have jobs that are more exposed to the virus, who take public transportation. Thus, the viral load that reaches these children is very high,” she says.
Indigenous people, in turn, are naturally more susceptible to the virus. “It is a classic way of exterminating indigenous people in Brazil. It was like this with measles, the flu, influenza.” Because they are more susceptible, the epidemiologist believes they should be much more protected. “Why haven’t we vaccinated all indigenous people over the age of 12?” she questions. Countries like the United States have already authorized vaccination of adolescents over 12 with Pfizer’s immunizer, now available in Brazil.
Epidemiologist Ethel Maciel, a professor at the Federal University of Espírito Santo (UFES), points to the end of Mais Médicos (More Doctors) as one of the reasons for the high death rate, particularly among the black and indigenous populations. One of the program’s goals was to guarantee basic health care to more remote communities, with precarious structures. “There was no replacement of professionals. The hardest to reach places, with a poor population, faced challenges in medical care.”
The lack of national coordination on the direction of education in Brazil is one of the main criticisms of specialists. Schools were closed during virtually the entire pandemic in Brazil and now, more than a year later, there are still no investments in readjusting the structures. Countries like the UK, for one, have launched national programs supporting education to reverse the losses caused by the pandemic.
“The Ministry of Education vanished, no one saw it, no one knows about it. It had its budget cut at a time when it should have invested in schools’ structures”, Ethel criticizes. She also says that there is a lack of criteria to direct the opening and closing of schools.
With no classes, no emergency aid to cover all household expenses and the resumption of activities, young children, particularly the most vulnerable, were more exposed because their parents had to go out to work. “We opened up the possibility for something that happened in Brazil in the 1980s, day-care mothers,” says Ethel. The term refers to women who take care of a group of children, usually from the same neighborhood, in exchange for some value.
For Fátima Marinho, children are no longer a priority in the country. “The Brazilian State abandoned children to their fate. They interrupted schools and offered no other alternative,” she says. She also criticizes the lack of public policies aimed at protecting childhood. ” In addition to Covid, children suffer from violence inside and outside the home,” she points out.
The two epidemiologists say that a federal effort is required to adapt schools to the new reality. “The pandemic will last 5 years, in the optimistic forecast. Are the children going to be out of school for five years?” asks Fatima.
The solutions they point out are to create classrooms with fewer students, hire younger teachers to safeguard the older ones, and mass testing. Another alternative is to install HEPA filters, which prevent the airborne spread of viruses. “If you prioritize children and increase the education budget, you can set up alternatives,” says Fatima.
Methodology
For the analysis, official data from each of the 11 countries was used. To determine the death rate per million people, the number of deaths by Covid of children aged between 0 and 9 was divided by the total number of inhabitants in this age group in each country. The data on population numbers are provided by the United Nations.