Second Pandemic Wave May Have Reached Brazil: More Worrisome Than First Wave?

RIO DE JANEIRO, BRAZIL – The second wave of the novel coronavirus pandemic may have reached the country – and be more worrying than the first.

The latest findings on cases, hospitalizations and deaths support the notion that we may be experiencing a second wave. One of the surveys shows a higher upward trend in infections and deaths since May. Other notifications show an increase in Covid-19 hospitalizations.

InfoMoney compiled these data and met with experts to understand what motivates this potential second wave in Brazil – and how we should address cases, deaths and hospitalizations.

“If we can’t change attitudes, we may have a much worse situation. We can’t have a normal life without first combining it with the virus”, said Natalia Pasternak, PhD in Microbiology and director-president of the Questão de Ciência Institute (IQC).

Natalia refrains from using the term second wave, however, because she says that Brazil has not really emerged from the first wave. “But we have a very worrying second peak, yes,” she says.

Dr. Renato Kfouri, director of the Brazilian Society of Immunization (SBIm), also believes that recent data on increased hospitalizations could signal a second wave, or at least a “first wave rebound”. However, the numbers need closer monitoring if any conclusions are to be drawn.

Kfouri alerts to a “known underreporting of cases in Brazil,” in addition to delayed and accumulated notifications. As the number of cases varies according to the availability and efficiency of testing, more attention must be paid to the number of deaths and hospitalizations. “It is difficult to draw specific conclusions. The data for the coming weeks will provide an insight into whether this growth we are witnessing is sustained over the coming days, which is what typifies a real increase”.

The doctor says that any new update on the pandemic should be considered at a regional level, given the extension of the Brazilian territory. “We have hundreds of different epidemiological moments at once. What happens in Manaus is certainly not what happens in São Paulo or in Florianópolis. Even within the cities, we see enormous disparities in numbers.”

Increased infections, deaths, and hospitalizations

A new survey of the pandemic situation in terms of cases and deaths was released on Tuesday, November 17th, by the media outlet consortium comprising G1, O Globo, Extra, O Estado de S.Paulo, Folha de S.Paulo and UOL. The survey was conducted based on data from the state Health Secretariats.

In terms of case numbers, the consortium states that 5,909,002 Brazilians have already been or are infected with the novel coronavirus; 32,262 of these cases were confirmed on Tuesday. The rolling average for the past seven days was 29,674 new daily diagnoses, an increase of 71 percent compared to the average of 14 days ago, which points to an upward trend in Covid-19 infections. This is the highest increase recorded since May.

Brazil registered 676 deaths from Covid-19 in the past 24 hours, totaling 166,743 fatalities since the start of the pandemic. The rolling average of deaths in Brazil in the past seven days was 557, the highest since October 12th. There was a 45 percent variation in the average number of deaths recorded two weeks ago. This is also the highest percentage growth recorded since May.

The media outlet consortium stresses that the variation may have been more than expected because there was a drop in records 14 days ago, as a result of the long All Souls’ Day holiday. Nevertheless, an average of nearly 30,000 cases and 550 deaths over the past seven days would be “worrying data”. Fourteen Brazilian states recorded an increase in the number of deaths, while eight states plus the Federal District experienced stability, and four recorded a drop.

Doctors urge lockdown in São Paulo

São Paulo has extended quarantine until December 16th, after an increase in hospitalizations. According to Folha de S.Paulo, municipal hospitals had 693 patients hospitalized as a result of Covid-19 on November 13th (last Friday). The number of hospitalizations have been growing over the days and reached 814 on Tuesday.

The São Paulo Government stated, also on Tuesday, that the ICU bed occupancy rates stand at 48.2 percent in Greater São Paulo and at 42.7 percent in the state. On Friday, the rates were 45.2 percent in Greater São Paulo and 41.4 percent in the state.

According to the newspaper, a group of São Paulo infectologists sent a letter to friends alerting them of an “appreciable increase of Covid-19 cases in São Paulo hospitals”. Health institutions are said to be completely crowded because of a “100 percent” increase in some services.

In the letter, the doctors again recommend home isolation. “Do not go to bars, restaurants or parties. Do not organize meetings or social events. We know you are tired of all this, but remember that we are VERY much more…. and we are still watching people die, whole families infected, and cases increase progressively without any action being taken by governments,” they write.

The TV Globo evening news stated that the increase in hospitalizations can also be seen in private hospitals. Albert Einstein, in São Paulo, had seen an average of 50 to 55 patients hospitalized by Covid-19 over the past three months. The figure began to rise and reached 68 last Friday. Bed occupancy because of the disease reached 93 on Tuesday.

Second peak

While stressing that Brazil has never overcome the first wave, Pasternak points out that the country is facing a second alarming peak of the disease.

The PhD in Microbiology and director-president of IQC uses as a basis for her statement the fact that the transmission rate (Rt) has been greater than 1.0 since November 11th. This number provides an estimate of how the disease is spreading among the population, reflecting how many people will be contaminated by each new infected individual. When it is higher than one, it means that the number of cases tends to increase.

London Imperial College, a university focused on science, engineering and medicine, once again classified the epidemic in Brazil as “out of control,” also noting that the transmission rate is higher than one. Late last week, the institute had placed the country’s Rt at around 0.94. The new rate positions the country in a situation similar to European regions currently experiencing a second wave, such as Italy, Portugal and the United Kingdom.

The peak of the pandemic, or highest rolling average of deaths, was recorded on July 25th, with 1,097 deaths. But for the researcher, Brazil may ultimately experience a more alarming scenario in a second wave.

Asked if the country could record daily death rates higher than those registered in the peak period, in July, she answered: “This is not possible to know, medical care has improved greatly. But if hospitals become crowded, people will die due to lack of adequate care”.

She adds that even if we have developed a better medical understanding than at the start of infections, which would ensure better treatment and lower mortality, people are growing exhausted from social isolation measures.

“I expect a very worrying second peak of infections, driven mainly by the same reasons that caused the wave in Europe: psychological fatigue,” says Pasternak. The PhD says that schools in São Paulo are closing again because students are infecting each other outside the teaching environment – in meetings, parties and gatherings.

“Students becoming infected with the virus out of school and endangering the entire educational institution is an interesting fact, because it shows that the main problem really lies in people’s behavior, who no longer want to comply with preventive measures,” says Pasternak. “The virus is not exhausted. It is doing very well – and it hasn’t gone anywhere.”

Source: Infomoney