Brazil, a threat to global health security? That’s what Science magazine says

Understanding the behavior of SARS-CoV-2 and how its mutations test the management of the pandemic and even the effectiveness of vaccines developed in record time undoubtedly reveals women and men of science.

The prestigious cardiologist Eric J. Topol is professor of molecular medicine at the Scripps Research Institute and on his Twitter account he highlighted two articles published in the journal Science on COVID-19 in Brazil, documenting which caused the appearance of the P1 variant in Manaus and they analyze its high transmissibility, a possible increase in lethality and incomplete protection against the previous COVID.

The mutation of viruses is in their nature. To pretend that they don’t is to ask them to cease to exist. Thus, viruses frequently mutate, both in infected individuals and as they move from person to person.

The central challenge today is that SARS-CoV-2 continues to mutate and circulate, with the potential risk of it turning into another virus.

“We must redouble public health measures. The less a virus spreads, the less it mutates ”. For Anthony S. Fauci, director of the US National Institute of Allergy and Infectious Diseases, “There is a need to vaccinate as many people as possible with the vaccines currently available and to prepare for the potential event that they will need to be. updated in the future. . “.

The recent publication of the prestigious scientific journal highlights “the rapid spread of cases and deaths from COVID-19 in Brazil, with different patterns and burdens in different states”. According to the researchers, what is happening in this country “shows that no account explains the spread of the virus between the states of Brazil. Instead, layers of complex scenarios intertwine, resulting in simultaneous and varied outbreaks of COVID-19 across the country. “

When analyzing the relentless advance of the Manaus variant in this country, experts have deployed five causal factors.

“First, Brazil is vast and unequal, with disparities in the quantity and quality of health resources., such as hospital beds, doctors and income – developed -. Secondly, a dense urban network that connects and influences the municipalities by transport, services and business, which were not completely interrupted during peak cases or death ”.

Third, they observed, “the political alignment between the governors and the president played a role in the timing and intensity of the distancing measures, and the polarization politicized the pandemic with consequences for adherence to control actions“. While they were in fourth place, they found “SARS-CoV-2 circulated undetected in Brazil for over a month, due to the lack of well-structured genomic surveillance.”

Finally, “in fifth place, cities imposed and relaxed measures at different times, based on different criteria, facilitating dissemination“. “Our results speak to these problems, but also show that some states were resilient, such as Ceará, while others with comparatively greater resources were unable to contain the spread of COVID-19, such as Rio de Janeiro “, underlines the publication.

The P1 variant appeared in the city of Manaus, capital of the state of Amazonas, but was not identified as a new mutation until January, in Japan, in some travelers returning from this region of northern Brazil.

However, the emergence of the variant already detected in several South American countries, such as Argentina, Chile, Uruguay, Bolivia, Peru and Venezuela, was much earlier. “We show that P1 probably appeared in Manaus in mid-November, where high attack rates had previously been reported. High rates of accumulation of mutations over short periods of time have been reported in chronically infected or immunocompromised patients. Given a sustained generalized epidemic in Manaus, we believe this is a potential scenario for the emergence of P1. Genomic surveillance and early data sharing by teams around the world has led to the rapid detection and characterization of SARS-CoV-2 and new variants of concern, but such surveillance is still limited in many contexts», Highlights another publication of Science distinguished by Topol.

In such a scenario, swift and fair responses, coordinated at the federal level, are imperative to avoid the rapid spread of the virus and disparities in outcomes. However, the response to COVID-19 in Brazil has been neither swift nor fair. This is still not the case. “Brazil is currently facing the worst time of the pandemic, with a record number of cases and deaths, and the near collapse of the hospital system. Vaccination has started, but at a slow pace due to limited availability of doses. The disturbing new variant that has emerged in Manaus is estimated to be 1.4-2.2 times more transmissible and able to evade immunity from a previous non-P1 infection ”.

This variant is spreading throughout the country. It has become the most prevalent in circulation in six of the eight states where surveys have been conducted. As of March 11, 2021, Brazil had already reported 40% of total COVID-19 deaths in 2020. Manaus had already recorded 39.8% more deaths from COVID-19 in 2021 compared to 2020. “Without With immediate containment, coordinated epidemiological and genomic surveillance measures, and an effort to vaccinate as many people as possible as quickly as possible, the spread of P1 is likely to result in unimaginable loss of life. Failure to prevent this new wave of spread will facilitate the emergence of new VOCs, isolate Brazil as a threat to global health security, and lead to a completely preventable humanitarian crisis.“, Concluded the experts.

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