In Brazil 80% of intubated COVID patients die, the world average is 50%

RIO DE JANEIRO, BRAZIL – After months of analyzing data from patients intubated in Brazil as a result of Covid-19, Fiocruz researcher Fernando Bozza told CNN that the country “is heading toward the abyss.” The intensivist conducted a study last year that concluded that 80% of intubated Covid patients in Brazil died – the world average is 50%.

The research was published in the medical journal The Lancet Respiratory Medicine. Now, with the second stage of the study underway, in which he analyzes data from 2021, Fernando Bozza already sees a much worse scenario than the peak of the first wave.

“The data we are seeing are horrible, we are evolving to a situation that is not only worse than the previous one, but even more dramatic. The whole country is heading towards the abyss and we will soon have a general collapse of the national health system,” said the researcher, who is head of the Laboratory for Clinical Research in Intensive Care Medicine at the Evandro Chagas Institute, Oswaldo Cruz Foundation (Fiocruz).

Bozza explains that the high lethality of intubated patients was a consequence of three factors: lack of training of front-line professionals; concentration of ICU beds in capital cities and, therefore, distant from many municipalities, which causes many patients to arrive in a very serious condition; and the fake news of possible treatments for the disease, especially in the North region of Brazil, where the ICU beds are very concentrated in the capitals and the distances between municipalities are very large.

For this reason, the lethality rate among intubated patients is higher in the North and Northeast regions. While in the South and Southeast the rate is 76.8%, below the national average, but still much higher than the world average. In the North, this rate is 86.7%, in the Northeast 83.7%, and in the Midwest 83.6%.

“These rates reflect the differences and fragilities of the Brazilian health system. The teams have difficulty in dealing with the high demand, the workload is very large and causes the quality of service to fall, because these professionals are physically and mentally exhausted,” he concluded.

At the moment, when all the states in Brazil are collapsing, the doctor evaluates that “Brazil failed to learn from the pandemic last year, wasting time focusing on irrelevant things and failing to assimilate successful practices applied in other countries.”

According to him, this lethality rate could be reduced if we had applied treatments that have proven to be effective, such as the use of corticoids and early non-invasive ventilation.

“The country wasted a huge amount of time discussing things that are useless, such as the use of ivermectin and chloroquine. We didn’t train teams as we should have to better manage the critically ill, better ventilate these patients, and incorporate the evidence that we know works like, for example, corticoids for patients who need oxygen and that can prevent patients from being intubated, prone ventilation, early non-invasive ventilation, i.e., a series of measures that other countries have implemented and that have made a lot of difference.”

Unlike what happened in 2020, when we had different peaks at different times, this time Brazil is heading towards a “unified collapse”, in Bozza’s evaluation. And with this panorama the doctor foresees an even higher number of deaths among intubated patients.

Another point pointed out by the researcher is the dissemination of false information regarding the disease. Bozza sees no other solution than the hardening of restrictive measures and an acceleration in the National Immunization Plan (PNI). Still, even if we increase the vaccination capacity, the effects will only be felt in the 2nd semester.

“The speed of vaccination is not going to have an effect on this current moment we are going through. That moment depends on transmission control measures. People at home. The acceleration of vaccination will only have an effect in the second half of the year. It’s important to accelerate vaccination, but it won’t be enough to change the scenario that is shaping up for the next two months,” he lamented.

More young people hospitalized

Fernando Bozza also observed that there is a tendency that there will be an increase in serious cases in younger people, between 20 and 39 years old, with an increase in mortality in this age group.

“Just as it happened in Manaus recently, an increase in serious cases in younger people between 20 and 39 years old will happen all over the country, with an increase in mortality among this age group. Today it is also possible to see that there are more young people admitted to ICUs throughout Brazil, a direct reflection of these new variants in circulation and that seems, in fact, to lead to more severe cases.”

Bozza also criticized the thesis of herd immunity and said that it was also due to the circulation of people on the streets that we had new and more powerful variants. One of the examples is Manaus, which had a very strong first wave and then had a new, even more violent wave, with the new variant already in action.

“Herd immunity doesn’t exist. The more viruses circulating, the more variants and mutations will occur. Today we are one of the world’s largest producers of mutations and variants of this virus. This happens because we were not responsible, especially the federal government, in playing this transition down. The more people circulating on the streets, the more easily we will have new variants of the virus.”

Source: CNN Brasil