Periphery Leads Coronavirus Death Toll in São Paulo; Adult Women Most Infected

RIO DE JANEIRO, BRAZIL – One month after the first death reported due to coronavirus, São Paulo shows a map tainted by the spread of the disease, with deaths recorded in all regions of the city, particularly in the outlying suburbs. According to the Municipal Health Department, the highest numbers of suspected and confirmed Covid-19 deaths occur far from the center of town.

By Saturday, April 18th, of the 686 deaths that occurred in the city, at least 51 were in the district of Brasilândia, in the north zone, and 48 in the district of Sapopemba, in the southeast zone, followed by São Mateus and Cidade Tiradentes, both in the east zone and with 36 deaths respectively.

Moreover, most of the suspected coronavirus deaths seem to be focused on the fringes of the megalopolis, according to the map released by the city on Friday.

Examining the map, it appears that there are more suspected cases in the outlying neighborhoods and more confirmations in the most central region, although the city government has not provided figures with this specific classification.

“Testing is slower depending on your ZIP code,” says Paulo Saldiva, pathologist and professor at USP’s School of Medicine. “That’s why there are more suspected cases in the peripheries”. According to the city government, of the total number of tests sent since the onset of the pandemic for examination to the Adolfo Lutz Institute, the main public laboratory for Covid-19 testing, only 32 percent had their results released, and of these, 16 percent tested positive.

That is, there are currently some 15,000 tests awaiting some final stage for the result to be released.

Another social analysis of the coronavirus, in the epicenter of the pandemic in Brazil, shows that among both confirmed cases (9,428 until Saturday, April 18th) and suspected cases (about 35,000), women aged between 30 and 39 are the majority, followed by those aged between 40 and 49.

Saldiva believes that in Brazil, social standing may be more relevant than age when it comes to those infected and killed by the coronavirus. “We can’t be sure yet, but the data are showing that the vulnerable are not only the elderly,” he says.

“In Brazil and other Latin American countries, as well as in Africa, it is going to be different from Europe” according to Dr. Margareth Dalcolmo, a researcher at the Oswaldo Cruz Foundation (Fiocruz), who also said she sees a trend in Brazil towards the “rejuvenation” of the virus in relation to countries, due to age distribution.

A survey conducted with the secretariats of those Brazilian states now in an emergency situation – when the incidence of cases is higher than the national average – showed the highest percentage of hospitalized patients under the age of 60.

This is due to many factors that make up vulnerability; the vast majority of factors are present in the daily lives of marginalized residents. “Those who live far away not only work longer hours, but also spend more time commuting, they sleep less, eat poorly, don’t exercise,” he says. “That alone creates an intrinsic vulnerability. It’s as if the person loses his/her right to get sick”.

He recalls that the ability to maintain social isolation in the poor communities is also lessened by the housing conditions. Henrique Deloste, a community leader and member of the Residents’ Association of Brasilândia/Cachoerinha, the region leading in the number of deaths, says that in the community, those who can are complying with isolation.

“You see that people want to comply with isolation, but a portion of the people that go out on the streets are doing so because they need to work,” he says. “It may be that it gets a little better with the government’s help, but I doubt it. People are worried because the help is only for three months. What about after that?”

He reports that the region still holds a few funk parties, although it’s slowed down. “We’re trying to persuade the youths…” he says. But the main issue, according to him, is the lack of information among the population. “What I haven’t seen is action, guidance. There’s no specific campaign. What they ask me most when I go into the favela is about this issue, about the symptoms,” he says.

“Thank God you brought soap”

João Doria, governor of São Paulo, announced on Friday the extension of quarantine to May 10th as a means to prevent the “collapse of public and private hospitals”.

However, the capital already has the majority of its large hospitals with over 70 percent of ICU beds occupied. Emílio Ribas hospital announced mid-week that it already had all its 30 intensive care beds filled and that it intended to open 20 new beds.

Among the ICU beds belonging to the city, 53 percent are now occupied and up to Thursday, April 16th, there were 161 vacant beds in the city’s municipal hospitals. Creating new beds, according to Saldiva, is a palliative measure. “That’s what you have for now,” he says.

But while field hospitals are being inaugurated throughout the city – two are already in operation and one is under construction – health care workers are being sidelined because of the disease.

By April 15th, 223 of the city’s hospital network’s employees had been put on leave after testing positive for Covid-19, and six had died. A further 775 were withdrawn because of other influenza-type syndromes. For community leader Henrique Deloste, the shortage of beds is one of the peripheral areas’ shortcomings, but not the only one.

“We were handing out soap bars this week to the community and a person who welcomed us said ‘thank God you brought soap. We don’t even have money for milk. Everything is lacking here”.

Source: El País