The Covid-19 pandemic in Brazil
Brazil is facing a serious wave of Covid-19 cases this month. In early March the Brazilian president, Jair Bolsonaro insisted that Covid-19 is just a “gripezinha” (a little flu). He claimed that warnings about the serious risks of the pandemic were fake news and posted advice about using an unproven antiviral medicine on social media.
Some wealthy Brazilians who can afford to shelter in their homes from the epidemic are following Bolsonaro's advice to ignore quarantines. A 51-year-old dentist who was strolling with her 77-year-old mother supported Bolsonaro's view.
“People at risk, with respiratory problems, auto-immune diseases, should take care, which doesn’t mean they can’t go out,” Santiago said. “We can’t be locked inside an apartment or house. We need to circulate, but safely.”
“You don’t stand next to someone with a cold. Same thing,″ she said, echoing Bolsonaro’s belittling of the virus’ dangers. “Flu kills more than coronavirus, folks! A lot of things kill more than coronavirus!”
https://apnews.com/eeae3fd8920850cb1e42a2f89ce7a967
A 34-year-old with 4.5 million followers on Instagram caught the virus at a five-star resort. At first she said she agreed with the advice about sheltering at home, but after she recovered she threw a party in her home in Sao Paulo. Sao Paulo has an especially high rate of Covid-19 infections. The Party Animal, who might be able to become an asymptomatic carrier, shouted "Screw life!" at the camera along with her friends. Party Animal and her friends were not bothering to wear masks.
Many Brazilians do have better sense. More than 100,000 people unfollowed her and she lost about a dozen sponsors. The partier later apologized and suspended her Instagram account.
A TV talk show host, Tatá Werneck, was especially outraged and told the Party Animal:
“My cousin is a doctor and arrived home in tears. They already have to choose who to save,” Werneck posted on Pugliesi’s account. “This behavior of yours, even more so because you have so many followers ... is inadmissible.”
https://apnews.com/eeae3fd8920850cb1e42a2f89ce7a967
Many doctors are outraged by Bolsonaro's casual attitude toward the pandemic.
"People die on top of me, people die while waiting, people die because they don’t breathe," says a doctor, while Bolsonaro "doesn't care" if people stay home to combat the spread.
Dr. Gustavo Janot who works in an intensive care unit on the southwestern outskirts of Sao Paolo is especially distraught about the loss of physicians who were his friends.
“It's very heavy emotionally to us to see your friends in the ICU bed under mechanical ventilation,” he said in a Skype interview. “I think this is the toughest part, to see our colleagues in the firing line.” But Janot credits Mandetta, the health minister, with doing “very positive things,” adding the medical community is satisfied with the minister’s actions.
Dr. Filho is worried that they will run out of space in the ICU at his hospital.
“At some point, the health system will not be able to deal with all of them,” he said, likening his future to that of doctors in Italy. “We will have to start to choose which patient will have mechanical ventilation — I don’t even want to think about it.”
https://www.nbcnews.com/news/latino/brazil-s-doctors-fight-coronavirus-p...
Another physician, Dr. Joao Miori, a resident at Sao Paulo’s Federal University Hospital, said that the scarcity of testing means that patients who do not have severe cases are told to go home and quarantine themselves. Many people do not want to leave and try to wait at the hospital until they can get care. Even if they did not have the virus when they arrived there is a serious risk that they will catch it while they wait.
“They think we’re just blowing them off, so that we don’t have to take care of them,” he said in a recent phone interview. “They’re scared, and I totally understand.”
https://www.nbcnews.com/news/latino/brazil-s-doctors-fight-coronavirus-p...
Fox News reported that some of the hospitals now just have to send people home to die. According to Fox News, a well-known bastion of liberal-thinking, Trump-bashing spreader of panic about Covid-19 (/s):
Brazil officially reported about 4,200 deaths and almost 62,000 confirmed infections, but the true numbers there are believed to be vastly higher given the lack of testing and the number of people without severe symptoms who have not sought hospital care.
Some scientists have estimated over 1 million in Brazil are probably infected.
. . . .
Manaus, an Amazon city of 1.8 million, recorded 142 deaths on Sunday, the most yet. In the main cemetery, workers have been digging mass graves. Brazil's funeral industry warned last week that the city was running out of coffins and "there could soon be corpses left on corners.”
https://www.foxnews.com/world/brazil-spike-coronavirus-cases-hospitals-o...
In the well-off Rio neighborhood of Leblon the death rate is reported to be 2.4%. In the low-income Rio neighborhood of Iraja it is reported to 15%. In Sao Paolo the poor neighborhood Brasilandia has the highest death toll in that city; the death rate for those infected is reported to be 52%
https://www.reuters.com/article/us-health-coronavirus-brazil-poor-idUSKB...
The much higher-than-expected death rate in Brazil indicates there are many more cases of the virus than are being counted, with the study estimating only 8% of cases are being officially reported.
The government has focused on testing serious cases rather than all suspected cases, according to the consortium, known as the Center for Health Operations and Intelligence. The center and medical professionals have also complained of long wait times to get test results.
Year to date, the number of hospitalizations for severe respiratory symptoms has been over three times higher than usual for the time of year, but only 12% of those have been confirmed as COVID-19, the severe respiratory disease caused by the new coronavirus.
https://www.reuters.com/article/us-health-coronavirus-brazil-cases-idUSK...
Many favelas, as the labyrinths of cinder block homes that constitute the poorest neighborhoods are known, suffer from a lack of running water, septic systems and healthcare facilities.
Perhaps more challenging still, the state is weak in the favelas, with drug gangs often the de facto authority. That would make lockdown measures difficult to enforce - even if they had the support of the country’s skeptical leader, President Jair Bolsonaro, who has repeatedly shrugged off fears about the coronavirus and described state and city measures to slow its spread as extreme.
Residents in Brasilandia, a poor district at the north end of Sao Paulo with the highest coronavirus death toll in the city, told Reuters that bars were still crowded and open-air dance parties attracted thousands of revelers on the weekends.
https://www.reuters.com/article/us-health-coronavirus-brazil-poor-idUSKB...
Even if people in the favelas try to quarantine themselves the crowded conditions make it impractical. Without running water and septic systems there is no way to shelter in place or maintain proper sanitation. These people also need to work or else to be provided with food and other necessities. Bolsonaro is refusing to consider the medical needs of these citizens. Although the long neglect to provide adequate health services cannot be remedied in the next few weeks Bolsonaro does not seem interested in trying to mitigate the problem. (Does this remind anyone of some leaders in the USofA?)
MODELS OF AN EPIDEMIC SPREADING THROUGH A POPULATION
One of the values used to determine how fast an epidemic spreads is Ro, which is how many other people get the virus from each infected person.
If the Ro is 2 then each infected person gives the virus to two other people.
If the Ro is 4 then each infected person gives the virus to four other people.
Early studies of Covid-19 showed values of Ro from 1.4 to 7.23. This means that each infected person might give the virus to 1.4 other people on the average or maybe as many as an average of 7.23 people. (Liu et.al. JournalofTravelMedicine, 2020, 1–4)
Values of Ro between 2 and 4 were most commonly cited before cities, states and countries began to shut down.
A SIMPLE SIS MODEL OF THE EPIDEMIC IN BRAZIL
This sort of model is like the Ghost of Christmas Future. The outcome of the model can be changed by changes in human behavior.
My simple model assumes a value for Ro of 3. That means that each infected person passes the virus on to three other people. In the crowded favelas most people are probably in close contact with more than three other people.
Most people develop symptoms in 5-7 days after exposure. Presymptomatic people shed viruses for several days before they become ill. A significant number of people never have symptoms but can infect others.
Calculations for the newly infected assume that there will be 1,000,000 infectious people in the Brazil by next week and that people can give the disease to others for about one week.
People can actually keep shedding the virus for a week or two after the symptoms appear but it is assumed that they only infect others for about a week.
It is assumed that only about 10% of the new cases are people who will experience serious illness and that they will remain ill for about 3 weeks. These people are likely to need hospitalization at some point in their illness. Many of them will need oxygen and some will need ventilators. Other people will need to care for them and they will not be able to work.
Date_____Newly Infected___New serious cases_____Seriously ill
5/8______1 million__________100,000_______________100,000
5/15_____3 million__________300,000_______________400,000
5/22_____9 million__________900,000______________1,300,000
5/29____27 million_________2,700,000_____________3,900,000
6/5_____81 million_________8,100,000____________11,700,000
6/12_____[243 million]
The population of the Brazil is about 212 million. When the curve rises so rapidly there is not really time to develop herd immunity, but by early June most people will be coughing on someone who is already infected. Anyone who has not isolated themselves is likely to be exposed.
Ro can be changed to a smaller number by good hygiene and wearing masks. Testing and isolating infected people can greatly decrease the Ro. Effective quarantine can get the Ro down to 0 and can stop an epidemic. This is what they have done in New Zealand.
People are likely to change their behavior as the severity of the problem become apparent and this will change the Ro. It takes a couple of weeks for the benefits of quarantine to become obvious and the rate of deaths will drop 3-4 weeks after the change in Ro.
The US Embassy in Brazil warns US citizens about the dangers of favelas. The danger of Covid-19 will overshadow the danger of the gangs.
Do not travel to informal housing developments (commonly referred to in Brazil as favelas, vilas, comunidades, and/or conglomerados), even on a guided tour. Neither the tour companies nor the police can guarantee your safety when entering these communities. Even in these communities that the police or local governments deem safe, the situation can change quickly and without notice. While some informal housing developments have clear boundaries or gates, or even names such as “favela”, “vila”, “comunidade”, or “conglomerado”, other such developments may be less obvious, and may be identified by crowded quarters, poorer conditions, and/or irregular construction. In addition, exercise caution in areas surrounding these communities, as occasionally, inter-gang fighting and confrontations with police move beyond the confines of these communities.
The situation is already horrific in some parts of Brazil and Bolsonaro is not providing leadership.
Undertakers in Manaus even resorted to burying coffins one on top of the other this week, but the city stopped the practice after grieving relatives protested.
Brazilian right-wing President Jair Bolsonaro, who has downplayed the gravity of the virus, calling it a “little cold,” came under new criticism for his remarks on the soaring deaths.
“So what? I’m sorry, but what do you want me to do?” Bolsonaro told reporters on Tuesday, saying he could not “work miracles.”
In Manaus, which is accessible only by plane or boat from the rest of Brazil, corpses are accumulating in a refrigerated container improvised as a morgue freezer as they await burial.
https://www.reuters.com/article/us-health-coronavirus-brazil/amazon-city...
Brazil’s president Jair Bolsonaro wants soccer players to entertain the public, but at least he does have some inkling that they might not be enthusiastic about the risk of infecting their families as well as endangering their own health.
“There is a lot of people in soccer that are favourable to a return because unemployment is knocking on clubs’ doors too,” Bolsonaro said in an interview with Radio Guaiba. “Footballers, if infected with the virus, have a small chance of dying. That’s because of their physical state, because they are athletes.”
Brazil’s president said his new health minister will issue a suggestion that games return without any fans in the stadiums, but he acknowledged many players might be reluctant.
A director at Sao Paulo FC, 1994 World Cup winner Raí, said his club is against resuming play during the pandemic. He also called for Bolsonaro’s resignation because of his “irresponsible” management of the crisis.
“We want to return in the proper time, in accord with recommendations, and gradually,” Raí told GloboEsporte.
https://www.theguardian.com/football/2020/may/01/jair-bolsonaro-says-foo...
It may be difficult to prevent spread of the virus from Brazil to other countries.
In Paraguay, soldiers enforcing anti-virus measures have dug a shallow trench alongside the first 800 feet (244 meters) of the main road entering the city of Pedro Juan Caballero from the neighboring Brazilian city of Punta Porá, to prevent people from walking along the road from Brazil and disappearing into the surrounding city.
Argentine officials say they are particularly worried about truck traffic from Brazil, their top trading partner. In provinces bordering Brazil, Argentina is working to set up secure corridors where Brazilian drivers can access bathrooms, get food and unload products without ever coming into contact with Argentines.
In Uruguay, President Luis Lacalle Pou said the spread of the virus in Brazil was setting off “warning lights” in his administration and authorities are tightening border controls in several frontier cities.
Thirty workers recently crossed from Brazil to the Uruguayan border city of Rio Branco to help build a cement plant. Four tested positive for the virus, prompting Uruguay to place the whole crew in quarantine.
https://www.nbcnews.com/news/latino/brazil-s-surge-coronavirus-cases-its...
The US Department of State is taking the situation seriously, but there is not a travel ban from Brazil to the US.
The Department of State has issued a Global Level 4 Health Advisory which advises U.S. citizens to avoid all international travel due to the global impact of COVID-19. In countries where commercial departure options remain available, U.S. citizens who live in the United States (i.e. are temporarily overseas) should arrange for immediate return to the United States, unless they are prepared to remain abroad for an indefinite period. U.S. citizens who live abroad should avoid all international travel.
There are quite a few Brazilian Americans living in Florida. There is also a significant population of Brazilian citizens who own a second home in central Florida near Orlando. There are also other places in Florida with people who travel to Brazil regularly. People fleeing an epidemic in Brazil will need to quarantine themselves for 14 days or they could create problems in the US.
Some regularly scheduled commercial flight options remain available departing Brazil for the United States. Domestic flight schedules within Brazil are also being reduced significantly, and U.S. citizens currently outside of the international gateways should also monitor their ability to obtain a connecting flight by consulting the website of their nearest airport. You may also contact your airline directly.
Location: Brazil Event: Commercial Flight Update – Increased Availability Beginning May 1, U.S. bound commercial flights from Brazil are expected to increase to 13 flights per week. Flights include daily service on United Airlines from Sao Paulo (GRU) to Houston (IAH) and flights on Azul from Campinas (VCP) twice per week to Fort Lauderdale (FLL) ...
Per the CDC, travelers returning from Brazil should stay home for 14 days after returning from travel, monitor their health, and practice social distancing.
Comments
4200 dead and they believe the infection
Rate is 1 million. So a death rate of 0.42%. Far less than the flu.
People do not die instantaneously on contact with the virus.
Most people are asymptomatic for 5-7 days. They may be ill at home for several days to a week before going to the hospital. People who do not survive generally are on a ventilator for 2-3 weeks.
The increase in the number of infections is not linear but logarithmic.
There were not nearly as many people infected four weeks ago.
Repeat to yourself.....
Regardless of the path in life I chose, I realize it's always forward, never straight.
Wrong, wrong, and damned wrong.
Wrong: 4200 dead
Nobody who is paying any attention attaches any credibility at all to Brazil's official death tally (which, incidentally, is already considerably more than twice Brazil's typical annual flu mortality -- which itself has risen considerably since the 2009 H1N1 swine flu outbreak). As with everywhere else in the world, Covid-19 deaths are being grossly undercounted. People dying before they get to a hospital are not being tested or counted. Out in the slums and shanty towns of the large cities, nobody is testing the dead or dying. They couldn't if they wanted to, due to Bolsonaro's who-gives-a-fuck anti-science attitude, which has left them woefully short of tests.
Wrong: 4200 dead?
Even if those numbers were credible, they are already 5 days out of date, and in that time Brazil's "official" death tally has risen 50%, to 6,300.
Damned Wrong:
I don't know where you get the notion that 0.42% is "far less than the flu". As I've repeatedly documented, estimates of flu's lethality are generally somewhere in the 0.1% to 0.2% range. In the worst outbreak in recent American history, 2017-18, the CDC's most recent lethality estimate was 0.14%: 61,000 dead of 45,000,000 cases. Note that in other posts I have cited as many as 80,000 deaths for that year, but that doesn't seem to be the current estimate. Also note, BTW, that these numbers come from exactly the sort of counting that the "Covid-19 = No BFD" crowd scream about for Covid-19: If somebody with severe respiratory symptoms tests positive for the flu and then dies, That's +1 flu death.
One must wonder, why is it so damned important to you for this pandemic to be something less than what almost all available evidence is telling us it is? Aggregate national, state and city mortality rates have been rolling in from around the globe, and they do a serious beating on the uncertainty about just how deadly this thing is, with mortality spikes running as much as 4 or 5 times the usual rates, and excess deaths everywhere exceeding -- sometimes significantly -- the official Covid-19 death tallies. At the same time, health professionals are testifying to the undercounting. In the face of this evidence, you do not merely maintain doubt, you maintain adamant denial. Why?
I acknowledge, it's still possible we'll discover that after ravaging "our" (America's) elderly population, we'll look around and see that "only" 40 or 50 thousand under-60s have died. And maybe when we lift the lid off the stay-at-homes, and the fever rampages through 100,000,000 or so of our population, we'll see that "only" another 100,000 or so have died. Maybe. I mean ... there's not one whit of evidence to support that optimism -- but maybe, because we just do not know. And by the same token, maybe lifting the lid will result in a tidal wave of 200,000,000 infections and 3,000,000 deaths -- because we just Do. Not. Know.
I find your certainty more than disquieting -- I find it bizarre. As the song says: The stakes we are gambling are frighteningly high.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
Much better
to be cautious than foolish.
Excellent rebuttal.
Regardless of the path in life I chose, I realize it's always forward, never straight.
Thank you.
You summed up the facts beautifully. I was looking for a non-technical source for the CFR for flu. If there are better treatments for Covid-19 in six months I am hoping it will eventually be no worse than the 1918 flu; maybe that is just wishful thinking, but it is a good reason to slow this down as much as possible.
I can think of three reasons to insist that the pandemic is not really happening.
1. Fear.
Most people here are over 40 and at personal risk from this virus. So are many people we care about.
2. Greed.
Those two Drs. in California want to make more money with their quickie-care clinic. I read that they got censured by a professional association. Good.
3. Bigotry.
The PTB seemed to notice in January that this virus attacks old people, poor people and people with disabilities.
A lot of people live long, productive lives with diabetes or high blood pressure, but it does cost a little money to care for them.
The complete abandonment of any effort to protect people in nursing homes reminds me of the Reagan approach to HIV. His supporters did not care much for gays, Haitians and/or drug addicts.
Poor people are often members of minority groups and decimating them would be fine with some of the supporters of this administration. This epidemic is devastating for the Navaho people as well as poor folks in cities.
Many people in the favelas are not white.
This:
It's a nearly autonomic response to almost any negative local, national, international event. In real time, they always see black helicopters/false flags and ignore/dismiss the usually few but most available and solid facts. Then they scramble around for anything, numbers or anecdotal reports, that in their minds fits with their worldview. In this instance, they dismiss the fact that China locked down a entire important province to minimize the transmission once it was endemic. Those with this mindset are as dangerous to public health and well-being as those in positions of authority that can (and too often do) significant harm to others.
Current rate of death is orders of magnitude worse than the flu
If you follow the daily report on Covid-19 at https://www.worldometers.info/coronavirus/ you will see that we have "flattened the curve" to a constant 2000 +/- deaths per day in the US, and 30,000 +/- new cases per day. In one year's time that will be 730,000 deaths and 10 million new cases. If we "open up", these numbers will be much higher. We have only seen high rates in the last month, that is, this pandemic has had big number of increase for a very short time. We now have to live with huge numbers on a daily basis. On March 30 we had 159,000 active cases. Today we have over 900,000 active cases. These are the individuals with viral loads who are going to infect new people. Take a good look at the curves. They mercilessly continue to climb. As NY starts to decrease their rate of new infections, other states are moving up the curve rapidly. Take a look at the curve of active cases for China. It goes up, peaks, and then goes down to almost zero. Then they opened up. Take a look at our curve. It goes up, and that's it.
I took a snapshot of 30 states on April 8. Comparing total number of cases now to then all states are between three and four times. That's in three weeks. The only state with a slower growth rate is NY at just over two times, they are actually doing something about the problem. The country as a whole is not. When we "open up" the results will be catastrophic for the US.
Deaths and infections from the flu are insignificant relative to these numbers. There were 7,428 verified deaths from the flu last year. Please folks, drop the right wing meme that this is no worse than the flu and that its a plot to kill the country. This is deadly serious and we have not figured out how to get out of this pandemic, short of a working vaccine, or extreme quarantine, which the US population is totally incapable of. Think Sweden is a good example staying open working to herd immunity? Sweden has the highest number of daily deaths per capita than any other country in the world, by a lot. Don't believe me, here you go:
Country, Population, New Deaths, Per Million
USA, 330, 2201, 6.7
Spain, 47, 268, 5.7
Italy, 60, 285, 4.8
UK, 68, 674, 9.9
France, 65, 289, 4.4
Germany, 84, 156, 1.9
Turkey, 84, 93, 1.1
Russia, 146, 101, 0.7
Iran, 84, 71, 0.8
Brazil, 212, 390, 1.8
China, 1440, 0, 0.0
Canada, 38, 188, 4.9
Belgium, 12, 93, 7.8
Netherlands, 17, 84, 4.9
Peru, 33, 108, 3.3
India, 1380, 75, 0.1
Switzerland, 9, 21, 2.3
Portugal, 10, 16, 1.6
Ecuador, 18, 17, 0.9
Saudi Arabia, 35, 5, 0.1
Sweden, 10, 124, 12.4
Capitalism has always been the rule of the people by the oligarchs. You only have two choices, eliminate them or restrict their power.
Why is it important?
because we are being manipulated.
Because the cure is worse than the disease.
Because once we let ourselves be herded down this road there may be no way back.
Because this is 911 all over again and we lost so much to the totalitarians then.
This epidemic is real and lethal.
About 3000 people were lost on 9/11. There have also been first responders and neighbors lost to illnesses caused by the dust in the area. This could have been prevented by proper personal protective equipment, which is a failure of the government to maintain and distribute adequate supplies of PPE.
I do not cry easily but I cried as I watched the 9/11 news coverage. I cried not only for the lives lost that day but also for the lives that would likely be lost in whatever war this act was likely to cause. I cried for our soldiers who would die in the war, and the healthy young soldiers who would come home disabled. I cried because wars precipitate jingoism and hate speech at home that leads to destroyed lives and a few murders at home. I cried for innocent civilians who would die in the war zone, especially the children.
This pandemic is not anything like 9/11. The US has lost more people in the last two months than all the US casualties from 9/11 combined. This epidemic is only getting started.
Yes, the PTB are planning on using this to strip us of the freedoms we have left. A second, much worse wave of this epidemic caused by refusing to properly quarantine will cause a public panic that will give them the excuse to put a US Stasi in place. I do not want Bill G*tes to microchip me like his pet poodle. At this point using phones for contact tracing is pointless from an epidemiological standpoint. That does not mean that a frightened population will not agree to it.
Yet, you have no idea how bad the disease is.
You choose to simply accept the most pollyannish "evaluations" -- in truth, they scarcely deserved to be called anything but fantasies -- because that let's you grind your anti-authoritarian gears. The aggregate all of available data makes it quite clear that this is worse than any influenza that we've seen in at least 60 years -- and how much worse, we cannot say, because we can't even figure out such critical bits of info as:
A. How does it kill?
B. How does it injure?
C. How prevalent is it?
D. Why is it so bad in some people, and so mild in others?
E. How many "positive" tests are actually flagging other coronavirus infections (which are endemic)?
F. Does previous infection with one of those other coronaviruses confer some level of immunity?
G. If so, how much?
H. Does previous infection with SARS-Cov-2 confer some level of immunity?
I. If so, how much?
You are absolutely adamant that the virus is widespread and that deaths are being overstated, but in fact that best evidence is that the virus is not that widespread (if it were, there wouldn't be such a high rate of negatives in people who show up at hospitals with fever/cough -- evidently caused by something else), and that deaths are being understated (as I've explained here several times).
You -- specifically you, BoBM -- "know" almost nothing about the virus, the disease, or the pandemic, but you "believe" an extraordinary array of things that are at best improbable.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
Yes:
"but in fact that best evidence is that the virus is not that widespread (if it were, there wouldn't be such a high rate of negatives in people who show up at hospitals with fever/cough -- evidently caused by something else), and that deaths are being understated (as I've explained here several times)"
Although I suspect that a high proportion of those negative test results are for people that are able to demand a test but don't have any symptoms and have no known contact with a COVID-19 patient. Little, to be generous, contact tracing is being done in the US. However, South Korea has done extensive contact tracing (>80% of the patients), claims that tests are almost exclusively administered only to those with symptoms and a known contact, and has gotten positive test results on only 1.73%. In all reports, more testing results in more cases, but the percentage of negative results increases. Again using SK as an example, only 0.22% of the latest 108,448 tests were positive.
You are comparing apples to oranges.
Very few people have been tested in Brazil so all the reported numbers are much lower than the actual cases. The number of deaths among those who were tested should be compared to the number of people with a diagnosis confirmed by testing.
The estimate of one million cases is a reasonable guess, but it is based on an assumption that the mortality rate is about 2%. The one million should be compared to the estimated number of actual deaths.
Of course you can always assume that these death rates are correct.
Data was from:
https://www.reuters.com/article/us-health-coronavirus-brazil-poor-idUSKB...
Edited for correct formatting of quotation marks
A 52% case death rate in Brasilandia
is fine with Bolsanaro and his ilk. What they'd prefer is that the case rate is 100% in the poorest communities.
The poorest in Brazil are, as usual, on their own with little to no medical assistance. However, they've been there before and found low cost and effective means to reduce the spread of a disease, but in that instance, HIV, they did have support from the government. Adult prevalence held to 0.60% unlike other countries with a large population of poor people such as South Africa and its 18.9% rate. (Brazil declined PEPFAR funding because the restrictions were contrary to the public health policy they had been using.)
That I refer to as "barefoot doctors" can be exceedingly effective in disease containment; provided they have the support of their local community. That's how Liberia managed the 2014 Ebola outbreak and performed much better than neighboring Guinea and Sierra Leone. If activated, the working class and poor in Brazil can deny Bolsonaro his wet dream.
The mortality rate only looks like 52%
because nobody bothers to test the poor. A lot of people in the favelas will have mild or moderate cases. (Descriptions of moderate cases sound like a young person having the flu.) The only people from the favelas who are likely to be tested are those who make it to the hospital when it is almost too late. Half of them are too ill by that time to be saved. Most people in the favelas will never be tested whether they survive or not.
My guess, which is just based on descriptions of the disease progression, is that the mortality rate will be around 10% in the favelas. That is just a guess and I hope it is too high. The average age among the poor tends to be younger and other illnesses have already attacked poor people who are immunocompromised.
Many of the poor people who will not survive would have had a good chance with oxygen, good nutrition, a lower initial viral load and good care during their illness. If all members of a family get sick at the same time or healthy people flee the area in fear the basic needs of the sick for food water and sanitation may not be met. This is a tragic cause of significant amounts of mortality in historical epidemics.
About 20% of the people are said to get severe cases but that was based on testing of people who were sick enough to get medical attention. My guess is that about 10% will be severely affected. Nobody really knows so it is not possible to make good models.
quite so.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
Uh ...
Unwittingly, that is the position of the denialists wrt the case fatality rate in the US, etc.
Wouldn't quarrel with an assumption of high infection rates in very poor and crowded communities, but why would nearly all those cases be mild or moderate and recover with no medical attention?
I have little confidence that Brazil is doing an accurate count of the deaths in the poor communities. Brazilian authorities don't enter such communities. Thus, a true picture of the case fatality rate in those communities will be less accurate than whatever is presented for other communities.
Let's add to this the limits of the test itself. Is there any public information as to how soon after being infected the test detects the virus? South Korea, that has been more transparent than most countries, claims that with minor exceptions, tests are only administered to those that 1) had contact with a case and 2) exhibits symptoms. With that South Korea has been getting mostly negative test results (609 thousand compared to 11 thousand) and 620 thousand tests are only slightly more than 1% of the population. While the case death rate in SK for those under age 60 (76.4%) are extremely low, all of them may have been very ill and some were hospitalized.
@Marie
There were several review articles summarizing the observations Chinese physicians made about Covid-19. Physicians in Europe and in NY made similar observations. Early conclusions about the severity of Covid-19 infections were based on test results for people who were sick enough to seek medical care.
According to:
2019 NOVEL CORONAVIRUS (COVID-19) A PRIMER FOR HEALTH CARE PROVIDERS
by Demetre Daskalakis MD MPH
Deputy Commissioner, Disease Control
New York City Department of Health and Mental Hygiene
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-provider-pres...
Once testing became more available quite a few people were found who were only mildly ill for a day or two and who never even realized they had been infected with Covid-19. A significant number of people never even noticed any symptoms although they were shedding the virus and cold infect others (asymptomatic carriers). Chinese health care workers had already found people with few or no symptoms because they did contact tracing. The substantial number of asymptomatic carriers became more apparent as testing became more available.
Younger people are more likely to be asymptomatic carriers. The number of asymptomatic carriers will probably depend on the age distribution in the community. These people are not even included in the group that has mild to moderate symptoms.
The effects of the illness are likely to make many people in the favelas very miserable, most should have a decent chance to recover.
One thing I have not factored into my guesses is that Brazil is going to start their winter flu season along with this pandemic. Things may go badly for younger people who get the flu at the same time as the coronavirus.
Usually I try to make suggestions about possible solutions to problems, but this whole thing just makes me feel helpless and sick. Maybe we can educate people elsewhere so they do not follow the path Brazil is taking, though.
You swallow whole the hyperbole
and blindly accept wild estimates of one million affected and with the same face say 4200 deaths are under reported.
Shame on you.
the only person swallowing anything whole around here
is you.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
The number of deaths is just one thing
You should look into how many people who recovered from the virus have been left with disabling conditions in their lungs or other organs. In some cases they are left with Christian infections. This is why I take this seriously.
Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.
Voting is like driving with a toy steering wheel.
Say whaa?
Wa-choo be talkin' bout dare, dawg?
Lol
I love what autocorrect comes up with when I fail to hit the word I'm writing. I meant chronic. I can't tell you how many times I do have to edit my comment cuz of this. But ya have to admit it was funny..
Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.
Voting is like driving with a toy steering wheel.
Deadly bug
Actually, I know some severe cases of folks with Christian infections. In extreme forms, it seems to affect the mind. Kind of a mind parasite type of thing.
May 25th 800,000 diagnosed
by April 25th those either died or recovered. According to JAMA 81% are mild. Minimum recovered on April 25th would have been 648,000.
Instead they claimed 248,000 had recovered.
Their numbers never add up and they ALWAYS are less recoveries more deaths.
Meanwhile WHO now says only 12% of those Italian deaths attributed to CV were correct.
Only 12%.
If you understood the numbers, and the dynamics of
disease epidemiology, and what is meant by "mild", and "recovered", and who is being tested and who is not, you would understand that they add up just fine. Well, I mean, they don't quite, because the Covid-19 deaths are being undercounted, which causes some problems when we look at aggregate death totals from all causes in various political districts.
But you don't understand these things, so you decide to believe that you're being lied to. And don't get me wrong, you are being lied to -- the problem is, you're being lied to by the people you've chosen to believe.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
I don't see how this negates what I said
Many people who have recovered from COVID are left with horrific disabilities. I'm not sure why you overlooked this? I wasn't talking about deaths. Can you explain what point you are trying to make here?
Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.
Voting is like driving with a toy steering wheel.
You are absolutely correct.
I am also worried about long-term health effects on people who get this disease.
SARS was caused by a coronavirus that is similar to the virus that is causing Covid-19. People who survived the SARS epidemic in 2003 often had long-term health problems afterwards.
https://www.ncbi.nlm.nih.gov/pubmed/15018132
Some SARS survivors still had lung problems two years after they recovered. (DLCO is a measurement of lung function.) Two years after they had SARS 30% of the people in this study had not recovered enough to go back to work.
https://www.ncbi.nlm.nih.gov/pubmed/20337995
Much of the damage to the lungs took a year or two to heal. Damage to the thigh bone was caused by potentially life-saving treatment with steroids, but some of the damage was permanent.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018717/pdf/41413_2020_Arti...
Another paper I read a couple weeks ago said that people who had recovered from SARS were more likely to get other respiratory infections even after several years.
Covid-19 causes clotting problems. Someone who has a heart attack or stroke during their illness may have long-term problems from that even after they recover from the infection itself.
Younger people like many health care workers are getting seriously ill because they are being exposed to high concentrations of the virus.
The favelas are very crowded so younger people in poor Brazilian neighborhoods may have worse cases of the illness than would be expected in people of their age. The illness is also likely to be much more severe if they get the flu at the same time. There does not appear to be a real medical support system to help them cope with any long-term health problems they may develop.
Good to see that we do agree:
WRT to the high incidence of doctors/nurses contracting the virus and dying during the initial outbreaks, it was of course an issue of inadequate PPE. However, did they acquire such a high viral load from a single patient or were they getting infected multiple times over the course of a day as they cared for many patients, all of whom were ill at that stage? This would differ from SARS. SARS patients only became infectious when they were seriously ill and at that point were highly infectious. A similarity to the disease progression of Ebola, but that one isn't respiratory transmission. China was extremely careful with the health care workers they sent to Wuhan/Hubei after the latter lost so many. Adequate PPE during their shifts but also isolated during their off duty hours. Zero fatalities among those workers - no report I've seen as to whether any of them contracted and recovered from the disease.
Still much to discover about this disease.
Jair Bolsonaro means Donald Trump in Portuguese
Apparently. "Fake News" "Just a little flu" Will he tell Brazilians to swallow Lysol next?
I've seen lots of changes. What doesn't change is people. Same old hairless apes.
Always refreshing after a bracing dip in
a sewage pool.
The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.
Drinking Lysol
Always reminds me of my mother saying "Would you jump in the lake if every one else did?"
I guess Trumpsters would.
Maybe next week DT will suggest taking shots of neat Drano. Let's hope so.
I've seen lots of changes. What doesn't change is people. Same old hairless apes.
You asked.
Liquid Plumber Cocktail.
http://www.robinetdesign.com/Rhodes/cktlrec143.html
There's also a Liquid Drano Cocktail.
No current tanslation of recipe is available.
Regardless of the path in life I chose, I realize it's always forward, never straight.
OT Note on New Zealand
They did close the borders to all non-residents on March 19. https://www.bloomberg.com/news/articles/2020-03-19/new-zealand-closes-bo...
My friend tells me that they are living like us with social distanting etc, most everything shut down.
Orwell: Where's the omelette?
They have new cases in the single digits.
Apparently their lockdown was more strict than ours and it was over the whole country.
They are using contact tracing to keep the epidemic from flaring up again.
On April 27 they started to open up
https://www.npr.org/sections/coronavirus-live-updates/2020/04/27/8453049...
One meter is too close
Even the six feet, although better, falls down when people are coughing.
I've seen lots of changes. What doesn't change is people. Same old hairless apes.
Six feet is fine IF everyone wears a mask,
cloth or surgical mask is fine. Twelve feet is possibly too close to those wearing an N-95 mask with a release valve, and as I've encountered many who are wearing these virus spreaders, I wear the uncomfortable N-95 (without a release valve) when grocery shopping.