Sharp Increase in Covid-19 Cases: More than 92,000 infected in Brazil

Sharp Increase in Covid-19 Cases: More than 92,000 infected in Brazil

Brazil sees sharp increase in Covid-19 cases; now at more than 92,000 infected, researchers warn that total could actually be 12 times higher

By Marques Travae

According to official data on the coronavirus pandemic, there has been a relatively quick spike in the cases confirmed in Brazil. These numbers seem to get worse daily and weekly,  but what is perhaps most troublesome about the situation is the worst case scenario.

Just two weeks ago, on April 15th, it was being reported that Brazil had broken the record for confirmed cases of the new coronavirus (Covid-19) cases in one day.

That report by the Ministry of Health showed that 3,058 cases of infection were registered, bringing the total at that time to 28,320. Within a period of 24 hours, the number of deaths was 204, bringing to the total to 1,736 deaths across the country.

Considering the the increase in the number of cases compared to Tuesday, 14, the increase was 12% when 25,262 were registered, and 27% when the data was compared to Monday, 13, when these numbers indicated that there were 22,169 infected people.

Compared to April 14, the death count rose 13% when there were 1,532 deaths accounted for. Just one day, from Monday the 13th to Tuesday the 14th saw an increase of deaths from 1,223 to 1,532.

At that time, as now, the state of São Paulo led Brazil’s 26 states in total numbers of deaths from the vírus with 778, which was three times higher than the state coming in second place,  Rio de Janeiro with 265. The states rounding the top five state were Pernambuco (143), Ceará (116) and Amazonas (106).

Looking inside the data, 60% of Brazilians dying from the vírus are men and 40%, women. People over the age of 60 represent 73%. But the percentage of deaths of this age group, considered high risk, has fallen. Two weeks previously it was about 90%.

Further data shows that among those who died, 73% had someother factoring disease, conditions that doctors consider “risk factor”. Of the official deaths, 502 had a heart problem, 508 had diabetes, 152 had some respiratory complication (pneumopathy) and 119 had some sort of neurological condition.

Persons going to the hospital due to the vírus came to 6,634. According to the Ministry of Health, 21,746 people hospitalized with Severe Acute Respiratory Syndrome (SARS) are still having the cause investigated. Another 13,232 fall into this category which the Ministry of Helath has defined as “unspecified SRAG”.

At the times, the Minister of Health, Luiz Henrique Mandetta said that there difficulties attaining personal protective equipment and devices such as ventilators and respirators, complaining that largest provider of supplies, China, shut down exports during February and most of March.

According to reports, the lethality of the vírus in the country, meaning death to case ratio, was 6.1%. From there, the numbers have consistently increased, showing that Covid-19 has yet to reach its peak in Brazil.

From that report on April 15th, to the next report on April 19th, the numbers of cases again jumped, this time from 28,320 to 38,654 cases with deaths from the vírus jumping from 1,736 to 2,462.  São Paulo remained the state with the most affected by the vírus with 1,015 fatalities and 14,267 infections. The interesting thing is that as the numbers continue to rise, demonstators having to the streets calling for the end of social isolation precautions. The protesters are most supporters of President Jair Bolsonaro who has consistently downplayed the severity of the pandemic.

By April 23, the Ministry of Health reported another surge in the numbers, going to 43,079 total cases reported with 2,741 deaths. From the April 22 to April 23, another 166 deaths and 2,498 cases were reported.

Broken down by regions, the Southeast Region, which includes the states of São Paulo and Rio de Janeiro, reported the highest numbers with 23,133 (53.7%) confirmed cases of the disease. In second place came the the Northeast region, including states such as Bahia, Pernambuco and Ceará, with 10,868 (25.2%); the North, with 4,431 (10.3%); South, with 2,991 (6.9%), and Center-West, with 1,656 (3.8%).

But even with the sharp increase in numbers of cases and deaths, perhaps the worst news to be reported during this period was the possibility that Brazil could have up to 12 times more cases of coronavirus than those officially released by the government’s Ministry of Health, as there have been such a low number of tests and the long waits to confirm the results.

Research carried out by a group of universities and institutes across the country examined the proportion of cases that resulted in deaths up to April 10, considering cases in which there was recovery or death but excluding patients that were still under some sort of treatment.

These figures were compared to the predicted mortality rates based on the age of patients in data released by the World Health Organization. (Sharp Increase in Covid-19 Cases: More than 92,000 infected in Brazil)

Based on official data, the much higher than expected mortality rate in Brazil indicates that there are many more cases of the virus than are being reported. The study estimates that only 8% of cases are being reported.

In accessing the spread of the vírus, the government has focused on testing serious cases rather than all suspected cases, according to the Center for Health Operations and Intelligence. Also figuring into this forecast were the long waiting times to obtain test results.

“The high degree of underreporting may suggest a false idea of disease control and, consequently, could lead to a decline in the implementation of containment actions, such as horizontal isolation,” says the document.

The researchers had predicted that by April 20 the number of cases would increase to 25,164 in the most optimistic scenario and 60,413 cases in the most pessimistic. According to the most recent numbers being released, Brazil now stands at 87,187 cases of Covid-19 with 6,006 deaths being reported  (see note one). These numbers again pale in comparison to the numbers being reported from the United States, by and far the country with the biggest numbers of cases and deaths reporting 1,095,304 cases and 63,871 deaths.

But amidst the media’s campaign of creating an environment of panic, I will also point out the other side of the story which suggests that the numbers of coronavirus cases and deaths could in fact be vastly overestimated. Why would I say this? I’m quite sure that by simply making this statement, there will automatically be people calling me some sort of coronavirus denier or something. So before I go any further, let me first state that I am simply presenting the other side of the story based on what various public health ministries, agencies and specialists around the world themselves are saying.

What is at question here is the protocol for recording that a person died from the coronavirus. Note that I am speaking here of recording a cause of death being Covid-19 rather than actually confirming that the death was caused by Covid-19. It makes a difference. Here’s why.

Sharp Increase in Covid-19 Cases: More than 92,000 infected in Brazil:

A number of countries had admitted that the way they have recorded coronavirus as the cause of death among patients is quite liberal. Again, I say a number of countries, not just one. For example, let’s consider Italy as it was perhaps the first country where the news had us believing that people were just dropping like flies due to Covid-19. But then we learn from Italy’s health minister advisor that the numbers are due to the “generous” manner in which death certificates were filled out. According to Professor Walter Ricciardi:

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.”

In fact, echoing what Ricciardi said, “a reassessment by the ISS shows that only 12% of the deceased showed causes of death directly related to the coronavirus, while 88% had at least one pre-existing disease.”

For purposes of clarity, the Telegraph UK website also points out that Ricciardi’s statement:

“does not mean that Covid-19 did not contribute to a patient’s death, rather it demonstrates that Italy’s fatality toll has surged as a large proportion of patients have underlying health conditions. Experts have also warned against making direct comparisons between countries due to discrepancies in testing.”

What’s important to point out here is that Italy is not distinguishing between people who are dying from coronavirus and those who die with a detection of the coronavirus in their system. In other words, whether a person actually dies from Covid-19 or they didn’t die from the vírus but that the vírus was simply in their system, coronavirus will be noted as cause of death, an important distinction that is being passed over. Then we have the fact that 99% of those deaths reported in Italy had at least one other chronic illness and 80% had two such illnesses.

In Germany, we see a similar practice.

The president of the German Robert-Koch-Instituts (Robert Koch Institute) confirmed on March 20, 2020, that test-positive deaths are counted as “corona deaths” regardless of the actual cause of death: “In Germany, a corona death is someone in which a corona virus infection has been detected,” said the institute president.

The article on Germany goes on to say that, like Italy, “according to experts, this puts the number of deaths into perspective, as in many cases patients die from their previous illnesses and not from the virus.”

Perhaps even more telling, the article goes on to say that:

“A look at the statistics of test-positive deaths in Germany shows that the median age of the deceased is over 80 years, similar to Italy, and that in most cases one or more serious pre-existing conditions were present. The so-called excess mortality due to Covid-19 is therefore likely to be at or near zero in Germany, similar to that in Austria.”

That article was published on March 24 and updated on April 28.

As if Italy and Germany weren’t enough to reveal some very strange methods of reporting on deaths caused by coronavirus, that’s not all.

According to HSC Public Health Agency guidelines from Northern Ireland, reports being released define a “Covid19 death” as: “individuals who have died within 28 days of first positive result, whether or not COVID-19 was the cause of death” (emphasis mine).

And what about the United States? Surely the US isn’t also playing this numbers, too, right? Well, considering that the US is by far the country that is believed to be most affected by coronavirus, maybe we should also look into the US is reporting on coronavirus deaths. One clue of how reports are being made in the US was revealed by Minnesota State Senator Scott Jensen. Jensen is also a physician and in a recent interview, he revealed that:

“doctors were receiving instructions from the Minnesota Department of Health to report Covid19 as a cause of death, even if the patient was never tested (emphasis mine). What?!? YES! Read it again and let that sink in. Jensen further stated that in his 35-year career he had never received specific instructions on how to fill out a death certificate.”

Sharp Increase in Covid-19 Cases: More than 92,000 infected in Brazil:

Describing the guidelines as “ridiculous”, Jensen cited a colleague in saying that it wasn’t a standard procedure to ever write “presumptions or probabilities” on a death certificate, but rather to “stick to the facts”. Why is this protocol being changed for the Covid-19 pandemic?

Jensen’s report should actually not come as a surprise when we consider how White House coronavirus task force coordinator, Dr. Deborah Birx laid it out. Asked if she was concerned that deaths being misreported as being caused by coronavirus, Birx responded this way:

 “So, I think in this country we’ve taken a very liberal approach to mortality. And I think the reporting here has been pretty straightforward over the last five to six weeks. Prior to that when there wasn’t testing in January and February that’s a very different situation and unknown.

“There are other countries that if you had a preexisting condition and let’s say the virus caused you to go to the ICU and then have a heart or kidney problem some countries are recording as a heart issue or a kidney issue and not a COVID-19 death. Right now, we are still recording it and we will I mean the great thing about having forms that come in and a form that has the ability to market as COVID-19 infection the intent is right now that those if someone dies with COVID-19 we are counting that as a COVID-19 death.”

So, let’s be clear on what she’s saying. In the United States, a person will be counted as a victim of the pandemic if they die while testing positive for the virus, even if something else actually causes the death.

So, now we see that liberal recording of deaths being attributed to coronavirus is being practiced in Italy, Germany, Northern Ireland and the United States. But that’s still not all. We also know, by their own admission, England is doing the same thing.

According to England’s Office of National Statistics, National Health Service orients doctors to fill out death certificates according to the following guidelines:

“…if before death the patient had symptoms typical of COVID19 infection, but the test result has not been received, it would be satisfactory to give ‘COVID-19’ as the cause of death”.

It continues by saying: “…share the test result when it becomes available. In the circumstances of there being no swab, it is satisfactory to apply clinical judgement.”

Basically, what the document confirms is that England’s government is advising its doctors to place coronavirus as the cause of death even if there is no actual evidence that the victim was actually infected. As if this weren’t shocking enough, it gets even more absurd. The UK’s Coronavirus Bill states that physicians can even issue make a confirmation on a cause of death of a body they’ve never even seen! Sounds like na exaggeration right. Well, read it for yourself:

“If no doctor has attended the deceased within 28 days of death (including video/visual consultation) or the deceased was not seen after death by a doctor, the MCCD (medical certificates of cause of death) can still be completed…. Medical practitioners are required to certify causes of death ‘to the best of their knowledge and belief’.

What does that sound like to you given the openly stated liberal recording of causes of deaths in the previously mentioned countries? And what does this mean in relation to the idea that cases in Brazil could actually be 12 times higher than the current numbers? This is all very difficult to say. I will say that I recently received word from a friend in the US who told me that the mother of one of his dear friends recently died. As with any cases of people passing away due to some illness, coronavirus or not, the news is always sad and in the end, when you lose a loved one, it doesn’t really matter what the cause of death was. But due to the symptoms that the young woman’s mother had, the manner in which the hospital denied her access to her mother and the fact that her mother was in her mid 80s, she questions whether her mother actually had coronavirus or whether she was simply told that she died of coronavirus, a practice documented above in several countries.

In this crazy world we live in, it’s nearly impossible to trust any and every source of information, but even so, I suggest that we all just take the necessary precautions. I haven’t pushed the emergency button and I don’t see the need for entering a state of panic because of what may be on the bottom of my shoes at the end of 15-30 minute walk (unless you work in a hospital). I also don’t panic if I happen to brush up against someone’s car in the street.

Even having read the worst case scenario for Brazil, I remain optimistic. And why shouldn’t I? After all, Brazil has actually reported more cured patients than those hospitalized with the infection and waiting on test results. Walking around fearing that “the rona” is gonna get you wherever you go is no way to live. And neither is living with an extreme sense of pessimism.

Be safe, wherever you are.

Note

1. Just between the time I began putting this article together (May 1) to the time of this piece being published, the numbers have gone from 87,187 cases of Covid-19 with 6,006 deaths to 92,109 cases and 6,410 deaths.

With information from Agência Brasil, Correio Braziliense, Brasil 247, Notícias UOL