The Brazilian mutation of the coronavirus is more contagious, more deadly, attacks very young people, and it is not clear that vaccines will work against it. The P1 variant is wreaking havoc in Brazil. And it is an alarm signal for the entire planet. By Jan Christoph Wiechmann/ Photos: Bruno Kelly
• Worrying mutations in COVID-19: why they are so dangerous
As dawn breaks over Manaus, the city of two million inhabitants on the banks of the Amazon, three people resume their fight against the P1 mutation.
Indigenous nurse Vanda Ortega begins a round of visits to remote towns, where the number of reinfected people continues to grow.
The gravedigger Ulisses de Souza Xavier confronts with his shovel the consequences of the enormous mortality of this pandemic and says that every time he has to bury younger victims.
Scientist Lucas Ferrante examines the latest figures for those infected by the new mutation and warns the world of the imminence of an "announced catastrophe": there are indications that the P1 variant is resistant to vaccines.
The mutant advances unleashed on Brazil, which is now going through the worst days of the pandemic. Worse than in May 2020, when the images of the mass graves in Manaus went around the world. Worse than in January 2021, when the oxygen supply to hospitals collapsed and patients suffocated in their beds. "And the worst is yet to come," Lucas Ferrante announces. A third wave in the Amazon starting in May. And, with it, the danger of new mutations. You Europeans should urgently isolate Brazil.
Diego Neves, 24, struggling to survive. This judoka was known for his strength. Despite this, the mutant coronavirus nearly finished him off.
Ferrante already saw the tragedy coming last August. Since then, this biologist from the INPA Amazon Research Institute has had to change his phone number every few days. His public calls for total confinement lead to his constant death threats.
Who's behind them?
People from the powerful business community, he supposes. "They want to prevent the closure." But Ferrante is more concerned about the new mutations than death threats. “If the virus continues to spread uncontrollably, there will be more mutations. The key question is whether or not the vaccines will then be effective."
This young researcher, only 35 years old, caused a huge stir due to the accuracy of his calculations, published in the prestigious journal Science. In August of last year, Ferrante and his colleagues warned that tens of thousands of deaths from coronavirus could be registered in Manaus until the end of the year. Politicians reacted by accusing them of being alarmists and inciting panic. In the end, the estimate fell short.
Ferrante takes out some sheets with the latest figures and reviews the spread of the P1 variant in Manaus. November 2020: 0 cases. December 2020: 50 percent of the cases. January 2021: 91 percent. At the moment, P1 is spreading unstoppably throughout Brazil.
P1 seems like the name of a car model, but from one day to the next it has become one of the biggest threats facing the world.
The breeding ground of Manaus
Lucas Ferrante continues reviewing figures: records of deaths are being recorded throughout the country, almost 2,000 daily. And he makes a terrifying prognosis: "Manaus is the ideal breeding ground for new and more dangerous variants of the virus."
As you walk the streets of what is probably the place in the world hardest hit by the pandemic, the dimension of the catastrophe looms around every corner. White vans with the inscription "SOS Funeral" circulate everywhere, collecting the bodies of the deceased from the houses. And in the central cemetery of Taruma they are using excavators because with pick and shovel the gravediggers can no longer keep up with the pace of the disease.
Overflowing cemetery. The new section of the Taruma cemetery did not take two months to fill up. Lack of space means that coffins are now stacked.
"P1 is twice as contagious as the original virus and causes reinfections," says Ferrante. Brazilian and British scientists have found that P1 evades immunity caused by a previous infection in between 25 and 61 percent of cases. Furthermore, at least the Chinese vaccine used in Brazil, Coronavac, is relatively ineffective against the new mutation.
The supposed herd immunity, which was already considered achieved in Manaus due to the enormous number of infections registered in 2020, does not exist. Right now there is only one way to prevent a global wave of P1, says Ferrante, and his voice almost breaks when he adds: "We repeat it, but nobody pays attention to us. A total confinement of between 20 and 30 days must be decreed. And the immediate vaccination of 70 percent of the city's inhabitants. And close the Manaus airport. Not let one more flight leave Brazil."
“Now, the dead are the age of my children”
In the Taruma cemetery, in the north of Manaus, the high number of deaths in the first months forced the creation of a new section for bury COVID victims. Hundreds of wooden crosses today stand next to each other on the damp reddish earth. But the originally designated area is already complete and the graves continue to spread until they reach the jungle.
Another section for the victims of the second wave, wave P1, was opened on January 9, but it has filled up so quickly that a third has already been opened, in which the coffins will be placed one on top of the other between cement walls.
At the end of the rows of graves, in row 80, stands Ulisses de Souza Xavier. The undertaker, 52 years old.
How many names of those killed by the coronavirus have you had to write on crosses?
“Hundreds,” he answers. Maybe thousands."
Is it becoming a chore?
"No, when I write the names, I always think of the victims, especially when they are as young as now." Xavier carefully writes down Joene's date of birth, 10.10.92, and says, “The ages of my children. This second wave is affecting people from 25 to 50 years old.
He knows very well what he is talking about, he works on the front lines of this pandemic. The world is still not aware of this, and scientists prefer to wait for enough data to pronounce themselves, but a walk among the graves shows the obvious: the victims of P1 are very young, from the years 1988, 1997, 1992... even the 2000.
Xavier says: "I can't take the grief anymore. Up to 80 deaths a day. It's terrible, but I don't want my family to notice it." He has seen so much suffering that he has decided to save his family from the virus, to take them to a town far from the city. "Many of those who stayed in Manaus are now dead," he says. I do not know of a single family that has not been affected by the coronavirus. I was recently on duty and saw a friend's family arrive. He had died suddenly. He was a young man. It was a jolt. They die so fast that you don't even know they were sick."
Among the indigenous people, even children die
About 20 kilometers away from the cemetery, where the jungle begins, nurse Vanda Ortega heard a piece of news that is also a warning to the world: a neighbor from the town of the bars has been infected with COVID again. And what's worse: her 40-year-old daughter is also seriously ill, and this is the third time.
"I have to go, it's my obligation," affirms Ortega emphatically, 33, the only indigenous nurse in the entire metropolitan area of Manaus. She gets in the car and drives down a red dirt road. Lately, this small and frail-looking woman spends a lot of time driving, canoeing or walking to remote settlements, sometimes taking days to travel. His own town is six days from Manaus.
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Indigenous people are being particularly affected by the pandemic. “Many times they do not have antibodies against the simplest viruses. Seven Yanomami children have already died of coronavirus. And the last descendant of the Juma people. With them, a culture is also dying. For now, the great tragedy that would be the disappearance of entire towns has been avoided. "Many of our brothers and sisters have isolated themselves in the depths of the jungle," says Ortega.
The nurse moves safely through the brush and makes her way to the Valerio family home. Marlene Valerio, 61, has difficulty breathing and pains in her chest and stomach. "The first time I had milder symptoms," he says.
“Reinfection”, Ortega says with a worried tone. "I have patients like her everywhere. Not to mention immunity... and less than herd immunity.
Like the gravedigger, nurse Vanda Ortega works on the front lines and knows the evolution of this pandemic in real time, long before the researchers have collected and analyzed the data and verified something that is already known here: that the P1 mutated virus reinfects people who have previously had COVID.
Nurse Vanda Ortega -the only indigenous health worker in the metropolitan area of Manaus- examines Glauciane Melguero, infected with COVID for the third time.
The second patient is Glauciane, Marlene's daughter, 40 years old and with a high fever. "I thought that this time I was dying," she says weakly. "Everything hurts. And it is the third time that I have been infected, “he adds.
"We've never had a third infection," the nurse says with bewilderment. This is bad news, for her and for everyone. "Now the question is: if your antibodies don't protect you from mutations, will vaccines at least protect you?" Ortega does not have the answer.
In his opinion, Manaus is now the laboratory of the entire planet. But the rest of the world still has time to protect itself.
Maria Barboza -director of a small health post in the town of Careiro Castanho- is also seeing something new in her patients: that the P1 variant is more aggressive than the first wave virus. It attacks several organs at once, not just the lungs. «I have had it myself and I have spent four weeks very seriously. He had pain in his kidneys, in his liver, everywhere. The researchers have not yet confirmed this, but Barboza affirms that "P1 is not only more contagious, it is also more dangerous."
If there is one thing that Ortega, Ferrante and Barboza agree on, it is that the Brazilian government has left its people in the lurch. The far-right president Jair Bolsonaro, who called COVID-19 a “little flu”, had come to appoint a military man with no idea on the matter as Health Minister. And when someone demanded that he buy vaccines, he called them an idiot. Now -already late- he says he believes in them...
The balance so far: almost 330,000 deaths. P1 is everywhere and it is a danger to the world. And the Government of Brazil flies blind. There is no end in sight.
Opening photo: Terrible goodbye. Regina Marao, with her daughter and her husband, says goodbye to her mother in a cemetery in Manaus. The deceased was 61 years old. It is the country where the most people die from COVID, an average of 2,300 per day. It has already exceeded 300,000 deaths in the pandemic.
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