India, Brazil grapple with massive COVID-19 surges

India's cases topped 200,000 today with some of its major cities announcing new restrictions, as Brazil's outbreak continues to overwhelm many of the country's hospitals, a situation Doctors Without Borders said today is a humanitarian catastrophe.

The World Health Organization (WHO) has said different parts of the world are facing different COVID situations, with some parts of Europe see promising signs of declining cases.

More measures, limited oxygen in India

Surges in India and Brazil are fueling a steady rise in global cases, given that they are among the world's most populous countries: India the second, and Brazil as the sixth.

India reported a record single-day high of 200,739 cases, and the burden of cases has pushed the country's oxygen production to full capacity over the last 2 days, with the health ministry announcing that it now needs to import 50,000 metric tons, according to Reuters. Media reports describe patients waiting for hospital beds to open up and even patients on oxygen being placed two to a bed.

Mumbai, India's financial capital, began a lockdown last night, and officials today announced a weekend curfew for Delhi, the country's capital region, according to CNN.

The new wave of lockdowns is raising fears in India again of a mass exodus from cities, heightening the risk of people carrying the virus to more rural areas that aren't equipped to handle the virus, according to the New York Times.

Brazil battles variant spread

Meanwhile in Brazil, Doctors Without Borders (MSF) today said the Brazilian government's failed response is fueling a humanitarian catastrophe, and it called on the country's leaders to muster the political will to respond to the threat, which it said is killing people by the thousands.

Christos Christou, MD, PhD, MSF's international president, said public health measures have become a political battlefield in Brazil, with science-based policies relegated to political opinions rather than measures to protect people and communities. "Brazilian authorities’ refusal to adopt evidence-based public health measures has sent far too many to an early grave," Christou said. "This has put Brazil in a permanent state of mourning and led to the near collapse of Brazil's health system."

MSF said last week, intensive care units (ICUs) were at capacity in 21 of 27 states, and hospitals across the country are struggling with shortages of oxygen for treatment and sedatives needed for intubation. It also said the country has a critical need for rapid antigen tests to quickly confirm infections in an effort to limit spread.

Pierre Van Heddegem, who coordinates MSF's emergency response in Brazil, said, "The devastation due to shortages and high demand for care that MSF teams first witnessed in the Amazonas region has become the reality across the majority of Brazil." He added that a lack of coordination between federal health officials and those in states and cities has led to life or death consequences, with patients dying from lack of healthcare access and medical staff exhausted and experiencing emotional trauma.

An overwhelming amount of misinformation is complicating Brazil's outbreak response, with masks, physical distancing, and other measures shunned or politicized and unproven treatment such as hydroxychloroquine and ivermectin touted by politicians and prescribed by doctors, MSF said.

In a related development, scientists from Brazil's Fiocruz Institute warned that the P1 SARS-CoV-2 variant, which is currently fueling the country's massive outbreak, is evolving in ways that would make it more able to evade antibodies, according to Reuters. Researchers said the changes are similar to the B1351 variant, first seen in South Africa, which has already been shown to evade some vaccines.

Other global developments

  • The WHO's COVID-19 emergency committee is meeting today for the seventh time to assess the latest developments and make recommendations. The group, which in January 2020 said the situation warrants a public health emergency of international concern under International Health Regulations, meets every 3 months or more often as needed.

  • Europe is seeing early signs that transmission may be slowing in several countries, but hospitalizations levels are still high and virus levels need to be driven to low levels and kept that way, Hans Henri Kluge, MD, MPH, director of the WHO European regional office, said today at a briefing.

  • MSF yesterday called on the Biden administration to take urgent steps to share COVID-19 vaccine surplus. The group said vaccinating people in the United States alone won't end the pandemic and acknowledged that the US government is hosting a meeting of global leaders today to raise funds for COVAX, the WHO-led effort to equitably distribute vaccine.

  • In other vaccine developments, Denmark is exploring ways to share the supply of AstraZeneca-Oxford vaccine that is opting not to use, due to concerns about extremely rare blood clot side effects, and Poland is launching its Johnson & Johnson vaccine campaign, despite similar worries and noting that the benefits far outweigh the risks.

  • In Asia, two countries known for controlling the spread of the virus—Thailand and Cambodia—are experiencing rising cases, with Thailand anticipating ramped-up restrictions and Cambodia announcing a lockdown for Phnom Penh.

  • A US Government Accountability Office (GAO) investigation into global health security funding requested by US House members found that, in the 5 years before the COVID-19 pandemic began, the United States did much to help other countries. It said the US Agency for International Development and the Centers for Disease Control and Prevention spent about $1 billion, spanning 30 countries. The departments, though, faced challenges in building health capacity in some countries.

  • The global total today passed 138 million and is at 138,658,491 cases with 2,978,601 deaths, according to the Johns Hopkins online dashboard.

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