LIMA, Peru – The doctor watched in horror as patients rushed to his intensive care unit.
For weeks, Cesar Salome, a doctor at Mongrut Hospital in Lima, followed the horrific reports. A new version of the coronavirus, born in the Amazon rainforest, has invaded Brazil, bringing its healthcare system to the brink of collapse. Now his patients were getting much sicker, their lungs were full of disease, they were dying days later. Even the young and the healthy were not protected.
The new version, he realized, is here.
“We had more time,” Salome said. “Now we have patients coming in. In a few days they have lost the use of their lungs.”
Option P.1, which packs a number of mutations that make it more transmissible, potentially more dangerous, is no longer simply Brazil’s problem. That is the problem of South America and the world.
In recent weeks, it has moved across rivers, avoiding restrictive measures aimed at curbing its progression, which helps boost the coronavirus virus across the continent. It is now a matter of concern in some parts of South America that P.1 could quickly become the dominant option, shifting the humanitarian catastrophe to Brazil, with cases of patients suffering without care, of fatal flight growth to their home countries.
“It is spreading,” said Julio Castro, a Venezuelan infectious disease specialist. “It is impossible to stop.”
In Lima, scientists have found a variant of 40% of coronavirus cases. In Uruguay, it is found in 30%. In Paraguay, officials say half the cases on the border with Brazil are P.1. Other South American countries – Colombia, Argentina, Venezuela, Chile – have found it in their territories. Restrictions on the genome’s sequence made it difficult to know the true breadth of the variant, but it has been found in more than two dozen countries, from Japan to the United States.
Hospital systems throughout South America are being pushed to their limits. Uruguay, one of the richest countries in South America, is a success story at the beginning of the epidemic, and the medical system is failing. Health officials say Peru is in the abyss, with only 84 resuscitation beds left by the end of March. Paraguay’s intensive care unit, which complained of medical malpractice last month, has run out of hospital beds.
“Paraguay is unlikely to stop the spread of version P.1,” said Elena Candia Florenti, president of the Paraguayan Society of Infectious Diseases.
“The medical system has collapsed, medicines and supplies have been chronically depleted, early detection is incomplete, communication investigations are non-existent, patients are waiting for treatment on social media, insufficient vaccinations for healthcare workers, uncertainty about when the general vulnerable population will be vaccinated. “It is dark in Paraguay,” he said.
How P.1 spread throughout the region is a clear South American story. Almost every country on the continent has a land border with Brazil. People gather in border towns, where crossing to another country can be as simple as crossing the street. Limited control և Border security has made the region a haven for smugglers. But they also made it almost impossible to control the spread of the version.
“We share a 1,000-kilometer dry border with Brazil, the world’s largest plant and the epicenter of the crisis,” said Gonzalo Moratorio, a molecular virologist in Uruguay who is tracking the growth of the variant. “And now it is not just one country.”
Deep in the Amazon rainforest, the Brazilian city of Tabatinga, where officials suspect the virus has spread to Colombia-Peru, is a symbol of the fight against the virus. The city of 70,000 was honored by P.1 earlier this year. Many in the area have family ties in several countries and are used to crossing borders easily. Cross the Amazon River by canoe to Peru or walk to Colombia.
“People have put an end to the virus from one side to the other,” said indigenous leader Sinesio Ticuna Trovjo. “The passage was free, both sides lived on top of each other.”
Now that the version has penetrated many countries, it is difficult to prevent its spread. Most South American countries, with the exception of Brazil, imposed austerity measures last year. But they have been eliminated because of poverty, indifference, distrust, and exhaustion. In the face of severe economic downturns and a sharp rise in poverty, public health professionals fear it will be difficult to maintain greater restrictions. In Brazil, despite record death tolls, many states are lifting restrictions.
That left vaccination as the only way out. But coronavirus vaccines are the white spot in South America. It is often discussed, but rarely. The continent has not developed its own vaccine or signed a regional agreement with pharmaceutical companies. It is one of the most affected regions in the world, but has managed only 6% of the world’s vaccine doses, according to Our World in Data. (The way out is Chile, which is vaccinating people faster than anywhere else in America, but there is still a big wave of cases).
“We should not blame only the policy response,” said Luis Felipe Lopez-Calva, director of the United Nations Program Acceleration Program for Latin America and the Caribbean. “We need to understand the vaccine market.”
“And there is a failure in the market,” he said.
The vaccine has become so scarce, Lopez-Calva said, that officials are imposing restrictions on information. It is almost impossible to know how much governments pay for doses. Some regional blocs, such as the African Union and the European Union, have negotiated joint agreements. But in South America, it was each country for itself, reducing the bargaining power for each.
“It’s harmful to these countries, to the whole world, to stop the virus,” Lopez-Calva said. “Because it has never been clearer that no one is protected until everyone is protected.”
Prominent Brazilian scientist Paulo Buss says it does not have to be this way. He was Brazil’s health representative at the United Nations in South America, which was negotiating with several pharmaceutical companies in the region before the coronavirus epidemic. But the union disbanded amid political controversy shortly before the virus arrived.
“It was the worst possible moment,” Bush said. “We have lost our capabilities, our negotiation efforts are fragmented. “Versatility has weakened.”
The shortage of vaccines has led to scandals across South America, but especially in Peru. Hundreds of politically connected people, including cabinet ministers and former President Martin Viscara, have been vaccinated early. Now people are calling for criminal cases.
As officials argue that the vaccination campaign has been postponed, the option continues to spread. According to officials, P.1 accounts for 70% of cases in some parts of the Lima region. Last week, the country recorded its highest August count of more than 11,000. There were 294 deaths in the country on Saturday, the most in a single day since the epidemic began.
Peruvians are amazed at how fast the tide is putting pressure on the healthcare system. Public health analysts and government officials believe Peru is ready for a second wave. But he was not ready for the version.
“We did not expect such a strong second wave,” said Percy Maita-Tristan, director of research at Southern University of Lima. “The first wave was so large. “Having a Brazilian version helps explain why.”
McCoy reported from Missison, Weiss, Fayola from Miami. This report was supported by Washington Post’s Rio de Janeiro’s Heloísa Traiano and Caracas’ Ana Vanessa Herrero.