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The speed and severity of the evolution of covid-19 in patients seeking emergency services in Manaus have drawn the attention of health professionals working on the front line.
It is even forming more serious infections and in less time than first wave disease.
For four days in the capital of Amazonas, the Twitter I heard reports from professionals who testify that the new phase of covid-19 has a higher transmissibility caused by mutations that have generated a new variant in the state.
Furthermore, the data shows that younger people are now dying. According to death records in the past 30 days, four out of ten fatalities were under the age of 60 in the state.
“In Manaus something very different is happening. I do not know if it is a new strain or if it is something different. But those who are on the front line are seeing an increase in the severity of cases,” says infectologist and researcher Noaldo Lucena, who works in popular clinics, home care and public hospitals.
The changes, he says, go beyond the already known greater contagion of the new variant of the virus.
Clearly, we are facing an invisible being that is much more pathogenic and transmissible. Today, entire families arrive with symptoms at the same time, before one at a time.
Noaldo Lucena, infectologist
Exams show greater severity
Lucena says that in more recent examinations of patients there are more serious lung lesions.
“This year, I have seen 150 more people here in the clinic and 300 more in the public service. I say that less than 2% of them had mild deterioration. The rest were compromised above 50%. Some with 70%, 80%, 90%, requiring immediate hospitalization and even ventilatory support ”, he says.
According to him, the disease now has fewer symptoms than can be noticed on a clinical examination. “You listen to the patient’s lungs and you don’t hear anything. But when you see the CT image, you don’t believe how there is such a great compromise with so little noticeable clinical repercussion.”
More youth deaths
Another reported issue is the mortality of younger people, which would also be associated with the greater pathogenicity of the virus.
OR Twitter analyzed the most recent data from the Transparency Portal of the registry offices. There were 710 deaths in the state (a figure that may still increase), of which 285 were people under 60 years old, or 40.1% of the total. Before that period, this percentage was 36.5%.
“Without a doubt, many more young people are dying. We are not talking only about a risk group: this is in all age groups, affecting babies, children, adolescents even without comorbidity”, points out the infectologist Silvia Leopoldina, who also works in state public networks. and municipal of Manaus.
The doctor says that there were changes in the behavior of the disease in the state. “Before, the first serious symptoms appeared around the tenth day onwards. Now there are patients who, at seven, eight days, are involved in 75% of both lungs ”.
This shortening of the time to aggravation makes recovery difficult, he says.
The Governor of Amazonas, Wilson Lima, and the Minister of Health, Eduardo Pazuello, in early January.
Image: Disclosure / Secom-AM
“Too quiet”
Nurse and teacher Ana Paula Rocche agrees that “the virus is no longer the same.” She reports that the drop in patient saturation occurs much more quickly and silently.
“The patient begins the first day feeling a sore throat; then he feels a headache; on the third day he already starts to have a fever, but on the fourth day he begins to gasp, and when you put an oximeter, the saturation that was supposed to It was at 98%, it is 70%, 75%. That is not normal! It is a very serious thing that attacks the airways and lungs, and very silently “, he points out.
She works with patient care, including accompanying serious private moves to other states.
The nurse says that, instead of pain, many patients have reported “agony” in the chest.
“The lung seems to dry up, to shrink; and then you enter with everything that is antibiotic, anticoagulant and the lung does not expand. That is not normal, ”he says.
We don’t know how to deal with it. It’s very weird. People look bad in other places, but not as we see. This is something else.
Ana Paula Rocche, nurse
Collapse and new variant aggravate the situation
Professor Bernardino Albuquerque, from UFAM (Federal University of Amazonas) and researcher at Fiocruz Amazônia, estimates that this perception comes from the collapse of the health system.
“At the end of December there was a saturation in attendance. We have seen patients waiting hours in an ambulance. The clinical picture worsens with this pilgrimage, in addition to the lack of supplies, “he says.
If we had a health system prepared to face this second moment, there would not be so many deaths. The government dismantled all the structures it had before, we are starting over.
Bernardino Albuquerque, researcher
One point that aggravated the state’s situation was the new variant of SARS-CoV-2. “Opportunity [de causar doença mais grave] it exists, but there is still no evidence that it is more pathogenic ”, explains researcher Felipe Naveca, from Fiocruz Amazônia.
According to an article published yesterday, the new variant could pierce the immunity acquired by another strain.
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