Pregnant women and their unborn babies dying in Brazil as COVID deaths set to pass 500k mark
Brazil is likely to pass the awful mark of 500,000 COVID-related deaths in the next two days. Only the United States has a higher number of dead across the world.
Currently averaging 2,500 deaths a day, Brazil’s P1 variant has long been identified as a highly virulent cause for concern, prompting travel bans to most countries.
But researchers in Sao Paulo, one of the worst-hit cities in the country, say the P1 variant has started infecting and killing pregnant women and their unborn children in startling numbers.
Thais Ferreira de Lomes and her three-month-old baby Ezequiel, who has just been released from hospital
Currently 42 pregnant women die every week from COVID-19; many more women are being intubated and their premature children delivered by caesarean section without consultation with obstetricians, according to medical researchers at the Brazilian Obstetric Observatory.
Dr Rossana Pulcineli Vieira Francisco from the observatory said: “The virus transmissibility is higher with this variant and I think the big problem is that the health system for maternal care in Brazil is very bad.
“In some states the patient starts treatment in one hospital, a general hospital, and when her condition starts to worsen, and she needs to deliver the baby, she will be transported while intubated because they’re not at the right hospital to do the delivery.”
This, she believes, is part of the reason Brazil is seeing a higher rate of maternal mortality.
She says obstetricians and intensivists should be working together to find the right outcomes for mother and child, otherwise it will be very difficult to stop maternal mortality during COVID.
“I think we have more cases because of the variant, and because our maternal health system is very fragile, we have this result.”
People queueing for a COVID vaccine jab in Sao Paulo, but overall rollout in Brazil is slow
I asked her if it’s a perfect storm.
“Yes”, she replied, “and I think our only chance to stop this is the vaccine.”
The data from her and her colleagues’ research reveals that last year 10 pregnant women were dying each week from COVID-19.
This year, with the emergence of the new variant, the new figure is more than 40 per week.
Poor medical care and facilities already contributed to a high death rate for pregnant women in Brazil of 55 per 100,000 women. In Britain the figure is just 9.7.
But Dr Francisco says their research so far indicates that with COVID-19 as a factor the new number could double to over 100 per 100,000 by the end of the year.
The high overall transmission of the P1 variant (it accounts for nine in 10 coronavirus cases in Sao Paulo) combined with an overwhelmed health service, puts pregnant women at extreme risk.
When her kidneys failed the doctors told Thais she wouldn’t live to see her third child
The practice of intubating pregnant women and delivering the baby while the mother is in a highly stressed condition is criticised by the researchers as a “bad outcome” for both the mother and her child.
For their part, doctors working in overstretched public hospitals prioritise the life of the mother over the child and without extensive experience of intubating anyone, let alone pregnant women, they have little choice but to deliver the baby while saving the mother.
In Jardim Almeida Prado, a poor neighbourhood in the south of the city of Sao Paulo, Thais Ferreira de Lomes looks down at her tiny three-month-old baby Ezequiel, who has just been released from hospital.
Ezequiel was born 12 weeks prematurely, after Thais was intubated.
Previously fit and healthy, like most people, Thais and her family thought she was in no danger when the first symptoms of COVID developed, but they were wrong.
When her kidneys failed, the doctors said she wouldn’t live to see her third child.
She’s still scarred by her near-death experience – her uncle had died of COVID when she first got sick.
“It was great to come home, see my family, and know that God gave me the opportunity to live again,” she tearfully told me.
“Seeing so many people dying, so many people dying like my uncle died with COVID. Many people are dying with COVID.”
Even though she is over the worst of her experience, she is scared for her and her children’s futures, and worries Ezequiel might still get coronavirus.
“Even today I’m afraid because he’s tiny, he was born prematurely. I told my mother-in-law that it’s hard for me to look at him and not think that something might happen.”
Dr Patricia Sella, who treated Ezequiel, says the P1 variant is infecting young pregnant women like she hasn’t seen before
At the Graiau Hospital, the maternity ward and its premature babies section where Ezequiel was cared for, are currently free of COVID cases, but doctors and nurses have no expectation that it is going to stay this way – other hospitals in the city are still treating infants with COVID-19 and their sick mothers.
Dr Patricia Sella, the medical coordinator for gynaecology – and the doctor who treated baby Ezequiel – says she has no doubt that the P1 variant, sweeping across the country, is infecting young pregnant women like she hasn’t seen before.
“In 2021 we observed an increase in pregnant women affected by COVID, likely because of the new strain.
“In 2020, in our hospital mainly, we had a very small number of pregnant women with COVID, but this year we have at least one pregnant woman hospitalised with COVID every week,” she explained to me, standing in the hospital’s neonatal intensive care unit.
She puts this down to the high infection rate of the P1 variant.
“So, actually, I think that with the change in the strain, we saw that the inflammatory process, [and] the vasculitis caused by the virus is much greater, right, and that ended up changing, bringing it to pregnant women.
“[Pregnant women] already have decreased lung compliance due to the pregnancy itself and the evolution of the pregnancy. With the COVID infection, this ends up getting worse.
“What we observed is that this strain ended up infecting pregnant women who do not have any other pre-existing conditions, so they do not have hypertension, and do not have diabetes during pregnancy. We observed that there was an increase and an increase in severity of the cases.”
Douglas Silverio with his sons, Pedro, 5, and Bento, 3, and their sister, Maria Helena
In the middle-class suburb of Jardim America, Douglas Silverio proudly shows off the latest addition to his family, three-month-old Maria Helena.
She has two elder brothers Pedro, five, and Bento, three, who run around their home playing with toys while their grandmother prepares lunch.
She now lives with the family because her daughter and the children’s mother, Vanessa, is dead; killed by COVID-19.
Vanessa was just 33 when coronavirus struck.
Within five days she deteriorated and was intubated, and Maria Helena was delivered by caesarean section, coincidentally on her dad’s birthday.
Vanessa never recovered.
“I told my sons, ‘let’s say goodbye to her’.
“Pedro, who is five years old, cried too, and he said, ‘goodbye mother, you are going to heaven’.
“The youngest one did not understand what happened. And it was crazy, that was a crazy time, because we had prayed a lot for the baby, a lot of prayers from our family, but I was not ready to bury my wife in this process.”
Vanessa Silverio, 33, seen with husband Douglas, died from COVID while pregnant and her daughter was delivered by caesarean section
On the day Douglas held mass for his wife’s death, baby Maria Helena was released from hospital.
He wants everyone to fear COVID and to listen to the warnings about the disease.
“I miss my wife. And she was my friend, we had a lot of plans together.
“I get scared when I see on the streets some pregnant women without masks. I say to them please take care of yourself.”
The entire medical profession in Brazil now acknowledges that the only way to fight the virus and to stop the country being a petri dish for creating COVID-19 variants that will continue to threaten the world, is for the country’s vaccination programme to speed up and reach all members of society.
The rollout is currently very slow and so far has only started to include 56-year-olds in Sao Paulo.
Many in the profession directly blame the country’s president, Jair Bolsonaro, for the country’s poor response to the pandemic.
He still refuses to take the vaccine, has continuously played down the danger of coronavirus and still discourages the use of face masks anywhere.
The identification of the virus as a specific threat to young pregnant women has set off the alarm bells here that COVID-19 variants are attacking younger and younger members of society, who were previously thought to be relatively safe from serious illness.
World
‘It is truly monstrous’: Inside the besieged Sudanese city where families are forced to eat animal feed to live
Al Fashir is being suffocated to death.
The paramilitary Rapid Support Forces (RSF) has held the capital of North Darfur hostage in a 14-month siege – blocking food or fuel from entering the locality and forcing starvation on its 900,000 inhabitants.
The entire city is currently a militarised zone as Sudan‘s army and the Darfur Joint Protection Force fend off the RSF from capturing the last state capital in the Darfur region not currently under their control.
Rare footage sent to Sky News from inside al Fashir town shows streets emptied of cars and people.
The city’s remaining residents are hiding from daytime shelling inside their homes, and volunteers move through town on donkey carts distributing the little food they can find.
Al Fashir is the capital of North Darfur
‘It is truly monstrous’
Journalist Muammer Ibrahim sent Sky News voice notes from there.
“The situation is monstrous,” he says. “It is truly monstrous.
“The markets are emptied of food and partially destroyed by shelling. Civilians were killed at the market, just a day ago. People have fled market areas but there is also shelling in residential areas. Every day, you hear of 10 or 12 civilians killed in attacks.”
His voice sounds shallow, weakened by the dire conditions, and gunshots can be heard in the background.
“The intense fighting has meant that people cannot safely search for anything to eat, but there is also nothing for their money to buy. The markets are depleted. Hundreds of thousands here are threatened by a full-blown famine,” he says.
“There has been a full blockade of any nutritional supplies arriving in al Fashir since the collapse of Zamzam camp. It closed any routes for produce or supplies to enter.”
The city’s remaining residents hide from daytime shelling
The RSF ransacked the famine-ridden Zamzam displacement camp 7.5 miles (12km) south of al Fashir town in April, after the military reclaimed Sudan’s capital Khartoum.
The United Nations believes that at least 100 people were killed in the attacks, including children and aid workers.
The majority of Zamzam’s half a million residents fled to other areas for safety. Hundreds of thousands of them are now squeezed into tents on the edges of al Fashir, completely cut off from humanitarian assistance.
The capture of the camp allowed the RSF to tighten their siege and block off the last remaining supply route. Aid convoys attempting to enter al Fashir have come under fire by the RSF since last year.
Aid convoys attempting to enter al Fashir have come under fire by the RSF since last year
“Already, between June and October 2024, we had several trucks stuck and prevented by the Rapid Support Forces from going to their destination which was al Fashir and Zamzam,” says Mathilde Simon, project coordinator at Medicins Sans Frontieres.
“They were prevented from doing so because they were taking food to those destinations.”
“There was another UN convoy that tried to reach al Fashir in the beginning of June. It could not, and five aid workers were killed.
“Since then, no convoy has been able to reach al Fashir. There have been ongoing negotiations to bring in food but they have not been successful until now.”
Mathilde Simon says malnutrition rates in al Fashir are ‘catastrophic’
Families are resorting to eating animal feed to survive.
Videos sent to Sky News by volunteers show extreme suffering and deprivation, with sickly children sitting on thin straw mats on the hard ground.
Community kitchens are their only source of survival, only able to offer small meals of sorghum porridge to hundreds of thousands of elderly men, women and children facing starvation.
The question now is whether famine has fully taken root in al Fashir after the collapse of Zamzam camp and intensified RSF siege.
‘Malnutrition rates are catastrophic’
“The lack of access has prevented us from carrying out further assessment that can help us have a better understanding of the situation, but already in December 2024 famine was confirmed by the IPC Famine Review Committee in five areas,” says Mathilde.
“It was already confirmed in August 2024 in Zamzam but had spread to other displacement camps including Abu Shouk and it was already projected in al Fashir.
“This was more than eight months ago and we know the situation has completely worsened and malnutrition rates are absolutely catastrophic.”
Fatma Yaqoub said her family have nothing to eat but animal feed
Treasurer of al Fashir’s Emergency Response Rooms, Mohamed al Doma, believes all signs point to a famine.
He had to walk for four hours to escape the city with his wife and two young children after living through a full year of the siege and offering support to residents as supplies and funding dwindled.
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“There is a famine of the first degree in al Fashir. All the basic necessities for life are not available,” he says.
“There is a lack of sustenance, a lack of nutrition and a lack of shelter. The fundamental conditions for human living are not living. There is nothing available in the markets – no food or work. There is no farming for subsistence. There is no aid entering al Fashir.”
“All of this points towards a full-blown famine.”
Hamas has said it is ready to cooperate with a request to deliver food to Israeli hostages in Gaza, if Israel agrees to permanently open a humanitarian corridor into the enclave.
The militant group’s statement comes amid international outcry over two videos it released of Israeli hostage Evyatar David, who it has held captive since 7 October 2023.
The now 24-year-old looks skeletal, with his shoulder blades protruding from his back.
The footage sparked huge criticism, with EU foreign policy chief Kaja Kallas labelling the videos “appalling” and saying they “expose the barbarity of Hamas”.
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Video released of Israeli hostage
Israeli Prime Minister Benjamin Netanyahu said on Sunday he had asked the Red Cross to give humanitarian assistance to the hostages.
Hamas’s military spokesperson Abu Obeidah said it is “ready to engage positively and respond to any request from the Red Cross to bring food and medicine to enemy captives” if certain conditions are met.
These are that Israel must permanently open a humanitarian corridor and halt airstrikes during the distribution of aid, he said.
Gaza’s health ministry said on Sunday that six more people had died of starvation or malnutrition in the enclave in the past 24 hours.
This raises the number of those who have died from what multiple international agencies warn may be an unfolding famine to 175 since the war began, the ministry said. This includes 93 children, it added.
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Baby Zainab starved to death in Gaza
No aid entered Gaza between 2 March and 19 May due an Israeli blockade and deliveries of supplies including food, medicine and fuel have been limited since then.
Israeli authorities have previously said there is “no famine caused by Israel” – and that its military is “working to facilitate and ease the distribution of humanitarian aid in the Gaza Strip”.
Meanwhile, Palestinian health authorities also said at least 80 people in Gaza were killed by Israeli gunfire and airstrikes on Sunday.
These included people trying to reach aid distribution, Palestinian medics said.
The Israel Defence Forces (IDF) has repeatedly said it “categorically rejects the claims of intentional harm to civilians” and has previously blamed Hamas militants for fomenting chaos and endangering civilians.
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Hamas killed around 1,200 people, mostly civilians, in its attack on 7 October 2023 and abducted 251 others. Of those, they still hold around 50, with 20 believed to be alive, after most of the others were released in ceasefires or other deals.
Israel’s retaliatory offensive has killed more than 60,000 Palestinians, according to Gaza’s Hamas-run health ministry, which does not differentiate between militants and civilians in its count.
We’ve seen this many times before.
Highly anticipated talks and meetings with America, Israel’s closest ally and the one country with the power to pressure Israeli Prime Minister Benjamin Netanyahu to change course, then nothing changes.
We need to give Steve Witkoff time to report his assessments back to the White House before we can give a complete verdict on this visit but what we’ve seen and heard so far has offered little hope.
The pressure on Donald Trump to stop the humanitarian catastrophe in Gaza is mounting after a small but vocal contingent of his base expressed outrage.
Even one of his biggest supporters in Congress, Marjorie Taylor Green, has referred to it as a genocide.
It was little coincidence Mr Witkoff was dispatched to the region for the first time in three months to speak to people on both sides and “learn the truth” to quote US ambassador to Israel, Mike Huckabee, who accompanied him to an aid site in Gaza.
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Gaza nurse: ‘We’re rationing care’
The pair spent five hours in Gaza speaking to people at a Gaza Humanitarian Foundation centre and it’s understood saw nothing of the large crowd of Palestinians gathering a mile away waiting for food.
Their sanitised tour of Gaza did not include a visit to a hospital where medics are receiving casualties by the dozen from deadly incidents at aid sites, and where they’re treating children for malnutrition and hunger.
A critical trauma nurse at Nasser hospital told us a 13-year-old boy was among the people shot while Mr Witkoff was in the enclave.
An American paediatrician at the same hospital who had publicly extended an invitation to meet with Mr Witkoff heard nothing from the US delegation.
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Dr Tom Adamkiewicz described people “being shot like rabbits” and “a new level of barbarity that I don’t think the world has seen”.
The US delegation was defensive of the controversial GHF aid distribution that was launched by America and Israel in May, hailing its delivery of a million meals a day.
But if their new system of feeding Gaza is truly working, why are we seeing images of starved children and hearing deaths every day of people in search of food?
The backdrop of this trip is very different to the last time Mr Witkoff was here.
In May, life was a struggle for Palestinians in Gaza, people were dying in Israeli bombings but, for the most part, people weren’t dying due to a lack of food or getting killed trying to reach aid.
Mr Netanyahu’s easing of humanitarian conditions a week ago, allowing foreign aid to drop from the sky, was an indirect admission of failure by the GHF.
Yet, for now, the US is standing by this highly criticised way of delivering aid.
A UN source tells me more aid is getting through than it was a week ago – around 30 lorries are due to enter today compared to around five that were getting in each day before.
Still nowhere near enough and it’s a complex process of clearances and coordination with the IDF through areas of conflict.
Lorries are regularly refused entry without explanation.
Then there was Mr Witkoff’s meeting with hostage families a day later where we began to get a sense of America’s new plan for Gaza.
The US issued no public statement but family members shared conversations they’d had with Mr Trump’s envoy: bring all the hostages home in one deal, disarm Hamas and end the war. Easier to propose than to put into practice.
Within hours of those comments being reported in the Israeli media, Hamas released a video of hostage Evyatar David looking emaciated in an underground tunnel in Gaza.
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Video released of Israeli hostage
Now 24 years old, he was kidnapped from the Nova festival on 7 October and is one of 20 hostages understood to be still alive. The release of the video was timed for maximum impact.
Hamas also poured water on any hopes of a deal in a statement, refusing to disarm unless an independent Palestinian state is established.
Hamas has perhaps become more emboldened in this demand after key Israeli allies, including the UK, announced plans for formal recognition in the last week.
It’s hard to see a way forward. The current Israeli government has, in effect, abandoned the idea of a two-state solution.
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The Trump administration’s recent boycott of international conferences on the matter suggests America is taking a similar line, breaking with its long-standing position.
Arab nations could now be key in what happens next.
In an unprecedented move, Saudi Arabia, Qatar and Egypt joined a resolution calling for Hamas to disarm and surrender control of Gaza following a UN conference earlier this week.
This is hugely significant – highly influential powers in its own backyard have not applied this sort of pressure before.
For all the US delegation’s good intentions, it’s still political deadlock. Israeli hostages and Palestinians in Gaza left to starve and suffer the consequences.
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