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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 looks down at her three-month-old baby Ezequiel, who has just been released from hospital
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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.

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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.”

Queueing for a COVID vaccine jab in Sao Paulo
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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
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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
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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 with his sons, Pedro, 5, and Bento, 3, and their sister, Maria Helena
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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
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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.

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Israel announces military operation expanding in Gaza to seize ‘large areas’

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Israel announces military operation expanding in Gaza to seize 'large areas'

Israel is beginning a major expansion of its military operation in Gaza and will seize large areas of the territory, the country’s defence minister said.

Israel Katz said in a statement that there would be a large scale evacuation of the Palestinian population from fighting areas.

In a post on X, he wrote: “I call on the residents of Gaza to act now to remove Hamas and return all the hostages. This is the only way to end the war.”

He said the offensive was “expanding to crush and clean the area of terrorists and terrorist infrastructure and capture large areas that will be added to the security zones of the State of Israel”.

The expansion of Israel’s military operation in Gaza deepens its renewed offensive.

The ceasefire between Israel and Hamas that had begun in January ended in March as Israel launched various air strikes on targets across Gaza.

The deal had seen the release of dozens of hostages and hundreds of Palestinian prisoners, but collapsed before it could move to phase two, which would have involved the release of all hostages and the withdrawal of Israeli forces from Gaza.

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26 March: Anti-Hamas chants heard at protest in Gaza

The Israel Defense Forces (IDF) had already issued evacuation warnings to Gazans living around the southern city of Rafah and towards the city of Khan Yunis, telling them to move to the al Mawasi area on the shore, which was previously designated a humanitarian zone.

Israeli forces have already set up a significant buffer zone within Gaza, having expanded an area around the edge of the territory that had existed before the war, as well as a large security area in the so-called Netzarim corridor through the middle of Gaza.

This latest conflict began when Hamas launched an attack on Israel on 7 October 2023, killing around 1,200 people and taking around 250 hostages.

The ensuing Israeli offensive has killed more than 50,000 Palestinians, according to Gaza’s Hamas-run health ministry.

Read more:
Father demands protection after Gaza aid workers’ deaths
Anti-Hamas chants heard at rare protest in Gaza

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Bodies of aid workers found in Gaza

Aid group Doctors Without Borders warned on Wednesday that Israel’s month-long siege of Gaza means some critical medications are now short in supply and are running out, leaving Palestinians at risk of losing vital healthcare.

“The Israeli authorities’ have condemned the people of Gaza to unbearable suffering with their deadly siege,” said Myriam Laaroussi, the group’s emergency coordinator in Gaza.

“This deliberate infliction of harm on people is like a slow death; it must end immediately.”

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‘Liberation day is here’: But what will it mean for global trade?

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'Liberation day is here': But what will it mean for global trade?

“Liberation day” was due to be on 1 April. But Donald Trump decided to shift it by a day because he didn’t want anyone to think it was an April fool.

It is no joke for him and it is no joke for governments globally as they brace for his tariff announcements.

It is stunning how little we know about the plans to be announced in the Rose Garden of the White House later today.

It was telling that we didn’t see the President at all on Tuesday. He and all his advisers were huddled in the West Wing, away from the cameras, finalising the tariff plans.

Follow the events of Liberation Day live as they unfold

Three key figures are central to it all.

Treasury Secretary Scott Bessent is the so-called ‘measured voice’. A former hedge fund manager, he has argued for targeted not blanket tariffs.

Peter Navarro is Trump’s senior counsellor for trade and manufacturing. A long-time aide and confidante of the president, he is a true loyalist and a firm believer in the merits of tariffs.

More on Donald Trump

His economic views are well beyond mainstream economic thought – precisely why he appeals to Trump.

‘Stop that crap’: Trump adviser Peter Navarro reacts to Sky News correspondent’s question over tariffs

The third key character is Howard Lutnick, the commerce secretary and the biggest proponent of the full-throttle liberation day tariff juggernaut.

The businessman, philanthropist, Trump fundraiser and billionaire (net worth ranging between $1bn and $2bn) has been among the closest to Trump over the past 73 days of this presidency – frequently in and out of the West Wing.

If anything goes wrong, observers here in Washington suspect Trump will make Lutnick the fall guy.

What are Donald Trump’s tariffs, what is ‘liberation day’ and how does it all affect the UK?

And what if it does all go wrong? What if Trump is actually the April fool?

“It’s going to work…” his press secretary said when asked if it could all be a disaster, driving up the cost of living for Americans and creating global economic chaos.

“The president has a brilliant team who have been studying these issues for decades and we are focussed on restoring the global age of America…” Karoline Leavitt said.

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‘Days of US being ripped off are over’

Dancing to the president’s tune

My sense is that we should see “liberation day” not as the moment it’s all over in terms of negotiations for countries globally as they try to carve out deals with the White House. Rather it should be seen as the start.

Trump, as always, wants to be seen as the one calling the shots, taking control, seizing the limelight. He wants the world to dance to his tune. Today is his moment.

But beyond today, alongside the inevitable tit-for-tat retaliation, expect to see efforts by nations to seek carve-outs and to throw bones to Trump; to identify areas where trade policies can be tweaked to placate the president.

Even small offerings which change little in a material sense could give Trump the chance to spin and present himself as the winning deal maker he craves to be.

One significant challenge for foreign governments and their diplomats in Washington has been engaging the president himself with proposals he might like.

Negotiations take place with a White House team who are themselves unsure where the president will ultimately land. It’s resulted in unsatisfactory speculative negotiations.

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Treasury minister: ‘We’ll do everything to secure a deal’

Too much faith placed in the ‘special relationship’?

The UK believes it’s in a better position than most other countries globally. It sits outside the EU giving it autonomy in its trade policy, its deficit with the US is small, and Trump loves Britain.

It’s true too that the UK government has managed to accelerate trade conversations with the White House on a tariff-free trade partnership. Trump’s threats have forced conversations that would normally sit in the long grass for months.

Yet, for now, the conversations have yielded nothing firm. That’s a worry for sure. Did Keir Starmer have too much faith in the ‘special relationship’?

Downing Street will have identified areas where they can tweak trade policy to placate Trump. Cars maybe? Currently US cars into the UK carry a 10% tariff. Digital services perhaps?

US food? Unlikely – there are non-tariff barriers on US food because the consensus seems to be that chlorinated chicken and the like isn’t something UK consumers want.

Easier access to UK financial services maybe? More visas for Americans?

For now though, everyone is waiting to see what Trump does before they either retaliate or relent and lower their own market barriers.

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Bodies still remain among the ‘collapsed and inclining’ buildings in quake-hit Mandalay

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Bodies still remain among the 'collapsed and inclining' buildings in quake-hit Mandalay

A man inside Mandalay has told Sky News bodies remain under “collapsed and inclining” buildings after the Myanmar earthquake – as a woman was freed from rubble after 91 hours.

The local inside Myanmar said many of the structures in the city were wrecked or badly damaged after the 7.7 magnitude quake on Friday, adding: “There are some bodies, some dead bodies, that still remain and other destruction”.

Meanwhile, in a televised address, Myanmar’s military leader Min Aung Hlaing said the number of dead had risen to 2,719 and is expected to exceed 3,000.

Some 4,521 people have been injured, while a further 441 are missing.

More than 10,000 buildings are known to have collapsed or been severely damaged in central and northwest Myanmar, the World Health Organisation said.

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Before and after: Myanmar earthquake

Smell of dead bodies near destroyed buildings

In Mandalay, Myanmar’s second-largest city, which was close to the quake’s epicentre, 50 children and two teachers were killed when their preschool collapsed, the United Nations said.

The local in the city told Sky News that “a lot of local assistance associations like charity groups are still struggling with digging out the corpses, the dead bodies, from the destruction”.

He said that “when we pass near the destructions, the collapsed building or very damaged building, we can smell” dead bodies.

“The smell of the dead bodies after four days… it still remains,” he said, before adding: “For the social assistance association… they need permission [to give aid] especially from the government.

“If they don’t have permission, then they cannot do anything.”

People sheltering in a makeshift tent camp in Mandalay. Pic: Reuters
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People sheltering in a makeshift tent camp in Mandalay. Pic: Reuters

He also said others in Mandalay are struggling after the earthquake, which followed the city being affected by cyclones, the COVID-19 pandemic, and the civil war in Myanmar – where a junta seized power in a coup in 2021.

“Some people, they say they have nothing at all,” the local added. “They have no more home, they have no more belongings, because its already damaged.”

Woman freed after 91 hours under rubble

It comes after the fire department in Myanmar’s capital freed a woman trapped under rubble 91 hours after the building collapsed.

The 63-year-old woman was freed early on Tuesday in Naypyidaw.

As the country continues to recover, a worker from the International Rescue Committee said people fear aftershocks and are sleeping outside on roads or in open fields.

Communities are struggling to meet basic needs such as access to clean water and sanitation, and emergency teams are working “tirelessly” to locate survivors and provide aid, the UN said in a report.

Rescue efforts have been complicated by the civil war, as rebel groups say the junta has conducted airstrikes, even after the quake, while NGOs fear that certain areas could be denied vital supplies.

“Myanmar’s military has a longstanding practice of denying aid to areas where groups who resist it are active,” said Joe Freeman, a researcher with Amnesty Myanmar.

“It must immediately allow unimpeded access to all humanitarian organisations and remove administrative barriers delaying needs assessments.”

Read more:
Military regime targeting ‘civilian areas’ in ‘wake of disaster’
Myanmar earthquake leaves some areas almost completely destroyed

The quake was the strongest to hit the southeast Asian country in more than a century.

In neighbouring Thailand, rescuers are still scouring the ruins of a collapsed, unfinished skyscraper for any signs of life.

“There are about 70 bodies underneath, and we hope by some miracle one or two are still alive,” volunteer rescue leader Bin Bunluerit said.

Six human-shaped figures have been detected by scanners, said Bangkok’s deputy governor, Tavida Kamolvej.

Thirteen deaths have been confirmed at the building site, with 74 people still missing, while Thailand’s national number of dead stands at 20.

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