Pregnant women and their unborn babies dying in Brazil as COVID deaths set to pass 500k mark

Published

3 years ago

June 18, 2021

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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.

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.”

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.

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.”

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.”

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.”

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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Keir Starmer talks up US-UK relationship – but questions remain over Ukraine’s use of long-range missiles

Published

2 hours ago

September 14, 2024

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Keir Starmer talks up US-UK relationship - but questions remain over Ukraine's use of long-range missiles

Sir Keir Starmer has talked up the US-UK relationship after a White House meeting with Joe Biden, but questions remain over Ukraine’s use of long-range missiles.

The prime minister travelled to Washington this week to meet with President Biden to discuss the wars in Ukraine and Gaza – among other issues.

Speaking before the “long and productive” meeting held in the White House on Friday, Sir Keir said the two countries were “strategically aligned” in their attempts to resolve the war.

Afterwards, he skirted around questions regarding Ukraine’s use of long-range missiles, saying: “We’ve had a long and productive discussion on a number of problems, including Ukraine, as you’d expect, the Middle East, and the Indo-Pacific, talking strategically about tactical decisions.

“This isn’t about a particular decision but we’ll obviously pick up again in UNGA (UN General Assembly) in just a few days’ time with a wider group of individuals, but this was a really important invitation from the president to have this level of discussion about those critical issues.”

Ukraine war latest: Putin threatens NATO with ‘war’

Decisions loom for Ukraine’s key Western allies as Volodymyr Zelenskyy has recently increased pressure on them to permit his forces to use long-range missiles to strike inside Russian territory.

However, despite repeated calls for a decision, the West has so far resisted green-lighting the use of the missiles.

Two US officials familiar with the discussions said they believed that Sir Keir was seeking US approval to let Ukraine use British Storm Shadow missiles for expanded strikes into Russia, according to Reuters news agency.

They added that they believed Mr Biden would be amenable.

The president’s approval would be needed because Storm Shadow components are made in the US.

But when speaking to journalists after the meeting, Sir Keir was repeatedly pressed on the long-range missile question but evaded giving a firm decision.

“This wasn’t a meeting about a particular capability. That wasn’t why we got our heads down today,” he said.

The US has been concerned that any step could lead to an escalation in the conflict and has moved cautiously so far, however, there have been reports in recent days that Mr Biden might shift his administration’s policy.

It wasn’t much, but it’s a start

There wasn’t much to say at the end, but it’s a start.

Both sides in these discussions had spent some time playing down expectations and the Americans were insistent their stance wasn’t changing on Ukraine and long-range missiles.

“Nothing to see here” seemed to be the message.

Only, there clearly was – a glance at the headlines gave that the lie.

It’s not every day a Russian president threatens war with the West.

The UK and US were discussing a change in strategy because they must – anything less would be a dereliction of duty for two leaders pledging a commitment to Ukraine’s fight.

Just ask Kyiv’s president Volodymyr Zelenskyy.

Following the meeting, Sir Keir Starmer said they’d talked tactics and strategy.

It will have had missiles, range, and Russian territory at the heart of it.

That is the material change in strategy demanded by Ukraine and supported widely among its backers.

A plan discussed by both sides of the special relationship will now be floated to other, allied nations in an effort to build a coordinated coalition behind a change in strategy.

And they’ll do it against the clock.

There is the unpredictability of the war itself in Ukraine and no less certainty surrounding the political battle at home.

A Trump victory in November’s US election would change the picture – here and there.

Vladimir Putin previously threatened the West, warning that allowing Ukraine to use long-range missiles to strike inside Russian territory would put Moscow “at war” with NATO.

Speaking to Russian state television, he insisted the decision would “significantly change” the nature of the war.

He added: “This will be their direct participation, and this, of course, will significantly change the very essence, the very nature of the conflict.

“This will mean that NATO countries, US, European countries are at war with Russia.

“If this is so, then, bearing in mind the change in the very essence of this conflict, we will make appropriate decisions based on the threats that will be created for us.”

When asked about the threats, Mr Biden brushed them aside, saying: “I don’t think much about Vladimir Putin.”

There remains some scepticism within the US over the impact that allowing Kyiv to unleash long-range missiles would have.

US officials, according to Reuters, have pointed out that Ukraine already has the capability to strike into Russia using drones, and while US missiles would enhance that they are too costly and limited in number to change the overall picture.

World

British citizen among 37 people sentenced to death in DR Congo over failed coup

Published

5 hours ago

September 14, 2024

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British citizen among 37 people sentenced to death in DR Congo over failed coup

A British citizen is among 37 people who have been sentenced to death in the Democratic Republic of Congo (DRC) after being found guilty of an attempted coup in the central African country.

A foreign office spokesperson told Sky News they are giving consular assistance to “a British man detained in DRC” and are in contact with the local authorities.

“We have made representations about the use of the death penalty to the DRC at the highest levels, and we will continue to do so.”

Three US citizens, a Belgian and a Canadian were also among those sentenced, along with several Congolese.

Judge Major Freddy Ehuma, speaking at an open-air military court in Kinshasa that was broadcast live on television, said they had been given “the harshest penalty, that of death”.

The defendants have five days to appeal their verdicts after being convicted on charges that included terrorism, murder and criminal association.

Fourteen people were acquitted in the trial, which opened in June.

Six people were killed during the attempted coup in May, which was led by Christian Malanga, a little-known opposition figure.

The rebels occupied DRC President Felix Tshisekedi’s office in the presidential palace for almost an hour before they were arrested, mediacongo.net said.

Mr Malanga was fatally shot while resisting arrest soon after live-streaming the attack on his social media, the Congolese army said.

Mr Malanga’s 21-year-old son, Marcel, who is a US citizen, was convicted, along with fellow Americans, Tyler Thompson Jr and Benjamin Reuben Zalman-Polun.

Marcel Malanga’s mother Brittney Sawyer has said her son is innocent and was simply following his father, who believed himself to be president of a shadow government in exile.

Mr Thompson Jr flew from Utah with Mr Malanga for what his family believed was a holiday. Mr Zalman-Polun, 36, is reported to have known Christian Malanga through a gold mining company set up in Mozambique in 2022.

Mr Thompson Jr’s family said he didn’t know what Christian Malanga was scheming and wasn’t even planning to enter the DRC.

The British citizen has not been named.

Earlier this year, the DRC reinstated the death penalty after more than 20 years amid growing violence and militant attacks.

Despite that, Richard Bondo, the lawyer who defended the six foreigners, said he disputed whether the death penalty could be imposed and said his clients had inadequate interpreters during the investigation.

He said they would appeal.

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Stranded astronauts say space is ‘happy place’ – but admit ‘tough times’

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5 hours ago

September 14, 2024

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Stranded astronauts say space is 'happy place' - but admit 'tough times'

Two astronauts who are set to be stuck in space for eight months have said the International Space Station is now their “happy place” but admitted to “tough times”.

Butch Wilmore and Suni Williams said in a press conference on Friday that it was hard to watch their Boeing Starliner capsule return to Earth without them last week – but said they do not feel let down by the company.

The pair expected to be in space for eight days but will remain there until 2025 after NASA determined the problem-plagued capsule posed too much risk for them to return to Earth.

The two Starliner test pilots – both retired Navy captains and longtime NASA astronauts – will now be staying at the space station until late February.

“That’s how it goes in this business,” said Ms Williams, adding that “you have to turn the page and look at the next opportunity”.

Mr Wilmore said: “It’s been quite an evolution over the last three months, we’ve been involved from the beginning through all the processes of assessing our spacecraft.

“And it was trying at times. There were some tough times all the way through.”

Ms Williams said that the transition to station life was “not that hard” since both had completed previous stints there.

“This is my happy place. I love being up here in space,” she said.

Mr Wilmore said he was “on board” with “changes that need to be made” at Boeing.

“Obviously, when you have issues like we’ve had, there’s some changes that need to be made.

“Boeing’s on board with that. We’re all on board with that.”

He added: “When you push the edge of the envelope again and you do things with spacecraft that have never been done before, just like Starliner, you’re going to find some things.”

The pair also said they will vote in November’s US elections.

Mr Wilmore and Ms Williams are now fully-fledged station crew members, chipping in on routine maintenance and experiments.

They, along with seven others on board, welcomed a Soyuz spacecraft carrying two Russians and an American earlier this week, raising the station population to 12 – a near record.

Ms Williams will soon take over as station commander.

The pair will have to wait until next year for a SpaceX capsule to bring them back to Earth. That spacecraft is due to launch later this month with a reduced crew of two, with two empty seats for the stranded astronauts for the return leg.

Mr Wilmore and Ms Williams also said they appreciated all the prayers and well wishes from Earth.

Mr Wilmore revealed he will miss out on family milestones including his youngest daughter’s final year of high school.

Their Starliner capsule marked the first Boeing spaceflight with astronauts. It endured a series of thruster failures and helium leaks before arriving at the space station on 6 June.

It landed safely in the New Mexico desert earlier this month, but Boeing’s path forward in NASA’s commercial crew programme remains uncertain.

The space agency hired SpaceX and Boeing as an orbital taxi service a decade ago after the shuttles retired. SpaceX has been flying astronauts since 2020.