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
27 Palestinians killed by Israeli fire while waiting for aid distribution, says Hamas-run Gaza health ministry
Twenty-seven Palestinians have been killed by Israeli fire while waiting for aid to be distributed, according to Gaza’s health ministry.
They were reportedly killed in the Rafah area of southern Gaza early on Tuesday.
The Hamas-run ministry claimed that more than 90 people were injured, with some in a serious condition.
The Israel Defence Forces (IDF) said it had fired shots about half a kilometre from the aid distribution site of the US-backed Gaza Humanitarian Foundation (GHF), adding that people were moving towards its forces in a way that “posed a threat to them”.
A woman reacts after 24 Palestinians were reportedly killed in the Rafah area. Pic: Reuters
A mourner reacts during the funeral of Palestinians killed in alleged Israeli fire. Pic: Reuters
The IDF said in a statement: “Earlier today (Tuesday), during the movement of the crowd along the designated routes toward the aid distribution site – approximately half a kilometre from the site – IDF troops identified several suspects moving toward them, deviating from the designated access routes.
“The troops carried out warning fire, and after the suspects failed to retreat, additional shots were directed near a few individual suspects who advanced toward the troops.”
It also highlighted that IDF troops were “not preventing the arrival of Gazan civilians to the humanitarian aid distribution sites”.
The International Committee of the Red Cross said its field hospital in Rafah received 184 casualties. A spokesperson added that 19 of those were declared dead upon arrival, and eight died of their wounds shortly after.
There were three children and two women among the dead, according to Mohammed Saqr, who is the head of nursing at Nasser Hospital in Gaza.
The Hamas-run Gaza government media office said in a statement that Israel was transforming aid distribution centres “into mass death traps and bloodbaths” as 102 people were killed and 490 more injured in just eight days since the centres opened on 27 May.
The aid centres were “luring starving civilians to them as a result of the crippling famine”, according to the media office, which called for humanitarian aid delivered through UN agencies and neutral international organisations rather than the GHF.
An ambulance outside Nassar hospital in Gaza, where people allegedly injured by Israeli fire were taken
Palestinians arriving at Nassar hospital following alleged Israeli fire near an aid distribution site
The alleged shooting comes just two days after reports that 31 people were killed as they walked to a distribution centre run by the GHF in the Rafah area.
Witnesses said the deaths came after Israeli forces opened fire, while Palestinian and Hamas-linked media attributed the deaths they reported to an Israeli airstrike.
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The IDF later said its forces “did not fire at civilians while they were near or within the humanitarian aid distribution site and that reports to this effect are false”.
On Monday, three more Palestinians were reportedly killed by Israeli fire.
UN secretary general Antonio Guterres said he was “appalled” by reports of Palestinians killed and injured while seeking aid.
He called for an independent investigation and said: “It is unacceptable that Palestinians are risking their lives for food.”
Two women cry during the funeral of Palestinians killed early Tuesday. Pic: Reuters
Palestinians arrived to collect aid from a Gaza Humanitarian Foundation hub in Rafah last week. File pic: Reuters
Last week, Israel accepted a US-brokered ceasefire proposal, which would see the release over the course of a week of nine living hostages and half of the known hostages who have died.
But Hamas said that it was seeking amendments to the proposed 60-day truce, offering 10 living Israeli hostages and the bodies of 18 in exchange for Palestinian prisoners.
There is a distinct moment when the tranquillity of the Tacugama Chimpanzee Sanctuary envelops our car as we drive higher up the mountain.
The buzz of Freetown gives way to the hushed calm of this pocket of pristine rainforest reserved for critically endangered western chimpanzees rescued from across Sierra Leone.
The quiet is necessary. These bright primates – closest related to humans in the animal kingdom – are easily disturbed and the ones living in Tacugama are particularly sensitive.
The more than 120 chimpanzees brought here are traumatised survivors of mistreatment, hunting and violent separation from their families in the wild.
They are now facing another existential threat. Illegal encroachment is eating away at the edges of the conservation area. Despite wildlife laws, forest has been cleared to make way for houses being constructed closer and closer to chimp enclosures.
Forest has been cleared to make way for houses being constructed closer and closer to chimp enclosures
“We’ve been issuing several warnings over the last year,” says Tacugama founder Bala Amarasekaran. “Four months ago – again – we gave a warning. Then we had presidential intervention say that some of this encroachment will be stopped. It started very well for the first month then everything stopped again and we are back at square one. So, we are very tired and very stressed.”
Thirty years ago, Mr Amarasekaran appealed to the government to donate land and partner with him to create a sanctuary for the protection of the abused orphaned chimps he was finding across Freetown. Today, land in the Western Area Forest Reserve is being grabbed right under the government’s nose.
“The government has been very good in terms of helping us in every way – however we expect the leadership to be more firm,” says Mr Amarasekaran.
“When we talk to them, they are all with us. They all want to help. But when it comes to action it looks like some of the departments that have the mandate to institute certain laws and take the necessary law enforcement action are not acting.”
Tacugama founder Bala Amarasekaran
Sanctuary closes its doors to focus on conservation, rehabilitation and research
Tacugama has grown to become Sierra Leone’s most popular tourist attraction over the last three decades. But in a stand against the fast-approaching illegal encroachment, the sanctuary has closed its doors to visitors to focus on conservation, rehabilitation and research.
“It is not a tourist attraction – we made it become a tourist attraction. It is supposed to be an orphanage for rescued chimpanzees,” Mr Amarasekaran says.
“They are used to us and some visitors but they will start to see strangers come and that is where the problems start. They are not comfortable with strangers – don’t forget it is the stranger who killed their mother. It is the stranger that wiped out their group.”
‘A complex problem’
We asked Sierra Leone’s government spokesperson and minister of information and civic education, Chernor Bah, about the illegal encroachment.
“It is a complex problem. You have a city that is growing. People need places to stay and we have not done the best job in terms of enforcing all these limitations,” he replied. “Some of our agents seem to have been complicit in allocating and giving people land in places they are not supposed to stay. So, I don’t think I can sit here and say we have done enough – there is much more we can do.
“[Tacugama] is probably our most cherished and significant wildlife asset in the country.”
A national symbol for tourism
In 2019, the government designated the western chimpanzee as the national animal and national symbol for tourism. The image of a chimp is now etched in Sierra Leonean passports, a result of Tacugama’s advocacy Mr Amarasekaran and his team hope will entrench a love and respect for chimps that will curb the need for intervention.
“We wanted something more – that is how the national animal bill came through,” says Mr Amarasekaran.
“We thought if the agencies that are mandated to do all the law enforcement are not active and effective, then maybe we need to create a synergy between the people and the animals.”
Chimpanzees hunted for bushmeat
But chimpanzees are still being hunted as bushmeat for food across Sierra Leone and baby chimps are being torn from their families to be kept as illegal pets. Tacugama’s latest rescue is only eight months old.
Baby Asana is frail with thinning hair and is being nursed back to health by his chimp mum, Mama P, when we meet him. He was rescued after an informant sent a video of Asana wearing human clothes and being mistreated as an illegal pet in Bo, Sierra Leone’s second largest city.
“For me as the founder of the sanctuary, I feel defeated,” says Mr Amarasekaran with Asana being cared for behind him.
“These chimps shouldn’t be arriving here if we have done enough work outside – there shouldn’t be any killings, there shouldn’t be any rescues. That is the time when I can say that I achieved something.”
Research from the Jane Goodall Institute identified that between five and 10 chimpanzees die for every surviving rescued chimpanzee. And with the sanctuary closed, much-needed public advocacy work will take a hard hit.
‘Until I came to the sanctuary, I didn’t see a chimpanzee’
“I’m really concerned because I only even started to experience chimpanzees when I started working here. I knew that we had chimps here. But until I came to the sanctuary, I didn’t see a chimpanzee,” says 25-year-old Tacugama communications officer, Sidikie Bayoh.
“Now, we are at a situation where we are closed indefinitely but what if this becomes something wherein we can never open the sanctuary again for people to visit? Then you will have all these young Sierra Leoneans never fully understanding what their national animal is.”
Tacugama communications officer Sidikie Bayoh
The closure also means there will be no revenue from visitors at a time when USAID funding has been halted.
“In the absence of funding from – at the moment – the US government, it is going to be difficult for us to turn around quickly,” says Mr Amarasekaran.
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He then shrugs and smiles knowingly, adding: “We are very resilient – we are like chimpanzees. So, we will manage somehow.”
A senior official in former president Joe Biden’s administration has told Sky News that he has no doubt that Israel has committed war crimes in Gaza.
Speaking to the Trump 100 podcast, Matthew Miller, who, as a state department spokesman, was the voice and face of the US government’s foreign policy under Mr Biden, revealed disagreements, tensions and challenges within the former administration.
In the wide-ranging conversation, he said:
• It was “without a doubt true that Israel has committed war crimes”;
• That Israeli soldiers were not being “held accountable”;
• That there were “disagreements all along the way” about how to handle policy;
• And that he “would have wanted to have a better candidate” than Mr Biden for the 2024 election.
Mr Miller served as the state department spokesman from 2023 until the end of Mr Biden’s presidential term. From the podium, his job was to explain and defend foreign policy decisions – from Ukraine to Gaza.
“Look, one of the things about being a spokesperson is you’re not a spokesperson for yourself. You are a spokesperson for the president, the administration, and you espouse the positions of the administration. And when you’re not in the administration, you can just give your own opinions.”
Now out of office, he offered a candid reflection of a hugely challenging period in foreign policy and US politics.
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Miller: Israel ‘committed war crimes’
Gaza disagreements
Asked about Gaza, he revealed there were “small and big” disagreements within the Biden administration over the US-Israeli relationship.
“There were disagreements all along the way about how to handle policy. Some of those were big disagreements, some of those were little disagreements,” he said.
Pushed on rumours that then-secretary of state Antony Blinken had frustrations with Mr Biden over both Gaza and Ukraine policy, Mr Miller hinted at the tensions.
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“I’ll probably wait and let the secretary speak for himself… but I will say, speaking generally, look, it is true about every senior official in government that they don’t win every policy fight that they enter into. And what you do is you make your best case to the president.
“The administration did debate, at times, whether and when to cut off weapons to Israel. You saw us in the spring of 2024 stop the shipment of 2,000-pound bombs to Israel because we did not believe they would use those in a way that was appropriate in Gaza.”
Through the spring and summer of 2024, the Biden administration was caught between its bedrock policy of the unconditional defence of its ally Israel and the reality of what that ally was doing in Gaza, with American weapons.
Mr Mill said: “There were debates about whether to suspend other arms deliveries, and you saw at times us hold back certain arms while we negotiated the use of those arms…
“But we found ourselves in this really tough position, especially in that time period when it really came to a head… We were at a place where – I’m thinking of the way I can appropriately say this – the decisions and the thinking of Hamas leadership were not always secret to the United States and to our partners.”
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Matthew Miller during a news briefing at the state department in 2023. Pic: AP
He continued: “And it was clear to us in that period that there was a time when our public discussion of withholding weapons from Israel, as well as the protests on college campuses in the United States, and the movement of some European countries to recognise the state of Palestine – appropriate discussions, appropriate decisions – protests are appropriate – but all of those things together were leading the leadership of Hamas to conclude that they didn’t need to agree to a ceasefire, they just needed to hold out for a little bit longer, and they could get what they always wanted.”
“Now, the thing that I look back on, that I will always ask questions of myself about, and I think this is true for others in government, is in that intervening period between the end of May and the middle of January [2025], when thousands of Palestinians were killed, innocent civilians who didn’t want this war, had nothing to do with it, was there more that we could, could have done to pressure the Israeli government to agree to that ceasefire? I think at times there probably was,” Mr Miller said.
Asked for his view on the accusation of genocide in Gaza, he said: “I don’t think it’s a genocide, but I think it is without a doubt true that Israel has committed war crimes.”
Challenged on why he didn’t make these points while in government, he said: “When you’re at the podium, you’re not expressing your personal opinion. You’re expressing the conclusions of the United States government. The United States government had not concluded that they committed war crimes, still have not concluded [that].”
Anthony Blinken, left, with then US President Joe Biden. Pic: AP
He went on to offer a qualification to his accusation.
“There are two ways to think about the commission of war crimes,” he said.
“One is if the state has pursued a policy of deliberately committing war crimes or is acting recklessly in a way that aids and abets war crimes. Is the state committing war crimes?
“That, I think, is an open question. I think what is almost certainly not an open question is that there have been individual incidents that have been war crimes where Israeli soldiers, members of the Israeli military, have committed war crimes.”
The Israeli government continues to strongly deny all claims that it has committed war crimes in Gaza.
On Joe Biden’s election hopes
Mr Miller also offered a candid reflection on the suitability of Mr Biden as a candidate in the 2024 US election. While Mr Biden initially ran to extend his stay in the White House, he stepped aside, with Kamala Harris taking his place as the Democratic candidate.
“Had I not been inside the government, had I been outside the government acting kind of in a political role, of course, I would have wanted to have a better candidate,” he said.
“It’s that collective action problem where no one wants to be the first to speak out and stand up alone. You stand up by yourself and get your head chopped off, stand up together, you can take action.
“But there was never really a consensus position in the party, and there was no one that was willing to stand up and rally the party to say this isn’t going to work.
“I don’t think there is anyone on the White House staff, including the most senior White House staffers, who could have gone to Joe Biden in the spring of 2023 or at any time after that and told him: ‘Mr President, you are not able to do the duties of this job. And you will not win re-election.’ He would have rejected that outright.”
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Biden’s presidency in 60 seconds
The Trump presidency
On the Donald Trump presidency so far, he offered a nuanced view.
He described Mr Trump’s Middle East envoy Steve Witkoff as “an extremely capable individual” but expressed his worry that he was being manipulated by Russian President Vladimir Putin.
“I know the people in the Biden administration who worked with him during the first negotiations for Gaza ceasefire thought that he was capable.
“I think at times he doesn’t know what he doesn’t know. And you see that especially in the negotiations to end the war in Ukraine, where you see him go into a meeting with Vladimir Putin and come out spouting Russian propaganda… I think he would benefit from a little diplomatic savvy and some experienced diplomats around him.”
Trump’s Middle East envoy Steve Witkoff, left, with Vladimir Putin. Pic: Sputnik/AP
He continued: “But I do think it’s extremely important that when people sit down with an envoy of the United States they know that that envoy speaks for the President of the United States and it is very clear that Witkoff has that and that’s an extremely valuable asset to bring to the table.”
On the months and years ahead under Mr Trump, Mr Miller said: “The thing that worries me most is that Donald Trump may squander the position that the United States has built around the world over successive administrations of both parties over a course of decades.
“I don’t think most Americans understand the benefits that they get to their daily lives by the United States being the indispensable nation in the world.
“The open question is: will the damage that he’s doing be recoverable or not?”
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