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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
Image:
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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Video emerges of aid workers being fired on in Gaza – contradicting Israeli account of deadly attack

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Video emerges of aid workers being fired on in Gaza - contradicting Israeli account of deadly attack

Footage has emerged of the moment 15 aid workers were killed in Gaza last month – showing their ambulances and fire insignia were clearly visible when Israeli troops are believed to have opened fire on them.

The bodies of 15 aid workers – eight medics working for the Palestine Red Crescent Society (PRCS), six civil defence members, and one United Nations employee – were found in a “mass grave” after the incident, according to the head of the UN Office for Coordination of Humanitarian Affairs Jonathan Whittall.

The Israeli military said it is investigating – claiming before the video came to light that its initial inquiry found its troops opened fire on vehicles without headlights or emergency signals, which therefore looked “suspicious”. It also says there was an evacuation order in place in the area at the time of the incident.

But video footage obtained by the PRCS – and verified by Sky News – shows ambulances and a fire vehicle clearly marked with flashing red lights.

The three vehicles are seen with red flashing lights in the footage
Image:
Vehicles are seen with red flashing lights in the footage

Sky News has used aftermath video and satellite imagery to verify the location and timing of the footage.

It was filmed on 23 March north of Rafah. It shows a convoy of marked ambulances and a fire-fighting vehicle travelling south along a road towards central Rafah. All of the vehicles visible in the convoy have their flashing lights on.

It was filmed early in the morning, with a satellite image seen by Sky News taken at 9.48am local time on the same day showing a group of vehicles bunched together off the road.

The PRCS first posted about losing contact with its crews just before 7am local time.

Satellite imagery shows the area on 26 March, three days later. Tyre tracks are visible, as are groundworks likely created by military vehicles.

Pic: Planet Labs PBC
Image:
Pic: Planet Labs PBC

The footage is first filmed from inside a moving vehicle, through the windscreen a convoy of vehicles is visible – including ambulances and a fire truck with flashing emergency signal lights.

When the convoy stops, a vehicle is seen having veered off the road to the left-hand side.

The vehicle where the video is being filmed from stops and the aid workers get out. Intense gunfire then breaks out and continues for around five minutes.

The paramedic filming the video is heard saying in Arabic that there are Israelis present – and reciting a declaration of faith used before someone dies.

Hebrew voices are also heard in the background but it is not clear what they are saying.

Stills from video footage shows a Red Crescent symbol on the back of one of the vehicles
Image:
The footage was filmed from a moving vehicle

Israel conducting ‘thorough examination’

In a fresh statement on Saturday, the Israel Defence Forces (IDF) said the incident is “under thorough examination”.

“All claims, including the documentation circulating about the incident, will be thoroughly and deeply examined to understand the sequence of events and the handling of the situation,” it added.

In its statement on Saturday, the PCRS said the clip was “found on the phone of martyred EMT Rif’at Radwan, after his body was recovered” and that it “clearly shows that the ambulances and fire trucks they were using were visibly marked, with flashing emergency lights on at the time they were attacked”.

“This video unequivocally refutes the occupation’s claims that Israeli forces did not randomly target ambulances, and that some vehicles had approached ‘suspiciously without lights or emergency markings’,” it added.

‘They should have been protected’

Speaking at the United Nations on Friday, PRCS president Dr Younis Al Khatib said the organisation has “asked for an independent investigation”.

He added: “Something I can release, I heard the voice of one of those kids. I heard the voice of one of those team members who was killed and his phone was found with his body and he recorded the whole event.

“His last words before being shot, ‘Forgive me, mom. I just wanted to help people. I wanted to save lives’.”

Pic: Palestine Red Crescent Society (PRCS)
Image:
Pic: Palestine Red Crescent Society (PRCS)

Dylan Winder, permanent observer of the International Federation of the Red Cross (IFRC) said it is “outraged at the deaths of eight medics from the Palestinian Red Crescent Society killed on duty in Gaza“.

“They were humanitarians. They wore emblems that should have been protected. Their ambulances were clearly marked, and they should have returned to their families. They did not,” he said.

“Even in the most complex conflict zones, there are rules. These rules of international humanitarian law could not be clearer: civilians must be protected, humanitarians must be protected, health services must be protected.”

In a statement issued before the footage of the incident emerged, the IDF said it condemned “the repeated use of civilian infrastructure by the terrorist organisations in the Gaza Strip, including the use of medical facilities and ambulances for terrorist purposes”.

It claimed that several members of the militant groups Hamas and Palestinian Islamic Jihad were killed in the incident.

It did not comment directly on the deaths of the Red Crescent workers but later told the Reuters news agency it had allowed the bodies to be recovered from the area, which it described as an active combat zone.

The clip is filmed through a vehicle windscreen - with three red light vehicles visible in front
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Fifteen people died in the incident on 23 March

Bodies found in ‘mass grave’

The bodies of the missing aid workers were found in sand in the south of the Gaza Strip in what Mr Whittall, called a “mass grave”, marked with the emergency light from a crushed ambulance.

He posted pictures and video of Red Crescent teams digging in the sand for the bodies and workers laying them out on the ground, covered in plastic sheets.

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Bodies of aid workers found in Gaza

Philippe Lazzarini, head of the UN agency for Palestinian Refugees (UNRWA), said that the bodies had been “discarded in shallow graves” in what he called “a profound violation of human dignity”.

According to the UN, at least 1,060 healthcare workers have been killed in the 18 months since Israel launched its offensive in Gaza after Hamas fighters stormed southern Israel on 7 October 2023.

The UN is reducing its international staff in Gaza by a third because of safety concerns.

Palestinian health authorities say more than 50,000 people have been killed since Israel launched its campaign in Gaza in response to the 7 October assault, when Hamas militants crossed the border into southern Israel, killing more than 1,200 people, and taking some 250 hostage.

Gaza’s health ministry records do not distinguish between civilians and combatants.

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Hundreds of names removed from official Gaza war death list

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Hundreds of names removed from official Gaza war death list

Gaza’s health ministry has removed 1,852 people from its official list of war fatalities since October, after finding that some had died of natural causes or were alive but had been imprisoned.

The list of deaths currently stands at 50,609 following the removals. Gaza’s health ministry records do not distinguish between civilians and combatants.

Almost all of the names removed (97%) had initially been submitted through an online form which allows families to record the deaths of loved ones where the body is missing.

The head of the statistics team at Gaza’s health ministry, Zaher Al Wahidi, told Sky News that names submitted via the form had been removed as a precautionary measure pending a judicial investigation into each one.

“We realised that a lot of people [submitted via the form] died a natural death,” Mr Wahidi said. “Maybe they were near an explosion and they had a heart attack, or [living in destroyed] houses caused them pneumonia or hypothermia. All these cases we don’t [attribute to] the war.”

Others submitted via the form were found to be imprisoned or to be missing with insufficient evidence that they had died.

Some families submitting false claims, Mr Wahidi said, may have been motivated by the promise of government financial assistance.

It is the largest removal of names from the list since the war began, and comes after 1,441 names were removed between August and October – 54% of them originating in hospital morgue records rather than the online form.

chart

Mr Wahidi says his team audited the hospital data after receiving complaints from people who had ended up on the list despite being alive.

They found that hospital clerks, when operating without access to the central population registry and lacking full names or dates of birth for the dead, had marked the wrong people as dead in their records.

In total, 8% of people who were listed as dead in August have since been removed from the official death toll. Many of those may later be added back in, as the judicial investigations proceed.

‘It doesn’t look like manipulation’

Gabriel Epstein, a research assistant at US thinktank The Washington Institute for Near East Policy, said there’s no reason to think the errors are the result of deliberate manipulation intended to inflate the share of women and children among the dead.

“If 90% of the removed entries were men aged 18-40, that would look like manipulation,” he said. “But it doesn’t look like that.”

Of those entries removed since the start of the war and whose demographic information was recorded, 41% are men aged 18 to 60, while 59% are women, children and elderly people.

By comparison, 44% of remaining deaths are working-age men. This means that the removals have had the effect of slightly reducing the share of women and children in the official list.

chart

Names were previously added to the list without verification

Until October, Mr Wahidi said, names submitted via the online form had been added to the official list of registered deaths before undergoing a judicial confirmation process.

The publication of unverified deaths submitted via the form had previously led to issues with the data, with 1,295 deaths submitted via the form being removed from the list prior to October. This included 474 people who were later added back again.

Sky News previously understood that names from the form were only published after undergoing judicial confirmation. However, Mr Wahidi says this practice only began in October.

“This does cause me to downgrade the quality of the earlier lists, definitely below where I thought they were,” said Professor Michael Spagat, chair of Every Casualty Counts, an independent civilian casualty monitoring organisation.

Read more:
Analysis: Gaza aid workers’ deaths
What happened to the ceasefire?

A Ministry of Health document from July 2024 confirms that names submitted through the online form were, at the time, included in the official fatality list before being verified.

These names “are initially included in the final count of martyrs, but verification procedures are undertaken afterward”, the document says.

“They basically said that they were posting these things provisionally pending investigation,” said Prof Spagat.

“There may have been literally zero people, including us, who actually absorbed this message, but they weren’t hiding it either.”

More than 1,200 Israelis have been killed in the 7 October attack and ensuing war.


The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.

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Global markets have given Trump a clear no-confidence vote – and his fickleness is making the problem worse

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Global markets have given Trump a clear no-confidence vote - and his fickleness is making the problem worse

Global financial markets gave a clear vote of no-confidence in President Trump’s economic policy.

The damage it will do is obvious: costs for companies will rise, hitting their earnings.

The consequences will ripple throughout the global economy, with economists now raising their expectations for a recession, not only in the US, but across the world.

Tariffs latest: FTSE 100 suffers biggest daily drop since COVID

Financial investors had been gradually re-calibrating their expectations of Donald Trump over the past few months.

Hopes that his actions may not match his rhetoric were dashed on Wednesday as he imposed sweeping tariffs on the US’ trading partners, ratcheting up protectionism to a level not seen in more than a century.

FILE PHOTO: U.S. President Donald Trump holds a "Foreign Trade Barriers" document as he delivers remarks on tariffs in the Rose Garden at the White House in Washington, D.C., U.S., April 2, 2025. REUTERS/Carlos Barria/File Photo
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On Wednesday, Donald Trump announced global tariffs, ratcheting up protectionism. Pic: Reuters

04 April 2025, Hesse, Frankfurt/Main: Stock exchange traders watch their monitors on the trading floor of the Frankfurt Stock Exchange while the display board with the Dax curve shows falling prices. US President Trump had issued a huge tariff package against trading partners around the world. The European Union and China have already announced countermeasures. Photo by: Arne Dedert/picture-alliance/dpa/AP Images
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Traders at the Frankfurt stock exchange watched the DAX plummet on Friday. Pic: Picture-alliance/dpa/AP

Markets were always going to respond to that but they are also battling with another problem: the lack of certainty when it comes to Trump.

More on Donald Trump

He is a capricious figure and we can only guess his next move. Will he row back? How far is he willing to negotiate and offer concessions?

Read more:
No winners from Trump’s tariff gameshow
Trade war sparks ‘$2.2trn’ global sell-off

These are massive unknowns, which are piled on to uncertainty about how countries will respond.

China has already retaliated and Europe has indicated it will go further.

Aerial view of a ro-ro terminal for vehicle shipment in Yantai in eastern China's Shandong province, Thursday, April 3, 2025. (Chinatopix Via AP) CHINA OUT
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Vehicles destined for export, like these in Yantai in eastern China, face massive US tariffs. Pic: Chinatopix/AP

Cargo containers line a shipping terminal at the Port of Oakland on Thursday, April 3, 2025, in Oakland, Calif. (AP Photo/Noah Berger)
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Container ports like Oakland in California might expect activity to fall. Pic: AP

That will compound the problems for the global economy and undoubtedly send shivers through the markets.

Much is yet to be determined, but if there’s one thing markets hate, it’s uncertainty.

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