Friday, April 17, 2020
Brazil braces for onslaught of COVID-19 cases as virus advances
Joshua Howat Berger. AFP. April 15, 2020
Rio de Janeiro (AFP) - Dr. Valdilea Veloso is racing against time: she needs ventilators, face masks and medical staff before the coronavirus outbreak peaks in Brazil, where social distancing is proving problematic, not least because of President Jair Bolsonaro.
With Brazilians increasingly ignoring health officials' warnings to stay home -- encouraged by their far-right president, who has condemned the "hysteria" over the virus -- predictions for how the pandemic will play out in the hardest-hit country in Latin America are getting dire.
Brazil, an country of 210 million people, has registered 1,532 deaths from the new coronavirus so far.
But the state of Sao Paulo alone is expecting 111,000 deaths over six months, nearly equal to the entire worldwide toll to date.
A number of states face the possibility that their healthcare systems will collapse.
They include Sao Paulo; Rio de Janeiro, the second-hardest hit; and Amazonas, a huge territory with a large number of indigenous communities that have a tragic history of being decimated by new diseases.
Veloso, the head of the main hospital fighting COVID-19 in Rio de Janeiro, says her staff are already tired, sick and running out of protective equipment.
Her hospital, the National Infectious Diseases Institute, is rushing to build a new facility with 200 intensive care beds, train new staff, and buy scarce ventilators and face masks.
What happens if they are not ready for the crush of patients expected to start later this month?
"I try not to think about that," she told AFP.
"It's too much stress. When I do think about it, I think about all the deaths we'll have here, and how they will hit us unequally. The wealthiest people will not be hurt as much as the poorest, the people who live in the favelas" -- the crowded slums of tin-roof shacks that coexist, sometimes side by side, with Brazil's posh neighborhoods.
- Anti-isolationist-in-chief -
Known for its wild carnivals, sultry climate, pulsing mega-cities and sprawling size, Brazil has not been very good at social distancing.
Surfers in Rio de Janeiro, anti-isolation protesters in Sao Paulo and people who simply need to work are increasingly flouting state and local authorities' measures to "flatten the curve."
In Sao Paulo, the proportion of the population staying home has dipped as low as 47 percent, according to monitoring based on cell phone location data -- far below the goal of 80 percent.
The offender-in-chief is Bolsonaro, who has compared the virus to a "little flu," condemned the economic impact of stay-at-home measures and proudly broken them himself, insisting on his "constitutional right to come and go as I please."
Dr Veloso said she was worried by a visible decline in social distancing.
"It's the only chance we have to avoid the collapse of the healthcare system," she said.
- Alarm bells -
There are worrying signs in various places.
Sao Paulo has at least five hospitals with more than 70 percent of intensive care beds occupied by coronavirus patients -- a percentage that is rising rapidly.
A study found the municipal health system faced collapse by April 19 if social distancing measures were not intensified.
Rio Health Secretary Edmar Santos said his state can handle around 16,000 hospitalizations, but fears the number will reach 40,000 to 50,000.
Rio Governor Wilson Witzel, himself fighting off the virus, said the state could run out of ventilators by April 28.
In Amazonas, the health system is already on the brink of collapse.
Its capital, Manaus, is the only city with an intensive care unit.
Its 50 beds serve a state more than four times the area of Germany. Brazilian media report that new patients have to wait for someone to die to be admitted.
The government has started building field hospitals to boost capacity in such cases. It is urgently sourcing ventilators and medical supplies, and deploying more than 1,000 nurses and 80 doctors as reinforcements.
"The curve (of infections) in Manaus is very close to the line of health system capacity... So we are trying to move that line, to increase capacity," health ministry official Joao Gabbardo said Saturday.
But there are limits to how far and how fast it can move.
Public health officials report that vital supplies and equipment such as face masks and ventilators are increasingly difficult to source, with international suppliers sometimes charging quadruple the usual price or more.
Brazil's Bolsonaro accuses house speaker of trying to remove him from office
Reuters. April 17, 2020
BRASILIA (Reuters) - Brazil’s right-wing President Jair Bolsonaro on Thursday accused the speaker of the lower house of Congress Rodrigo Maia of turning state governors against him in the coronavirus crisis and seeking to remove him from the presidency.
Bolsonaro fired Health Minister Luiz Henrique Mandetta on Thursday, saying he was not adequately taking the economic fallout from coronavirus lockdowns into consideration.
In an interview with CNN Brasil, Bolsonaro appealed to the governors to rethink their quarantine restrictions to allow the economy to breathe, warning that Brazil risked going broke and ending up “the same as Venezuela.”
Maia, who defended Mandetta’s insistence on social distancing to curb the epidemic, told CNN Brasil separately that the country’s Congress was passing the legislation needed to pull the economy through the crisis and accused the president of playing politics.
Maia said the firing of Mandetta in the midst of the coronavirus outbreak scared most Brazilians. The virus has killed roughly 400 people in Brazil in the last 48 hours.
Brazil’s Bolsonaro fires Health Minister Mandetta after differences over coronavirus response
Marina Lopes. Washington Post. April 16, 2020
Brazilian President Jair Bolsonaro fired Luiz Henrique Mandetta as minister of health Thursday, after the two officials sparred publicly over the need for social distancing to fight Latin America’s largest coronavirus outbreak.
The country has reported more than 29,000 cases and more than 1,760 deaths from covid-19, the disease caused by the virus, numbers second only to the United States in the Western Hemisphere. Given Brazil’s sharply limited testing, actual cases and deaths are believed to be significant undercounts.
But much of the country’s focus in recent days was on widespread speculation that Bolsonaro was about to fire Mandetta, after the minister criticized the president on a popular news show for refusing to abide by the Health Ministry’s social distancing guidelines.
Bolsonaro described Mandetta’s departure as a “mutual divorce.”
“I do not condemn, I do not recriminate, and I do not criticize Minister Mandetta,” Bolsonaro told reporters at the Planalto presidential palace in Brasilia. “He did what, as a doctor, he thought he should do at the time. Isolation, increasingly, became a reality. But we cannot make decisions that destroy the work that has already been done.”
Brazil’s Bolsonaro, channeling Trump, dismisses coronavirus measures — it’s just ‘a little cold’
He named oncologist Nelson Teich as his new health minister.
Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked in the newsletter are free to access.
“Everything will be analyzed in a scientific way,” Teich said. “There is a complete alignment between the president, myself and the ministry. We are working to make sure society returns to normal life as quickly as possible.”
Lucas Barreto, a senior representative of Bolsonaro’s government in the country’s Senate, resigned in protest.
“I’m leaving because firing Luiz Henrique Mandetta is absurd,” he told reporters.
The move comes as hospitals and clinics teeter on the brink of collapse. Emergency rooms in Amazonas state are running at capacity, with 95 percent of intensive care beds and ventilators occupied. Rio de Janeiro’s famed Maracana soccer stadium has been converted to a makeshift hospital to accommodate coronavirus patients. Gravediggers in the country’s largest cemeteries are working overtime to bury the dead.
Bolsonaro, meanwhile, has repeatedly downplayed the severity of the outbreak — dismissing the virus as a “little flu,” shrugging off social distancing recommendations from the World Health Organization and sharing videos calling for an end to the country’s lockdown.
“Gradually we have to open employment in Brazil,” he said Thursday. “The great humble masses cannot stay at home.”
His push to restart the economy set up a direct confrontation with Mandetta, who became a voice of resistance within the administration. A pediatric orthopedist who has served in Brazil’s National Congress since 2010, Mandetta insisted that businesses shut down and people stay home to reduce the spread of the virus.
Bolsonaro largely ignored those calls. On a visit with Mandetta last weekend to a pop-up hospital outside Brasilia, the president walked into a crowd, took off his mask, extended his hand for a supporter to kiss and autographed jerseys.
It was too much for the minister.
“Brazilians don’t know whether they should listen to their health minister or to their president,” Mandetta told the Globo news program Fantástico on Sunday.
Brazil’s densely packed favelas brace for coronavirus: ‘It will kill a lot of people’
Those who think relations between President Trump and infectious-disease chief Anthony S. Fauci are awkward might want to consider Bolsonaro and Mandetta.
Mandetta clearly and consistently walked back Bolsonaro’s erroneous claims on covid-19 with science and data. When deaths began to soar, Bolsonaro said the virus appeared to be going away; Mandetta warned of “tough days” ahead. When Bolsonaro touted an unproven cure for the virus — “This medicine here, hydroxychloroquine, is working everywhere,” he claimed in a video on Facebook and Twitter — Mandetta said he would not endorse widespread use of the drug without a peer-reviewed study. (Facebook and Twitter removed the videos.)
The health minister’s insistence on facts and figures clashed with Bolsonaro’s freewheeling approach, which often involves impromptu social media provocations with misinformation and conspiracy theories.
“Bolsonaro’s style has never been tied to facts,” said Anya Prusa, a senior associate at the Wilson Center’s Brazil Institute. “He prefers a more informal, off-the-cuff engagement. It is a style that served him well during the election, but it has not served him well as a leader.”
Bolsonaro’s approval ratings have fallen to a record low of 28 percent during the outbreak, according to an XP Investments poll published last week. Sixty-eight percent of those surveyed, in contrast, said Mandetta and his Health Ministry were doing a good or excellent job.
Those numbers weren’t lost on Bolsonaro, who said he wouldn’t hesitate to fire any members of his cabinet who “became stars.”
When speculation surfaced last week that Bolsonaro was ready to fire Mandetta, Brazilians protested from quarantine, banging pots and pans from their windows. Mandetta called a news conference Monday to announce that he was still on the job. But on Tuesday, he reportedly told his team that he expected to be dismissed by the end of the week.
It was Mandetta who announced the news, in a tweet.
“I just received notice from President Jair Bolsonaro of my resignation from the Ministry of Health,” he wrote. “I want to thank you for the opportunity I was given, to lead our [public health system], to launch a plan to better the health of Brazilians and to plan the combat of the coronavirus pandemic, this great challenge that our health system faces. . . . I wish my replacement success in his role as minister of health.”
Later, he addressed his now former staff at a news conference.
“Don’t be afraid,” he said. “Don’t do things one millimeter differently than you know how to do. I’m leaving this ministry, but I know I am leaving the best team behind. We have to unconditionally defend life, [the public health system], and science.”
The president of the Brazilian Medical Association said Teich has the group’s “total support.”
“He is respected by the medical class, a technically minded manager and highly prepared to lead the ministry of health,” Lincoln Lopes Ferreira said.
The news of Mandetta’s dismissal was greeted with more pot-banging. Shouts of “Killer!” and “Bolsonaro out!” could be heard in Rio de Janeiro.
“Mandetta was fired because he was unwilling to give up scientific and medical principles for the Brazilian people,” said Major Olímpio, a senator from Sao Paulo and former Bolsonaro ally. “Good luck to the new minister, but better luck to the Brazilian people and to public health.”
Bolsonaro’s political rivals have urged the people to ignore the president.
“Don’t follow the guidelines of the president of the republic,” said João Doria, governor of Sao Paulo state. “He does not lead the population correctly and unfortunately does not lead Brazil in the fight against the coronavirus and in the preservation of life.”
Doria, also a former Bolsonaro ally, this month called for a strict lockdown in his state, Brazil’s most populous.
Some critics said Bolsonaro’s opposition to Mandetta was strategic. By positioning himself as the health minister’s rival and a champion for the economy, he was shielding himself from blame for the inevitable recession that will follow the country’s lockdown.
“For Bolsonaro, the facts don’t matter. What matters is the narrative he constructs,” said Guilherme Casarões, a political scientist at the Getúlio Vargas Foundation, a university in Sao Paulo.
“The political narrative here is convenient because it transfers responsibility for the crisis and the economic collapse to other operatives,” Casarões said. “He can shrug off responsibility while he casts himself as the person who tried, against the will of the system, the governors and the media, to keep the economy going.”
Climate-driven megadrought is emerging in western US, says study
Warming may be triggering an era worse than any in recorded history
April 16, 2020
Earth Institute at Columbia University
A new study says a megadrought worse than anything known from recorded history is very likely in progress in the western United States and northern Mexico, and warming climate is playing a key role.
https://www.sciencedaily.com/releases/2020/04/200416151750.htm
With the western United States and northern Mexico suffering an ever-lengthening string of dry years starting in 2000, scientists have been warning for some time that climate change may be pushing the region toward an extreme long-term drought worse than any in recorded history. A new study says the time has arrived: a megadrought as bad or worse than anything even from known prehistory is very likely in progress, and warming climate is playing a key role. The study, based on modern weather observations, 1,200 years of tree-ring data and dozens of climate models, appears this week in the leading journal Science.
"Earlier studies were largely model projections of the future," said lead author Park Williams, a bioclimatologist at Columbia University's Lamont-Doherty Earth Observatory. "We're no longer looking at projections, but at where we are now. We now have enough observations of current drought and tree-ring records of past drought to say that we're on the same trajectory as the worst prehistoric droughts."
Reliable modern observations date only to about 1900, but tree rings have allowed scientists to infer yearly soil moisture for centuries before humans began influencing climate. Among other things, previous research has tied catastrophic naturally driven droughts recorded in tree rings to upheavals among indigenous Medieval-era civilizations in the Southwest. The new study is the most up-to-date and comprehensive long-term analysis. It covers an area stretching across nine U.S. states from Oregon and Montana down through California and New Mexico, and part of northern Mexico.
Using rings from many thousands of trees, the researchers charted dozens of droughts across the region, starting in 800 AD. Four stand out as so-called megadroughts, with extreme aridity lasting decades: the late 800s, mid-1100s, the 1200s, and the late 1500s. After 1600, there were other droughts, but none on this scale.
The team then compared the ancient megadroughts to soil moisture records calculated from observed weather in the 19 years from 2000 to 2018. Their conclusion: as measured against the worst 19-year increments within the previous episodes, the current drought is already outdoing the three earliest ones. The fourth, which spanned 1575 to 1603, may have been the worst of all -- but the difference is slight enough to be within the range of uncertainty. Furthermore, the current drought is affecting wider areas more consistently than any of the earlier ones -- a fingerprint of global warming, say the researchers. All of the ancient droughts lasted longer than 19 years -- the one that started in the 1200s ran nearly a century -- but all began on a similar path to to what is showing up now, they say.
Nature drove the ancient droughts, and still plays a strong role today. A study last year led by Lamont's Nathan Steiger showed that among other things, unusually cool periodic conditions over the tropical Pacific Ocean (commonly called La Niña) during the previous megadroughts pushed storm tracks further north, and starved the region of precipitation. Such conditions, and possibly other natural factors, appear to have also cut precipitation in recent years. However, with global warming proceeding, the authors say that average temperatures since 2000 have been pushed 1.2 degrees C (2.2 F) above what they would have been otherwise. Because hotter air tends to hold more moisture, that moisture is being pulled from the ground. This has intensified drying of soils already starved of precipitation.
All told, the researchers say that rising temperatures are responsible for about half the pace and severity of the current drought. If this overall warming were subtracted from the equation, the current drought would rank as the 11th worst detected -- bad, but nowhere near what it has developed into.
"It doesn't matter if this is exactly the worst drought ever," said coauthor Benjamin Cook, who is affiliated with Lamont and the Goddard Institute for Space Studies. "What matters is that it has been made much worse than it would have been because of climate change." Since temperatures are projected to keep rising, it is likely the drought will continue for the foreseeable future; or fade briefly only to return, say the researchers.
"Because the background is getting warmer, the dice are increasingly loaded toward longer and more severe droughts," said Williams. "We may get lucky, and natural variability will bring more precipitation for a while. But going forward, we'll need more and more good luck to break out of drought, and less and less bad luck to go back into drought." Williams said it is conceivable the region could stay arid for centuries. "That's not my prediction right now, but it's possible," he said.
Lamont climatologist Richard Seager was one of the first to predict, in a 2007 paper, that climate change might eventually push the region into a more arid climate during the 21st century; he speculated at the time that the process might already be underway. By 2015, when 11 of the past 14 years had seen drought, Benjamin Cook led a followup study projecting that warming climate would cause the catastrophic natural droughts of prehistory to be repeated by the latter 21st century. A 2016 study coauthored by several Lamont scientist reinforced those findings. Now, says Cook, it looks like they may have underestimated. "It's already happening," he said.
The effects are palpable. The mighty reservoirs of Lake Mead and Lake Powell along the Colorado River, which supply agriculture around the region, have shrunk dramatically. Insect outbreaks are ravaging dried-out forests. Wildfires in California and across wider areas of the U.S. West are growing in area. While 2019 was a relatively wet year, leading to hope that things might be easing up, early indications show that 2020 is already on a track for resumed aridity.
"There is no reason to believe that the sort of natural variability documented in the paleoclimatic record will not continue into the future, but the difference is that droughts will occur under warmer temperatures," said Connie Woodhouse, a climate scientist at the University of Arizona who was not involved in the study. "These warmer conditions will exacerbate droughts, making them more severe, longer, and more widespread than they would have been otherwise."
Angeline Pendergrass, a staff scientist at the U.S. National Center for Atmospheric Research, said that she thinks it is too early to say whether the region is at the cusp of a true megadrought, because the study confirms that natural weather swings are still playing a strong role. That said, "even though natural variability will always play a large role in drought, climate change makes it worse," she said.
Tucked into the researchers' data: the 20th century was the wettest century in the entire 1200-year record. It was during that time that population boomed, and that has continued. "The 20th century gave us an overly optimistic view of how much water is potentially available," said Cook. "It goes to show that studies like this are not just about ancient history. They're about problems that are already here."
The study was also coauthored by Edward Cook, Jason Smerdon, Kasey Bolles and Seung Baek, all of Lamont-Doherty Earth Observatory; John Abatzaglou of the University of Idaho; and Andrew Badger and Ben Livneh of the University of Colorado, Boulder.
Story Source:
Materials provided by Earth Institute at Columbia University. Original written by Kevin Krajick. Note: Content may be edited for style and length.
Journal Reference:
A. Park Williams, Edward R. Cook, Jason E. Smerdon, Benjamin I. Cook, John T. Abatzoglou, Kasey Bolles, Seung H. Baek, Andrew M. Badger, Ben Livneh. Large contribution from anthropogenic warming to an emerging North American megadrought. Science, 2020; 368 (6488): 314 DOI: 10.1126/science.aaz9600
https://www.sciencedaily.com/releases/2020/04/200416151750.htm
With the western United States and northern Mexico suffering an ever-lengthening string of dry years starting in 2000, scientists have been warning for some time that climate change may be pushing the region toward an extreme long-term drought worse than any in recorded history. A new study says the time has arrived: a megadrought as bad or worse than anything even from known prehistory is very likely in progress, and warming climate is playing a key role. The study, based on modern weather observations, 1,200 years of tree-ring data and dozens of climate models, appears this week in the leading journal Science.
"Earlier studies were largely model projections of the future," said lead author Park Williams, a bioclimatologist at Columbia University's Lamont-Doherty Earth Observatory. "We're no longer looking at projections, but at where we are now. We now have enough observations of current drought and tree-ring records of past drought to say that we're on the same trajectory as the worst prehistoric droughts."
Reliable modern observations date only to about 1900, but tree rings have allowed scientists to infer yearly soil moisture for centuries before humans began influencing climate. Among other things, previous research has tied catastrophic naturally driven droughts recorded in tree rings to upheavals among indigenous Medieval-era civilizations in the Southwest. The new study is the most up-to-date and comprehensive long-term analysis. It covers an area stretching across nine U.S. states from Oregon and Montana down through California and New Mexico, and part of northern Mexico.
Using rings from many thousands of trees, the researchers charted dozens of droughts across the region, starting in 800 AD. Four stand out as so-called megadroughts, with extreme aridity lasting decades: the late 800s, mid-1100s, the 1200s, and the late 1500s. After 1600, there were other droughts, but none on this scale.
The team then compared the ancient megadroughts to soil moisture records calculated from observed weather in the 19 years from 2000 to 2018. Their conclusion: as measured against the worst 19-year increments within the previous episodes, the current drought is already outdoing the three earliest ones. The fourth, which spanned 1575 to 1603, may have been the worst of all -- but the difference is slight enough to be within the range of uncertainty. Furthermore, the current drought is affecting wider areas more consistently than any of the earlier ones -- a fingerprint of global warming, say the researchers. All of the ancient droughts lasted longer than 19 years -- the one that started in the 1200s ran nearly a century -- but all began on a similar path to to what is showing up now, they say.
Nature drove the ancient droughts, and still plays a strong role today. A study last year led by Lamont's Nathan Steiger showed that among other things, unusually cool periodic conditions over the tropical Pacific Ocean (commonly called La Niña) during the previous megadroughts pushed storm tracks further north, and starved the region of precipitation. Such conditions, and possibly other natural factors, appear to have also cut precipitation in recent years. However, with global warming proceeding, the authors say that average temperatures since 2000 have been pushed 1.2 degrees C (2.2 F) above what they would have been otherwise. Because hotter air tends to hold more moisture, that moisture is being pulled from the ground. This has intensified drying of soils already starved of precipitation.
All told, the researchers say that rising temperatures are responsible for about half the pace and severity of the current drought. If this overall warming were subtracted from the equation, the current drought would rank as the 11th worst detected -- bad, but nowhere near what it has developed into.
"It doesn't matter if this is exactly the worst drought ever," said coauthor Benjamin Cook, who is affiliated with Lamont and the Goddard Institute for Space Studies. "What matters is that it has been made much worse than it would have been because of climate change." Since temperatures are projected to keep rising, it is likely the drought will continue for the foreseeable future; or fade briefly only to return, say the researchers.
"Because the background is getting warmer, the dice are increasingly loaded toward longer and more severe droughts," said Williams. "We may get lucky, and natural variability will bring more precipitation for a while. But going forward, we'll need more and more good luck to break out of drought, and less and less bad luck to go back into drought." Williams said it is conceivable the region could stay arid for centuries. "That's not my prediction right now, but it's possible," he said.
Lamont climatologist Richard Seager was one of the first to predict, in a 2007 paper, that climate change might eventually push the region into a more arid climate during the 21st century; he speculated at the time that the process might already be underway. By 2015, when 11 of the past 14 years had seen drought, Benjamin Cook led a followup study projecting that warming climate would cause the catastrophic natural droughts of prehistory to be repeated by the latter 21st century. A 2016 study coauthored by several Lamont scientist reinforced those findings. Now, says Cook, it looks like they may have underestimated. "It's already happening," he said.
The effects are palpable. The mighty reservoirs of Lake Mead and Lake Powell along the Colorado River, which supply agriculture around the region, have shrunk dramatically. Insect outbreaks are ravaging dried-out forests. Wildfires in California and across wider areas of the U.S. West are growing in area. While 2019 was a relatively wet year, leading to hope that things might be easing up, early indications show that 2020 is already on a track for resumed aridity.
"There is no reason to believe that the sort of natural variability documented in the paleoclimatic record will not continue into the future, but the difference is that droughts will occur under warmer temperatures," said Connie Woodhouse, a climate scientist at the University of Arizona who was not involved in the study. "These warmer conditions will exacerbate droughts, making them more severe, longer, and more widespread than they would have been otherwise."
Angeline Pendergrass, a staff scientist at the U.S. National Center for Atmospheric Research, said that she thinks it is too early to say whether the region is at the cusp of a true megadrought, because the study confirms that natural weather swings are still playing a strong role. That said, "even though natural variability will always play a large role in drought, climate change makes it worse," she said.
Tucked into the researchers' data: the 20th century was the wettest century in the entire 1200-year record. It was during that time that population boomed, and that has continued. "The 20th century gave us an overly optimistic view of how much water is potentially available," said Cook. "It goes to show that studies like this are not just about ancient history. They're about problems that are already here."
The study was also coauthored by Edward Cook, Jason Smerdon, Kasey Bolles and Seung Baek, all of Lamont-Doherty Earth Observatory; John Abatzaglou of the University of Idaho; and Andrew Badger and Ben Livneh of the University of Colorado, Boulder.
Story Source:
Materials provided by Earth Institute at Columbia University. Original written by Kevin Krajick. Note: Content may be edited for style and length.
Journal Reference:
A. Park Williams, Edward R. Cook, Jason E. Smerdon, Benjamin I. Cook, John T. Abatzoglou, Kasey Bolles, Seung H. Baek, Andrew M. Badger, Ben Livneh. Large contribution from anthropogenic warming to an emerging North American megadrought. Science, 2020; 368 (6488): 314 DOI: 10.1126/science.aaz9600
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