Brazil Lifts Covid Restrictions as Cases, Deaths Finally Ease

(Bloomberg) — Brazilian states and cities are preparing to suspend most limitations on businesses and gatherings as Covid cases and deaths drop to the lowest in months while vaccinations pick up speed.

In Sao Paulo, many schools have reopened at full capacity for in-person classes this week, and the state will end restrictions on opening hours and capacity for most businesses starting Aug. 17. Rio de Janeiro also has plans to ease rules as of Sept. 2, including on the use of masks. The reopening will include a four-day celebration, Mayor Eduardo Paes said, adding that New Year’s festivities will be the largest in the city’s history.

The aggressive push to end restrictions, which have been in place for more than 15 months — albeit with spotty enforcement and often contradictory rules that made them less effective — comes amid a respite in the pandemic.

While the virus is still killing almost 1,000 people a day, that’s down from a peak of more than 4,200. The moving average has fallen below 1,000 for the first time since January. Occupancy in hospitals has plummeted too, with intensive-care units across the nation about 60% to 65% full, down from more than 95% earlier this year.

All the optimism could quickly fade if the delta variant, which has caused a resurgence of the virus in Europe and the U.S., spreads across Latin America’s largest nation. While experts say it’s still too soon to say if the strain will cause a third wave in Brazil, the push to end restrictions increases the risk.

“I am afraid the population is too excited about the drop in Covid numbers,” said Pedro Hallal, an epidemiologist and former dean of Pelotas Federal University. “Delta can ‘have a party’ and infect a lot of people.”

Delta is the most worrisome coronavirus variant to emerge so far, spreading to more than 100 countries since it was first reported in India in October. The strain, which is estimated to be almost twice as infectious as the original virus from early 2020, has become dominant now in many countries, including in the U.K. and the U.S. It’s hit hardest in places where less than half the adult population has been fully immunized.

In Brazil, its impact so far has been muted. The latest Health Ministry data show the country has identified some 250 cases of the variant, up from 170 a week ago. But the number likely doesn’t reflect the strain’s true toll as the country doesn’t test enough, said Gulnar Azevedo e Silva, the president of the Brazilian Association for Collective Health, known as Abrasco.

Delta also faces competition from the gamma variant, first traced to the Amazonian city of Manaus, which experts say is also much more contagious than the original strain.

“Gamma is just as concerning as delta and it continues to be predominant in Brazil,” said Marcelo Paiva, a professor at Pernambuco Federal University and researcher at Fiocruz, which is doing studies to track the virus. “Introducing a new variant to the mix will only highlight our slow immunization campaign.”

While the pace of vaccinations has improved, with more than half the population now inoculated with one dose, only 20% have been fully immunized. That’s because doses of two of the shots available in Brazil — AstraZeneca and Pfizer — are being given three months apart. Doses of CoronaVac, which accounts for about 37% of the vaccines deployed, are given a month apart.

Emerging data suggest there will be differences in efficacy depending on the vaccines. Research by Public Health England released before peer review found two doses of the AstraZeneca vaccine, which is being widely used in Brazil, were less effective at preventing Covid from delta compared with a double dose of the Pfizer shot. Data from Indonesia, which is mostly using CoronaVac, signaled a lower prevalence of deaths among the vaccinated.

Brazil should have at least 70% of the population totally immunized in order to be in a more comfortable position regarding delta, said Silva, who’s also a professor at Rio de Janeiro State University. The Health Ministry estimates half of the adult population will have received two shots in September.

Fernando Spilki, a Covid researcher at the Science and Technology Ministry, said Brazil should focus on shortening the period between shots to fully immunize as many people as possible to prevent the delta variant from spreading. Officials recently announced they are considering reducing the period between Pfizer shots to 21 days, but only after the whole population over 18 has received the first dose.

For now, experts urge caution. The variant has been spotted across the sprawling nation, including in the states of Sao Paulo, Rio de Janeiro, Parana and Ceara. While mobility isn’t back to pre-pandemic levels, restaurants in big cities are regularly packed and, either out of exhaustion or boredom, Brazilians are taking their chances and traveling, causing services inflation to jump.

“Even as we see a drop in cases and deaths, the virus is still circulating widely,” said Spilki. “There’s still a risk we see a spike if people don’t protect themselves.”

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