Child deaths from covid-19 in Brazil are growing at an alarming rate

(CNN) – “Who is mommy’s baby?” Asks Sameque Gois, 22, as she plays with her baby’s hand in one of the many videos she showed to CNN. In the imagesLittle Sarah is only a few months old, but you can already see that she has a playful personality when she responds to her mother’s mischief with a smile from ear to ear.

“He used to wake up at 6:00 am smiling, he wanted to play and that was how he spent the whole day,” says his mother. But that was before he caught COVID-19.

Sarah was born in January this year and, despite the fact that Sameque Gois had a somewhat difficult pregnancy, she says that her daughter was healthy, strong and did not suffer from any disease.

On April 27, Gois took her little girl to Hospital Casa de Saúde in Praia Grande, on the outskirts of Sao Paulo, to treat her for a urinary infection. Just 24 hours later, Sarah developed symptoms of Covid-19.

“When the symptoms started, the doctors said it was bronchiolitis, that it was nothing serious,” Gois explained. But her daughter did not get better.

“We asked them to do a covid-19 test and they always refused to do it,” Gois said. “Only when I tested positive did they test her. Then she also tested positive and they began to treat her for covid-19 ”.

Little Sarah’s condition quickly deteriorated and she was transferred to a larger hospital in Santos where she was admitted to the pediatric ICU.

“I thought it was something that I had done, that I had done something and that I had given him the virus … what happened … I did not know what was happening,” Gois said trying to hold back tears. “The only thing I knew is that she was in serious condition and that she could leave at any moment.”

“I knew the only thing I could do was kneel down and pray,” he added.

Despite her pleas, little Sarah died on May 27. He was barely five months old.

“When she died and they gave us the news, I was able to hug her and feel her one last time,” Gois said.

Alarm for the rate of death by covid-19 among children

According to the researchers, Sarah’s case is one of many in Brazil where children die from COVID-19 at a higher rate than almost anywhere else.

Brazil’s Ministry of Health says 1,122 children under the age of 10 have died from covid-19 since the pandemic began. But Vital Strategies, a public health research group, says its studies show that reported cases are well below the true numbers. According to their figures, 2,975 children have died since the pandemic began, 1,013 this year alone.

“What we see in Brazil is that the number of children who die whose specific cause of death is covid-19 is higher than what we see in other countries. It’s 10 times higher, ”said Dr. Ana Luisa Bierrenback, an epidemiologist at Vital Strategies.

Bierrenback added that the variant that was first identified in Brazil, the Gamma or P1, may not be the culprit. “What we see when we look at the data is that more children have died here in Brazil since the first variant. So it was not the addition of the P1 variant that caused more children to die here than in other countries, ”he said.

According to Sarah’s mother, the little girl was tested 12 days after she developed the first symptoms of covid-19.

One of the reasons suggested by doctors and researchers for why perhaps the procedure was like this is that there is a perception in the country that the impact of covid-19 on children is very slight.

Pediatrician Andre Laranjeira says it is a common misconception in Brazil.

“At the beginning of the pandemic, it was estimated that most pediatric cases were only mild infections, in fact covid-19 in children was neglected,” explained Dr. Laranjeira.

“Many of the pediatricians were reluctant to request covid-19 tests for children when they had those normal respiratory symptoms – nasal congestion, cough, fever. Virtually all children have these symptoms at this time of year, in the fall, and some doctors did not do the tests, “he said, warning that” if you do not do a test, you run the risk of not getting the diagnosis right.

Dr. Marisa Dolhnikoff, a lung specialist and researcher at the Faculty of Medicine of the University of Sao Pablo, has studied the impact of covid-19 on children and adolescents.

It says that children with COVID-19 may have different symptoms than infected adults.

“If a child has a high fever, skin irritation, abdominal pain, doctors may be able to think of some other diagnosis and not something related to COVID-19,” said Dr. Dolhnikoff. “We have to be aware that these different symptoms can be related to covid-19 and that these children can develop a very serious disease.”

The impact of vulnerability

But while the different symptoms may be confusing for some doctors, most doctors and researchers agree that the main culprit for the higher rate of death from covid-19 in children in Brazil is the country’s health system – or the lack of this.

“In large centers we are prepared to treat these children and we have very, very good intensive care units. But this is not the case across the country, ”explained Dr. Dolhnikoff. “We have many poor regions in the country that have great difficulty dealing with this situation.”

Dr. Bierrenbach agrees. “Why is this happening? Probably due to greater vulnerability, lack of access to good medical care, ”he said. “Perhaps they are malnourished and die more from covid-19.”

For Dr. Laranjeira, inequality is shown not only in the quality of medical care that people have access to, but also in how the disease affects them. “Children from families in an unfavorable situation, from the socioeconomic point of view, are admitted in greater numbers and with a more serious condition,” he explained.

“When the figures for fatalities are taken from the pediatric group, more than 60% are from vulnerable groups at a socioeconomic level,” concluded Laranjeira. “It is impossible to turn a blind eye on it.”

In Praia Grande, Sameque Gois is still trying to make sense of everything, looking for explanations, trying not to blame himself for what happened to his little girl.

“Some people think that what happened in a way is punishment,” he said. “They think she got COVID-19 because I took her out of the house, because I did something wrong.”

“We went to the hospital because she was sick, she had a fever, she couldn’t leave her at home in that state, and after that she got COVID-19,” she said in tears.

“In this story, nobody can be blamed.”