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What you need to know about the new Manaus coronavirus variant
Renato Alves . Jan 19, 2021
Health workers scramble to save patients. Photo: Ingrid Anne/FP
The world looked on in horror last week as the Amazonian city of Manaus faced a second collapse of its local health system under the variant of a second wave of coronavirus contagion. With an extreme shortage of oxygen cylinders in the city’s hospitals, intensive care patients had to be manually ventilated by already overworked medical staff. Many Covid-19 sufferers died from suffocation in what was the lowest point of Brazil’s coronavirus epidemic to date.
Besides a series of factors — including insufficient planning and national coordination and the loosening of social distancing in the city — experts say that one of the explanations for the devastation seen in Manaus is that a new variant of the coronavirus is now circulating in the Amazon region.
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<p>On Friday, Brazil’s Health Ministry confirmed a case of Covid-19 reinfection with a new variant of the virus in the state of Amazonas. The patient is a 29-year-old woman who was initially infected in March of last year. Her second diagnosis was confirmed at the end of December.</p>
<p>The results of her Covid-19 test identified a mutation of the coronavirus, previously discovered by Japan’s Ministry of Health, Labor and Welfare and deemed to have originated in Amazonas. Japan announced that it had detected a new variant of the virus in travelers arriving from Manaus, convincing a number of European countries to ban all flights arriving from Brazil.</p>
<p>“There is a possibility [that the new variant is more contagious], I cannot confirm that is the case, but the possibility exists due to the mutations it has undergone at [peptide amino acid] positions 484 and 501, which are associated with higher transmissibility,” explains virologist Felipe Naveca.</p>
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<p>Working at the <a href="https://portal.fiocruz.br/">Oswaldo Cruz Foundation</a> in Amazonas state, Mr. Naveca led studies on the new variant. Along with researchers from ten institutions — among them Imperial College London and Oxford University — he is the co-author of a paper describing cases of this new coronavirus variant, which has been given the name P.1.</p>
<p>The research concluded that the new variant originated in Brazil’s Amazon region, but displays some of the same mutations as the variants discovered in the United Kingdom and South Africa. The paper is available for download on <a href="https://virological.org/t/sars-cov-2-reinfection-by-the-new-variant-of-concern-voc-p-1-in-amazonas-brazil/596">Virological.org</a>, a discussion forum containing the most recent information on virus molecular evolution and epidemiology. </p>
<p>Indeed, it is expected that a virus will undergo mutations during a pandemic. The monitoring of these alterations in genetic code helps to oversee concerning cases and take measures to block the transmission chain.</p>
<p>What is notable about the new Manaus variant is that mutations occurred on the genes that code the spike protein, which allows the coronavirus to invade human cells.</p>
<p>Scientists analyzed genetic material from 31 samples of Covid-19 patients in Manaus, collected between December 15 and 23. Of these, 13 individuals had been infected with the new variant of the virus.</p>
<h2>No oxygen and no control</h2>
<p>With over 230,000 confirmed Covid-19 cases and 5,900 deaths, the state of Amazonas is currently in chaos. Hospitals have been left without sufficient oxygen stocks to meet the escalating demand. Currently, the state requires 76,500 cubic meters of oxygen per day, while the production capacity of local suppliers is just 28,200 cubic meters a day.</p>
<p>State governments and celebrities have banded together to send donated oxygen cylinders to the city of Manaus. The Venezuelan government also sent aid, though it was <a href="https://brazilian.report/newsletters/brazil-daily/2020/09/22/brazilian-congress-corners-bolsonaro-mike-pompeo-visit/">not acknowledged by the Brazilian administration</a>. Trucks carrying oxygen tanks crossed the border into Brazil on Sunday and arrived in Manaus on Monday evening.</p>
<p>The current situation became so dramatic last week that state health authorities decided to transfer patients so that they may receive care in neighboring states. Roughly 235 patients are to be sent to hospitals in seven states and the capital Brasília.</p>
<p>The collapse of the Manaus health system was mentioned at a meeting of the World Health Organization (WHO) on Friday, who warned that countries cannot falter in their prevention efforts. </p>
<p>“What is happening in Manaus is an alert to several countries. Do not let a false sense of security bring your guard down. If you have built infrastructure, with ICU beds and oxygen, do not deactivate it, the pandemic is not over yet,” said Mariangela Simão, WHO Assistant Director General for Access to Medicines, Vaccines and Pharmaceuticals.</p>
<p>Mike Ryan, head of the WHO Emergencies Program, said that the situation in the Amazonian city has deteriorated significantly and that the entire system appears to be implosing. He stressed that this is not restricted to Manaus, but also other Amazonian states such as Amapá and Rondônia. </p>
<p>Mr. Ryan affirmed that a relaxed attitude from the population is the main factor responsible for the crisis. “We need to be able to accept — as individuals, communities, and governments — our part of responsibility in the virus spreading out of control.”
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