We’ve been here twice before, but she couldn’t get the vaccine, says Silva Santos. She gets in line, then the vaccines disappear and we have to leave.

At the gate, Silva Santos asked the guard if she could give the vaccine to her mother. He followed the CNN cameras closely and quickly brought them up to speed.

Five minutes later, the couple returned with bad news on their faces.

I think it’s very wrong, said a clearly angry and frustrated Silva Santos. Now we have to start looking again when they have vaccines, and you never know.

That frustration spilled over to the older crowd, as one after another was denied their first dose of vaccine after the state of Rio de Janeiro suspended its vaccination campaign because vaccine stocks had run out.

It’s a disaster, a complete disaster, one woman told CNN after she was denied the vaccine. Whose fault is that? I think our leaders, our politicians, are worthless.

A perfect storm in the making

The Covida 19 crisis in Brazil has never been more serious. Nearly all Brazilian states have an IC utilization rate of 80 percent or higher, according to a CNN analysis of state-by-state data. On Friday, 16 of the 26 states had a rate of 90 percent or higher, meaning those health systems are failing or at risk.

The seven-day average of new cases and deaths is higher than ever.

According to an analysis by CNN, about a quarter of all coronavirus deaths worldwide have been reported in Brazil over the past ten days.

These are clear signs that we are in a very critical acceleration phase of the epidemic, and this is unprecedented, said Jesem Orellana, a Brazilian epidemiologist.

If vaccines are the ultimate solution to this global pandemic, Brazil has a long way to go.

As of Friday, fewer than 10 million people nationwide had received at least one dose, out of an estimated 220 million, according to federal health data. Only 1.57% of the population was fully vaccinated.

This is due to a slow roll-out of the programme, which has been delayed. When the distribution plan was announced in early February, the government promised to provide about 46 million doses of vaccine by March. This figure has had to be revised downwards several times and is now estimated at only 26 million at the end of the month.

Nationally, work is underway to produce what governments believe will eventually be hundreds of millions of doses of the Oxford-AstraZeneca vaccine that has just been released. The first 500,000 doses were delivered this week in Rio de Janeiro and celebrated by senior health ministry officials, despite a delay of several months in the planned schedule.

Natalia Pasternak, a Brazilian microbiologist, said there won’t be enough vaccines to really tackle the epidemic until the second half of the year.

If vaccines remain scarce in the near future, the only means left to control the exponential growth of the epidemic in Brazil are the methods the world has already heard ad nauseam: social distance, no large crowds, limited exercise and good hygiene.

But in many places in Brazil this is not the case. In the hustle and bustle of Rio de Janeiro, it’s easy to find crowds of people walking the streets without masks and talking to each other.

Although the city’s famous beaches are closed this weekend, restaurants and bars may be open until 9 p.m., and many will likely be full.

Many states have imposed much tighter restrictions, including nighttime curfews, but local leaders are troubled by the willingness, or lack thereof, of federal authorities to control the situation.

President Jair Bolsonaro, a 19-year-old skeptic who has ridiculed the efficacy of vaccines and not publicly accepted them, announced Thursday that he will take some states to the country’s Supreme Court, arguing that he is the only one who can impose a curfew, something he has promised never to do.

Despite the fact that thousands of people are dying from the virus every day, he says the real threat is that the restrictions imposed by the virus could cause economic damage.

Millions of his followers follow his example, openly defying the local rules of social distance and wearing masks.

All of this would be disturbing enough on its own, but there is another very disturbing reality: the proliferation of Covid 19 variants.

People don’t realize how much worse it is P.1.

The R.1 variant was discovered in Japan. Health authorities have detected a virus mutation in many travelers returning from the state of Amazonas, a remote area of northern Brazil full of tropical forests.

In late January, CNN reported on the region where a second brutal wave of Covid-19 devastated the city of Manaus.

Almost two months later, a growing body of research suggests that P.1 is the critical factor facing Brazil today, not only during the outbreak in Manaus but also during a national crisis.

A study conducted by Fiocruz, Brazil’s main medical research foundation, since early March, has found that Covid 19 variants, including P.1, occurred in at least 50% of new cases in the eight Brazilian states studied.

This option is generally more easily tolerated, up to 2.2 times, according to a recent study. According to a December study, this variant is more transmissible than the much-discussed B.1.1.7 variant, which was first identified in Britain and is up to 1.7 times more transmissible.

The same study also showed that the probability of overcoming existing protective immunity from previous non-P.1 infections was 25% to 65% higher.

Finally, there are still concerns that other vaccines may not be as effective as the P.1 variant.

Although a recent study in the United Kingdom has shown that existing vaccines can protect against the Brazilian variant of the coronavirus, CNN spoke with several epidemiologists who remain concerned.

The world has not yet woken up to the terrible potential reality that option P1 could represent, epidemiologist Dr. Eric Feigl-Ding said. People don’t realize how much worse P1 is.

Brazil is becoming a global threat

In the context of the unprotected spread of viruses in Brazil, there are two additional and distinct threats.

First, it is easier to export the existing version of P.1 abroad. They already exist in at least two dozen countries, and the number is growing. International travel to and from Brazil is still possible for most countries.

Second: If the P.1 option was created here, there may be others.

An out-of-control pandemic in Brazil caused the variant, said Pasternak, a Brazilian microbiologist. And that will lead to more options. This leads to more mutations, because that’s what happens when the virus gets a chance to multiply freely.

According to the laws of viral evolution, new variants appear that allow the virus to spread more easily. More dangerous iterations can be created along the way.

More options means there is a greater chance that one of those options will avoid all vaccinations, Pasternak said. It’s rare, but it can happen.

He said this makes Brazil a global threat not only to its neighbors but also to other countries around the world.

All of this should raise global alarms: we need to help Brazil contain the P1 virus so that we don’t all suffer the collapse of Brazil’s hospital system, Dr Feigl-Ding said.

Given the lack of vaccines and the unwillingness of the government to take the necessary measures to prevent this, it is difficult to see how Brazil will improve in the short term.

Journalist Eduardo Duve contributed to this report.

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