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When the history of the Covid-19 pandemic is recounted by future generations, the ordeal of Manaus will be recalled with reverence, grief and horror. Once known as the “Paris of the tropics”, this Amazonian rainforest city has, in the last year, become a sweltering necropolis: not once, but twice.
What happened in Manaus, as portrayed in this compelling photo essay edited by Jon Jones, is a terrible warning to the rest of the world of the power of virus variants. It is a parable of evolutionary spite, and the cunning of the pathogen: its vicious capacity to adapt, morph and return to the battlefield of disease and death, newly-strengthened and ready, once more, to wreak havoc.
With more than 255,000 deaths to date, Brazil is second only to the US in the grim league table of Covid-19 fatalities. Manaus, a city of 2.2 million inhabitants, was especially badly hit in the first wave of the pandemic, the first place in Brazil where mass graves had to be dug and mortuaries could not keep pace with the number of dead bodies arriving at their doors. Grave-diggers were overwhelmed, doctors desperate.
From this carnage arose one slender cause for hope. By October, more than 70 per cent of the surviving population appeared to have developed antibodies, making Manaus enormously interesting to the global scientific community as a mass-population area that might have achieved something approaching herd immunity. Yet this was not the case. The Brazilian variant known as P1 – first isolated in Japan, and now detected in at least six people in the UK – tore into the city in December and smashed through the inhabitants’ apparent resistance to the original virus.
In May 2020, about 80 coronavirus deaths a day were being recorded in Manaus. By January 2021, in the grip of the second wave, the figure was closer to 100. On 6 February it was 140. Dismayed municipal leaders and public health officials pleaded for help with oxygen, basic medical supplies, hospital beds. Patients were being manually ventilated, panicked families driving off to buy oxygen from private suppliers.
Jair Bolsonaro, Brazil’s populist rightwing president, had dismissed the virus from the start as a “little flu” – though he tested positive himself in July – and the federal assistance that Manaus desperately needed was haphazard at best.
Vaccination roll-out – mostly using the Chinese Sinovac jab – only began on 19 January and has been woefully patchy. What happened in Manaus is not going to be replicated in the UK, where the health infrastructure is much stronger, lockdowns have been stricter, vaccine roll-out has been so successful, and levels of immunity against the variants so far isolated remain, to date, encouragingly high (although data on the vaccines’ performance against P1 specifically is still too scant to form a clear judgment).
Instead, the city’s dreadful experience has been an unforeseen test-case with an unhappy outcome: we now know that virus mutations can cause reinfection, at scale. The evolutionary potential of the pathogen has already proven remarkable (in Kentish, South African and now Brazilian variants).
So, too, of course, has the ingenuity of the scientists who, at breakneck speed, developed highly-effective vaccines. Now, the UK is preparing for a phased lockdown relaxation, families are looking forward to reunions and summer holidays, and offices are laying plans for reopening.
Yet, like a skull in a Renaissance painting, the coffins, makeshift graves and bereaved faces of Manaus are a warning against complacency. This nimble enemy is not done with us yet. Matthew d’Ancona, Editor
Photographs by Michael Dantas, Jonne Roriz, Andre Coelho, Marcio James and Ricardo Oliveira: Getty Images/AFP/Bloomberg
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Friday 5 March 2021
For those keen to dig a little deeper and find out more about Covid-19 mutations, herd immunity and the science behind it all…