A health worker prepares a shot of Covid-19 vaccine in Brasilia, Brazil. Photo / AP
Children are dying from Covid-19 in Brazil at alarming rates, with actual figures believed to be much higher than the country's official toll.
As the South American nation passed more than 516,000 Covid-related deaths this week, a study has revealed that the number of children believed to have died from the virus could be twice as high as what has been reported.
Brazil's Ministry of Health has reported 1122 coronavirus deaths in children aged under 10 since the pandemic began, but United States-based not-for-profit health group Vital Strategies believes the figure could be closer to 3000 deaths, CNN has reported.
More than 1000 children are believed to have lost their lives to Covid this year alone.
The number of children dying from the virus is 10 times higher than what is being reported in other countries around the world, causing extreme concern among health authorities.
Worryingly, Brazil has recorded a spike in deaths among children from respiratory-related illnesses since the pandemic, compared with figures from these illnesses in 2018 and 2019, with in excess of 2975 deaths believed to be from Covid-related syndrome.
Researchers say the respiratory syndrome, which causes inflammation of the vital organs, is an extreme immune response to Covid and commonly affects babies.
As the country continues to battle the deadly health crisis, experts believe many Brazilian children are going undiagnosed or are arriving at hospital too late, with some doctors reluctant to test for the virus in children.
Surprisingly, the highly contagious Gamma variant, which was first detected in the Amazon, is not believed to be a contributor to the spike in child deaths, with more children dying in Brazil than any other country ever since the original variant emerged.
However, when compared with the country's overall death toll, children are still dying in much smaller numbers than adults - but experts believe that fact could be leading some doctors to avoid diagnosing youngsters with the virus.
"Truthfully, Covid-19 in children was neglected at the beginning of the pandemic," Brazilian paediatrician Dr Andre Laranjeira told CNN.
"A lot of paediatricians had a certain resistance when it came to requesting Covid-19 tests for children, when they were exhibiting those typical respiratory tract symptom – runny nose, cough, fever – practically all children have those symptoms this time of the year, in the autumn, and some doctors were not testing them."
There are also concerns for Brazil's pregnant women, with 42 dying from Covid every week. These figures are predicted to rise to as many as 100 deaths a week due to the highly transmissible Gamma variant.
The sheer number of Covid cases in Brazil has made children more susceptible to the virus overall, while a lack of testing and misdiagnoses are believed to be other major contributors.
"We have a serious problem detecting cases. We don't have enough tests for the general population, even fewer for children. Because there is a delay in the diagnosis, there is a delay in care for the child," Dr Fatima Marinho, who is also a senior adviser to the international health NGO Vital Strategies, told the BBC.
Additionally, the symptoms displayed by children with Covid are often different to those seen in adults, making it easier for doctors to miss.
"A child has a lot more diarrhoea, a lot more abdominal pain, and chest pain, than the classic Covid picture. Because there is a delay in diagnosis, when the child arrives at the hospital they are in a serious condition and can end up complicating – and dying," Marinho said.
Poverty and access to health care are major concerns for Brazil's children, with young people from poor backgrounds at heightened risk of contracting Covid and dying.