Opinion | Why Are So Many Children in Brazil Dying From Covid-19?

By Peter J. Hotez and Albert I. Ko

Dr. Hotez is a professor of pediatrics and molecular virology and microbiology as well as the dean of the National School of Tropical Medicine at Baylor College of Medicine. Dr. Ko is a professor of epidemiology and medicine as well as the chair of the department of epidemiology of microbial diseases at the Yale School of Public Health.

In the modern history of catastrophic infectious diseases in Brazil, children often suffer the most in terms of deaths and disability. When dengue epidemics emerged in Brazil in 2007 and 2008, children accounted for more than half of the fatalities. When pregnant women became infected with the Zika virus during an epidemic that began in 2015, more than 1,600 newborn Brazilian infants were born with devastating microcephaly birth defects, far more than in any other nation. Respiratory viruses continue to disproportionately affect Brazil’s children, while hookworms and other intestinal parasites stunt childhood growth and development, especially in poor rural areas.

Now Covid-19 is causing severe illness in young Brazilian children at levels not seen in other parts of the world. Research by Dr. Fatima Marinho of Vital Strategies, a nongovernmental organization, has found that more than 2,200 children under the age of 10 have died from Covid-19. While this number represents less than 0.5 percent of Brazil’s 467,000 Covid-19 deaths, more than 900 of the fatalities occurred in children under the age of 5. The United States has recorded nearly 600,000 deaths from Covid-19, but only 113 of those have been of children under the age of 5.

We studied Covid-19 infection rates for adolescents and children in the state of São Paulo, home to more than 20 percent of Brazil’s population. Our analysis found a surge in the numbers of both reported cases and hospitalizations among adolescents and children since the end of 2020. Approximately half of those hospitalizations, more than 900, were among children younger than 5, including many infants.

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