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Covid-19 Variant in Brazil Overwhelms Local Hospitals, Hits Younger Patients

SÃO PAULO—Researchers and doctors are sounding the alarm over a new, more aggressive coronavirus strain from the Amazon area of Brazil, which they believe is responsible for a recent rise in deaths, as well as infections in younger people, in parts of South America.

Brazil’s daily death toll from the disease rose to its highest level yet this week, pushing the country’s total number of Covid-19 fatalities past a quarter of a million. On Tuesday, Brazil reported a record 1,641 Covid fatalities. Neighbor Peru is struggling to curb a second wave of infections.

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The new variant, known as P.1, is 1.4 to 2.2 times more contagious than versions of the virus previously found in Brazil, and 25% to 61% more capable of reinfecting people who had been infected by an earlier strain, according to a study released Tuesday.

With mass vaccination a long way off across the region, countries such as Brazil risk becoming a breeding ground for potent versions of the virus that could render current Covid-19 vaccines less effective, public-health specialists warned.

A more prolonged pandemic could also devastate the economies of countries such as Brazil, slowing growth and expanding the country’s already large debt pile as the government extends payouts to the poor, economists said.

“We’re facing a dramatic situation here—the health systems of many states in Brazil are already in collapse and others will be in the next few days,” said Eliseu Waldman, an epidemiologist at the University of São Paulo.

Healthcare workers checked arrivals at a field hospital in Manaus, Brazil, on Feb. 11.



Photo:

raphael alves/EPA-EFE/Shutterstock

Several doctors have reported a surge in younger patients in their Covid-19 wards, many in their 30s and 40s with no underlying health problems. In Peru, some doctors said patients are becoming seriously ill faster, just three or four days after the first symptoms emerged, compared with an average of nine to 14 days last year.

“The virus is behaving differently,” said Rosa Lopez, a doctor in the intensive-care unit at Lima’s Guillermo Almenara Irigoyen Hospital. “It’s really aggressive…the situation is very difficult, really terrible.”

The Amazonian strain, P.1, emerged in the Brazilian city of Manaus late last year and quickly caught the attention of Brazilian and international scientists who raced to map its spread. The variant’s large number of mutations to the spike protein, which helps the virus penetrate cells, have caused particular concern.

“We’re in the worst moment. I wouldn’t be surprised if P.1 is all over Brazil by now,” said Felipe Naveca, a researcher at the Oswaldo Cruz Foundation who has studied the new strain. He estimated that Brazil is already home to hundreds of new Covid-19 variants, although P.1. is the most worrying so far, he said.

However, researchers are still at a loss as to why more young people appear to be falling ill and if P.1 is more deadly, or just more contagious.

“The recent epidemic in Manaus has strained the city’s healthcare system, leading to inadequate access to medical care,” wrote the authors of the P.1 study, which was led by Nuno Faria, a professor of virus evolution at Oxford University and Imperial College London.

People waited to refill empty oxygen cylinders on the southern outskirts of Lima, Peru, on Feb. 25.



Photo:

ernesto benavides/Agence France-Presse/Getty Images

“We therefore cannot determine whether the estimated increase in relative mortality risk is due to P.1 infection, stresses on the Manaus healthcare system, or both,” they wrote.

A study led by Mr. Naveca released last week showed that in some cases the P.1 strain carried a viral load about 10 times higher than the initial versions of the virus that were circulating in Brazil for most of the pandemic. But the group of international scientists led by Mr. Faria concluded that it wasn’t possible to determine whether P.1 infection is associated with increased viral loads until detailed clinical investigations are conducted.

Researchers in South Africa struggled with the same questions when studying another new variant, B.1.351. Doctors there also reported a rise in hospitalizations and deaths of younger patients, but researchers concluded that more younger people were getting seriously ill because more people were being infected overall. The likelihood of younger people dying increased, they said, because hospitals were overwhelmed, not because the variant itself was more deadly.

Another possible explanation for the rise in younger patients is that the virus has already moved its way through many older hosts who passed away, said Francisco Cardoso, an infectious-disease specialist at the Emílio Ribas hospital in São Paulo.

Latin America has been one of the world’s Covid-19 hot spots since the pandemic began, but in recent days doctors in Brazil have grown ever more desperate, describing scenes of horror across the country. While the new strain is largely to blame, so too is a lack of preparation and prevention by the region’s governments, said public-health specialists.

Hospitals are operating at ICU occupancy rates above 80% in almost two-thirds of Brazilian states. After scores of patients suffocated to death in Manaus earlier this year when hospitals ran out of oxygen, prosecutors are investigating reports from another Amazonian city that intubated patients were tied to their beds following a shortage of sedatives.

In Peru, where the government has detected the P.1 strain, hospitals were quickly pushed beyond capacity as infections surged in January after one of the world’s worst outbreaks last year. Doctors are now choosing among dozens of patients when an ICU bed opens up, while Chile is donating lifesaving oxygen amid acute shortages.

The scenes come as the U.S., the U.K. and Israel celebrate falling rates of infection amid mass vaccination campaigns, evidence of a widening immunity gap between rich and poorer nations. While more than 15% of people in the U.S. have received a Covid-19 shot, Brazil has administered vaccines to only 3% of its population. Peru and Colombia have vaccinated less than 1%.

If Latin America doesn’t find a way to speed up its vaccination campaigns, other countries such as Colombia and Bolivia that have seen recent slowdowns in new infections could also fall victim to the new variant, infectious-disease specialists said.

The longer the disease is left to fester in countries such as Brazil, the greater the chance that new variants will emerge that reduce the effectiveness of Covid-19 vaccines, thereby also posing a threat to nations that have already immunized their populations.

“Unless everyone in the world gets the vaccine soon, none of us will be protected,” said Patricia Garcia, a former Peruvian health minister and epidemiologist. “It will never stop.”

Cesar Palacios, a 44-year-old pediatrician in Peru’s northern city of Piura, lost his parents and younger sister to the disease earlier this year. He spent 10 days on a ventilator after getting sick himself, the illness advancing quickly as his blood-oxygen levels fell into dangerous territory, at 86% just a day after his first symptom. A few days later he was in an ICU.

“When you are going to be put on a mechanical ventilator, you think, am I going to live? Am I going to die?” said Dr. Palacios. “I had no other option. I was so scared.”

While Peru has imposed a nighttime curfew in Lima and other states with high infections, Brazilian cities such as São Paulo and the capital, Brasília, have introduced tougher restrictions over recent days.

But many Brazilians have defied the rules, taking a cue from the country’s president. Right-wing leader Jair Bolsonaro has played down the disease and attacked state governors for imposing lockdowns, accusing them of destroying local businesses.

Military police in São Paulo raided about 50 establishments over the weekend that refused to comply, including a group of 190 elderly Brazilians holding a clandestine party.

As highly transmissible coronavirus variants sweep across the world, scientists are racing to understand why these new versions of the virus are spreading faster, and what this could mean for vaccine efforts. New research says the key may be the spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood/WSJ

Write to Samantha Pearson at samantha.pearson@wsj.com and Ryan Dube at ryan.dube@dowjones.com

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Dominion Sues MyPillow, CEO Mike Lindell Over Election Claims

WASHINGTON—One of the largest makers of voting machines in the U.S. on Monday sued a prominent supporter of former President Donald Trump, alleging that the businessman had defamed the company with false accusations that it had rigged the 2020 election for Joe Biden.

Dominion Voting Systems sued Mike Lindell, chief executive of Minnesota-based MyPillow Inc., and his company in the U.S. District Court for the District of Columbia, seeking more than $1.3 billion in damages.

In its complaint, the company cites a number of statements made by Mr. Lindell, including in media appearances, social-media posts, and a two-hour film claiming to prove widespread election fraud. Mr. Lindell said he helped produce the film, which he released online in early February.

The complaint alleges that Mr. Lindell made false claims about the integrity of Dominion’s voting machines and that he knew no credible evidence supported his claims that the company had stolen the election from Mr. Trump—what Dominion has called the “Big Lie.”

“He is well aware of the independent audits and paper ballot recounts conclusively disproving the Big Lie,” the complaint states. “But Lindell…sells the lie to this day because the lie sells pillows.”

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Hacker Claims to Have Stolen Files Belonging to Prominent Law Firm Jones Day

A hacker claims to have stolen files belonging to the global law firm Jones Day and posted many of them on the dark web.

Jones Day has many prominent clients, including former President Donald Trump and major corporations.

Jones Day, in a statement, disputed that its network has been breached. The statement said that a file-sharing company that it has used was recently compromised and had information taken. Jones Day said it continues to investigate the breach and will continue to be in discussion with affected clients and appropriate authorities.

The posting by a person who self-identified as the hacker, which goes by the name Clop, includes a few individual documents that are easily reviewed by the public, including by The Wall Street Journal. One memo is to a judge and is marked “confidential mediation brief,” another is a cover letter for enclosed “confidential documents.” The Journal couldn’t immediately confirm their authenticity.

The Journal was able to see the existence of many more files—mammoth in size—also purported to belong to Jones Day, posted by the hacker on the so-called dark web. Hackers typically post such stolen information after the hacked entity fails to pay a ransom. The Journal was able to contact the hacker using an email on its blog.

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Tencent Executive Held by China Over Links to Corruption Case

An executive at Tencent Holdings Ltd. , China’s most valuable publicly listed company, has been held by Chinese authorities, part of a probe into a high-profile corruption case involving one of the country’s former top law-enforcement officials, people familiar with the matter said.

Zhang Feng has been under investigation by China’s antigraft inspector since early last year for alleged unauthorized sharing of personal data collected by Tencent’s social-media app WeChat, the people said. They said Mr. Zhang was suspected of turning over WeChat data to former Vice Public Security Minister Sun Lijun, who is being investigated by Beijing for undisclosed violations of Communist Party rules.

Investigators are looking at what type of data Mr. Zhang allegedly might have shared with Mr. Sun and what Mr. Sun might have done with it, the people said.

Hong Kong-listed Tencent, which has a market capitalization of about $900 billion, confirmed Thursday that Mr. Zhang is under investigation. The case “relates to allegations of personal corruption and has no relation to WeChat or Weixin,” a spokesman said in a statement to The Wall Street Journal. Weixin is WeChat’s sister app for the Chinese market.

Mr. Zhang was referred to as a Tencent vice president in a statement released by the municipal government of Zhangjiakou, a city near Beijing, in which he was described as having met the city’s mayor in October 2018.

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McKinsey Agrees to $573 Million Settlement Over Opioid Advice

Consulting giant McKinsey & Co. has reached a $573 million settlement with states over its work advising OxyContin maker Purdue Pharma LP and other drug manufacturers to aggressively market opioid painkillers, according to people familiar with the matter.

The deal, reached with 47 states and the District of Columbia and expected to be publicly announced Thursday, would avert civil lawsuits that attorneys general could bring against McKinsey, the people said. The majority of the money will be paid upfront, with the rest dispensed in four yearly payments starting in 2022.

McKinsey said last week it is cooperating with government agencies on matters related to its past work with opioid manufacturers, as state and local governments sue companies up and down the opioid supply chain. At least 400,000 people have died in the U.S. from overdoses of legal and illegal opioids since 1999, according to federal data.

The consulting firm stopped doing opioid-related work in 2019 and said in December its work for Purdue was intended to support the legal use of opioids and help patients with legitimate medical needs.

While some companies have reached deals with individual states to avoid trials, the McKinsey settlement marks the first nationwide opioid pact to come from the flood of litigation that began in 2017. A much larger, $26 billion deal with three drug distributors and Johnson & Johnson has been in the works for more than a year but is still being negotiated.

The Wall Street Journal reported last week that McKinsey was close to a settlement with states and that a deal could be worth hundreds of millions of dollars. The negotiations occurred as hundreds of exhibits describing McKinsey’s work to boost OxyContin sales were made public in recent months during Purdue’s chapter 11 bankruptcy case in White Plains, N.Y.

Memos McKinsey sent Purdue executives in 2013 that have been made public in bankruptcy court filings included recommendations that the company’s sales team target health care providers it knew wrote the highest volumes of OxyContin prescriptions and shift away from lower-volume prescribers. McKinsey’s work became a Purdue initiative called “Evolve to Excellence,” which the U.S. Justice Department described in papers released last year in connection with a plea agreement with Purdue as an aggressive OxyContin marketing and sales campaign.

According to bankruptcy court records, McKinsey sent recommendations to Purdue in 2013 that consultants said would boost its annual sales by more than $100 million. McKinsey recommended ways Purdue could better target what it described as “higher value” prescribers and take other steps to “Turbocharge Purdue’s Sales Engine.”

Stamford, Conn.-based Purdue pleaded guilty in November to three felonies, including paying illegal kickbacks and deceiving drug-enforcement officials. The drugmaker filed for chapter 11 protection in 2019 to address thousands of opioid-related lawsuits brought against it. Purdue said in a lawsuit filed last week against its insurers that creditors have asserted hundreds of thousands of claims in the bankruptcy case and collectively seek trillions of dollars in damages.

McKinsey also advised other opioid makers on sales initiatives. The firm’s work for

Johnson & Johnson

came up in a 2019 trial in a case brought by Oklahoma against the drug company for contributing to the opioid crisis in the state through aggressive marketing of prescription painkillers. The trial ended with a $572 million verdict against Johnson & Johnson, which was later reduced to $465 million and is still on appeal.

The vast majority of the money McKinsey will pay in the settlement will be divided among the participating states, with $15 million going to the National Association of Attorneys General to reimburse it for costs incurred in the investigation, one of the people familiar with the deal said.

The settlement also includes some nonmonetary provisions, like requiring McKinsey to create a repository of documents related to its work for opioid makers, the person said.

The holdout states include Nevada, which said Wednesday night that its investigation into the consulting giant continues “and we are conversing with McKinsey about our concerns.”

Purdue has been negotiating with creditors, which include states, since filing for bankruptcy, but finalizing a deal has been slowed by demands from some states that the company’s owners, members of the Sackler family, contribute more than the $3 billion they have agreed to.

States have been keenly focused on ensuring any settlement money from the opioid litigation goes toward helping alleviate the impact of the crisis, including through beefing up treatment programs and helping overstretched law enforcement. The states are looking to avoid the outcome of the 1990s tobacco litigation, when a $206 billion settlement was often spent to fill state budget holes. The McKinsey settlement documents say the money is intended for abatement, the person familiar with the deal said, though state laws differ widely on how settlement funds can be earmarked.

Write to Sara Randazzo at sara.randazzo@wsj.com and Jonathan Randles at Jonathan.Randles@wsj.com

Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8

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Apollo CEO Leon Black to Step Down Following Review of Jeffrey Epstein Ties

Leon Black plans to step down as chief executive of Apollo Global Management Inc. after an independent review revealed larger-than-expected payments to disgraced financier Jeffrey Epstein that it nevertheless deemed justified.

The monthslong review by Dechert LLP found no evidence that Mr. Black was involved in the criminal activities of the late Epstein, who was indicted in 2019 on federal sex-trafficking charges involving underage girls, according to a copy of the law firm’s report that was viewed by The Wall Street Journal.

In its report, Dechert found the fees that the billionaire had paid Epstein were for legitimate advice on trust- and estate-tax planning that proved to be of significant value to Mr. Black and his family. Mr. Black paid Epstein a total of $148 million, plus a $10 million donation to his charity—far more than was previously known.

Mr. Black wrote in a letter to Apollo’s fund investors that he would cede the role of CEO to co-founder Marc Rowan on or before his 70th birthday on July 31 while retaining the role of chairman. In the letter, a copy of which was viewed by the Journal, Mr. Black detailed other governance changes he is recommending to the board, including the appointment of more independent directors and the elimination of Apollo’s dual-class share structure.

Mr. Black also pledged to donate $200 million of his family’s money to women’s initiatives.

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