April is shaping up to be Brazil’s darkest month yet in the pandemic, with hospitals struggling with a crush of patients, deaths on track for record highs and few signs of a reprieve from a troubled vaccination programme in Latin America’s largest nation, AP reports.

The health ministry has cut its outlook for vaccine supplies in April three times already, to half their initial level, and the country’s two biggest laboratories are facing supply constraints.

The delays also mean tens of thousands more deaths as the particularly contagious P1 variant of Covid-19 sweeps Brazil. It has recorded about 350,000 of the 2.9 million virus deaths worldwide, behind only the US toll of over 560,000.

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China’s top disease control official has said the country is formally considering mixing Covid-19 vaccines, as a way of further boosting vaccine efficacy, Reuters reports.

The currently available vaccines “don’t have very high rates of protection”, Gao Fu, the director of the Chinese Centres for Disease Control and Prevention, told a conference in the Chinese city of Chengdu on Saturday. “Inoculation using vaccines of different technical lines is being considered.”

Gao said that taking steps to “optimise” the vaccine process including changing the number of doses and the length of time between doses was a “definite” solution to the efficacy issues.

“How to improve the protection rate of vaccines is a problem that requires global scientists to consider,” Gao said, adding that mixing vaccines and adjusting immunisation methods were solutions that he had proposed.

Canada is shifting its vaccination campaign to target frontline workers, moving away from a largely age-based rollout as the country tries to get a handle on the raging third wave of the pandemic, Reuters reports.

Targeting frontline workers and addressing occupation risk is vital if Canada wants to get its third wave under control, says Simon Fraser University mathematician and epidemiologist Caroline Colijn, who has modelled Canadian immunisation strategies and found “the sooner you put essential workers [in the vaccine rollout plan], the better.”

“If you protect these individuals you also protect someone in their 60s whose only risk is when they go to the store. [...] The variants are here now. So if we pivot now, but it takes us two months to do it, then we will lose that race.”

The Netherlands has reported 8,218 new coronavirus cases over the past 24 hours, the highest daily increase in more than two weeks, according to data released by Dutch health authorities.

Reuters reports that the rise comes as the Dutch government discusses a possible easing of restrictions, including lifting a night-time curfew, despite concerns among doctors and scientists that infection rates remain too high.

Sindh has reported 376 new cases of the coronavirus and one death in the last 24 hours, according to an update from Chief Minister Murad Ali Shah’s office.

This has taken the provincial caseload to 269,126 and the death toll to 4,530.

As per the update, 154 more people recovered from the virus in Sindh, where 9404 tests were conducted.

The coronavirus variant discovered in South Africa can “break through” Pfizer/BioNTech’s Covid-19 vaccine to some extent, a real-world data study in Israel found, though its prevalence in the country is low and the research has not been peer reviewed.

The South African variant, B-1-351, was found to make up about one per cent of all the Covid-19 cases across all the people studied, according to the study by Tel Aviv University and Israel’s largest healthcare provider, Clalit.

But among patients who had received two doses of the vaccine, the variant’s prevalence rate was eight times higher than those unvaccinated — 5.4pc versus 0.7pc.

This suggests the vaccine is less effective against the South African variant, compared with the original coronavirus and a variant first identified in Britain that has come to comprise nearly all Covid-19 cases in Israel, the researchers said.

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Iran's health ministry has reported 258 deaths from Covid-19 in the past 24 hours, the highest daily toll since early December.

Reuters reports that health ministry spokeswoman Sima Sadat Lari told state TV that 21,063 new cases were identified in the past 24 hours, taking the total number of identified cases since the pandemic began to 2,070,141.

“Unfortunately, in the past 24 hours, 258 people have died from the virus,” Lari said. Iran’s Health Minister Saeed Namaki, in a televised news conference, warned about more fatalities in the coming week if Iranians failed to adhere to health protocols.

A spokesman for President Rodrigo Duterte has said that strict Covid-19 lockdowns in the Philippines capital and four adjacent provinces will be eased from April 12, Reuters reports.

Metro Manila and the provinces of Bulacan, Rizal, Laguna and Cavite will be placed under a less restrictive community quarantine status until April 30, spokesman Harry Roque told a virtual briefing.

Roque gave the briefing from a hospital where he is being treated for Covid-19. He gave no details on which restrictions would be eased but said details would be released on Monday.