Brazil's worsening COVID Epi-Curve - Credit FIOCRUZ
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As we've been following now for two months, the second pandemic wave in Brazil continues to worsen as the P.1 variant runs rife through what was assumed to have been a largely immune population (see The Lancet: Resurgence of COVID-19 in Manaus, Brazil, Despite High Seroprevalence).
A combination of increased transmissibility, along with an apparent high re-infection rate, have raised serious concerns over its international spread.
Two weeks ago, in FIOCRUZ Special Bulletin: Brazil's Worsening Pandemic Situation, we looked at a warning issued by Fundação Oswaldo Cruz - one of the most prestigious scientific research institutes in South America - on the deteriorating situation across Brazil.
Yesterday, FIOCRUZ issued a second Boletim Extraordinário, warning of the imminent collapse of the local healthcare delivery system. First, the (translated) press release, then a link and some excerpts from this special bulletin.
Covid-19 Observatory points to the biggest sanitary and hospital collapse in the history of Brazil
3/17/2021
Regina Castro (Fiocruz News Agency)
Faced with the current pandemic scenario, Fiocruz will release, this Tuesday (3/16), another edition of the Covid-19 Fiocruz Observatory Extraordinary Bulletin . The analysis draws attention to the indicators that point to an extremely critical situation across the country. In the view of the researchers who carry it out, this is the biggest sanitary and hospital collapse in the history of Brazil.
The Bulletin shows that, at the moment, of the 27 federative units, 24 states and the Federal District have occupancy rates for ICU Covid-19 beds for adults in the Unified Health System (SUS) equal to or greater than 80%, 15 of which with rates equal to or greater than 90%. In relation to capital cities, 25 of the 27 have these rates equal to or higher than 80%, 19 of which are higher than 90%.
The data are from the state health departments and the Federal District, and the health departments of the capitals. The new information obtained was added to the historical series already presented by the Bulletin . The mapping brings data obtained since July 17, 2020.
In order to prevent the number of cases and deaths from spreading further across the country, as well as to reduce bed occupancy rates, the researchers advocate the strict adoption of prevention and control actions, such as stricter measures for restricting non-essential activities. They also emphasize the need to expand measures of physical and social distance, the use of masks on a large scale and the acceleration of vaccination.
The municipality of Araraquara, in São Paulo, is presented in the Bulletin as one of the current examples of how measures to restrict non-essential activities prevent the collapse or prolongation of the critical situation in health services and systems. With the measures adopted by the municipality, Araraquara managed to reduce the transmission of cases and deaths, protecting the life and health of the population.
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EXTRAORDINARY BULLETIN
A pandemic involves an infectious disease that affects populations in many countries, in different regions, although in different ways, as in the case of Covid-19. If these countries are not prepared to control its dissemination, its effects may result in a serious interruption in the functioning of a company and exceed your responsiveness using resources own, so that a pandemic can be understood like a disaster.However, when the responsiveness, as the actions developed by the services and systems of health, presents himself in an extremely critical situation or even collapsing, as seen in almost every country, being unable to meet the needs of all patients serious and leading health workers to situations of exhaustion, we are close to or facing a catastrophe.
Currently there are 24 states and the Federal District, among the 27 federative units, with rates equal to or greater than 80%, with 19 of them exceeding 90%. The situation is absolutely critical. As in previous bulletins, we draw attention to the fact that the situation of the Covid-19 pandemic is very serious. One set of indicators, including the moving averages of cases and deaths and occupancy rates of Covid-19 ICU beds for adults, point to an extremely critical situation or even collapse, across the country.As a matter of urgency, it is essential expand and intensify a set of non-pharmacological measures, with measures to suppress or block transmission and use protection masks as the main control measure and reduction in the number of cases by Covid-19, seeking to reverse or avoid collapses in the health system, to drastically reduce the levels of transmission and cases and, consequently, the number of preventable deaths.This set of actions is necessary in a coordinated manner and with monitoring of epidemiological panorama in the states, until vaccination is intensified and broad vaccination coverage is achieved. It is also important to effectively communicate the risks of transmission, necessary care and the justification for the measures.
While we are seeing genuine signs of progress in the United States (and many other countries) in this ongoing pandemic, the news is not universally positive. Europe is backsliding, and Brazil appears to be teetering on the brink of disaster.
New variants, like P.1, B.1.1.7 and B.1.351, have the potential to stall, or even reverse, recent positive trends.
While Brazil's experience is not necessarily a harbinger of what is to come with this pandemic for the rest of the world, it is a cautionary tale that needs to be taken seriously if that outcome is to be avoided.
