Sunday, May 30, 2021

Brazil FIOCRUZ: InfoGripe Bulletin Points to Increase in Cases of SRAG & Covid-19 in Brazil

 

Credit https://qsprod.saude.gov.br/

#15,989

Because short-term fluctuations in daily COVID case counts can be misleading, most countries report either a 7-day or 14-day moving average, in order to smooth out the data and better identify trends.  Brazil reached its peak in new cases in the last week of March, with a 14-day moving average (see graphic below) of just over 75K. 


By the end of April the trend has reversed and the average number of cases had dropped by roughly 20% to just under 60 thousand. We looked at this trend on April 30th in Brazil FIOCRUZ Bulletin: Cases Slowly Dropping But Case Fatality Rate Has Risen.

Fast forward another month, however, and we see cases rising again in Brazil to over 65K, albeit not yet at the heights seen in March. 


This recent increase now has public health officials warning of a possible resurgence of COVID - perhaps even the beginning of a `3rd wave' - in Brazil over the summer. 

I've posted the (translated) update from FIOCRUZ (Fundação Oswaldo Cruz). The full (16-page) report (in Portuguese) is available at this LINK. 

Note: SRAG ( Síndrome Respiratória Aguda Grave) is the Portuguese acronym for SARS.  I'll have a brief postscript after the break.


InfoGripe Bulletin points to increase in cases of SRAG and Covid-19 in Brazil
05/28/2021
By: Regina Castro (CCS / Fiocruz)
 
The InfoGripe Bulletin warns of a growing trend in cases of Severe Acute Respiratory Syndrome (SARS) in most states, Brazilian capitals and the Federal District. The analysis refers to Epidemiological Week (SE) 20, from 16 to 22 May. About 96% of cases of SARS with positive laboratory results are due to the new coronavirus. The document also points out that both the signs of stabilization and the resumption of case growth are occurring at high levels, similar to the peaks recorded throughout 2020. 

“The data presented must be used in combination with the other relevant indicators, such as the bed occupancy rate of the respective health regions, for example. The study indicates that the current scenario is associated with the resumption of activities at an early stage. This situation will maintain the number of hospitalizations and deaths at high levels, with a tendency to worsen in the coming weeks ”, said researcher Marcelo Gomes, coordinator of InfoGripe.

“Amazonas, Mato Grosso do Sul and Rio Grande do Sul show a strong sign (prob.> 95%) of growth in the long-term trend up to SE 20. Alagoas, Federal District, Goiás, Maranhão, Mato Grosso, Paraíba, Pernambuco, Paraná, Santa Catarina, São Paulo and Tocantins show a moderate sign (prob.> 75%) of growth in the long-term trend ”, noted researcher Marcelo Gomes, coordinator of InfoGripe.

Fall interruption

In the other states, there was a sign of interruption in the downward trend - such as Acre, Espírito Santo, Minas Gerais, Rio de Janeiro, Rio Grande do Norte and Rondônia. Ceará, on the other hand, has been showing signs of stabilization. The Bulletin warns that, since the update of SE 14, several of these states are still with values ​​similar or even higher than the peaks observed throughout 2020.

Gomes points out that such estimates reinforce the importance of caution in relation to the flexibility of the distance measures to reduce the transmission of Covid-19. These actions should be taken even when the downward trend has stabilized long enough for the number of new cases to reach significantly low values. "The interruption of the fall at high levels and the resumption of the growth of cases can be attributed in part to the resumption of circulation of the population and, consequently, the greater exposure due to the relaxation measures", warns Marcelo.

Capitals and Federal District

Eleven of the 27 capitals show signs of growth until SE 20. They are Campo Grande (MS), Cuiabá (MT), Curitiba (PR), Goiânia (GO), João Pessoa (PB), Maceió (AL), Manaus (AM) ), Palmas (TO), Porto Alegre (RS), Salvador (BA), São Paulo (SP). Fortaleza (CE) and Vitória (ES). Only four capitals show signs of falling - Aracaju (SE), Boa Vista (RR), Macapá (AP) and Teresina (PI).

In Curitiba, Palmas and Porto Alegre, there is a strong sign of growth in the long-term trend. In Campo Grande, Cuiabá, Goiânia, João Pessoa, Maceió, Manaus, Salvador and São Paulo, there is a moderate sign of growth in the long-term trend up to SE 20. In Fortaleza and Vitória, a moderate sign of growth was observed only in the short-term trend until the same period.

As well as alerting for some states, it was observed that 10 capitals show signs of stabilization, indicating an interruption of the tendency for the plateau to fall or maintain: Belém (PA), Belo Horizonte (MG), Florianópolis (SC), Natal (RN), Porto Velho (RO), Recife (PE), pilot plan of Brasília and surroundings (DF), Rio Branco (AC), Rio de Janeiro (RJ) and São Luís (MA).

Deaths due to SRAG in the country

Deaths reported from Severe Acute Respiratory Syndrome (SARS) in Brazil, regardless of the presence of fever, remain in the risk zone, with very high deaths. The scenario is the same in the regions of the country: all (North, Northeast, Midwest, Southeast and South) are in the risk zone with a very high number of deaths.



Brazil continues to be one of the world's most concerning COVID hotspots, not only because cases are rising again, but because we are also seeing a shifting of the burden of the pandemic to a younger demographic (see Brazil FIOCRUZ: Median Age For COVID Hospitalization Drops Below 60 For the 1st Time) and a high rate of reinfections reported with the P.1. variant.

From the BMJ earlier this week:


(Published 25 May 2021) Cite this as: BMJ 2021;373:n1353

Even though the United States is going into this Memorial Day weekend with the lowest average number of daily cases in nearly a year, our ability to keep the pandemic in retreat depends in large measure on what changes occur in the virus in places like Brazil, India, Vietnam, and even China.

While there is light at the end of the tunnel, SARS-CoV-2 may yet have a few more surprises in store.