Development of an Index to Assess COVID-19 Hospital Care Installed Capacity in the 450 Brazilian Health Regions.

OBJECTIVE: The article seeks to assess the Brazilian health system ability to respond to the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic by measuring the capacity of Brazilian hospitals to care for COVID-19 cases in the 450 Health Regions of the country during the year 2020. Hospital capacity refers to the availability of hospital beds, equipment, and human resources. METHODS: We used longitudinal data from the National Register of Health Facilities (CNES) regarding the availability of resources necessary to care for patients with COVID-19 in inpatient facilities (public or private) from January to December 2020. Among the assessed resources are health professionals (certified nursing assistants, nurses, physical therapists, and doctors), hospital beds (clinical, intermediate care, and intensive care units), and medical equipment (computed tomography scanners, defibrillators, electrocardiograph monitors, ventilators, and resuscitators). In addition to conducting a descriptive analysis of absolute and relative data (per 10,000 users), a synthetic indicator named Installed Capacity Index (ICI) was calculated using the multivariate principal component analysis technique to assess hospital capacity. The indicator was further stratified into value ranges to understand its evolution. RESULTS: There was an increase in all selected indicators between January and December 2020. It was possible to observe differences between the Northeast and North regions and the other regions of the country; most Health Regions presented low ICI. The ICI increased between the beginning and the end of 2020, but this evolution differed among Health Regions. The average increase in the ICI was more evident in the groups that already had considerably high baseline capacity in January 2020. CONCLUSIONS: It was possible to identify inequalities in the hospital capacity to care for patients affected by COVID -19 in the Health Regions of Brazil, with a concentration of low index values in the Northeast and North of the country. As the indicator increased throughout the year 2020, inequalities were also observed. The information here provided may be used by health authorities, providers, and managers in planning and adjusting for future COVID-19 care and in dimensioning the adequate supply of hospital beds, health-care professionals, and devices in Health Regions to reduce associated morbidity and mortality. We recommend that the ICI continue to be calculated in the coming months of the pandemic to monitor the capacity in the country's Health Regions.

Covid-19: temporal evolution and immunization in the three epidemiological waves, Brazil, 2020-2022.

OBJECTIVE: Describe the temporal evolution of morbimortality due to Covid-19 and vaccination coverage during the health emergency in Brazil. METHODS: Number of cases and deaths due to Covid-19 were extracted from the public panel of the Brazilian Ministry of Health, according to epidemiological week (EW) and geographic region. Data on vaccines and variants were obtained, respectively, from the Information System of the National Immunization Program and the Genomic Surveillance System of SARS-CoV-2. RESULTS: Three peaks of deaths characterized the evolution of the Covid-19 pandemic: in EW 30 of 2020, in the EW 14 of 2021 and in the EW six of 2022; three case waves, starting in the North and Northeast regions, with higher rates in the third wave, mainly in the South region. Vaccination started in the epidemiological week three of 2021, rapidly reaching most of the population, particularly in the Southeast and South regions, coinciding with a reduction exclusively in the mortality rate in the third wave. Only from the beginning of the second wave, when Gama was the dominant variant, 146,718 genomes were sequenced. From the last EW of 2021, with vaccination coverage already approaching 70%, the Omicron variant caused an avalanche of cases, but with fewer deaths. CONCLUSIONS: We noticed the presence of three waves of Covid-19, as well as the effect of immunization on the reduction of mortality in the second and third waves, attributed to the Delta and Omicron variants, respectively. However, the reduction of morbidity, which peaked in the third wave during the domination of the Omicron variant, remained the same. The national and centralized command of the pandemic confrontation did not occur; thus, public administrators took the lead in their territories. The overwhelming effect of the pandemic could have been minimized, if there had been a coordinated participation of three spheres of the Brazilian Unified Health System administration, in the joint governance of the pandemic fight.

Scientific ways to confront covid-19 fake news / Os caminhos da ciência para enfrentar fake news sobre covid-19

Resumo Paralelamente à pandemia de covid-19, a Organização Mundial da Saúde alerta para uma infodemia de fake news relacionadas à doença. Objetiva-se, neste trabalho, conhecer a dimensão do fenômeno e alguns caminhos já identificados pela ciência para enfrentá-lo. Trata-se de uma revisão integrativa da literatura, realizada nas bases Scopus/Elsevier e Medline/PubMed, que incluiu 23 artigos. Por meio de análise da literatura, identificou-se que fake news oferecem falso suporte social e mobilizam sentimentos capazes de torná-las mais aceitáveis do que notícias verdadeiras. Dessa forma, as redes sociais e a internet despontam como plataformas disseminadoras de informações falsas. As pesquisas sugerem que instituições governamentais e midiáticas podem utilizar os canais de comunicação como aliados, com tecnologias de monitoramento e infovigilância para alertar, esclarecer e remover conteúdo enganoso. Também deve haver investimentos em ações de alfabetização científica e digital, de forma que as pessoas tenham condições de avaliar a qualidade das informações recebidas. Propõe-se a adoção de estratégias criativas, que despertem a capacidade de raciocínio, aliadas a informações científicas traduzidas em linguagem acessível, de preferência com aprovação de autoridades sanitárias e institucionais.

Abstract Parallel to the covid-19 pandemic, the World Health Organization warns of an infodemic of fake news related to the disease. This integrative review investigates the dimension of this phenomenon and how science found ways to confront it. A bibliographic search was conducted on the Scopus/Elsevier and Medline/PubMed databases, retrieving 23 articles. Literature analysis found that fake news provide false social support and mobilize feelings which make them more acceptable than the truth. Hence, social media and the internet emerge as platforms to spread false information. Research suggests that government and media institutions can use communication channels and monitoring and infoveillance technologies as allies to alert, elucidate, and remove misleading content. We find the need of investments in scientific and digital literacy actions so people may assess the quality of the information they receive. Finally, this study proposes the adoption of creative strategies to foster reasoning skills together with scientific information translated into an accessible language, preferably approved by health and institutional authorities.

Covid-19: temporal evolution and immunization in the three epidemiological waves, Brazil, 2020-2022.

OBJECTIVE: Describe the temporal evolution of morbimortality due to Covid-19 and vaccination coverage during the health emergency in Brazil. METHODS: Number of cases and deaths due to Covid-19 were extracted from the public panel of the Brazilian Ministry of Health, according to epidemiological week (EW) and geographic region. Data on vaccines and variants were obtained, respectively, from the Information System of the National Immunization Program and the Genomic Surveillance System of SARS-CoV-2. RESULTS: Three peaks of deaths characterized the evolution of the Covid-19 pandemic: in EW 30 of 2020, in the EW 14 of 2021 and in the EW six of 2022; three case waves, starting in the North and Northeast regions, with higher rates in the third wave, mainly in the South region. Vaccination started in the epidemiological week three of 2021, rapidly reaching most of the population, particularly in the Southeast and South regions, coinciding with a reduction exclusively in the mortality rate in the third wave. Only from the beginning of the second wave, when Gama was the dominant variant, 146,718 genomes were sequenced. From the last EW of 2021, with vaccination coverage already approaching 70%, the Omicron variant caused an avalanche of cases, but with fewer deaths. CONCLUSIONS: We noticed the presence of three waves of Covid-19, as well as the effect of immunization on the reduction of mortality in the second and third waves, attributed to the Delta and Omicron variants, respectively. However, the reduction of morbidity, which peaked in the third wave during the domination of the Omicron variant, remained the same. The national and centralized command of the pandemic confrontation did not occur; thus, public administrators took the lead in their territories. The overwhelming effect of the pandemic could have been minimized, if there had been a coordinated participation of three spheres of the Brazilian Unified Health System administration, in the joint governance of the pandemic fight.