Monitoring the Establishment of VOC Gamma in Minas Gerais, Brazil: A Retrospective Epidemiological and Genomic Surveillance Study.

Since its first identification in Brazil, the variant of concern (VOC) Gamma has been associated with increased infection and transmission rates, hospitalizations, and deaths. Minas Gerais (MG), the second-largest populated Brazilian state with more than 20 million inhabitants, observed a peak of cases and deaths in March-April 2021. We conducted a surveillance study in 1240 COVID-19-positive samples from 305 municipalities distributed across MG's 28 Regional Health Units (RHU) between 1 March to 27 April 2021. The most common variant was the VOC Gamma (71.2%), followed by the variant of interest (VOI) zeta (12.4%) and VOC alpha (9.6%). Although the predominance of Gamma was found in most of the RHUs, clusters of Zeta and Alpha variants were observed. One Alpha-clustered RHU has a history of high human mobility from countries with Alpha predominance. Other less frequent lineages, such as P.4, P.5, and P.7, were also identified. With our genomic characterization approach, we estimated the introduction of Gamma on 7 January 2021, at RHU Belo Horizonte. Differences in mortality between the Zeta, Gamma and Alpha variants were not observed. We reinforce the importance of vaccination programs to prevent severe cases and deaths during transmission peaks.

Seroprevalence, Prevalence, and Genomic Surveillance: Monitoring the Initial Phases of the SARS-CoV-2 Pandemic in Betim, Brazil.

The COVID-19 pandemic has created an unprecedented need for epidemiological monitoring using diverse strategies. We conducted a project combining prevalence, seroprevalence, and genomic surveillance approaches to describe the initial pandemic stages in Betim City, Brazil. We collected 3239 subjects in a population-based age-, sex- and neighborhood-stratified, household, prospective; cross-sectional study divided into three surveys 21 days apart sampling the same geographical area. In the first survey, overall prevalence (participants positive in serological or molecular tests) reached 0.46% (90% CI 0.12-0.80%), followed by 2.69% (90% CI 1.88-3.49%) in the second survey and 6.67% (90% CI 5.42-7.92%) in the third. The underreporting reached 11, 19.6, and 20.4 times in each survey. We observed increased odds to test positive in females compared to males (OR 1.88 95% CI 1.25-2.82), while the single best predictor for positivity was ageusia/anosmia (OR 8.12, 95% CI 4.72-13.98). Thirty-five SARS-CoV-2 genomes were sequenced, of which 18 were classified as lineage B.1.1.28, while 17 were B.1.1.33. Multiple independent viral introductions were observed. Integration of multiple epidemiological strategies was able to adequately describe COVID-19 dispersion in the city. Presented results have helped local government authorities to guide pandemic management.

Concepções sobre riscos na perspectiva de profissionais de vigilância sanitária / The meaning of risk for the professionals from health surveillance agencies

A Vigilância Sanitária (VISA) é definida como um conjunto de ações capaz de eliminar, diminuir ou prevenir riscos à saúde e de intervir nos problemas sanitários decorrentes do meio ambiente, da produção e circulação de bens e da prestação de serviços de interesse da saúde. Tal definição introduziu o conceito de risco, destacando a função da VISA: controlar o risco no consumo de produtos e tecnologias, na utilização de serviços de saúde e na exposição a condições ambientais. Operando sobre o risco sanitário, além da interação social, o profissional de VISA necessita integrar conhecimento técnico e o arcabouço legal para controlar um objeto que possui múltiplas dimensões e propriedades e que requer diferentes formas de investigação. Porém, existe uma lacuna precariamente explorada no âmbito da VISA no que se refere ao entendimento do risco, sobretudo quando se considera a magnitude deste objeto para suas ações e, os significados atribuídos por seus profissionais não foram estudados. Para compreender os significados atribuídos ao risco nas ações de VISA, foi realizada uma pesquisa qualitativa utilizando o Interacionismo Simbólico como referencial teórico e a Teoria Fundamentada nos Dados como método. Através de entrevistas com gestores e profissionais das vigilâncias sanitárias municipal, estadual e ANVISA foi construída uma estrutura teórica que contém os significados do risco e suas categorias relacionadas. A compreensão dos significados não se restringiu à expressão sendo abordados os contextos, as condições, ações e consequências para compreender como os profissionais interpretam o risco e assumem suas significações nos locais em que atuam. O risco passa pela descrição técnica, no sentido objetivo, e remete tanto aos aspectos formais relativos às questões administrativas, políticas e jurídicas, quanto aos aspectos subjetivos, ligados às representações e sistemas de valores, ultrapassando seu sentido meramente quantitativo...

Health surveillance (HS) is defined as a group of actions capable of eliminating, reducing or preventing health risks and of intervening in sanitary problems resulting from the environment, the production and circulations of goods and the provision of health-care related services. This definition introduced the concept of risk, highlighting the role of HS: to control the risk in the consumption of products and technologies, in the use of health services, and in the exposition to environmental conditions. When intervening in sanitary risk, the HS professional needs to not only interact with others, but also integrate technical knowledge and legal framework in order to control an object which has multiple dimensions and properties and requires various forms of investigation.. However, there is a gap that is precariously explored within the HS regarding the comprehension of risk, especially when the magnitude of this objection to its actions is considered and the meanings of risk assigned by its professionals have not been studied. To understand the meanings attributed to risk in HS actions, a qualitative study was conducted using Symbolic Interactionism as a theoretical background and Grounded Theory as a method. Based on interviews with managers and professionals from local, state and national health surveillance agencies, a theoretical structure that contains the meanings of risk and its related categories was created.Understanding the meanings of risk was not restricted to its expression approaching the contexts, conditions, actions and consequences for understanding how professionals interpret the risk and assume its meanings in places in which they operate. The risk passes through the technical description, in the objective sense that refers to both formal aspects related to administrative, political and legal issues, as to the subjective aspects, linked to representations and value systems, surpassing the merely quantitative sense. These meanings...