RESUMEN
At the beginning of 2020, feelings of fear and uncertainty spread throughout the world after the novel coronavirus rapid propagation. The world was not ready to face such a situation. Countries implemented emergency measures to contain it, which included social distancing and shutting down the economy. Social and economic impacts were unpredictable. This manuscript aims to present the application of a remote scenario planning method that identifies threats, opportunities, and subsidies to a strategic evaluation in a short term. The main results identified 15 key trends, four critical uncertainties, four scenarios, ten opportunities, and 13 threats. They were debated and presented to some Brazilian organizations' decision-makers to help develop strategies to curb the aftermath of COVID-19. Our findings show that it is possible to use this agile method to build consistent and coherent scenarios that support the decision-making process. Part of the experts said that participating in the process was essential to comprehend it better. The process also contributed to their learning process and their organization on anticipatory strategy thinking concerning possible future. They agree that the scenarios were relevant, defiant, and plausible and incorporated meaningful events and real challenges to their organizations' strategy formulation or decision-making.
RESUMEN
ABSTRACT BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions ("hospital and outpatient care", "primary care", "prophylactic and therapeutic support" and "epidemiological surveillance"). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare.