A traveling SARS-CoV-2 laboratory as part of a pandemic response among vulnerable Brazilian populations.

BACKGROUND: Brazil has been dramatically hit by the SARS-CoV-2 pandemic and is a world leader in COVID-19 morbidity and mortality. Additionally, the largest country of Latin America has been a continuous source of SARS-CoV-2 variants and shows extraordinary variability of the pandemic strains probably related to the country´s outstanding position as a Latin American economical and transportation hub. Not all regions of the country show sufficient infrastructure for SARS-CoV-2 diagnosis and genotyping which can negatively impact the pandemic response. METHODS: Due to this reason and to disburden the diagnostic system of the inner São Paulo State, the Butantan Institute established the Mobile Laboratory (in Portuguese: LabMovel) for SARS-CoV-2 testing which started a trip of the most important "hotspots" of the most populous Brazilian region. The LabMovel initiated in two important cities of the State: Aparecida do Norte (an important religious center) and the Baixada Santista region which incorporates the port of Santos, the busiest in Latin America. The LabMovel was fully equipped with an automatized system for SARS-CoV-2 diagnosis and sequencing/genotyping. It also integrated the laboratory systems for patient records and results divulgation including in the Federal Brazilian Healthcare System. RESULTS: Currently,16,678 samples were tested, among them 1,217 from Aparecida and 4,564 from Baixada Santista. We tracked the delta introductio in the tested regions with its high diversification. The established mobile SARS-CoV-2 laboratory had a major impact on the Public Health System of the included cities including timely delivery of the results to the healthcare agents and the Federal Healthcare system, evaluation of the vaccination status of the positive individuals in the background of exponential vaccination process in Brazil and scientific and technological divulgation of the fieldwork to the most vulnerable populations. CONCLUSIONS: The SARS-CoV-2 pandemic has demonstrated worldwide the importance of science to fight against this viral agent and the LabMovel shows that it is possible to integrate researchers, clinicians, healthcare workers and patients to take rapid actions that can in fact mitigate this and other epidemiological situations.

A traveling SARS-CoV-2 laboratory as part of a pandemic response among vulnerable Brazilian populations

Background Brazil has been dramatically hit by the SARS-CoV-2 pandemic and is a world leader in COVID-19 morbidity and mortality. Additionally, the largest country of Latin America has been a continuous source of SARS-CoV-2 variants and shows extraordinary variability of the pandemic strains probably related to the country´s outstanding position as a Latin American economical and transportation hub. Not all regions of the country show sufficient infrastructure for SARS-CoV-2 diagnosis and genotyping which can negatively impact the pandemic response. Methods Due to this reason and to disburden the diagnostic system of the inner São Paulo State, the Butantan Institute established the Mobile Laboratory (in Portuguese: LabMovel) for SARS-CoV-2 testing which started a trip of the most important “hotspots” of the most populous Brazilian region. The LabMovel initiated in two important cities of the State: Aparecida do Norte (an important religious center) and the Baixada Santista region which incorporates the port of Santos, the busiest in Latin America. The LabMovel was fully equipped with an automatized system for SARS-CoV-2 diagnosis and sequencing/genotyping. It also integrated the laboratory systems for patient records and results divulgation including in the Federal Brazilian Healthcare System. Results Currently,16,678 samples were tested, among them 1,217 from Aparecida and 4,564 from Baixada Santista. We tracked the delta introductio in the tested regions with its high diversification. The established mobile SARS-CoV-2 laboratory had a major impact on the Public Health System of the included cities including timely delivery of the results to the healthcare agents and the Federal Healthcare system, evaluation of the vaccination status of the positive individuals in the background of exponential vaccination process in Brazil and scientific and technological divulgation of the fieldwork to the most vulnerable populations. Conclusions The SARS-CoV-2 pandemic has demonstrated worldwide the importance of science to fight against this viral agent and the LabMovel shows that it is possible to integrate researchers, clinicians, healthcare workers and patients to take rapid actions that can in fact mitigate this and other epidemiological situations.

Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy

Abstract Introduction Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. Objectives Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. Methods A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. Results From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p= 0.002), hospital admission (p= 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. Conclusion The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.

Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy.

Introduction: Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. Objectives: Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. Methods: A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. Results: From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p = 0.002), hospital admission (p = 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. Conclusion: The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.

Genomic epidemiology of the SARS-CoV-2 epidemic in Brazil

The high numbers of COVID-19 cases and deaths in Brazil have made Latin America an epicentre of the pandemic. SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, but important gaps remain in our understanding of virus transmission dynamics at a national scale. We use 17,135 near-complete genomes sampled from 27 Brazilian states and bordering country Paraguay. From March to November 2020, we detected co-circulation of multiple viral lineages that were linked to multiple importations (predominantly from Europe). After November 2020, we detected large, local transmission clusters within the country. In the absence of effective restriction measures, the epidemic progressed, and in January 2021 there was emergence and onward spread, both within and abroad, of variants of concern and variants under monitoring, including Gamma (P.1) and Zeta (P.2). We also characterized a genomic overview of the epidemic in Paraguay and detected evidence of importation of SARS-CoV-2 ancestor lineages and variants of concern from Brazil. Our findings show that genomic surveillance in Brazil enabled assessment of the real-time spread of emerging SARS-CoV-2 variants.

Genomic epidemiology of the SARS-CoV-2 epidemic in Brazil

The high numbers of COVID-19 cases and deaths in Brazil have made Latin America an epicentre of the pandemic. SARS-CoV-2 established sustained transmission in Brazil early in the pandemic, but important gaps remain in our understanding of virus transmission dynamics at a national scale. We use 17,135 near-complete genomes sampled from 27 Brazilian states and bordering country Paraguay. From March to November 2020, we detected co-circulation of multiple viral lineages that were linked to multiple importations (predominantly from Europe). After November 2020, we detected large, local transmission clusters within the country. In the absence of effective restriction measures, the epidemic progressed, and in January 2021 there was emergence and onward spread, both within and abroad, of variants of concern and variants under monitoring, including Gamma (P.1) and Zeta (P.2). We also characterized a genomic overview of the epidemic in Paraguay and detected evidence of importation of SARS-CoV-2 ancestor lineages and variants of concern from Brazil. Our findings show that genomic surveillance in Brazil enabled assessment of the real-time spread of emerging SARS-CoV-2 variants.

Genomic monitoring unveil the early detection of the SARS-CoV-2 B.1.351 (beta) variant (20H/501Y.V2) in Brazil.

Sao Paulo State, currently experiences a second COVID-19 wave overwhelming the healthcare system. Due to the paucity of SARS-CoV-2 complete genome sequencing, we established a Network for Pandemic Alert of Emerging SARS-CoV-2 Variants to rapidly understand and monitor the spread of SARS-CoV-2 variants into the state. Through analysis of 210 SARS-CoV-2 complete genomes obtained from the largest regional health departments we identified cocirculation of multiple SARS-CoV-2 lineages such as B.1.1 (0.5%), B.1.1.28 (23.2%), B.1.1.7 (alpha variant, 6.2%), B.1.566 (1.4%), B.1.544 (0.5%), C.37 (0.5%) P.1 (gamma variant, 66.2%), and P.2 (zeta variant, 1.0%). Our analysis allowed also the detection, for the first time in Brazil, the South African B.1.351 (beta) variant of concern, B.1.351 (501Y.V2) (0.5%), characterized by the following mutations: ORF1ab: T265I, R724K, S1612L, K1655N, K3353R, SGF 3675_F3677del, P4715L, E5585D; spike: D80A, D215G, L242_L244del, A262D, K417N, E484K, N501Y, D614G, A701V, C1247F; ORF3a: Q57H, S171L, E: P71L; ORF7b: Y10F, N: T205I; ORF14: L52F. The most recent common ancestor of the identified strain was inferred to be mid-October to late December 2020. Our analysis demonstrated the P.1 lineage predominance and allowed the early detection of the South African strain for the first time in Brazil. We highlight the importance of SARS-CoV-2 active monitoring to ensure the rapid detection of potential variants for pandemic control and vaccination strategies. Highlights Identification of B.1.351 (beta) variant of concern in the Sao Paulo State. Dissemination of SARS-CoV-2 variants of concern and interest in the Sao Paulo State. Mutational Profile of the circulating variants of concern and interest.

Genomic monitoring unveil the early detection of the SARS-CoV-2 B.1.351 (beta) variant (20H/501Y.V2) in Brazil

Sao Paulo State, currently experiences a second COVID-19 wave overwhelming the healthcare system. Due to the paucity of SARS-CoV-2 complete genome sequencing, we established a Network for Pandemic Alert of Emerging SARS-CoV-2 Variants to rapidly understand and monitor the spread of SARS-CoV-2 variants into the state. Through analysis of 210 SARS-CoV-2 complete genomes obtained from the largest regional health departments we identified cocirculation of multiple SARS-CoV-2 lineages such as B.1.1 (0.5%), B.1.1.28 (23.2%), B.1.1.7 (alpha variant, 6.2%), B.1.566 (1.4%), B.1.544 (0.5%), C.37 (0.5%) P.1 (gamma variant, 66.2%), and P.2 (zeta variant, 1.0%). Our analysis allowed also the detection, for the first time in Brazil, the South African B.1.351 (beta) variant of concern, B.1.351 (501Y.V2) 0.5%, characterized by the following mutations: ORF1ab: T265I, R724K, S1612L, K1655N, K3353R, SGF 3675_F3677del, P4715L, E5585D; spike: D80A, D215G, L242_L244del, A262D, K417N, E484K, N501Y, D614G, A701V, C1247F; ORF3a: Q57H, S171L, E: P71L; ORF7b: Y10F, N: T205I; ORF14: L52F. The most recent common ancestor of the identified strain was inferred to be mid-October to late December 2020. Our analysis demonstrated the P.1 lineage predominance and allowed the early detection of the South African strain for the first time in Brazil. We highlight the importance of SARS-CoV-2 active monitoring to ensure the rapid detection of potential variants for pandemic control and vaccination strategies.

A gestão por processos na indústria farmacêutica / Management through processes in the pharmaceutical industry

As organizações estão cada vez mais competitivas na busca de ferramentas degestão para qualificar seus produtos e serviços. A maioria das indústrias busca a implementação da gestão da qualidade. A partir do século XX, a qualidade sempre esteve no diaa dia dos processos. A gestão por processos, utilizada para a implementação da gestão daqualidade, é difundida nas indústrias farmacêuticas que buscam controlar seus processos. Há diversas ferramentas que podem ser aplicadas. Uma delas é o diagrama de SIPOC, quemelhora os processos e o desempenho da organização. A utilização permite uma visão holística e sistêmica da organização, possibilitando uma melhoria constante nos processos.

Organizations are increasingly competitive in the pursuit of management tools to qualify products and services. Most industries seek the implementation of quality management.Quality has been present in the processes day–by–day since the 20th Century. The process management used for the implementation of quality management is widespread in pharmaceutical industries that aim to control their processes. There are several tools which can be applied forthis purpose. One of them is the SIPOC diagram that improves both the organization’s processes and performance. The use of SIPOC provides a holistic and systemic view of the organization, allowing a constant improvement in the processes.

Normas Técnicas CADI: projeto favela / CADI Technical norms: poverty areas project

Nas últimas décadas o Brasil vem sofrendo empobrecimento em todos os sentidos, principalmente nos aspectos sócio econômicos, acarretando grande inversão desordenada, principalmente nas regiões periféricas das grandes metrópoles. O estado de São Paulo têm sofrido movimento migratório desenfreado, ficando à frente de todos os outros estados do País, aumentando, consequentemente, a população carente e o número de favelas, principalmente na Grande São Paulo. Segundo a Secretaria de Habitação do Estado de São Paulo, conceitua-se como favela aquele Conjunto de Unidades domiciliares contituídas de madeira, zinco, lata, papelão ou mesmo alvenaria (tijolos) em geral, distribuídas desorganizadamente em terrenos cuja propriedade geralmente não é legalizada . A população moradora das favelas na região é precária, não dispondo de infra-estrutura mínina de Saneamento Básico, Educação, Assistência à Saúde, e Habitação. A partir de novembro de 1988, a Secretaria de Estado da Saúde iniciou o PROJETO FAVELA, com o intuito de minimizar os problemas básicos vitais da população desprivilegiada, moradora de favelas ou similares. Consciente das dificuldades enfrentadas pela população carente, o Governo do Estado, por intermédio da Secretaria de Estado da Saúde, priorizou o PROJETO FAVELA, cujo conteúdo técnico básico é apresentado neste documento.

Projeto Favela: fase II: conjuntos sanitários / Slum project: phase II: surveillance groupes

Dando continuidade ao Projeto Favela (plano de melhoria das condições de vida nas favelas), onde já foram implantados os CADIs - Centro de Acompanhamento e Desenvolvimento Infantil - daremos início à segunda fase: a implantação dos Conjuntos Sanitários. As áreas faveladas se concentram na maioria das vezes em locais de topografia acidentada, onde ocorre o acúmulo de grandes quantidades de matéria orgânica devido ao lixo ali depositado ao longo dos anos. Esses fatores, aliados à ocupação desordenada e espontânea do solo, dificultam o acesso de veículos e máquinas, impedindo a implantação dos serviços de saneamento básico. A insalubridade consequente dos esgotos lançados a céu aberto, correndo lado a lado com a água utilizada para consumo e higiene, deixa um grande saldo de contaminações e doenças. Nossa proposta é a implantação de Conjuntos Sanitários em pontos estratégicos em que haverá um trabalho conjunto com as companhias concessionárias de saneamento (SABESP, etc), a fim de eliminar os fatos acima descritos. Paulatinamente serão desativados os coletores de esgotos a céu aberto, substituindo-os pelos coletores sanitários públicos, concomitante à substituição dos poços.

Informe sobre la industria de la harina de pescado en Mar del Plata, Argentina

Contiene un resumen y conclusiones de las molestias a la comunidad y los métodos de control empleado para prevenir la contaminación del aire. Se refiere brevemente a esta industria y trata de los problemas que presenta. Describe la situación en Mar del Plata y trata de la desodorización del aire. Estudia la desodorización de los gases producidos en las fabricas de harina de pescado y propone soluciones a la problemática de Mar del Plata (Argentina)

Informe sobre la industria de la harina de pescado en Mar del Plata, Argentina

Contiene un resumen y conclusiones de las molestias a la comunidad y los métodos de control empleado para prevenir la contaminación del aire. Se refiere brevemente a esta industria y trata de los problemas que presenta. Describe la situación en Mar del Plata y trata de la desodorización del aire. Estudia la desodorización de los gases producidos en las fabricas de harina de pescado y propone soluciones a la problemática de Mar del Plata (Argentina)

La contaminación atmosférica en Sào Paulo Metropolitano, Brasil / Air pollution in the Metropolitan area of Sao Paulo, Brasil

In connection with an advisory program conducted by PAHO in Brazil, a study was made of the air pollution problem in the metropolitan area of Sào Paulo. The general background to air pollution is given, as are vital and industrial statistics on the State of Sào Paulo. Some measurements taken during the study are included, although these are very rough owing to the lack of proper equiment. The causes of pollution in metropolitan Sào Paulo are analyzed, fuel consumption and meteorological data are presented, and the consequences of air pollution are examined. Mention is made of the possible effects of this contamination on health and of the measures taken by the authorities, and the immediate adoption of a program for measuring, controlling, and eliminating this hazard is recommended(AU)

La contaminación atmosférica en São Paulo Metropolitano, Brasil / Air pollution in the Metropolitan area of Sao Paulo, Brasil

In connection with an advisory program conducted by PAHO in Brazil, a study was made of the air pollution problem in the metropolitan area of São Paulo. The general background to air pollution is given, as are vital and industrial statistics on the State of São Paulo. Some measurements taken during the study are included, although these are very rough owing to the lack of proper equiment. The causes of pollution in metropolitan São Paulo are analyzed, fuel consumption and meteorological data are presented, and the consequences of air pollution are examined. Mention is made of the possible effects of this contamination on health and of the measures taken by the authorities, and the immediate adoption of a program for measuring, controlling, and eliminating this hazard is recommended(AU)