The fourth covid wave is already a reality

Covid-19 experts have no hesitation. Brazil is suffering from another wave of coronavirus disease. In two weeks – between 05/20 and 06/02 – the number of covid cases in Brazil rose by 122%, from 14,000 to 31,000 confirmed cases.

The actual number of infections, however, is underestimated. The number of tests being conducted in the country today is very small. In May, SUS ran only 176,000 tests, up from 1.7 million in January. Without specific data to prove the increase in the number of cases, the population is left without information and cannot act to protect itself.

Testing is essential for detecting infections over time to break the transmission chain and help health care managers make decisions. “In Brazil, it has been little tested, in every wave. We never had a test strategy, and even after more than 2 years of pandemic, we still don’t have a policy for that,” says Federal epidemiologist Alexandra Boing. University of Santa Catarina (UFSC), member of the Brazilian Collective Health Association (Abrasco) and member of the Covid-19Br Observatory.

Tests are usually performed on symptomatic patients. “We don’t have the usual tests available for asymptomatic people, we don’t know the importance of the test for the population,” says Boing. “Surveillance teams were also not strengthened to act on these positive cases,” he says.

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Even without testing, however, it was already possible to identify the new wave. One of the most reliable tools for predicting Covid’s behavior, a joint investigation between the University of Maryland (USA) and Facebook showed that the downward trend in Brazilian cases was reversed on April 11th.

This survey is conducted through the social network with a “covid-like” symptom questionnaire. As the survey reaches a large number of people and the results are calculated immediately, it is able to receive changes before the official numbers, which depend on the tests.

It is likely that this wave will not cause as many deaths as it has seen in 2020 and 2021. This has been the result of the vaccination, which has caused the proportionate death toll in the country to fall in the January 2022 wave. However, there is. concern. “Vaccines do not prevent transmission: the more the virus is transmitted, the greater the chances of new variants appearing,” Boing said. “Furthermore, research shows that even non-serious cases can lead to long-term covid, a condition that can last for months or years after the infection,” he says.

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Because now?

There are many reasons for the increase in cases. One of them is the arrival of the cold season in the South and Southeast. It is a time of increasing incidence of respiratory diseases in these regions due to the tendency to close environments for greater thermal comfort. The numbers in the North and Northeast are not showing high at the moment.

According to Isaac Schrarstzhaupt, a data scientist and coordinator of the Covid-19 Analysis Network, the Brazilian hospital system has always had difficulty coping with the season of respiratory illnesses. “Even before the pandemic, there was a lack of ICU beds at the time,” he says.

With Kovida, the situation is much worse. “Currently in Brazil we have about 100 deaths from a single disease. By 2019, that number did not reach 15, considering all the causes of severe acute respiratory syndrome (SARS),” he explained.

Even considering a scenario with less concern about reporting, since there was no pandemic, the numbers are contradictory. In 2020, the daily average SARS death toll reached 730 and rose to 1,100 in 2021. In 2022, there are 340 deaths a day, 22 times more than in 2019.

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End of health emergency

The hospital situation is deteriorating as the Ministry of Health closes funding for extra beds, one of the many consequences of the end of Brazil’s health emergency, which was set for April. Without that money, opening beds will be much more difficult than in 2020 and 2021.

Another consequence of this decision by the Bolsonaro government is symbolic. “When the emergency is over, there is an implicit message that everything is fine,” says Schrarstzhaupt.

The easing of measures to sustain transmission, which took place during the first half of 2022, also had an impact on numbers. The closure of mandatory masks in several states and cities made the virus easier to spread. “The country already had fragile preventive measures and, in the two and a half years since the pandemic, has not put in place measures to control ambient air quality,” says Boing.

For him, the completion of mandatory masks, a very effective measure and low individual and collective cost, did not and does not make sense in the country. “Now we are receiving the wrong messages from the decisions and the public authorities,” he believes.

The most transmissible variants

Another point that helps to shape the image of covida today is the emergence of more contagious variants. Omikron variants called B4 and B5 are even more transmissible than the original voltage. They also have an immune leak associated with the first variants of omicron, B1 and B2. They were only detected in the country at the end of May, which is likely to infect people who have been covid in recent times.

The cessation of the covid vaccine in Brazil is another reason that is helping to increase the number of cases. The state has not been able to universalize the second dose of the vaccine. The so-called booster dose, which is essential for maintaining protection against the disease, has a much lower adherence. In São Paulo, the state with the highest vaccine coverage, only 58% of the population is immunized with a third dose. About 50% of the population of Piauí, Paraná, Rio Grande do Sul and Minas Gerais are completely immunized.

containment measures

For Boing and Schrarstzhaupt, pandemic control actions remain the same. It is necessary to strengthen the vaccine with aggressive campaigns, active search for health services, population mobilization and struggle. fake news. It is essential to re-start the mandatory use of the mask in closed environments. This measure not only prevents the transmission of covid, but also a number of respiratory diseases.

Other measures include the dissemination of tests and the monitoring of cases and contacts that may occur in order to isolate and interrupt the transmission chain and to warn the population of the real dangers at this time.

In the perfect scenario, the country should make an effort to implement air quality monitoring in the environment so that it can focus on actions that improve traffic in schools, shops and other closed areas of public use. “We are in a time of great threat to nature, which creates opportunities for new pathogens to appear,” says Schrarstzhaupt. “Better ventilation of the environment is a key long-term action, as new pandemics are likely to emerge in the coming years,” he added.

Editing: Glauco Faria

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