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Source: https://www.publico.pt/2020/04/15/mu...perior-1912436
Actual number of covid-19 cases in Brazil may be 15 times higher
The lack of tests on the population makes Brazil one of the countries with the highest underreporting rate in the world.
Jo?o Ruela Ribeiro
April 15, 2020, 4:19 p.m.
Brazil may have 12 to 15 times more cases of infection with the new coronavirus than the one currently counted, according to two studies published in the last days. The lack of tests on the population is the main cause of underreporting in the country.
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Reliable information on the number of people infected with the new coronavirus is considered vital in determining what measures should be taken to prevent contagion on a large scale. Given the high number of people without symptoms, Sars-CoV-2 is particularly difficult to detect in the population. In Brazil, underreporting appears to be particularly broad. Only those who have severe symptoms and are hospitalized are currently being tested.
A study carried out by a group of researchers from several Brazilian universities and institutes indicates that only 8% of cases of infection are being reported by the Ministry of Health, which means that the real number could be over 235 thousand. The analysis carried out by the Center for Operations and Health Intelligence has as reference the number of cases officially released on Friday, 19,638. This Wednesday there were already more than 25 thousand.
The authors compared the lethality rates of the virus in Brazil with that of other countries and concluded that if the value is much higher among Brazilians, it is because there is a high underreporting.
Another study by Covid-19 Brasil, a research group that also brings together scientists and students from various universities, determined that by Saturday, Brazil will have had 313,000 cases of infection, a figure 15 times higher than officially released.
The researchers based themselves on the evolution of the epidemiological curve in South Korea, the country where the population was most tested and, therefore, offers the most reliable data. The number of deaths among South Koreans was adapted through a mathematical model to the Brazilian age pyramid in order to reach the estimate.
Rodrigo Gaete, a specialist in public health nursing and a professor at the University of S?o Paulo, told UOL he considers the accounts made by the study “conservative”, since there is also an underreporting of deaths in Brazil.
In the dark
An analysis carried out worldwide by a group of researchers at the University of G?ttingen, in Germany, also points to a very low notification rate in Brazil. Worldwide, only 6% of infections have been officially confirmed, but in Brazil this rate is less than 1%, the study concludes.
Brazil would have on March 31st - the reference date of the survey - 602 thousand cases and not 5700 as was disclosed.
There are several reasons that may help the lack of control in confirming Brazilian cases, but the lack of coverage of vast areas by health units is the main one. Researchers give the example of states like Amazonas or Pernambuco, which a few days ago had few confirmed cases and have since become very close to the collapse of their health systems.
“We missed the arrival of the epidemic in those places where it was decided to make notifications from people who needed health services. Meanwhile, mild or asymptomatic cases traveled around the country, ”says USP professor Domingos Alves to UOL.
Earlier this month, the Ministry of Health admitted that it does not know how many tests were carried out in the country, but that more than 500,000 kits were distributed, mostly rapid tests with limited results. By comparison, South Korea, with less than a quarter of Brazil's population, performed half a million tests.
At a time when there is a strong debate between defenders and critics of social isolation policies in Brazil, the enormous underreporting hinders the development of measures to contain contagion. "The results show that governments and legislators must be very cautious when interpreting case numbers for planning purposes," Sebastian Vollmer, responsible for the University of G?ttingen study, told Deutsche Welle
Actual number of covid-19 cases in Brazil may be 15 times higher
The lack of tests on the population makes Brazil one of the countries with the highest underreporting rate in the world.
Jo?o Ruela Ribeiro
April 15, 2020, 4:19 p.m.
Brazil may have 12 to 15 times more cases of infection with the new coronavirus than the one currently counted, according to two studies published in the last days. The lack of tests on the population is the main cause of underreporting in the country.
More popular
Reliable information on the number of people infected with the new coronavirus is considered vital in determining what measures should be taken to prevent contagion on a large scale. Given the high number of people without symptoms, Sars-CoV-2 is particularly difficult to detect in the population. In Brazil, underreporting appears to be particularly broad. Only those who have severe symptoms and are hospitalized are currently being tested.
A study carried out by a group of researchers from several Brazilian universities and institutes indicates that only 8% of cases of infection are being reported by the Ministry of Health, which means that the real number could be over 235 thousand. The analysis carried out by the Center for Operations and Health Intelligence has as reference the number of cases officially released on Friday, 19,638. This Wednesday there were already more than 25 thousand.
The authors compared the lethality rates of the virus in Brazil with that of other countries and concluded that if the value is much higher among Brazilians, it is because there is a high underreporting.
Another study by Covid-19 Brasil, a research group that also brings together scientists and students from various universities, determined that by Saturday, Brazil will have had 313,000 cases of infection, a figure 15 times higher than officially released.
The researchers based themselves on the evolution of the epidemiological curve in South Korea, the country where the population was most tested and, therefore, offers the most reliable data. The number of deaths among South Koreans was adapted through a mathematical model to the Brazilian age pyramid in order to reach the estimate.
Rodrigo Gaete, a specialist in public health nursing and a professor at the University of S?o Paulo, told UOL he considers the accounts made by the study “conservative”, since there is also an underreporting of deaths in Brazil.
In the dark
An analysis carried out worldwide by a group of researchers at the University of G?ttingen, in Germany, also points to a very low notification rate in Brazil. Worldwide, only 6% of infections have been officially confirmed, but in Brazil this rate is less than 1%, the study concludes.
Brazil would have on March 31st - the reference date of the survey - 602 thousand cases and not 5700 as was disclosed.
There are several reasons that may help the lack of control in confirming Brazilian cases, but the lack of coverage of vast areas by health units is the main one. Researchers give the example of states like Amazonas or Pernambuco, which a few days ago had few confirmed cases and have since become very close to the collapse of their health systems.
“We missed the arrival of the epidemic in those places where it was decided to make notifications from people who needed health services. Meanwhile, mild or asymptomatic cases traveled around the country, ”says USP professor Domingos Alves to UOL.
Earlier this month, the Ministry of Health admitted that it does not know how many tests were carried out in the country, but that more than 500,000 kits were distributed, mostly rapid tests with limited results. By comparison, South Korea, with less than a quarter of Brazil's population, performed half a million tests.
At a time when there is a strong debate between defenders and critics of social isolation policies in Brazil, the enormous underreporting hinders the development of measures to contain contagion. "The results show that governments and legislators must be very cautious when interpreting case numbers for planning purposes," Sebastian Vollmer, responsible for the University of G?ttingen study, told Deutsche Welle