COVID-19 in northeast Brazil: first year of the pandemic and uncertainties to come

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2021055003728

Keywords:

Coronavirus infections, epidemiology, Communicable diseases, emerging, prevention & control, Pandemics, Epidemiology, descriptive

Abstract

OBJECTIVE To analyze the epidemic of COVID-19 in northeastern Brazil, one of the regions most affected by the virus. METHODS The official data for COVID-19, from March 2020 to March 2021 in the states of the Northeast Region (NE), were used. The analysis of capital cities and states for accumulated weekly cases and confirmed deaths was made using the JoinPoint Trend Analysis application. RESULTS In one year, the Northeast region reported 22.9% of the cases and 21.5% of the deaths in the country due to COVID-19. At the beginning of the pandemic, all states showed a growing number of cases, first in the capitals and then in the interior. Following this wave, decreases are observed in all states and their capitals, but with many still reporting a large number of cases. In the middle of the 2nd semester of 2020 the number of cases begins to increase again simultaneously in states and their capitals—some at explosive speed—especially in late 2020 and early 2021. A similar pattern is observed in deaths, which exceed or approach the peak seen in the first wave. In the first wave, all capitals and northeastern states adopted intense isolation measures. Fortaleza, Recife and Teresina reached the highest isolation index of all capitals, close to 0.60. This index decreases, with a slight growth trend until the end of December. With the exception of Fortaleza and Salvador, the other capitals fell to less than 0.40. CONCLUSION The Brazilian NE and the country are in increasingly complicated health, social and economic situations. It is necessary to speed up vaccinations and maintain non-pharmacological measures: face masks, social distancing measures and hygiene care, in addition to policies to protect workers who have lost their incomes and to subsidize small business owners.

References

The Global Change Data Lab. Our world in Data. Daily confirmed deaths. Oxford (UK): Oxford Martin School/University of Oxford; 2021 [cited 2021 Mar 29]. Available from: https://ourworldindata.org/grapher/confirmed-covid-19-deaths-cumulative-vs-daily?tab=table [ Links ]

The Global Change Data Lab. Our world in data. Contry-by-country data on confirmed cases. Oxford (UK): Oxford Martin School/University of Oxford/; 2021 [cited 2021 Mar 29]. Available from: https://ourworldindata.org/covid-cases#global-comparison-where-are-confirmed-cases-increasing-most-rapidly [ Links ]

Brasil. Ministério da Saúde (BR), Secretaria de Vigilância em Saúde. Doença pelo Coronavírus COVID-19. Bol Epidemiol. 2021 [cited 2021 Feb 21_27];(52 Nº espec):1-85. Available from: https://www.gov.br/saude/pt-br/media/pdf/2021/marco/05/boletim_epidemiologico_covid_52_final2.pdf [ Links ]

Leung K, Shum MH, Leung GM, Lam TT, Wu JT. Early transmissibility assessment of the N501Y mutant strains of SARS-CoV-2 in the United Kingdom, October to November 2020. Eurosurveillance. 2021;26(1):2002106. https://doi.org/10.2807/1560-7917.ES.2020.26.1.2002106 [ Links ]

Tegally H, Wilkinson E, Giovanetti M, Iranzadeh A, Fonseca W, Giandhari J, et al. Emergence and rapid spread of a new severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) lineage with multiple spike mutations in South Africa. medRxiv [Preprint]. 2020. https://doi.org/10.1101/2020.12.21.20248640 [ Links ]

Faria NR, Claro IM, Candido D, Franco LAM, Andrade PS, Coletti TM, et al. Genomic characterisation of an emergent SARS-CoV-2 lineage in Manaus: preliminary findings. Virological org [Preprint]. 2021 [cited 2021 Jan 18]. Available from: https://virologicalorg/t/genomiccharacterisation-of-an-emergent-sars-cov-2-lineage-in-manaus-preliminary-findings/586 [ Links ]

Naveca F, Nascimento V, Souza V, Corado A, Nascimento F, Silva G, et al. Phylogenetic relationship of SARS-CoV-2 sequences from Amazonas with emerging Brazilian variants harboring mutations E484K and N501Y in the Spike protein. Virological org. 2021 [cited 2021 Jan 11]. Available from: https://virological.org/t/phylogenetic-relationship-of-sars-cov-2-sequences-from-amazonas-with-emerging-brazilian-variants-harboring-mutations-e484k-and-n501y-in-the-spike-protein/585 [ Links ]

Aquino EML, Silveira IH, Pescarini JM, Aquino R, Souza-Filho JA, Rocha AS, et al. Medidas de distanciamento social no controle da pandemia de COVID-19: potenciais impactos e desafios no Brasil. Cienc Saude Coletiva. 2020;25 Supl 1:2423-46. https://doi.org/10.1590/1413-81232020256.1.10502020 [ Links ]

Holmes O. Israel Covid vaccine data shows extremely low rate of infections. The Guardian (Jerusalem). 31 jan 2021 [cited 2021 Feb 25]. Available from: https://www.theguardian.com/world/2021/jan/31/israel-covid-vaccination-data-offers-hope-exit-pandemic. [ Links ]

Cotta W. COVID-19 in Brazil. Viçosa, MG: Instituto de Física da Universidade Federal de Viçosa; 2020 [cited 2020 Jul 6]. Available from: https://wesleycota.com/ [ Links ]

Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335-51. https://doi.org/10.1002/(sici)1097-0258(20000215)19:3<335::aid-sim336>3.0.co;2-z [ Links ]

In Loco. Mapa brasileiro da COVID-19. 2021 [cited 2021 Feb 20]. Available from: https://mapabrasileirodacovid.inloco.com.br/pt/ [ Links ]

Kerr L, Kendall C, Silva AAM, Aquino E, Pescarini JM, Almeida RLF, et al. COVID-19 in Northeast Brazil: achievements and limitations in the responses of the state governments. Cienc Saude Coletiva. 2020;25 Supl 2:4099-120. https://doi.org/10.1590/1413-812320202510.2.28642020 [ Links ]

Ximenes RAA, Albuquerque MFPM, Martelli CMT, Thália VBA, Miranda Filho DB, Souza WV, et al. COVID-19 no nordeste do Brasil: entre o lockdown e o relaxamento das medidas de distanciamento social. Cienc Saude Coletiva. 2021; 26: 1441-1456. https://doi.org/10.1590/1413-81232021264.39422020 [ Links ]

Tribunal Superior Eleitoral (BR). Câmara aprova PEC, e eleições municipais 2020 são adiadas para novembro. Brasília, DF; 2020 [cited 2021 Mar 10]. Available from: https://www.tse.jus.br/imprensa/noticias-tse/2020/Julho/camara-aprova-pec-e-eleicoes-municipais-2020-sao-adiadas-para-novembro [ Links ]

Madeiro C. Eleições 2020: convenções no Norte e Nordeste têm aglomeração e falta de prevenção à covid. Maceió, AL: UOL; 2020 [cited 2021 Feb 16]. Available from: https://noticias.uol.com.br/eleicoes/2020/09/15/convencoes-no-n-e-ne-tem-aglomeracoes-e-falta-de-prevencao-a-covid.htm [ Links ]

Fujino T, Nomoto H, Kutsuna S, Ijiie M, Suzuki T, Sato R, et al. Novel SARS-CoV-2 variant in Travelers from Brazil to Japan. Emerg Infect Dis. 2021;27(4):1243-5. https://doi.orh/10.3201/eid2704.210138 [ Links ]

Weisblum Y, Schmidt F, Zhang F, DaSilva J, Poston D, Lorenzi JC, et al. Escape from neutralizing antibodies by SARS-CoV-2 spike protein variants. Elife. 2020;9:e61312. https://doi.org/10.7554/eLife.61312 [ Links ]

Greaney AJ, Loes AN, Crawford KHD, Starr TN, Malone KD, Chu HY, et al. Comprehensive mapping of mutations to the SARS-CoV-2 receptor-binding domain that affect recognition by polyclonal human serum antibodies. bioRxiv [Preprint]. 2021. https://doi.org/10.1101/2020.12.31.425021 [ Links ]

Buss LF, Prete Jr CA, Abrahim CMM, Mendrone Jr A, Salomon T, Almeida-Neto C, et al. Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic. Science. 2021;371(6526):288-92. https://doi.org/10.1126/science.abe9728 [ Links ]

Coutinho RM, Marquitti FMD, Ferreira LS, Borges ME, Silva RLP, Canton O, et al. Model-based evaluation of transmissibility and reinfection for the P. 1 variant of the SARS-CoV-2. medRxiv [Preprint]. 2021. https://doi.org/10.1101/2021.03.03.21252706 [ Links ]

Naveca F, Nascimento V, Souza V, Corado A, Nascimento F, Silva G, et al. COVID-19 epidemic in the Brazilian state of Amazonas was driven by long-term persistence of endemic SARS-CoV-2 lineages and the recent emergence of the new Variant of Concern P.1. Nature Portfolio J [Preprint]. 2021 [cited 2021 Mar 15]. https://doi.org/10.21203/rs.3.rs-275494/v1. Available from: https://www.researchsquare.com/article/rs-275494/v1 [ Links ]

Challen R, Brooks-Pollock E, Read JM, Dyson L, Tsaneva-Atanasova K, Danon L. Increased hazard of mortality in cases compatible with SARS-CoV-2 variant of concern 202012/1-a matched cohort study. medRxiv [Preprint]. 2021. https://doi.org/10.1101/2021.02.09.21250937 [ Links ]

Sabino EC, Buss LF, Carvalho MPS, Prete Jr CA, Crispim MAE, Fraiji NA, et al. Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence. Lancet. 2021;397(10273):452-5. https://doi.org/10.1016/S0140-6736(21)00183-5 [ Links ]

Barberia LG, Gómez EJ. Political and institutional perils of Brazil’s COVID-19 crisis. Lancet. 2020;396(10248):367-8. https://doi.org/10.1016/S0140-6736(20)31681-0 [ Links ]

Hallal PC. SOS Brazil: science under attack. Lancet. 2021;397(10272):373-4. https://doi.org/10.1016/S0140-6736(21)00141-0 [ Links ]

Brum E. Pesquisa revela que Bolsonaro executou uma “estratégia institucional de propagação do coronavírus”. El País Brasil. 21 jan 2021 [cited 2021 Mar 20]. Available from: https://brasil.elpais.com/brasil/2021-01-21/pesquisa-revela-que-bolsonaro-executou-uma-estrategia-institucional-de-propagacao-do-virus.html [ Links ]

FIOCRUZ Observatório COVID-19. Fiocruz detecta mutação associada a variantes de preocupação do Sars-Cov-2 em diversos estados do país. Rio de Janeiro; 2021. [ Links ]

FIOCUZ Observatório COVID-19. Taxa de ocupação (%) de leitos de UTI COVID-19 para adultos. Rio de Janeiro; 2021. [ Links ]

Collucci C. Triplica mortalidade de pessoas até 45 anos nas UTIs brasileiras. Folha de São Paulo. 27 mar 2021. [ Links ]

The Global Change Data Lab. Our World in Data. Statistics and research: Coronavirus (COVID-19) vaccinations. Oxford (UK): Oxford Martin School/University of Oxford; 2021 [citado 25 mar 2021]. Disponível em: https://ourworldindata.org/covid-vaccinations [ Links ]

World Health Organization. The COVAX Facility: interim distribution forecast. Geneva: WHO; 03 fev 2021 [cited 2021 Mar 20]. (Tecnical Document). Available from: https://www.who.int/publications/m/item/the-covax-facility-interim-distribution-of-forecast [ Links ]

Ministério da Saúde (BR), Secretaria de Vigilância em Saúde, Departamento de Imunização e Doenças Transmissíveis, Coordenação-Geral do Programa Nacional de Imunizações. Plano Nacional de Operacionalização da Plano Nacional de Operacionalização da vacinação contra a Covid-19. Brasília, DF; 2021 [cited 2021 Mar 20]. Available from: https://www.gov.br/saude/pt-br/media/pdf/2020/dezembro/16/plano_vacinacao_versao_eletronica-1.pdf [ Links ]

Ceará tem queda de 46% na taxa de internação de idosos após vacinação contra a Covid-19, diz Sesa. Diário do Nordeste (Fortaleza, CE). 11 mar 2021. [ Links ]

Nóbrega F. Casos de Covid-19 em idosos com 85 anos e mais em Pernambuco caem 25% após início da vacinação. Folha de Pernambuco (Recife, PE). 5 mar 2021. [ Links ]

Reis V. Após vacinação, mortes de idosos entre 85 e 89 anos por Covid-19 caem 51% na cidade de SP em fevereiro e atingem menor nº desde outubro. G1 Globo (São Paulo). 17 mar 2021. [ Links ]

Romero M. Consórcio Nordeste vai assinar contrato de compra de 39 milhões de doses da vacina Sputnik, diz governador do PI. G1 Globo (Piaui). 12 mar 2021. [ Links ]

Brasil. Decreto Nº 10.659, de 25 de março de 2021. Institui o Comitê de Coordenação Nacional para Enfrentamento da Pandemia da Covid-19. Diário Oficial da União. 23 mar 2021. Seção 1:1 [ Links ]

Franco BM. Bolsonaro vive no mundo da fantasia, diz líder de prefeitos. O Globo. 24 mar 2021. [ Links ]

Pedro Hallal mostra ao CNS o tamanho do crime: Dos 300 mil óbitos por covid, 75% poderiam ter sido evitados. Viomundo. 29 mar 2021 [cited 2021 Mar 30]. Available from: http://www.sindfar.org.br/pedro-hallal-mostra-ao-cns-o-tamanho-do-crime-dos-300-mil-obitos-por-covid-75-poderiam-ter-sido-evitados/ [ Links ]

Lowy Institute. Covid Performance Index: deconstructing pandemic responses. Sidney (AUS); 09 fev 2021 [cited 2021 Mar 23]. Available from: https://interactives.lowyinstitute.org/features/covid-performance/ [ Links ]

Rocha HA, Sudfeld CR, Leite AJ, Rocha SG, Machado MM, Campos JC, et al. Coronavirus disease 19, food security and maternal mental health in Ceará, Brazil: a repeated cross-sectional survey. Public Health Nutr. 2021:1-5. https://doi.org/10.1017/S1368980021000628 [ Links ]

Published

2021-06-02

Issue

Section

Original Articles

How to Cite

Kerr, L. R. F. S. ., Kendall, C., Almeida, R. L. F. de ., Ichihara, M. Y., Aquino, E. M. L., Silva, A. A. M. da, Ximenes, R. A. de A. ., Albuquerque, M. de F. P. M. de, Almeida-Filho, N., Souza, R. F., Brandão Filho, S. P. ., Souza, W. V. de, & Barreto, M. L. (2021). COVID-19 in northeast Brazil: first year of the pandemic and uncertainties to come. Revista De Saúde Pública, 55, 35. https://doi.org/10.11606/s1518-8787.2021055003728