Covid: Half of cities didn’t have federal help for testing citizens, study says

The increase in the number of cases COVID-19 In Brazil, due to the arrival of the micron variant at the end of last year, it highlighted a problem that has persisted since the beginning of the epidemic: the lack of an effective national policy comprehensive test Of the population.

On September 17 last year, the Ministry of Health announced that the National Expansion of Testing for Covid-19 (PNE-Teste) scheme had not reached more than half of the municipalities in the country, according to a survey by the National Federation of Municipalities. (CNM).) Made exclusively for stadium.

The entity asked municipal councils whether the Ministry of Health had provided “some support” – with inputs or financial – in the national testing plan, and 51.8% answered in the negative. Another 40.6% said they received help from the file and 7.6% did not respond.

The survey, which was done on the basis of the sample, consulted 1,871 municipalities between January 10 and 13. And when the plan was launched four months ago, the Department of Health estimated that about 60 million antigen tests would be distributed by the end of 2021.

In a note, the ministry reported that it has so far distributed 43.7 million units across the country during the pandemic, equivalent to 20% of Brazil’s population, out of 213 million people, according to the Brazilian Institute of Geography and Statistics (IBGE).

According to the health, the ministry has distributed rapid antigen tests to all states every two weeks since the plan was launched. The ministry stated that the new acquisitions with the Oswaldo Cruz Foundation (Vecruz) are “under negotiation”.

to me stadiumThe President of the National Council of Health Ministers (CONAS), Carlos Lula, said that the ministry underestimated the epidemic by obtaining such a number of tests that he considered low.

“The most the ministry has done is distribute the tests casually, as you do again. There is no testing policy. We are testing, not to get a number, but to monitor the development of the disease. This has never been done for public policy in the country,” said Carlos Lula, Minister Health in Maranhão state, a state led by Flavio Dino (Socialist Workers’ Party), opposed to President Jair Bolsonaro.

“(With 60 million tests) that means you won’t be able to test everyone. More than that, (it means) the ministry also had a prediction that the epidemic was about to go away, which is the same mistake we made in 2020. Thinking that the epidemic will end because The year was about to end,” he says.

Mauro Junqueira, Executive Secretary of the National Council of Municipal Health Trustees, also stated that he estimated that the number of checks performed per day in Brazil was “less than needed”. “It’s a fact. We haven’t been able to get a test program that can meet the demand,” he said.

“But (the plan) is working, with federal resources and state and municipal efforts. Municipalities have testing sites, but they are much smaller than the real need.”

strategy

Since the start of the pandemic, the World Health Organization (WHO) has reiterated that mass testing and contact tracing are “very important” to controlling transmission of the coronavirus. Strategy is also considered essential by the experts who have heard of stadium, for whom the state has failed to implement this kind of policy.

They say what Brazil has is testing for people who show symptoms and who seek the health service. “There is no random test. It is almost directed,” said Cesar Eduardo Fernandez, president of the Brazilian Medical Association. .

“We have seen evidence of this policy without the efficacy we would like. After adding all the tests that were done here, we were not able to test even half the population. It is accepted that the infection rate here is that for every 10 people, 3 have been tested. In Portugal, it has been Test the same person twice.

For health doctor and former head of the National Health Surveillance Agency (Anvisa) Claudio Mairowicz, the spread of coronavirus could have been lower if the country had implemented mass testing. It will be possible, he says, to understand the dynamics of the disease to anticipate decisions, as in the case of the oxygen crisis in Manaus, a year in advance.

“We don’t know about these events until after the disaster has already occurred,” he said. “There was certainly a widespread epidemic in Manaus, but it only became an important public issue when there was a lack of space in the hospital and a lack of oxygen. If there had been an easier testing policy, it would have been possible to find out what was happening.”

A year ago, the health network in the Amazonian capital collapsed in the face of an explosion of hospital patients caused by the coronavirus.

guiding rules

The National Testing Scheme states that obtaining rapid antigen tests is up to the Health Surveillance Secretariat (SVS) of the Ministry of Health, and according to the document, the tests should be applied to both asymptomatic and asymptomatic individuals.

The plan states, “The Department of Health will distribute TR-AG (rapid antigen tests) to implement testing strategies, however, states, the Federal District and Municipalities can also acquire TR-AGs to further the large-scale testing strategy.”

In Mairowicz’s assessment, the Department of Health is responsible for directing national testing policy. He explained that “the Ministry of Health, in addition to not having a policy to confront the epidemic, does not have a testing policy, which will be one of the important components in the confrontation.”

“Every state can have a policy, every municipality, but the scope is more restricted, especially since it is the department that has the attribution and the ability to get a large number of tests to strengthen public laboratories or even outpatient services. The states and municipalities because this is less.”

good examples

Experts heard before stadium He points to South Korea and the United Kingdom as places where public testing policies have been successful.

Mairowicz recalls that at the first signs that the virus was turning into a pandemic, the South Korean government contacted diagnostic companies and offered them incentives to develop testing technologies.

“When the first cases arrived, there were already a huge number of tests available,” said the former head of Anvisa. “In England there are public posts where people can take a certain amount of tests and test themselves more than once, even. Everyone takes a box of seven tests. They do their own test, repeat the next day to be sure, she tests her family members. Depending on the situation, she can To order online and receive it at home.”

The self-test, commonly used in the United States and countries in Europe, Asia and Latin America to detect the coronavirus, is still not registered for commercialization in Brazil and is dependent on regulation. as shown stadiumThe government has asked Anvisa to use the coronavirus self-test as a “support tool”.

Plano

The creation of a national testing plan was announced by Quiroga at the beginning of his work at the head of the ministry, in March of last year. The minister, who has been heard by the Parliamentary Commission of Inquiry on Covid (CPI), in the Senate, twice, said he would put the policy into practice “in the shortest possible time” to “test up to 20 million Brazilians per month”.

“We are intent and have already agreed with Cunas and Conassimes for a major testing campaign in Brazil,” Quiroga said, in his testimony to the commission on June 8, in his testimony to the commission on June 8. Carlos Lula says the plan was completely prepared by Seid. According to the head of Kunas, the entity was heard as “a formality”.

“We suggested a lot and it was simply ignored. So we consider that she did not participate in it. There was not even a response from the ministry in formulating it. We cannot say that it was a plan drawn up by multiple parties,” said Mauro Junqueira. He believes that the “limited budget” did not allow the purchase of a number Bigger than exams.

“We have R$3.90 per inhabitant per day to take care of the health of the population, to do everything. From testing to organ transplants,” he says. For Mairowicz, the test should have been part of an interministerial policy, through which the Brazilian government will invite companies to speak and see how they can cooperate with the crisis.

“The government can’t just act as a buyer. This happened with the vaccine, it happened with the tests, with the equipment,” he said. “All of this should have been on the table as a priority, mobilizing many ministries, not just the Ministry of Health.”