Brazil Health Care System preparation against COVID-19

  1. Lincoln Luís Silva
  2. Amanda de Carvalho Dutra
  3. Pedro Henrique Iora
  4. Guilherme Luiz Rodrigues Ramajo
  5. Gabriel Antônio Fernandes Messias
  6. Iago Amado Peres Gualda
  7. Joao Felipe Hermann Costa Scheidt
  8. Pedro Vasconcelos Maia do Amaral
  9. Catherine Staton
  10. Thiago Augusto Hernandes Rocha
  11. Luciano de Andrade
  12. João Ricardo Nickenig Vissoci

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Abstract

Background

The coronavirus disease outbreak from 2019 (COVID-19) is associated with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a highly contagious virus that claimed thousands of lives around the world and disrupted the health system in many countries. The assessment of emergency capacity in every country is a necessary part of the COVID-19 response efforts. Thus, it is extremely recommended to evaluate the health care system to prepare the country to tackle COVID-19 challenges.

Methods and Findings

A retrospective and ecological study was performed with data retrieved from the public national healthcare database (DATASUS). Numbers of intensive care unit and infirmary beds, general or intensivists physicians, nurses, nursing technicians, and ventilators from each Regional Health Unity were extracted, and the beds per health professionals and ventilators per population rates were assessed. The accessibility to health services was also performed using a spatial overlay approach to verify regions that lack assistance. It was found that Brazil lacks equity, integrity, and may struggle to assist with high complexity for the COVID-19 patients in many regions of the country.

Conclusions

Brazil’s health system is insufficient to tackle the COVID-19 in some regions of the country where the coronavirus may be responsible for high rates of morbidity and mortality.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.09.20096719: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethics: In accordance with the Resolution No. 510/16 of the National Health Council and considering that we used secondary sources which are available in governmental and online databases, the dispensation of the consent form was requested to the Ethics Committee.
    IRB: Ethics: In accordance with the Resolution No. 510/16 of the National Health Council and considering that we used secondary sources which are available in governmental and online databases, the dispensation of the consent form was requested to the Ethics Committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data sources: To characterize the Brazilian ECS network, three sources were used: National Register of Health Facilities (CNES acronym in Portuguese), population data from the IBGE, and COVID-19 cases reported by Secretariat of Surveillance of the Ministry of Health (18, 26).
    Portuguese
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The limitations in this work rely on the complex data available. Health data from health information systems, including health-facility records, surveys or vital statistics, may not be representative of the entire population of a country and in some cases may not even be accurate (44). The CNES database presents some limitations well known by the Brazilian scientific community (45). Despite this, the information regarding the availability of COVID-19 beds was published just a month ago, calling attention to the occurrence of efforts aiming to improve the quality of the data available to policymakers.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.05.09.20096719 on medRxiv