Country reduces testing at critical moment of pandemic and has high levels of underreporting
Brazil has become the epicenter of the Covid-19 pandemic in the world and is experiencing an outbreak even worse than that indicated by the followed records of deaths and cases, since the low number of tests carried out points to a gigantic underreporting and the high percentage of positive tests shows the spread without control of the disease, warned experts.
With the highest daily average of deaths Covid-19 in the last 7 days, Brazil surpassed the United States, with 1,626 deaths compared to 1,460 in the USA, according to Reuters calculations, and it is also the country with the highest number of new cases per day on average in the period, with almost 70 thousand.
For the first time since the beginning of the pandemic, Brazil on Wednesday reached the mark of more than 2,000 deaths by Covid-19 registered in just one day, and experts point out that this number may soon exceed 3,000, since the campaign The vaccination rate continues at a very slow pace due to a lack of doses.
“The expectation taking into account the non-testing of all symptomatic patients is that the official number of 11 million cases is two to three times higher, between 22 million and 33 million infected people. It is the pattern of an epidemic that is completely uncontrolled the point of view of transmission ”, said Dr. Alexandre Naime Barbosa, head of infectology at Universidade Estadual Paulista (Unesp) and a consultant to the Brazilian Society of Infectious Diseases.
“We are in the worst moment, but we have not reached the peak. We are still climbing this mountain, probably at the end of March and beginning of April there will be 3,000 deaths per day. We can reach half a million deaths by the middle of next year, ”he added.
Despite going through the worst moment of the pandemic, Brazil does not comply with one of the main measures recommended by experts and adopted by other countries in the fight against Covid-19, mass testing and the active search for cases of the disease.
The daily average of tests performed, according to data the Ministry of Health, went 57,263 in January to 47,232 in February. The test record was reached in the penultimate week of last year, with an average of 65,441 per day, and since then the number has shown a downward trend, reaching 43,967 in the last week of February - the last with data available in the ministry's epidemiological bulletin. .
"We have a situation that is completely out of control and the tendency is to keep this contagion high," said researcher in public health Diego Xavier, the Oswaldo Cruz Foundation (Fiocruz).
“High positivity is another indicator that reflects this collapse that we are facing. What you need is case tracking. Identify, test and isolate. That kind of policy that interrupts the transmission chain, and that we unfortunately do not have. ”
The Ministry of Health did not respond to a request for comment on the reduction in the number of tests. In an epidemiological bulletin on the pandemic, the ministry states that it carried out the acquisition of automated extraction tests and the lending of equipment in order to increase Covid-19's analysis capacity.
With low testing, Brazil still has a positive rate, that is, the percentage of positive results in the total of tests, of 28.74%, almost six times above the index considered by the World Health Organization (WHO) as adequate to contain the pandemic, 5%.
In the last week of February, this Brazilian index reached 35.71%, the highest level not counting the first weeks of the pandemic, when there was a shortage of tests. In the United States, the average positivity in the last 7 days was 4.5%, with an average of 1,212,844 tests per day in the period, according to data the Center for Disease Control and Prevention (CDC).
In addition to low testing, Brazil also only manages to sequence the genome of a minimal portion of confirmed cases of Covid-19, which makes it difficult to monitor new variants, such as P1, which originated in Manaus at the end of last year and has caused fear around the world due to increased transmissibility and resistance to antibodies previous infections.
Since the beginning of the pandemic, Brazil has managed to sequence just over 4,500 samples, according to Fiocruz, in a total of more than 11 million confirmed cases of the disease. The United Kingdom, which leads the world in virus sequencing, has sequenced more than 336,000 samples, in a much smaller universe of total cases, with 4.2 million.
In the entire month of January, after the Manaus variant was identified, only 616 samples were collected in Brazil for sequencing, according to data the Genomic Network of the Oswaldo Cruz Foundation (Fiocruz). The low number makes it difficult to monitor the spread of the variant, which became prevalent in Brazil in February and may be even more widespread throughout the country.