A pandemia de COVID-19 tem desafiado pesquisadores e gestores a encontrar medidas de saúde pública que evitem o colapso dos sistemas de saúde e reduzam os óbitos. Esta revisão narrativa buscou sistematizar as evidências sobre o impacto das medidas de distanciamento social na epidemia de COVID-19 e discutir sua implementação no Brasil. Foram triados artigos sobre o efeito do distanciamento social na COVID-19 no PubMed, medRXiv e bioRvix, e analisados atos do poder público nos níveis federal e estadual para sumarizar as estratégias implementadas no Brasil. Os achados sugerem que o distanciamento social adotado por população é efetivo, especialmente quando combinado ao isolamento de casos e à quarentena dos contatos. Recomenda-se a implementação de medidas de distanciamento social e de políticas de proteção social para garantir a sustentabilidade dessas medidas. Para o controle da COVID-19 no Brasil, é imprescindível que essas medidas estejam aliadas ao fortalecimento do sistema de vigilância nos três níveis do SUS, que inclui a avaliação e uso de indicadores adicionais para monitorar a evolução da pandemia e o efeito das medidas de controle, a ampliação da capacidade de testagem, e divulgação ampla e transparente das notificações e de testagem desagregados.
Background: The emergence of COVID-19 in Latin America occurred within a troubled political, economic and social context, with growing trends of poverty and social inequality challenging already overburdened and underfinanced local healthcare systems. In the absence of a vaccine or of any treatment for COVID-19, public health measures such as social distancing had to be adopted. The objective of this paper is to describe the course of the COVID-19 pandemic in Latin American countries and to summarize the social distancing measures implemented in each one of these countries, discussing the changes that took place in the social mobility of the populations and their potential effects on the course of the epidemic up to June 2020. Results: Brazil has the highest cumulative number of cases and deaths; however, cumulative incidence rates are higher in Peru and Chile, while the highest cumulative mortality rates are in Ecuador, Peru and Brazil. Some countries implemented social distancing measures before the first case was registered, culminating in lockdown in eight countries before detection of the 100th case. The measures that appear to have had the greatest impact in reducing mobility include, in addition to lockdown, the closure of schools and prohibition of events. In general, the countries that implemented social distancing measures earlier and where the reduction in social mobility was greatest also recorded lower incidence and mortality rates. Brazil and Mexico failed to adopt lockdown and the number of cases of the disease continues to grow. Conclusions: As occurred in other continents, control of the COVID-19 pandemic was better in countries that were faster in adopting more restrictive measures. Nevertheless, this equation does not appear to guarantee a positive outcome in all settings, possibly due to the considerable social inequalities and chronic deficiencies of the healthcare systems, with the scenario being even more complex in view of the recurring political crises and the negationist view of some national leaders. The COVID-19 pandemic continues to spread in Latin America and exposes these contradictions. Further studies are required to gain a greater understanding and generate lessons on how to manage such a complex crisis.
Federal da Bahia (UFBA). Professora titular aposentada, integra o Programa de Pós-Graduação em Saúde Coletiva (PPGSC) da UFBA. Titular da Academia de Ciências da Bahia. Membro da Coordenação Executiva da Rede CoVida. Medidas de distanciamento social e uso de máscaras no contexto da COVID-19Construção de conhecimento no curso da pandemia de COVID-19 Cap. 1 9As diversas produções estão disponibilizadas no site da Rede CoVida, na seção "Publicações", disponível em: https://redecovida.org/. Medidas de distanciamento social e uso de máscaras no contexto da COVID-19Construção de conhecimento no curso da pandemia Cap. 1 Medidas de distanciamento social e uso de máscaras no contexto da COVID-19Construção de conhecimento no curso da pandemia
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