Deep impact of COVID-19 in the healthcare of Latin America: the case of Brazil

Cimerman, Sérgio; Chebabo, Alberto; Cunha, Clóvis Arns da; Rodríguez‐Morales, Alfonso J.

doi:10.1016/j.bjid.2020.04.005

Cited by 100 publications

(93 citation statements)

References 5 publications

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“…• All services of the Programa Federal Incluir Salud are available online, including day centres and rehabilitation 6,10,12,19 .…”

Section: Access To Healthcarementioning

confidence: 99%

“…On May 22, 2020, the World Health Organisation (WHO) announced that the epicentre of the pandemic had moved to South America. COVID- 19 cases have now been detected in all countries in South America [9], with Brazil and Peru being particularly affected [10], putting already overstretched healthcare systems under particular strain [11][12][13] (see Table 1). More than 70 million disabled people live in Latin America and the Caribbean region, and they are among the most excluded parts of the population, with high levels of poverty and unemployment [14].…”

Section: Introductionmentioning

confidence: 99%

“…Public health recommendations for physical distancing and hand-washing are often not realistic for slum residents, including disabled people, who may lack personal space and necessities, such as clean water. Overcrowded prisons, where disabled people are overrepresented [4], poorly resourced residential care (often acting as zones of social abandonment [17]), and a large population of indigenous people suffering the effects of discrimination [18], further complicate the situation, as does the ongoing dengue fever outbreak [12], particularly affecting Brazil. All these factors might disadvantage even further people who already have limited ways to protect themselves.…”

Section: Introductionmentioning

confidence: 99%

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Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study

Sakellariou

Malfitano

Rotarou

2020

Int J Equity Health

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Background: Disabled people are particularly exposed to the risks of COVID-19, as well as to the measures taken to address it, and their impact. The aim of the study was to examine the disability-inclusiveness of government responses to COVID-19 in four South American Countries: Argentina, Brazil, Chile, and Peru. Methods: We conducted documentary research, using framework analysis to analyse reports, legislation, decrees, and other official documents that communicated measures taken in response to the pandemic, published from February 1st until May 22nd, 2020. We included documents reporting measures that affected disabled people either directly (measures specifically designed for disabled people) or indirectly (measures for the general population). We developed an analytical framework based on recommendations for disability-inclusive response to COVID-19 published by the Economic Commission for Latin America and the Carribean, the World Health Organisation, and other international organisations. Results: We analysed 72 documents. The findings highlight that while some positive measures were taken, the needs of disabled people were not fully considered. Several countries published recommendations for a disabilityinclusive response to COVID-19, without ensuring their translation to practice. All countries took at least some steps to ensure access to financial support, health, and education for disabled people, but at the same time they also implemented policies that had a detrimental impact on disabled people. The populations that are most exposed to the impacts of COVID-19, including disabled people living in institutional care, were protected in several cases only by recommendations rather by legislation. Conclusions: This study illustrates how the official government responses taken by four countries in the regionwhile positive, in several aspectsdo not fully address the needs of disabled people, thus further disadvantaging them. In order to ensure response to COVID − 19 is disability inclusive, it is necessary to translate recommendations to practice, consider disabled people both in mainstream policy and in disability-specific measures, and focus on the long-term reconstruction phase.

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“…• All services of the Programa Federal Incluir Salud are available online, including day centres and rehabilitation 6,10,12,19 .…”

Section: Access To Healthcarementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study

Sakellariou

Malfitano

Rotarou

2020

Int J Equity Health

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“…The disease has now spread to Latin American countries, claiming the lives of hundreds of thousands of people [2]. While individuals living in rural communities of these countries are supposed to be especially vulnerable to this pandemic because of factors inherent to underdevelopment [3,4,8], data on SARS-CoV-2 transmission in these communities are scarce or non-existent.…”

Section: Introductionmentioning

confidence: 99%

Late incidence of SARS-CoV-2 infection in a highly-endemic remote rural village. A prospective population-based cohort study

Brutto

Costa²,

Mera

et al. 2020

Pathogens and Global Health

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Data on SARS-CoV-2 transmission in rural communities is scarce or non-existent. A previous cross-sectional study in middle-aged and older adults enrolled in the Atahualpa Project Cohort demonstrated that 45% of participants had SARS-CoV-2 antibodies, 77% of whom were symptomatic. Here, we assessed the incidence of SARS-CoV-2 infection in the abovementioned rural population. One month after baseline testing, 362 of 370 initially seronegative individuals were re-tested to assess incidence of seroconversion and associated risk factors. Twenty-eight of them (7.7%) became seropositive. The overall incidence rate ratio was 7.4 per 100 person months of potential virus exposure (95% C.I.: 4.7-10.2). Six seroconverted individuals (21.4%) developed SARS-CoV-2-related symptomatology. The only covariate significantly associated with seroconversion was the use of an open latrine. Predictive margins showed that these individuals were 2.5 times more likely to be infected (95% C.I.: 1.03-6.1) than those using a flushing toilet. Therefore, along one month, approximately 8% of seronegative individuals became infected, even after almost half of the population was already seropositive. Nevertheless, a smaller proportion of incident cases were symptomatic (21% versus 77% of the earlier cases), and no deaths were recorded. Whether this decreased clinical expression resulted from a lower viral load in new infections cannot be determined. Increased seroconversion in individuals using latrines is consistent with a contributory role of fecal-oral transmission, although we cannot rule out the possibility that latrines are acting as a proxy for poverty or other unknown interacting variables.

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“…The pandemic led to the adoption of several non-pharmacological interventions ranging from social distancing guidelines to national-level lockdowns by different countries (5). These stringent interventions have severely impacted the way of living of many people, and disrupted the already precarious health system in many countries (6). In response to the COVID-19 pandemic, several countries undertook analysis for the necessary health system strengthening efforts.…”

Section: Introductionmentioning

confidence: 99%

Brazil Health Care System preparation against COVID-19

Silva

Dutra

Iora

et al. 2020

Preprint

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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: Brazilian 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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Deep impact of COVID-19 in the healthcare of Latin America: the case of Brazil

Cited by 100 publications

References 5 publications

Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study

Disability inclusiveness of government responses to COVID-19 in South America: a framework analysis study

Late incidence of SARS-CoV-2 infection in a highly-endemic remote rural village. A prospective population-based cohort study

Brazil Health Care System preparation against COVID-19

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