Excesso de mortes durante a pandemia de COVID-19: subnotificação e desigualdades regionais no Brasil

Orellana, Jesem Douglas Yamall; Cunha, Geraldo Marcelo da; Marrero, Lihsieh; Moreira, Ronaldo I.; Leite, Iúri da Costa; Horta, Bernardo Lessa

doi:10.1590/0102-311x00259120

Cited by 61 publications

(55 citation statements)

References 38 publications

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“…Data from our study suggest the occurrence of underreporting of COVID-19 deaths, as described in other articles 6,7,20,21 . In several Brazilian states, there was an increase in mortality rate from ill-defined causes.…”

Section: Discussionsupporting

confidence: 82%

“…Moreover, most COVID-19 deaths occurred among the elderly, who commonly present with multiple co-morbidities, consequently increasing the difficulty in identifying the basic cause of mortality 1 . Another factor that may have contributed to the underreporting of COVID-19 deaths in Brazil was the collapse of the healthcare network, as reported in some states 7 . Thus, it was likely that people who died outside health services would have a more flawed notification of the cause of death 8 .…”

Section: Given the Low Rt-pcr (Reverse Transcription Polymerase Chainmentioning

confidence: 99%

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Excess Deaths From All Causes and by Covid-19 in Brazil in 2020

Santos

Souza

Carvalho

et al. 2021

Preprint

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Objective: To estimate the 2020 all-cause and COVID-19 excess mortality according to sex, age, race/color, and state, and to compare mortality rates by selected causes with that of the five previous years in Brazil. Methods: Data from the Mortality Information System were used. Expected deaths for 2020 were estimated from 2015 to 2019 data using a negative binomial log-linear model. Results: Excess deaths in Brazil in 2020 amounted to 13.7%, and the ratio of excess deaths to COVID-19 deaths was 0.90. Reductions in deaths from cardiovascular diseases (CVD), respiratory diseases, and external causes, and an increase in ill-defined causes were all noted. Excess deaths were also found to be heterogeneous, being higher in the Northern, Center-Western, and Northeastern states. In some states, the number of COVID-19 deaths was lower than that of excess deaths, whereas the opposite occurred in others. Moreover, excess deaths were higher in men, in those aged 20 to 59, and in black, yellow, or indigenous individuals. Meanwhile, excess mortality was lower in women, individuals aged 80 years or older, and in whites. Additionally, deaths among those aged 0 to 19 were 7.2% lower than expected, with reduction in mortality from respiratory diseases and external causes. There was also a drop in mortality due to external causes in men and in those aged 20 to 39 years. Furthermore, reductions in deaths from CVD and neoplasms were noted in some states and groups. Conclusion: There is evidence of underreporting of COVID-19 deaths and of the possible impact of restrictive measures in the reduction of deaths from external causes and respiratory diseases. The impacts of COVID-19 on mortality were heterogeneous among the states and groups, revealing that regional, demographic, socioeconomic, and racial differences expose individuals in distinct ways to the risk of death from both COVID-19 and other causes. Keywords: COVID-19, mortality, cause of death

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Section: Discussionsupporting

confidence: 82%

Section: Given the Low Rt-pcr (Reverse Transcription Polymerase Chainmentioning

confidence: 99%

Excess Deaths From All Causes and by Covid-19 in Brazil in 2020

Santos

Souza

Carvalho

et al. 2021

Preprint

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“…Outro efeito relevante é o excesso de mortalidade ocorrida no período da pandemia. Orellana et al 31 observaram um excesso de mortes de 46% em capitais do Brasil no primeiro semestre de 2020. Como agravante, os autores identificaram que apenas uma parte desses óbitos são diretamente atribuíveis à COVID-19.…”

Section: Modelo Teórico De Sindemia Da Covid-19unclassified

COVID-19 como sindemia: modelo teórico e fundamentos para a abordagem abrangente em saúde

Júnior

Santos

2021

Cad. Saúde Pública

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Este ensaio tem como objetivo apresentar e discutir o quadro teórico da sindemia da COVID-19. Na primeira parte, são apresentados os fundamentos e princípios da teoria sindêmica. Adotou-se o conceito de sindemia como processo de interação sinérgica entre duas ou mais doenças, no qual os efeitos se potencializam mutuamente. Foram discutidas as três principais tipologias de interação sindêmica: epidemias mutuamente causais; epidemias interagindo sinergicamente; e epidemias causais em série. Na segunda parte, a COVID-19 é analisada como uma sindemia resultante da interação entre vários grupos de doenças e o contexto socioeconômico. O modelo teórico considerou a interação entre COVID-19 e doenças crônicas não transmissíveis, doenças infecciosas e parasitárias e problemas de saúde mental. Abordou-se como as iniquidades sociais e as condições de vulnerabilidade atuam em diversos níveis e potencializam a atuação da COVID-19 e das demais pandemias. Na última seção, discute-se a necessidade de respostas abrangentes, multisetoriais e integradas ao enfrentamento da COVID-19. Foi apresentado um modelo de intervenção envolvendo as dimensões assistencial e socioeconômica. No âmbito assistencial, defendeu-se a estruturação de sistemas de saúde fortes, responsivos e acessíveis a toda a população. A dimensão econômica e social abordou o resgate dos ideais de solidariedade, da estratégia da promoção da saúde e a ênfase sobre os determinantes sociais. Conclui-se que as lições aprendidas com a abordagem sindêmica da COVID-19 exortam governos e a sociedade para o desenvolvimento de políticas que articulem intervenções clínicas, sanitárias, socioeconômicas e ambientais.

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“…It is noteworthy that in Brazil there is massive underreporting (Ribeiro and Bernardes, 2020) which suggests that the numbers do not reflect the reality as many deaths are not identified as Covid-19 related. Some analyses use the high percentages of excess deaths, deaths not explained directly by the pandemic but at extremely higher rates that from the previous years associated with respiratory symptoms (Orellana et al, 2021).…”

Section: Health Inequality Data From Brazilmentioning

confidence: 99%

COVID-19 magnifies the vulnerabilities: The Brazilian case

Denny

Duarte

Castro³

et al. 2021

International Journal of Discrimination and the Law

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This paper discusses inequalities of the health system in Brazil and advocates that now, more than ever in light of the Covid-19 pandemic, the world needs to put in place a more collaborative and egalitarian way of financing health research and investments in public health systems. The role of the state and institutions in the design of public policies for the realization of social rights is debated in the face of the economic and political crisis. Here we draw upon Martha Fineman’s vulnerability theory and Thomas Pogge’s view on justice with regard to health.

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Excesso de mortes durante a pandemia de COVID-19: subnotificação e desigualdades regionais no Brasil

Cited by 61 publications

References 38 publications

Excess Deaths From All Causes and by Covid-19 in Brazil in 2020

Excess Deaths From All Causes and by Covid-19 in Brazil in 2020

COVID-19 como sindemia: modelo teórico e fundamentos para a abordagem abrangente em saúde

COVID-19 magnifies the vulnerabilities: The Brazilian case

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