Brazil in the face of new SARS-CoV-2 variants: emergencies and challenges in public health

Abstract

This article discusses the epidemic situation of Covid-19 in Brazil, in the face of the emergence of a new strain called P.1, which is more transmissible and may be associated with reinfection. Given the collapse of hospital care in Manaus in January 2021 and the results of three recent preprints, each that reports increased transmissibility of the P.1 variant, we propose some urgent measures. Genomic surveillance based on multi-step diagnostics, starting with RT-PCR type tests and up to sequencing, should be established. Efforts to identify reinfections associated with this variant and the update of its definition in protocols should be prioritized, and studies on the efficacy of currently available vaccines in Brazil concerning the new variant should be conducted. We also propose improving the Brazilian health surveillance system such that genomic surveillance is coordinated and thereby better able to respond to future emergencies in a more timely fashion. We call on the public agents involved in health surveillance to share data and information regarding the epidemic in a clear, fast and transparent way. Finally, we propose a greater engagement in inter-institutional cooperation of all those involved in the response and production of knowledge about the pandemic in our country.

Molecular epidemiology of SARS‐CoV‐2 variants in circulation in the state of Maranhão, Brazil

“…Depending on their impact on public health, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants can be classified as Variants of Concern (VOC), Variants Under Monitoring (VUM) and Variants of Interest (VOI) 1,2 . Thus, variants such as Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2) and Omicron (B.1.1.529), due to rapid dissemination in their countries of origin, the high number of mutations in the Spike protein and the growing body of evidence of their ability to evade antibodies, they were classified as VOCs 3–5 …”

Modelling optimal vaccination strategies against COVID-19 in a context of Gamma variant predominance in Brazil

“…Routine monitoring & evaluation of disease transmission dynamics and local epidemiology are required, and its use is of utmost importance during a pandemic scenario, and should guide the formulation, implementation, and adjustments of public health policies. The emergence of new variants of concern (VOC), such as the Gamma variant [23] first identified in Brazil in late 2020, can pose additional challenges to public policy making. Being flexible and rethinking strategies has been mandatory in the context of the pandemic, particularly in settings present in Brazil, a large and diverse country, where many were the challenges faced for mitigating Covid-19 and efficiently rolling out its national Covid-19 vaccination strategy [24] .…”

Covid-19 em regiões de vulnerabilidade em Palmas, Tocantins: Relação entre fatores sociodemográficos, conhecimento e prevenção

“…Já é sabido que, os coronavírus humanos sazonais podem causar reinfecção, necessitando de vigilância ativa para esses casos. A identificação é feita quando há diagnóstico de infecções respiratórias por SARS-CoV-2 com intervalo de pelo menos 90 dias entre os dois eventos, comprovando que as variantes não são as mesmas nas duas infecções confirmados por exames de RT-PCR ou sequenciamento do genoma viral (FINTELMAN N, et al, 2021;MARQUITTI F, et al, 2021). Ainda assim, a Covid-19 poderá permanecer até duas vezes mais mortal que a gripe sazonal até o próximo ano, não esquecendo que existe a chance de surgimento de novas variantes de SARS-CoV-2 (CHEN J, 2022).…”