COVID-19 Mortality Underreporting in Brazil: Analysis of Data From Government Internet Portals

Abstract

Background In Brazil, a substantial number of coronavirus disease (COVID-19) cases and deaths have been reported. It has become the second most affected country worldwide, as of June 9, 2020. Official Brazilian government sources present contradictory data on the impact of the disease; thus, it is possible that the actual number of infected individuals and deaths in Brazil is far larger than those officially reported. It is very likely that the actual spread of the disease has been underestimated. Objective This study investigates the underreporting of cases and deaths related to COVID-19 in the most affected cities in Brazil, based on public data available from official Brazilian government internet portals, to identify the actual impact of the pandemic. Methods We used data from historical deaths due to respiratory problems and other natural causes from two public portals: DATASUS (Department of Informatics of the Unified Healthcare System) (2010-2018) and the Brazilian Transparency Portal of Civil Registry (2019-2020). These data were used to build time-series models (modular regressions) to predict the expected mortality patterns for 2020. The forecasts were used to estimate the possible number of deaths that were incorrectly registered during the pandemic and posted on government internet portals in the most affected cities in the country. Results Our model found a significant difference between the real and expected values. The number of deaths due to severe acute respiratory syndrome (SARS) was considerably higher in all cities, with increases between 493% and 5820%. This sudden increase may be associated with errors in reporting. An average underreporting of 40.68% (range 25.9%-62.7%) is estimated for COVID-19–related deaths. Conclusions The significant rates of underreporting of deaths analyzed in our study demonstrate that officially released numbers are much lower than actual numbers, making it impossible for the authorities to implement a more effective pandemic response. Based on analyses carried out using different fatality rates, it can be inferred that Brazil’s epidemic is worsening, and the actual number of infectees could already be between 1 to 5.4 million.

COVID-19 epidemic in Libya

“…By the end of April 2021, the estimated cumulative number of deaths due to COVID-19 will exceed 2200. However, high rates of under-reporting of death from COVID-19 have been described elsewhere [ 7 ]. With the assumption that COVID-19 deaths in Libya are under-reported by 30%, the model estimated that a total of 20% of the Libyan population (1.3 million individuals) have been exposed to the COVID-19 pandemic ( Figure 2 ).…”

Framework for enhancing the estimation of model parameters for data with a high level of uncertainty

“…Socioeconomic inequalities [15,16] and cultural factors [17,18] have a direct impact on access to information and health services, which translates into high rates of infection and, as a consequence, underreporting cases. Veiga e Silva et al [19] also analyze presumptive inconsistencies in the data collected and made available by the Ministry of Health in Brazil. They report that, according to the methodology adopted in their analysis, there may be a difference of approximately 41% in the number of deaths caused by complications arising from COVID- 19.…”

“…Veiga e Silva et al [19] also analyze presumptive inconsistencies in the data collected and made available by the Ministry of Health in Brazil. They report that, according to the methodology adopted in their analysis, there may be a difference of approximately 41% in the number of deaths caused by complications arising from COVID- 19.…”

Report From Bolsonaro’s Brazil: The Consequences of Ignoring Science

“…3,4 As in other countries, underreporting of mortality was a frequent complaint and could be quickly estimated using various methodologies. 5,6 However, among Brazilians, doubt arising from distrust in the data presented by the government continued to grow (https://coronavi rus.jhu.edu/).…”

“…According to the federal government, this would facilitate the communication of data to the public. However, this was understood as a way of hiding information about the real magnitude of the adverse effects, 5 which responded to the political interests of the government headed by President Bolsonaro. 7 As a response to this lack of transparency, the media organizations O Estado de S. Paulo, Folha de S. Paulo, O Globo, Extra, G1, and UOL decided to organize a network that would allow them to continue to have timely, quality data.…”