Health system collapse 45 days after the detection of COVID-19 in Ceará, Northeast Brazil: a preliminary analysis

Abstract

Introduction: COVID-19 emerged in late 2019 and quickly became a serious public health problem worldwide. This study aim to describe the epidemiological course of cases and deaths due to COVID-19 and their impact on hospital bed occupancy rates in the first 45 days of the epidemic in the state of Ceará, Northeastern Brazil. Methods: The study used an ecological design with data gathered from multiple government and health care sources. Data were analyzed using Epi Info software. Results: The first cases were confirmed on March 15, 2020. After 45 days, 37,268 cases reported in 85.9% of Ceará's municipalities, with 1,019 deaths. Laboratory test positivity reached 84.8% at the end of April, a period in which more than 700 daily tests were processed. The average age of cases was 67 (<1-101) years, most occurred in a hospital environment (91.9%), and 58% required hospitalization in an ICU bed. The average time between the onset of symptoms and death was 18 (1-56) days. Patients who died in the hospital had spent an average of six (0-40) days hospitalized. Across Ceará, the bed occupancy rate reached 71.3% in the wards and 80.5% in the ICU. Conclusions: The first 45 days of the COVID-19 epidemic in Ceará revealed a large number of cases and deaths, spreading initially among the population with a high socioeconomic status. Despite the efforts by the health services and social isolation measures the health system still collapsed.

Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data

“…Although different criteria for hospital admissions and other patient characteristics (eg, comorbidities) could explain some of the observed differences in hospital admissions, respiratory support, and mortality between countries, the mismatch between demand and supply leading to a collapse of the health-care system could partly explain the high in-hospital mortality in Brazil. 16 , 17 , 18 …”

Case Report: Recurrent Clinical Symptoms of COVID-19 in Healthcare Professionals: A Series of Cases from Brazil

“…In Ceará, northeastern Brazil, more than 140,000 cases of COVID-19 have been reported, with more than 7,000 deaths, 10 , 11 which has led the health system to collapse. Here, we describe six cases of healthcare professionals who recovered but again presented symptoms consistent with COVID-19, with new positive RT-PCR test results.…”

Increasing Demand for Chest CT Due to COVID-19 in Brazil

“…States from the North (Amazonas and Pará) and the Northeast (Ceará, Pernambuco, and Sergipe) regions had the highest increases in chest CT. These regions placed health systems in a critical situation 7 , with collapse occurring in some states, such as Amazonas 8 and Ceará 9 ( Table 1 ). Especially in territories with a difficult epidemic situation, chest CT can be an effective, convenient, and fast method to recognize COVID-19 cases, thus supporting the containment of the epidemic 3 .…”