RIO DE JANEIRO, BRAZIL – With 13,993 deaths and 202,918 confirmed cases of covid-19 by Thursday, Brazil is on an upward curve of transmission of the novel coronavirus, without having yet succeeded in solving the testing bottleneck it has been experiencing since the start of the epidemic.
Although it has announced efforts to increase the number of available tests, the country has so far only managed to distribute fewer than half (8.1 million) of the 17 million tests it plans to deliver by the end of May.
And it is not even aware of the total number of tests so far conducted on the population, since it has not yet managed to add the tests conducted on the private health care network to the data it collects (from public laboratories) – only the positive results from private labs enter the daily report released by the Ministry of Health.
International experience shows that countries that have tested the most have been more successful in fighting the coronavirus, since the data helped to plan strategies to be implemented against the disease, as well as to determine when social isolation measures could be relaxed.
Since the outbreak began, and particularly after officially detecting the first case of coronavirus in the country 78 days ago, the government has announced efforts to expand its testing capacity. But with a shortage of supplies and the delay in processing tests, it keeps looking at a snapshot of the past as the epidemic progresses through its territory.
The government announced weeks ago that it would conduct a type of survey in an attempt to determine what portion of the Brazilian population has already contracted the virus. With the help of IBGE (Brazilian Institute of Geography and Statistics) staff, it would test the population by sampling. The tests of this study – which will include three stages until June – only began to be implemented on Thursday, May 14th.
In this first stage, 33,250 people will be tested in 133 cities. It is the first step in a study that seeks to measure the extent of the epidemic in a diverse country of continental proportions. Last week, the Ministry of Health also announced a new testing program, in which mild cases would start to be tested in so-called sentinel health units, those selected to monitor the spread of the disease by sampling.
It also stated that it would increase the capacity of molecular tests in public laboratories (conducted when an individual is sick and more reliable than rapid tests, which need to be conducted later when the patient has developed antibodies).
And it estimated that it would soon clear the backlogged waiting list for tests. Currently, the country has some 150,000 samples waiting for a result. To date, 350,000 diagnoses have been made in public laboratories, according to the Ministry of Health.
But to date, only one-sixth of molecular tests – conducted in laboratories – that have been distributed to the states have actually been used. In all, 500,000 such tests have been collected, out of a total of three million delivered by the federal government.
The remaining five million already distributed by the portfolio are rapid tests, which do not require laboratory processing. Apart from the so-called sentinel units, only severe patients are still being tested using molecular tests.
Eduardo Macário, Deputy Secretary of the Ministry’s Health Surveillance Secretariat, says there has been an increase in the laboratories’ capacity in recent weeks, but he considers that testing involves a network that ranges from the availability of collection kits to having professionals trained to handle the material correctly and transport it. The states had been struggling even to purchase swabs to collects secretion from patients.
According to Macário, the Ministry of Health has been working to provide these supplies. He also stressed the difficulty in ensuring human resources to transport and receive the respiratory samples in laboratories due to the high demand for tests to be performed.
“The handling of this material is manual. A health professional places it in the means of transport so that it reaches the laboratory adequately. The laboratory needs to have a specialized technician to receive it. This process takes time, it is very intensive work performed by the central laboratories. The volume arriving is large, but the response varies according to the state”, he explains.
Health Minister Nelson Teich announced a few weeks ago that the country would achieve a total of 46 million tests to tackle the pandemic. A schedule released by the Ministry of Health on Thursday, May 14th, expects the distribution of these tests to occur before the end of the year, although experts project that the peak of the pandemic will occur by mid-year.
The amount that will effectively reach the states each month still hinges on suppliers’ ability to deliver in a scenario of global shortages of such supplies. To date, only 17.7 percent of the pledged amount of tests have in fact been delivered.
According to the Ministry of Health, Brazil is in the second of a total of five stages in the distribution of tests. To meet the target by late May, it will be required to double the 8 million tests already sent to the states. The country has developed public-private partnerships with laboratories to achieve 17 million tests over the next two weeks.
“We are finalizing bureaucratic procedures for the effective start of testing,” says Macário. The manager of the Ministry of Health argues that tackling the pandemic is not just about testing, but it also demands extensive monitoring to control the spread of the disease.
“It’s not simply about testing, monitoring actions must be implemented, identifying who had contact in order to achieve selective isolation,” he explains. This is a challenge that will remain for the coming months. Also on Thursday, the Secretary of the National Treasury, Mansueto Almeida, stated in Congress that “the way out of social isolation will hinge on a number of factors, such as the massification of tests”. The statement was issued during an online public hearing to assess the impacts of the coronavirus on the Brazilian economy.
The Ministry of Health concedes that Brazil is on a rising curve of coronavirus spread and that it is not yet possible to predict when the country will stabilize or slow down contagion. Infection is growing by an average of 7.3 percent each day in the country.
According to Macário, four states are on greater alert because they have a much faster rate of transmission of the disease than the national average: Paraíba, Maranhão, Pará, and Amazonas. The criteria for this alert are different from those that the portfolio had been disclosing in the past, which considered the total number of coronavirus cases.
As the epidemic spreads, the country is also facing difficulties with illness among professionals working in the front lines. Brazil has 31,798 health workers infected with covid-19 and another 199,768 professionals suspected of having contracted the disease. More than half of them (57.2 percent) have their tests under investigation.
The data, released by the Ministry of Health, includes countrywide data, excluding Paraná and Espírito Santo. These two states have their own platforms that are still being incorporated into the Ministry of Health’s system.
Source: El País