Federal Government Has 9.8 Million Covid Tests Stalled for Lack of Other Materials

RIO DE JANEIRO, BRAZIL – Almost six months after declaring the state of emergency because of Covid-19 in the country, the Ministry of Health still holds 9.85 million tests in its stocks, according to the portfolio’s internal documents.

The number is almost double the approximately five million units delivered so far by the federal government to states and municipalities. The backlog is for the PT-PCR type of test, considered the “gold standard” for diagnosing the disease.

The main reason for the tests to be stockpiled on the Ministry’s shelves is the lack of supplies used in laboratories to process patients’ samples. According to health secretaries, it is useless to send only the test, as specific reagents must also be distributed.

The federal government bought the test lots without being assured that it would have access to all such material, indispensable for using the tests. These products are not “regularly” delivered by the portfolio, says the National Council of Health Secretaries (CONASS).

When questioned, the Ministry of Health said it faced challenges in finding all supplies in the international market, but is stabilizing distribution as it receives imports from suppliers. The Ministry failed to explain whether it received any warnings from technicians during the planning process about the risk of the tests being stopped due to lack of supplies. It also failed to report how many reagents used in the sample extraction stage were delivered.

The shortage causes a kind of cascading effect in the states, which are left with their storage sites packed with the tests received and waiting for the other products. “At first we didn’t have any tests because they were scarce. Fiocruz began production, in addition to private laboratories. Then there was a shortage of tubes, extraction material, and then magnification,” Gonzalo Vecina, a professor at the University of São Paulo’s School of Public Health, says.

“Now only competence is lacking. The state’s willingness to distribute, collect and process is lacking,” Vecina, former president of the National Health Regulatory Agency (ANVISA) adds.

Data submitted on Friday by the Ministry show that Brazil has conducted 2.3 million RT-PCR tests for Covid-19, 1.4 million of which on the public health system and 943,000 on the private network. Over the same period, the country has conducted another 2.9 million rapid tests, which locate antibodies to the disease but are not suitable for diagnosis.

The partial kit delivery distances Brazil from the goal of tests for Covid-19. In addition to the shortage of reagents, the Ministry delivered insufficient equipment to collect and store patients’ samples. Data from the portfolio show that only 1.6 million swabs and 873,56 thousand laboratory tubes were sent until last week – a number well below the five million tests.

Executive Secretary of the National Council of Municipal Health Secretariats, Mauro Junqueira stresses that the tests were stored in the country due to the shortage of all the equipment needed for testing. “There was no harvesting material. It came incomplete. An agreement was made and (the purchase) is being centralized. The situation has already improved considerably in recent weeks,” he said.

Ministry technicians projected the country would conduct 110,500 tests a day, as per the minutes of the portfolio’s Emergency Operations Center (COE) meeting held on June 4th. However, the daily average in July was only 15,500 tests, according to the latest epidemiological health bulletin.

In the COE’s minutes of meeting on June 4th, the portfolio’s technicians listed as “critical points” the shortage of supplies for harvesting and processing the samples.

Despite the delay in diagnoses, interim Minister of Health Eduardo Pazuello has downplayed the lack of testing. “They devised the notion that you must test to tell it’s coronavirus. You don’t have to test, you have to have a medical diagnosis to say it’s coronavirus. And if the doctor certifies it, the treatment must start right away,” he said in an interview.

The lack of testing is reflected in the high number of cases without a proper diagnosis. Up to July 18th, Brazil recorded 441,194 hospitalizations for Severe Acute Respiratory Syndrome (SARS), 213,280 of them for Covid-19. There are still over 80,000 hospitalizations under investigation and 141,600 classified as an “unspecified” syndrome.

According to the president of the Brazilian Association of Collective Health, Gulnar Azevedo, the test kits stranded in the Ministry evidence the poor integration between the federal government, states, and municipalities.

Delivery and storage

According to Ministry data, the federal government has closed contracts to purchase 23.5 million RT-PCR tests, for R$1.58 billion. The portfolio is still waiting for the delivery of 8.65 million units to be passed on to states and municipalities. Regarding the stockpiles of kits, the Ministry of Health said that the states “do not have the capacity to store a large amount of supplies at once. Therefore, “the tests in stock are distributed according to state demand.”

Source: O Estado de S. Paulo