Brazil registered, in June 2022, 4,739 deaths from Covid-19, up 49.2% from May. It is the first time that the number of deaths from the disease has increased from one month to another since February.
The data were gathered by the consortium of press vehicles with the country’s Health Departments.
Deaths from Covid-19 per month in Brazil
Source: Health Departments/Consortium of press vehicles/Exclusive surveys G1
In this report, you will see that:
- Brazil presented the first monthly increase in deaths since February. Because of the large number of cases, however, the case fatality rate dropped;
- the cold, the increase in agglomerations and the removal of masks are pointed out as reasons for the increase in cases;
- there is a lot of regional inequality in vaccination;
- it is important to take the booster dose to avoid complications;
- Covid is a disease that can cause, in addition to death, symptoms for a long period (long Covid), and therefore the death/case ratio is not the only one that must be analyzed;
- for the same reason, the virus remains a threat to health, and we must continue protective measures.
Drop in lethality rate
Despite the increase in deaths in absolute numbers, the lethality of the disease – number of deaths in relation to the number of known cases – dropped from one month to the next. That’s because May recorded just over 570,000 cases of the disease, while June had more than 1.3 million cases.
Professor Eliseu Alves Waldman, from the Epidemiology Department of the School of Public Health at the University of São Paulo (USP), explains that the absolute increase in deaths was already expected, precisely because of the significant increase in the number of cases.
“It’s expected – because the number of cases increased a lot in June compared to May, and especially in relation to April”, he recalls. That month, about 500,000 cases of Covid were recorded in the country.
Covid’s lethality for the last 6 months was also the lowest for a semester since the beginning of the pandemic.
At the same time that official figures point to an increase in cases (see details below) and a drop in lethality, the experts heard by the g1 also consider that, today, it is more difficult to carry out analyzes with these data, because of the self tests.
“Especially from this year onwards, as there was an increase in the proportion of the population that has access to rapid diagnosis, this diagnosis is made in the pharmacy, which does not always notify, and many tests are being done by the individual, by the patient himself, and he does not notify”, observes Eliseu Waldman, from USP.
For Beatriz Klimeck, anthropologist and doctoral student in Public Health at the State University of Rio de Janeiro (Uerj), self-tests, despite having been a positive contribution, brought with them an even greater underreporting of cases than what was already seen in other phases of the pandemic.
“It’s a good thing we have this function [do autoteste]. It made access to diagnosis and later isolation cheaper for anyone who wants to do it, as they should,” says Klimeck.
- I took the Covid self-test and it was positive; what should i do with the result?
“But it generates a gigantic underreporting: there was no effort to make some form of mandatory or voluntary notification, but it worked, so we know that number [de casos] it is very outdated. We can talk about a much larger number of real cases – people who tested positive, [que o teste] gave a reagent and who were not notified to the health system“, emphasizes the researcher.
For Waldman, the increase in cases in recent months is mainly due to the seasonality – the arrival of autumn and winter brings an increase in the circulation of respiratory viruses, such as Sars-CoV-2 – and, also, the resumption of social events with agglomerations and without the use of the mask.
“I think it’s normal that the use of a mask on the street is no longer recommended. But it should be kept, even on the street, when there is agglomeration, and in a closed environment. And keep the same care of distance and hand hygiene. I think that was practically abandoned”, he ponders.
“June parties are back and social activities, parties, weddings, have returned without any apparent care. This contributes, in addition to seasonality, to intensify the current wave a little more. we have to convince ourselves that we’re going to have to keep being careful for a long time“, evaluates Waldman.
The epidemiologist also hypothesizes that we are entering an endemic phase of Covid-19: his prediction is that what was seen last year will be repeated – an increase in cases until the end of July, a stabilization and, at the end of August, a decrease.
“If we don’t have any variant with a great capacity for infection and to cause more severe forms, we should have another peak in the winter of next year. This is a hypothesis”, he says.
He also points out the existence of other respiratory viruses – such as bird flu and monkeypox – that are circulating at the same time as Sars-CoV-2 and that could become threats in the future.
“Avian flu lives around us. From one moment to the next, you can adapt [do vírus], and then we will have problems. Monkeypox should become endemic – there is nothing to indicate that this disease will no longer be on the list of endemic diseases. As of the end of the year, it’s probably going to be one more illness that you’re going to have to deal with,” he says.
Fiocruz’s June 23 bulletin on severe acute respiratory syndrome (SARS) points out that, this year, about 82% of SARS cases were caused by Covid-19. Another 9.3% were caused by respiratory syncytial virus (RSV), 5.1% by Influenza A and 0.1% by Influenza B.
In the last 4 epidemiological weeks, Covid was responsible for 81% of SARS cases.
Another factor is the subvariants of the omicroneven more transmissible than it – which was already more transmissible than the original variant of the coronavirus.
“What I see is that with the Ômicron – which has a great transmission capacity – we had an important increase [nos casos] in January, and now we have variants of the omicron, which also have a very large transmission capacity”, says Waldman, from USP.
Sequelae and preventive measures
An important point to understand the impacts of Covid in the country is to remember that the disease, even if it does not lead to death, can bring sequels that affect health in the short, medium and long term.
“Covid is a disease that causes an inflammatory storm, which can lead to multiple sequelae in a considerable part of the population”, reinforces Beatriz Klimeck, from Uerj.
“From immediate sequelae to later sequelae – months later, your body was weakened by that inflammatory storm and, then, something developed.
The scientist recalls that, today, with the release of the use of masks in most of the country, “there is no barrier between you and the virus proposed collectively”.
“People are coming out of isolation, still transmitting; we know that they are being encouraged to no longer wear masks, the only protection we had. And the virus has absolute freedom to circulate. significant, more importantly, for this to lead to the majority of the population with sequelae, it is very simple”, evaluates Klimeck.
Therefore, says the researcher, when the importance of preventive measures, tests and isolation of positive cases is reinforced, “it is because we no longer see barriers, unfortunately, to the circulation of this virus”, she explains.
“And he, though he had greatly diminished the number of deaths, it is not yet a virus that does not pose a risk to our health. On the contrary: it remains a very complex virus, which leads to complex processes within the body, of inflammation, that we still can’t understand. Then, It’s always important to say that we didn’t turn Covid into a little flu“, remember.
“It would have been great if it had happened, but it hasn’t happened yet – and it’s not because the death toll is down there, fortunately, because of vaccines, that we’ve arrived at a time when the virus is no longer dangerous, no longer threatening. our existence”, he concludes.
The drop in Covid lethality, even with the increase in cases, also did not occur by chance: vaccination, which began in January 2021, has been expanded over the past year.
Even so, less than half of the Brazilian population, about 47%, has already received the 3rd dose of the vaccine (first booster dose). In addition, vaccination coverage varies greatly between states (see map below).
“Now, vaccination cannot be considered just that primary schedule. Depending on the age group, you have to have 3 doses – the primary schedule plus a booster dose -, and, depending on the age group, you have to have the primary schedule and 2 booster doses”, reinforces epidemiologist Ethel Maciel, professor at the Federal University of Espírito Santo (Ufes).
The researcher points out that, although it is already scientifically proven that the 3rd dose significantly increases protection, the lack of information and communication with the population makes people think they do not need the booster.
“What’s up [a população] it is more susceptible to having a greater severity in these subvariants of the omicron, which have made so many changes that they have a greater escape from vaccines. That’s why the booster shot is important,” he says.
In a technical note released on the 29th, Fiocruz pointed out that stagnation in vaccine coverage and inequality between states threaten the fight against Covid-19.
The data collected by the foundation showed, for example, that the coverage of the primary regimen (two doses) and even the first dose alone is lower in cities in the Midwest and North; in these places, only about 50% of the population received the first booster dose.
São Paulo, Minas Gerais, Piauí, Paraíba, Bahia and the southern states have greater coverage. The difference was also observed in the coverage of adolescents aged 12 to 17 years.
Deaths from Covid in Brazil and other countries — Photo: Elcio Horiuchi/g1
Fiocruz also pointed out, in the document, that the stagnation of vaccination coverage did not occur only in Brazil.
In Chile, for example, coverage with the first two doses was 87%; in South Africa, the rate is only 32%. In South Korea and Vietnam, stagnation occurred in 81% of the population; while Uruguay and Argentina reached a plateau of around 72% of the population vaccinated with the primary regimen, and Mexico, 57%.
In the United States, about 67% of the population received the primary vaccine regimen. In Brazil, the rate of the population vaccinated with 2 doses or a single dose (primary regimen) is 78%.
Countries other than Brazil – including the US – face high deaths, such as Russia, Italy and China, according to the latest report from the World Health Organization (WHO).
However, Eliseu Waldman, from USP, believes that it is difficult to make comparisons with other countries. In the United States, for example, hesitation and refusal to vaccinate are considerably higher than in Brazil.
“It is difficult to make precise comparisons, because it will vary greatly depending on population density, the size of large cities, the life expectancy of the population, that is, the average age. For example, Italy is a country in which the proportion of elderly is higher”, he recalls.
Other factors that contribute to variations in scenarios are the degree of development and distribution of wealth in a country and the access and quality of health services – mainly hospital care for severe forms of Covid.
“And the governance of the country,” adds Waldman. “The countries that had the worst performance of the pandemic – the worst of all was the United States, then Brazil came, for similar reasons. In addition to all these complexities of the pandemic, governance there and here did not go well. Only in Brazil you had a positive participation, let’s say, from a good part of the state governors and, in the United States, not even that”, he evaluates.