Brazil May Have 2,500 Unreported Covid-19 Deaths

RIO DE JANEIRO, BRAZIL – On Tuesday, April 28th, Brazil reached the mark of 5,017 deaths by Covid-19 and, as a result, joined the list of the ten countries with the highest number of victims of the disease, according to a survey on the Worldometers website.

But data show that with over 2,500 potentially unnotified cases, Brazil may be the country with the sixth-most deaths – behind only the United States, Italy, Spain, France, and the United Kingdom.

Just as tests for patients with symptoms are lacking, there is also underreporting of deaths with no positive or negative diagnosis for Covid-19 throughout the country.

Without a specific diagnosis, deaths are recorded as Severe Acute Respiratory Syndrome (SARS), a designation that encompasses a number of respiratory diseases, such as influenza A and B, and now SARS-Cov-2, the scientific name for the novel coronavirus.

According to InfoGripe, a Ministry of Health platform in partnership with Fiocruz that collects data on respiratory diseases in the country, in the first week of March deaths classified as SARS began to grow exponentially compared to the preceding five years.

“To enter the SARS classification, patients must show a well-defined set of symptoms: fever, cough or sore throat, and difficulty breathing. Identifying which respiratory virus led to the patient’s death is a second step,” explains Marcelo Gomes, coordinator of InfoGripe.

The numbers show that in six weeks, from March 1st to April 18th (last available data), Brazil recorded 5,239 deaths classified as SARS. Over the past five years, the average for the same period was 770 deaths from respiratory diseases. Not even 2016, when the second-largest H1N1 outbreak occurred, comes close to this year’s data.

According to Gomes, there are a number of factors that support the assumption that these 700 deaths’ difference between Covid-19 and SARS records can be, to a large extent, the novel coronavirus.

“We are challenged by laboratory capacity to process tests, but the data are rich: this year, the over-60 age group is predominant in deaths, while other viruses tend to affect children more. The number of deaths is also completely atypical,” he says.

According to the Ministry of Health, there are currently 1,136 deaths under investigation, in addition to those already confirmed. In a technical interview on Monday, April 27th, the Health Surveillance Secretary of the Ministry of Health, Wanderson Oliveira, explained that there is a daily increase in the data of deaths that occurred at different times, but which are only now being finalized.

Another source of data that supports the assumption of underreporting of victims of the novel coronavirus is the Civil Register of Death Certificates. From March 1st to April 28th, the number of deaths suspected or confirmed of Covid-19 is 5,049, a difference of 500 deaths from the Health portfolio’s official data.

Furthermore, between February 26th, the date when the first case of coronavirus infection was recorded in Brazil, and April 17th, the Brazilian civil registries recorded a 43 percent increase in the number of notifications of deaths from undetermined causes.

According to data from the Civil Registry Transparency Portal, in 2020 the country recorded 1,329 deaths from undetermined causes in the period mentioned. In 2019, 925 deaths of this type were recorded by the registry offices in the same interval.

“The main problem in the country not knowing the real number of people who died from the novel coronavirus is that we will never know when we reached the peak of the pandemic, or even how many more patients we will have. We’re flying blindly into a storm,” says Gonzalo Vecina, former president of ANVISA and professor at the Public Health College of the University of São Paulo.

International trend

The challenge of correctly determining as many of the victims of Covid-19 as possible, however, is not exclusive to Brazil. According to a survey by the British magazine Financial Times, deaths from the disease may be 60 percent higher than the 200,000 reported today.

In an analysis of 14 countries, the publication identified 122,000 deaths above normal levels in locations, compared with data from the past five years. The estimate represents a 50 percent increase in overall mortality in relation to the historical average of the locations studied.

“There is no question that Covid-19 is causing worldwide concern. The influenza virus already has an expected pattern, it cannot grow twenty-fold or more from one year to another,” says Antônio Carlos Bandeira, coordinator of infectology at Hospital Aeroporto, in Salvador, the capital of Bahia.

The infectologist recognizes that it is challenging to say there are more deaths from Covid-19 than the numbers show. “But then I ask: prove that it is not the novel coronavirus. Nobody will be able to”, he says.

Source: Exame