Conass was not warned about the change in the Ministry of Health regarding deaths, says Carlos Lula; ‘The decision is wrong and must be reviewed immediately’ | Maranhao

• São Paulo says the change affected the death count: 281 in 24 hours

“The decision is incorrect, creates discredit and must be reviewed immediately,” he said.

When asked if the city council had been notified, Carlos Lula said:

We did not go and it is not possible to make changes like this, without prior notice ”.

Said Conass will ask the Ministry of Health to review the standard.

On Tuesday (23), the day that Brazil again broke the record of deaths from Covid-19 confirmed within 24 hours, the Ministry of Health changed the patient’s record in the Influenza Epidemiological Surveillance Information System (Sivep- Flu). The information is from technicians charged with completing daily updates on new deaths caused by the disease.

Carlos Lula affirmed that the reason for the change is the need to monitor eventual deaths after vaccination. “It’s important, but it can’t happen by surprise,” he says.

Another body of secretaries, the National Council of Municipal Health Secretaries (Conasems), said that it advocates the withdrawal of the new mandatory Sivep-Flu fields included by the Ministry of Health.

TO TV Globo sought the Ministry of Health to confirm that the change was agreed with the state and municipal departments, but had not received any feedback until the last update of this report.

In a note sent to TV Globo, the executive secretary of the National Council of Municipal Health Secretaries (Conasems) said that the new fields were already being discussed previously, but there was a “lack of adequate communication” at the time the change was officially instituted.

For this reason, we request the elimination of these fields as mandatory for the moment, ”says the city council.

Find out what the changes are

The new form distributed to the municipal and state sanitary surveillance caused a series of changes. For example, a field has been included to inform whether the patient belongs to a traditional community. On the other hand, other fields have been excluded, such as the international travel history.

Other changes, however, should affect the filling job more directly of the system, such as the obligation to report:

• the number of the National Health Card (SUS card);
• if the patient is Brazilian or foreign;
• me if you have already been vaccinated against Covid-19.

All these fields did not exist in the previous version of the form, in use since July 2020.

Additionally, the CPF number field, previously considered “essential”, becomes mandatory. If the patient does not have the CPF in hand, it is mandatory to complete the SUS National Card. The only exception to this requirement are patients declared indigenous on the form.

Instability on Tuesday

This Wednesday (24), at least two state governments and one municipal government reported a drop in notification new deaths from system changes.

In São Paulo, the government stated that “the measure took municipalities by surprise, causing many cities not to register all deaths in the official national system.”

Additionally, many cities have reported system instability to the State Department of Health since yesterday afternoon. [terça], which also makes data entry difficult. ”

On Tuesday, São Paulo confirmed 1,021 deaths, mainly from dams over the weekend, which is higher than on weekdays.

On Wednesday, however, there were 281 confirmed deaths in 24 hours, the lowest number for this day of the week since February 17, and well below Tuesday’s moving average of 532 daily deaths. With the drop in productivity, the average also dropped to 484.

In Mato Grosso do Sul, the Secretary of State for Health, Geraldo Resende, affirmed that the 20 new deaths confirmed in 24 hours do not represent “reality.”

“We are having many more deaths than announced today. But it is because the system, called Sivep, is oscillating, it is making data insertion difficult, and certainly tomorrow we will have an elastic number of deaths, since our moving average has already exceeded 30 daily deaths “, said the Secretary of Health of the MS, Geraldo Resende.

“And we know that this figure today is lower than in recent days due to this fluctuation in the Ministry of Health system.”

In Rio Grande do Sul, the Porto Alegre City Council also confirmed in a note “that it faces problems to insert data on the coronavirus in the Sivep-Flu system of the Ministry of Health” and that the situation has been in place since Tuesday.

According to the city council of the state capital, “the instability has possibly caused the data to be impounded,” as hospitals in the city also send data to the system.

The city says it is “investigating more information about the delay” and that the “Ministry of Health informed the municipality that ‘they are trying to locate the problem and solve it as soon as possible.”

Impact on death count

Sivep-Influenza is the official system where all new hospitalizations due to Severe Acute Respiratory Syndrome (SARS) must be notified since 2009. In 2020, with the new coronavirus pandemic, it also began to be used as an official source of confirmed deaths. by Covid-19.

The system file is valid for all hospitals and municipal surveillance in the country. As the patient evolves and new information is obtained, such as the results of the examinations, the need for admission to the ICU or mechanical ventilation, as well as the date of discharge or death, his record will be updated.

According to the Sivep user technicians consulted by the reporting team, in previous changes to the form, there was no need to retroactively fill in new fields for patients who were already in the system.

The two main impacts of the new form, according to them, were the lack of advance notice by the Ministry of Health and the secretariats, as happened last July, and the requirement to fill in new fields, which may increase the delay between the occurrence of deaths and their registration in the system, so that they are included in the official daily balance.

Marcelo Gomes, coordinator of InfoGripe, a Fiocruz platform that Sivep-Gripe used to track SARS cases in Brazil since the pandemic, explains that the change will affect the delay in the notification of cases and deaths.

According to him, “it is a change that facilitates the cleaning of duplicates and identification of suspected cases of reinfection, but the impact on the tip is very great due to the lack of easy access to the CPF and CNS of all hospitalized patients.”

He explains that “several patients seek care only with RG, so the absence of access to the PFC is important. In these cases, it is necessary for the health agent to investigate the patient’s CNS, if it is already registered, or to register the CNS otherwise ”.

According to Gomes, the change “tends to further delay the registration, increases the workload, due to having to search for the CNS of the patient who does not have PFC, and there is a risk of loss of records because of that.”