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The curve is clear: the new cases of Covid-19 registered in Fortaleza have been growing for eight weeks, and in the last seven the confirmations have exceeded a thousand. In the final stretch of November, between November 15 and 21, the confirmation of infections exceeded two thousand cases, according to data made available on the IntegraSUS platform of the Secretary of State for Health (Sesa). For health surveillance specialists, the indicators may signal a second wave of the disease in the capital.
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In the last epidemiological week of November, between November 22 and 28, the registries reached 1,173 positive diagnoses. From November 29 to December 3 there were 120 more confirmations. However, the platform may still have updates for the release of new tests that are still being analyzed in the labs, in the coming days.
For Caroline Gurgel, epidemiologist and professor at the Federal University of Ceará (UFC), Fortaleza is already experiencing the second wave. “In August and September, the curve narrowed, which made it safe for people to fill the shopping malls, celebrate. Now we have the image of that. Unfortunately it happened and now he comes with everything again ”, he considers.
The biomedical and virologist Mário Oliveira, for his part, prefers caution and expects the consolidation of the scenario in the coming weeks. “The beginning is a bit clear, but since a good part of the population is already infected, I don’t think it will last long. Even people who are being reinfected are taking milder forms, “he explains.
The common assessment among them, however, is the perception of non-compliance with social distance measures. This relaxation is also indicated by the Pnad Covid-19 survey, from the Brazilian Institute of Geography and Statistics (IBGE). In October, according to the survey, 533 thousand (5.8%) from Ceará did not adopt any restrictive measures, and another 3.7 million (40.2%) reduced contact, but continued to leave home.
According to the IBGE, women registered higher percentages of isolation than men. Even with a high isolation rate (74.5%), the group of people aged 60 years and over, with the highest risk of severe forms and deaths, showed a reduction in relation to September (79.5%).
The Secretary of Health of Ceará, Carlos Roberto Martins Rodrigues Sobrinho, Dr. Cabeto, avoids speaking in the 2nd wave, but confirms the greater positivity of the samples. He points out that 80% of newly infected people are under 50 years of age. The manager guarantees that the State has already anticipated measures to respond to this new scenario.
“We are expanding the beds in addition to our projections of increase. In the last four weeks, the Government has not evolved in the flexibility plan either. I think this is an important message: when the plan does not evolve, it says that there is no way to expand the opening, ”explains Cabeto, defending the regionalization of decisions according to each epidemiological scenario.
Restrictive measures
Epidemiologist Caroline Gurgel does not believe that the incidence can decrease with behavioral measures alone. He also warns about the lack of knowledge of how Sars-Cov-2 will interact with the respiratory viruses already known in Ceará, such as influenza and RSV, in the first months of 2021. “We still do not know if Covid can increase the severity of infections that we already know. And then maybe just the crash, unfortunately. I have eight years of experience with respiratory viruses and this is the worst, ”he says.
Mário Oliveira does not speak in favor of a new confinement, but agrees that more restrictive measures are necessary, especially with regard to movement in shops and parties. “Who knows how to touch the pocket, apply some economic punishment, especially in places that are promoting crowds,” he suggests, confirming that the positivity of the new tests has not been falling.
Throughout November, according to IntegraSUS, there was an increase in deaths in the capital of Ceará. From late September to mid-October, there were fewer than 10 deaths per week. However, as of November 1, this mark was exceeded with 15, 13, 19, and 21 deaths in the four weeks of the month, respectively.
Still, UFC’s Caroline Gurgel notes that the change in the proportion of cases by age group and the rating of professionals has reduced deaths. “Most economically active youth are not at risk and do not have comorbidities, so mortality does not follow the increasing incidence of the number of cases. In addition, you have gained experience. Today there is quantity and quality of studies that allow professionals to better manage each case ”.
The expert reflects that, with the easing of economic activities, in June, “people believed that the pandemic was decreasing to the point of feeling safe and they returned to frequent crowds.” However, remember: there are studies that document that only one infected person, in a closed environment, can transmit up to 100 others, which are considered “super transmission” events.
The infectologist Roberto da Justa, a member of the Coletivo Rebento – Doctors in Defense of Ethics, Science and the SUS, is also concerned about the trend of increasing deaths. For him, if there is no “awareness of the preservation of life” in the movement of Christmas parties, it is possible that the death toll, “which is already increasing, will increase even more.”
In the last month, the use of Intensive Care Units (ICU) has increased again, especially in the private sector. According to IntegraSUS, this Friday afternoon (4), Fortaleza had 68.9% of the ICUs exclusively for Covid-19. In total, 131 of the 190 available beds were occupied. In the public network, the capacity was 79.5% (62 of 78 employed). In the private network, 61.6% (69 of 112 employed).
In the past week, the Fortaleza General Hospital (HGF) field hospital also returned hospital patients with the disease. With the number of cases declining since June, she had started treating people with other illnesses. Sesa stated that the unit was never deactivated because, as the pandemic continues, it is necessary to maintain the structures.
For Professor Caroline Gurgel, the massive testing of the city’s population cannot be waived, even recognizing the logistical difficulty of investigating the 2.6 million inhabitants, and tracing the contacts of already infected people. “There is no way to isolate asymptomatic people. If you don’t take these steps, you won’t control the disease. It would be the correct way to contain the spread of the epidemic ”, he emphasizes.
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