Secretary says the test is not a ‘requirement’ to treat Covid and fatality fell after Pazuello’s administration | Coronavirus

Franco also affirmed that the lethality of the disease caused by the new coronavirus fell in Brazil after the arrival of Eduardo Pazuello at the head of the ministry.

The statement comes at a time when the Health Ministry is criticized by experts for handling the pandemic that led to:

• 7 million tests run the risk of not being used, as they are about to expire and now need the approval of Anvisa to extend their validity;
• Defense of the use of chloroquine and hydroxychloroquine, although the World Health Organization (WHO) indicates that the drug was not effective against the disease;
• Exclusion of post in social networks of the Ministry of Health with the statement: “There are no specific vaccines, foods, substances or remedies to prevent or end Covid-19.“;
• Reduction of the total number of tests carried out, an element considered essential for the follow-up and contact isolation of patients with Covid.

During a press conference, Elcio Franco did not address the importance of performing Covid molecular diagnostic tests to trace contacts and isolate confirmed cases. Experts warn that testing is essential to track and stop the progress of the pandemic.

“The test will be carried out at the request of the doctor. We emphasize that the doctor will be able to make the physical clinical diagnosis. (…) It is not a requirement that the patient necessarily undergo the test,” said the secretary.

The cardiologist and researcher at the University Hospital of USP, Marcio Bittencourt, says that the test is not a mandatory requirement, but it is “highly recommended.”

“It is not a mandatory requirement, but it is highly recommended. I can even make a clinical-epidemiological or CT diagnosis when I do not have the test. It is a game changer. I can make many more mistakes. We need the test and we had to have many more evidence of what it has, “he says.

Bittencourt also recalls that WHO recommends a test positivity rate of around 5% so that the spread of the disease is considered controlled. In Brazil, this rate is 30% (the positivity rate represents the percentage of positive cases in relation to the number of tests performed).

“ME [a taxa de positividade] it was never below 20% in a week. Our positive positivity is that we taste little, and when we taste little, the positivity is high. You have to test 5 to 10 times more than we test to reach 5% “says the USP doctor.

The declaration of the secretary of the ministry on the possibility that the doctors adopt behaviors independently of the confirmation of the diagnosis on the part of the laboratory was made after affirming that there are “surpluses” of tests already distributed to the states.

The statement was made in a context in which about 7 million PCR-type tests, considered the “gold” standard for Covid-19 diagnoses, are parked, near their expiration date, in a government warehouse.

A second survey, conducted by the Brazilian Chamber of Laboratory Diagnostics, indicates that there are at least another 8 million tests in this situation in the country, bringing the figure to at least 15 million Covid-19 tests that expire in March. 2021 in Brazil.

‘Learning’ from the pandemic

Presenting the ministry’s initiatives, Franco explained that there was “learning” during the pandemic.

“We had a learning with early treatment, with early clinical management, with oxygen therapy, and with the expansion of primary care, with the expansion of care in Basic Health Units, with referral and community centers,” said Franco.

Marcio Bittencourt, from USP, recalls, however, that “there is no evidence that any early treatment works beyond preventive measures”, such as the use of masks and social isolation.

The drugs cited by the government as effective to combat the new coronavirus, such as chloroquine and hydroxychloroquine, have already been studied by Brazilian and international scientists and have not shown any effectiveness against the disease. On the contrary, research from the University of Oxford in the UK shows that hydroxychloroquine can make the case worse for Covid patients.

“It’s simple: no country uses it, no international organization uses it,” summarizes Marcio Bittencourt.

The ministry also did not present studies that associated a decrease in fatality with early treatment.

The portfolio’s executive secretary also said there was a drop in fatality from Covid-19. However, fatality is a percentage that is calculated by dividing the number of people who die from a disease by the total number infected. When more people are diagnosed, the fatality decreases.

“The fatality is not falling because I saved anyone, but because we are being able to diagnose more”, explains Marcio Bittencourt.

The number of detected cases increased after the government determined that the diagnosis could be made with imaging tests, for example, and not necessarily with tests.

Despite this, Elcio Franco did not assess whether there is a relationship between the level of tests carried out and fatality. When he held the post of Minister of Health, Luiz Henrique Mandetta affirmed that fatality would progressively decrease with the increase in tests in Brazil.

Questioned by G1, Hélio Angotti Neto, Secretary of Science, Technology, Innovation and Strategic Supplies of the Ministry of Health, did not evaluate the impact of the increase in tests on the fatality rate.

Neto said it is “difficult” to pinpoint a “single cause” but reaffirmed that early treatment, including hydroxychloroquine and chloroquine, had an impact on the index. “There is a correlation, this correlation cannot be negligible,” he said.

This Friday (27), Brazil reached the mark of 171,998 deaths from Covid-19, the second largest number in the world, only behind the United States.

VIDEOS: G1’s most viewed in the last 7 days