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Every day, the media reports new data on the new coronavirus pandemic (covid-19), such as deaths, confirmations, hospitalized patients, people under observation and recovered, distributed teams, and incidence, mortality and mortality rates, among others.
Notifications
The cases are perceived by the local health authorities. They should notify people with flu syndrome and severe acute flu syndrome (SARS) hospitalized or whose course ends in death that meets the case definition. This registration must be done within 24 hours after the suspected infection.
Therefore, the agents of the public and private health units must do so. The Ministry of Health has systems in which information on patients and cases must be fed, such as the Epidemiological Surveillance (VE) e-SUS or the Influenza Epidemiological Surveillance Information System (SIVEP-Flu).
According to the Ministry of Health, when there are suspicious deaths, even if they did not occur after hospitalization, it is necessary to power the system. There is a document with guidelines for completing it, called Managing the body in the context of the new coronavirus COVID-19.
There may be situations where the test is processed after the patient’s death. If this occurs, the data on the cause of death, and the count of this death in the covid-19 statistics, can be added days after the occurrence.
Case definition
To collect and analyze information, a key definition is how to include a patient as a case of covid-19. The suspicion is related to two types of conditions: the flu syndrome and the severe acute flu syndrome (SARS).
According to the MS protocol, flu syndrome is characterized as “an individual with an acute respiratory condition, characterized by a sensation of fever or fever, even if reported, accompanied by cough or sore throat or runny nose or difficulty breathe”. In the case of the elderly, there is no obligation for fever and aggravating factors such as syncope (sudden fainting), mental confusion, excessive drowsiness, irritability and lack of appetite are considered.
Severe acute respiratory syndrome (SARS) occurs when there is “dyspnea (shortness of breath), shortness of breath or persistent pressure in the chest, or less than 95% O2 saturation in ambient air or bluish color of the lips or face.” In children, it includes nasal flutter, dehydration, and poor appetite.
A case is confirmed by laboratory tests or serology. The first is called RT-PCR, which detects the presence of the virus. The second maps the presence of antibodies that can indicate the existence of the virus. The latter is less effective than laboratory tests, but takes less time. Another form of confirmation is what professionals call the “clinical-epidemiological criteria”, when there is a person with flu-like syndrome or SARS and several questions are evaluated, including contact with infected people in the last seven days before the onset of symptoms. .
Systematization
The health units transmit the information to the municipal departments and these to the state departments. The information is loaded into the systems of the Ministry of Health. In general, state departments publish data from their states on a daily basis. The Ministry of Health publishes a daily update on the information sent until 2 p.m. of that day.
Additionally, the folder created an online platform to make the data available.
MS managers have already explained that despite computerized systems, data is not loaded in real time. For both deaths and data on infected people, the log is only added when confirmed by testing the infection and when feeding.
With that, data only enters the system when these procedures are met. Therefore, the Ministry of Health itself has already admitted on several occasions that there is a large underreporting of infected people. First, because more than 80% of people with coronaviruses have no symptoms. Second, due to the difficulty of testing, it has been trying to reverse itself with the acquisition of new kits and with “massive” testing initiatives, such as through-drive systems.
Under-registration
In the case of deaths, the EM team repeatedly stated that there were no minor reports, but that there may be a delay between death and confirmation that the cause was covid-19. Therefore, the daily death data also reflects situations from the previous days added to the balance sheet for that day.
The speed with which this information is sent depends on the testing capacity of hospitalized and deceased patients, but also on the agility of feeding. This process, for example, is less intense on weekends, due to the reduction of workers to carry it out. Therefore, the MS has already warned that the data for Saturday, Sunday and Monday may have fewer cases, as well as the data for Tuesday may have more to account for an update accumulation.
