MercoPress. South Atlantic News Agency

Covid-19 shows social inequalities in Brazil and kills 2 in Bolivia

Patients in private healthcare facilities in Brazil did better on average than those treated in public hospitals for Covid-19

According to a study by the National School of Public Health (Ensp/Fiocruz) released this week, COVID-19 turned out to be a reflection of the South American country's socioeconomic and health disparities while in Bolivia -a full Mercosur member since earlier this month- two people have died of the disease.

The “Inpatient mortality in Brazil from 2020 to 2022: a cross-sectional overview” based on secondary research carried out by scientists Margareth Portela, Mônica Martins, Sheyla Lemos, Carla Andrade, and Claudia Pereira underscored the urgency of addressing the lack of investment in the country’s public healthcare network known as SUS, Agencia Brasil reported.

Featured in the International Journal for Equity in Health, the study reveals that disparities in the mortality rates of Covid-19 hospitalized patients were linked not only to age group and case severity but also to social and regional inequities and disparities in access to high-quality care.

The study used data from public sources, revealing that the SUS handled over 70% of Covid-19 hospitalizations in Brazil, benefiting the most vulnerable groups. However, despite this coverage, the SUS had the highest hospital mortality rate. Conversely, non-SUS private and philanthropic hospitals produced better outcomes.

Southern Brazil exhibited the most favorable performance among the macro-regions, while the North performed the least favorably. The study's results further indicate higher hospital mortality rates from Covid-19 among black individuals nationwide and among indigenous populations in the North and Central-West regions. Black and indigenous individuals residing in municipalities with lower Human Development Index (HDI) scores and those admitted to hospitals outside their city of residence faced elevated risks of in-hospital mortality. Additionally, hospital mortality rates peaked during the height of the pandemic but significantly declined following the achievement of reasonable Covid-19 vaccination coverage, beginning in July 2021.

According to the researchers, “the findings underscore the crucial role of the SUS in delivering healthcare, as the majority of Covid-19 hospitalizations were managed by the Brazilian public health system. However, the results also reveal shortcomings in the performance of SUS hospital units compared to the private sector and, in some regions, even to public hospital units not affiliated with the SUS. These disparities reflect long-standing structural and funding issues.”

The study also highlighted increased hospital mortality during the initial wave of the pandemic (April to August 2020) and the subsequent wave (December 2020 to May 2021), with a decrease observed in 2022, despite the ongoing third wave (January to February). March 2021 saw a peak in deaths, coinciding with hospitals operating at or beyond maximum capacity, resulting in shortages of critical resources like ventilators, oxygen, and ICU beds across the country.

“Drawing from lessons learned, improvements need to be made to better prepare the health system for future pandemics or other large-scale health emergencies. This includes investing in more health infrastructure, increasing healthcare workforce, providing enhanced training and support for these professionals, as well as improving salaries and working conditions, including access to protective equipment,” the research suggests.

For the authors of the article, despite its challenges, the SUS has several strengths that make it essential, unique, and valuable to Brazilians, Agencia Brasil also pointed out.

Bolivia

In Santa Cruz de la Sierra, Bolivia, the death of two people infected with Covid-19 amid a surge in cases was confirmed. One of the deceased is a 14-month-old toddler from Roboré, who died while in hospital. The other victim is a 68-year-old woman with a pre-existing condition who had received three doses of coronavirus vaccine.

Authorities reported 110 infections last week from 28 cases the week before and 20 the previous one. “We are monitoring all the people with whom they have had contact,” the government of Santa Cruz explained while urging the population to show up at vaccination centers.

National Epidemiology Director Freddy Armijo said the number of confirmed cases had increased by 60% in the country.