Four years after the first covid-19 case in Brazil, there is still no pattern for the disease’s behavior. With vaccination, infection and death rates fell considerably, as did the severity of the disease for the majority of the population.
Nonetheless, the virus’s rapid rate of transmission and the unpredictable nature of mutations create a “precarious equilibrium” in the current epidemiological state.
According to Antonio Augusto Moura da Silva, an epidemiologist and professor of the Graduate Program in Collective Health at the Federal University of Maranhão (UFMA, in Portuguese), as the population develops immunity against the virus, a pandemic can evolve into a “endemic,” where a disease reoccurs in a region without a significant number of cases or deaths.
“The question that emerges is whether we have already reached this balance, that is, whether the situation has evolved into what we call an endemic. Currently, it’s difficult to determine whether or not it was reached. We can’t affirm it. However, every state of equilibrium for all infectious diseases is always very fragile and can be disrupted by anything new,” says the professor.
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According to Moura da Silva, although Brazil has not reached this point, “evidence indicates” that the country is moving “in this direction”. However, any equilibrium is unstable, particularly if the virus evolves into a more aggressive variant. A lethal mutation is possible. Mutations are random events, and we can’t tell which direction they’ll go,” he says.
This analysis agrees with Paulo Lotufo, a professor of Internal Medicine at the University of São Paulo Medical School, who believes that the disease’s behavior is not fully understood.
He says it is “interesting” to compare COVID-19 case peaks to those of influenza. “While the influenza season has a well-defined time pattern, COVID did not exhibit this clarity, making it difficult to predict how things will unfold. Although the vaccine has contributed to a decrease in major cases and deaths, it does not provide a comprehensive understanding of covid-19 peaks,” he says.
The current belief is that, as with other diseases, there will be more sensitive individuals, such as those in heat circumstances. This dynamic is comparable to that of influenza, but the pandemic continues to reveal details that have yet to be fully understood and recorded due to the ever-changing complexity.”
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of this view, continual data collection and recording is critical due to the constant transformations, contributing to a more thorough and efficient knowledge of health-care management.
Isaac Schrarstzhaupt, an epidemiologist and data scientist at the Rede Análise Covid (Covid Analysis Network in English), agrees that the virus’s activity does not follow a pattern. He goes on to say that because of the virus’s high transmissibility, he is unsure whether a pattern can be identified.
According to Schrarstzhaupt, SARS-CoV-2 is so infectious that it does not depend on the seasons, as flu does during the winter when people are crowded indoors. In Covid’s case, it’s more about people’s actions.
For example, if people utilize prophylactic measures less frequently, such as protective face masks, the rate of infection rises, regardless of whether it is winter or summer. As a result, the virus has a higher risk of evolving and undermining present disease control measures. “Mutation is a result of this fast transmission rate because the virus enters the body, enters cells, begins to multiply, and then mutates. A mutation might render the virus entirely ineffective or smarter. Then it becomes the new majority variety.”
Schrarstzhaupt’s inability to identify a pattern in the disease’s behavior stems primarily from this argument. “For this to occur, the virus would have to lose its ability to mutate and generate so many varieties, and the dominant variant that remains would have to be more or less predictable, similar to influenza. The high mutation rate of SARS-CoV-2 leads me to conclude that it is unpredictable, at least not in the long term,” according to the statistics.
Vaccination
COVID-19 is extremely contagious and has a low immunization rate, particularly among youngsters. Researchers stress that the current epidemiological condition differs dramatically from the picture that existed before to the vaccination. Despite this, adherence to the most recent vaccine doses is lower than ideal.
According to the Ministry of Health, from the start of COVID-19 immunization in Brazil on January 17, 2021, until February 6, 2024, 517 million doses were delivered to the general public, with 6.7 million going to children under five years old.
Currently, only 6% of children aged six months to two years and 6.4% of children aged three to four years have completed the monovalent immunization regimen. The rate is far lower than the aim of 90% vaccination coverage.
“To reduce cases, the population must take precautionary steps. However, only immunization will reduce major cases and deaths. Data suggest that the pandemic is far from an emergency, but it is nonetheless significant and responsible for a large number of serious respiratory infections,” particularly among youngsters and the elderly, according to the data researcher.
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In 2024, up to the sixth epidemiological week (February 10-16), there were 4,937 hospitalized cases of Severe Acute Respiratory Syndrome (SARS), with respiratory viruses accounting for 41% (2,020). COVID-19 was responsible for 64% of these cases. There were 506 SARS deaths reported within the same time period, with respiratory viruses accounting for 56% (283) of these. COVID-19 was responsible for 91% of these cases. The data comes from the Ministry of Health’s most recent Epidemiological Bulletin.
According to Ministry data, the elderly have a higher infection rate than children. The elderly account for the majority of deaths.
What has the Ministry of Health said?
According to Ethel Maciel, Secretary of Health and Environmental Surveillance at Brazil’s Ministry of Health, the present epidemiological condition is “very different” from when the World Health Organization (WHO) declared the pandemic a Public Health Emergency of International Concern (PHEIC). “Vaccination resulted in significant disease control. So we’ve gone from 3,000 deaths per day to an average of 30 to 50,” she said.
This year, the COVID-19 vaccine was included to the country’s National Immunization Program. The Ministry of Health prioritizes children aged six months to five years old and groups with a higher risk of developing severe forms of the disease: the elderly, immunocompromised people, pregnant and postpartum women, health workers, people with comorbidities, Indigenous people, river dwellers, and quilombola people; people in long-term care institutions and their workers, people with permanent disabilities, people deprived of their liberty, teenagers and young People undergoing socio-educational programs, jail personnel, and homeless individuals.
The secretary says that “new strains may emerge.” However, in the current situation, when the Omicron and its subvariants are dominant, our vaccinations remain effective. Our focus is for those who are extremely ill and dying, primarily children under the age of two and adults beyond the age of 70. As a result, these groups are our present primary concern.”
“We have already witnessed a decrease in the number of deaths. Because we have a vaccine and treatment, we do not want anyone to die. So even one fatality is a negative result. However, we will be unable to erase it overnight. And we never will. We’ll always have some leftovers. However, we intend to push towards an even higher reduction,” says Maciel.
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