Covid high shows that emergency continues, says health manager

Sanitary doctor Nésio Fernandes, 40, new president of Conass (National Council of Health Secretaries), says that the new wave of Covid cases arrives at a time when the public health network is overloaded with repressed care during the pandemic.

“It is the continuity of a state of emergency that remains for public health managers”, says Fernandes, secretary of Health of Espírito Santo and who presides over Conass this March.

Officially, on April 22, the government of Jair Bolsonaro (PL) announced the end of the health emergency caused by the Covid-19 pandemic in the country.

At the moment, other diseases are dividing the attention of health authorities: a still mysterious hepatitis that affects children, monkeypox and dengue, an old familiar to Brazilians.

According to Fernandes, in previous waves of Covid, in which there was some level of social isolation, there was a drop in trauma from traffic accidents, for example, but now this type of occurrence has increased a lot, strangling emergencies even more.

In the last ten years, traffic accidents consumed R$ 290 million of annual resources from the SUS (Unified Health System).

To make matters worse, states and municipalities are also facing a shortage of basic medicines, such as antibiotics, analgesics and anti-inflammatory drugs. In São Paulo, some hospitals even postponed surgeries and treatments last month due to lack of medicine.

In the list of another entity of secretaries, Cosems (Council of Municipal Health Secretaries of the State of São Paulo), antibiotics, analgesics, anti-inflammatories, anesthetics and even saline are lacking.

At the same time, the states this year face a cut of resources in the order of R$ 40 billion in relation to the 2021 budget, which resulted in a 60% reduction in ICU beds, according to Fernandes.

“All this in a context of economic crisis and a year of end of mandates, with fiscal and legal issues that prevent states from creating debts for their successors”, he says.

A major concern of health managers has been the stagnation of vaccination against Covid, a situation that brings a scenario of epidemiological insecurity to the country. The data point to a drop in the rate of application of the immunizing agent in children and little adherence to the fourth dose in the population over 60 years of age. “We want to achieve 90% vaccination coverage in all age groups in 90 days.”

The proposal to achieve this goal was approved on the 26th of the SUS tripartite commission — in addition to Conass, they are part of the council of municipal health secretaries and the Ministry of Health. It is the creation of a great national alliance for vaccination, involving health authorities, artists, religious and civil society in general.

The idea is that the mobilization deals with vaccination against Covid and other diseases that also face a drop in immunization rates. For every ten Brazilian children, three have not received vaccines against potentially fatal diseases, according to a survey carried out by Unicef ​​(United Nations Children’s Fund).

“We are on the verge of measles circulating throughout the country, the return of poliomyelitis and diseases already eradicated due to a succession of years of low vaccination coverage”, says Fernandes.

Measles was once considered eradicated in Brazil, but eventually came back — in 2019, there were more than 20,000 cases. Poliomyelitis is in circulation in some countries, and the lack of vaccination, therefore, can leave Brazil vulnerable to its return.

Regarding Covid, the president of Conass considers it likely that the country will have to distribute new booster doses later this year if new variants appear – and that they find people susceptible to contagion because they have not yet been vaccinated, have incomplete schemes or received the vaccine. last dose more than six months ago.

“We are very concerned about the second semester and the election period. The scenario is risky and we have to take measures immediately.”