Bolsonaro government repeats failure and stockpiles 1.2m Covid tests that expire this month

The Ministry of Health stores about 1.2 million RT-PCR tests for Covid that expire during the month of November.

Considered the “gold standard” for diagnosis, the tests can be incinerated if not used in the next few weeks. About 250,000 tests expire on November 18th. Another lot, of 942,000 units, expires on the 27th.

These products are valued at R$ 42.1 million and arrived at the ministry more than four months ago. At the end of 2020, Jair Bolsonaro’s (non-party) government became the target of criticism for stocking around 7 million exams with short validity.

The ministry hides the SUS input stock data. THE sheet revealed that vaccines, tests and medicines valued at R$ 243 million expired at the Ministry of Health warehouse in Guarulhos (SP).

The short validity of RT-PCR type exams worries managers of the SUS. Some states have already lost diagnostic products during the pandemic for missing the deadline for use.

In a statement, the Conass (National Council of Health Secretaries) said it does not have access to data on the tests stocked.

“We also do not have information about the possibility of the ministry distributing to the states inputs used in the RT-PCR tests with a short term of validity,” the entity said.

The volume of exams stored in Guarulhos and the expiration dates were collected by Folha based on internal documents from the Ministry of Health and confirmed by members of the folder.

Minister Marcelo Queiroga and his closest aides only found out about the short-lived stock after questioning the report, according to members of the folder.

Sought, the Health said that “all tests” in stock are in the “phase of distribution to the states”. The ministry, however, did not confirm the volume stored.

For Adriano Massuda, physician, professor at the Getulio Vargas Foundation (FGV) and former executive secretary of Health, the stock near the end of its validity shows “absolute managerial incompetence on a basic issue”, as well as “absolute disregard for public resources” .

“The Ministry of Health has ceased to command the response to the pandemic. Testing is central, no matter how much progress has been made in vaccination. We need to continue testing a lot to monitor the epidemic’s dynamics,” says Massuda.

​Consuming tests before the expiration date challenges the logic of SUS exams. This is because the number of RT-PCR tests performed on the public network is falling. It was below 1 million diagnoses in the last two months.

In addition, states do not only use products purchased by the Ministry of Health and have reduced requests for delivery to the federal government. In October, state secretariats asked the ministry to send 412.9 thousand tests against 1.2 million in the previous month.

Manufactured by the Seegene laboratory, in South Korea, and purchased by the Ministry of Health through PAHO (Pan American Health Organization), the exam that expires in November is not compatible with all laboratories in the public network.

Therefore, the folder also delivers exams from other brands, such as Fiocruz.

The Ministry of Health even started to bet on antigen tests for Covid, which are more agile and show good results. Still, Conass claims that RT-PCR tests play an “important role” and continue to be used as the “gold standard for diagnosis.”

The Bolsonaro government’s strategy for testing was marred by flaws. Health data indicate 24 million RT-PCR exams performed since the beginning of the pandemic in the SUS. The number is practically equal to the number of diagnoses that the government expected to carry out by December 2020.

RT-PCR tests are performed by analyzing samples collected from the nose and pharynx of patients. Exams of this type usually cost more than R$ 200 in the private network.

The Bolsonaro government had stockpiled nearly 7 million short-term tests at the end of last year.

Health technicians had warned that the lack of planning in purchases could lead to part of the exams being thrown away. The ministry did not acquire on the same scale all the inputs used in the diagnosis: collection materials, such as cotton swabs, reagents for extracting RNA from the samples and amplification.

Without the complete sets, some states were unable to use the exams delivered by the Ministry of Health and opted for their own purchases.

Under pressure, the then active minister and general, Eduardo Pazuello, minimized the stranded volume. He said, last December, that the stock size was adequate for Brazil and that part of the reagents in the RT-PCR kit was valid until 2023.

But what counts is the complete kit and Anvisa (National Health Surveillance Agency) only agreed to extend the validity of the products for another four months.

Test delivery failures undermined the government’s claim that Pazuello and his team were experts in logistics. In response to criticism, the Health said at the time that it only acted passively, delivering the tests according to the demands of the states.

Already the president said, in November 2020, that states and municipalities should explain the stock of exams almost expired, even if they were in the Ministry of Health’s warehouse.

After the agency’s decision to extend the validity, the folder tried to speed up the delivery of exams to get rid of the stock. In addition to expanding the pace of examinations in the SUS, the ministry made frustrated negotiations to donate lots to philanthropic hospitals and up to 1 million tests to Haiti.

Despite the efforts, Health technicians evaluated which part of the stock would expire. Before reaching the end of their validity, however, the exams ended up failing quality tests.

These reports forced the manufacturer to replace the restricted stock. But it is precisely part of these exams donated to the ministry that can now win.

The MPF (Federal Public Ministry), the TCU (Court of Accounts of the Union) and the CPI of Covid pointed out flaws in the distribution of these exams.

“Until mid-May 2021, the country did not have a well-developed strategy for carrying out detection and screening tests for covid-19”, states the final opinion of the Senate committee.

In a statement, Conass recognizes that the drop in suspected Covid cases influences the examination rite. “In addition, other methodologies have been progressively incorporated, such as rapid antigen tests. However, preparation was essential with the acquisition of sufficient tests for a worst-case scenario, especially with the increase in circulation of the delta variant”, says the entity.

In addition to the exams that expire in November, the Bolsonaro government has around 2.2 million RT-PCR tests that expire from February to June 2022. In total, Saúde invested around R$1.2 billion in the purchase of tests of this type in the pandemic.