For the 1st time in the pandemic, Covid ICUs across the country are outside the alert zone

For the first time during the pandemic, the map of Brazil is totally green in relation to occupancy rates of ICU-Covid beds for adults in the SUS. This is what the Covid-19 Fiocruz Observatory bulletin shows, released this Friday (25), which has been monitoring the health crisis since July 2020. .

The green map means that all intensive care units in all Brazilian states and the Federal District have occupancy rates below 60% and outside the alert zone for this indicator. The bulletin released this Friday refers to the period from March 6 to 19.

“It’s a relief. We got out of that [mapa do] Red Brazil, where the ICUs were under pressure, with a lack of beds, with overloaded teams. Everyone’s fingers are crossed for this to be maintained”, says intensive care physician Ederlon Rezende, coordinator of the Brazilian ICUs, a project that monitors data on intensive care.

According to him, intensive care teams are seeing a return to routine, now with beds occupied more by surgical patients. “But they haven’t recovered from these two uninterrupted years. There are still a lot of people with fatigue, the impact was very big.”

The scenario of optimism in ICUs is attributed to the advance of vaccination. Fiocruz data show that 82% of the Brazilian population has already taken the first dose, 74% with the complete vaccination and 34% vaccinated with the booster dose.

“Vaccination was responsible for a very important decrease in more severe forms of Covid and hospitalization. The worsening of the conditions is now observed in non-vaccinated people or in people with immunosuppression or immunosenescence [envelhecimento natural do sistema imunológico pela idade]”, says epidemiologist Ethel Maciel, a professor at the Federal University of Espirito Santo.

The researchers at the Fiocruz observatory warn that the moment still requires attention in health and care surveillance actions. “It is important to highlight that this drop is accompanied by still significant rates of [Síndrome Respiratória Aguda Grave] SARS and incidence of mortality by Covid-19”, they say.

Analyzes of hospitalizations and deaths from SARS and Covid-19 highlight that the extreme groups of the age pyramid are currently the most vulnerable: the elderly who have age as a risk factor and children aged 5 to 11 years, due to low adherence. of those responsible for vaccination.

In relation to the elderly, the researchers reinforce the need for an active search for those who are not yet fully vaccinated and for the application of the fourth dose to those eligible.

According to them, the control of the pandemic should not only focus on vaccination, but on a series of measures and recommendations, such as maintaining the use of masks.

“We consider it prudent to maintain the use of masks for certain closed environments, with large concentrations of people (such as collective transport) or open spaces where there are agglomerations”, they recommend.

Epidemiologist Ethel Maciel points out that, as there is no vaccination in an egalitarian way in the world, this can lead to the emergence of new variants. “We are seeing a growth of BA.2 in European countries and in the United States and here in Brazil as well.”

Data released this Thursday (24) by the Todos pela Saúde Institute show an increase in the proportion of suspected cases of BA.2: from 3.8% to 27.2% of positive samples. 118,638 Covid-19 tests were evaluated by DB Molecular and Dasa laboratories between December 5, 2020 and March 19 of this year.

Fiocruz’s epidemiological bulletin also describes the profile of patients admitted to the ICU for the treatment of active Covid-19. The most prevalent signs and symptoms were dyspnea (71%), low oxygen saturation (below 95%) and respiratory distress (60%).

The vast majority (70%) of patients have some chronic condition, the most prevalent being heart disease (43%), diabetes (39%) and obesity (9%). The demographic profile shows that the most critical situations occur mainly among men (51%), elderly people (62%), and blacks and browns (49%).

Data from the last two epidemiological weeks (from March 6th to 9th) confirm the maintenance of the downward trend of indicators of incidence and mortality by Covid-19, however, at a lower speed.

For the researchers, this reduction may point to a period of stability of transmission in the coming weeks, with still high rates of incidence and mortality.

An average of 42,000 daily cases was recorded, representing a decrease of 32% compared to the previous two weeks (February 20 to March 5).

There was also a reduction in the number of deaths from Covid-19 in the period, with a daily average of 570 deaths, about 35% below the values ​​of the previous two weeks.

The Covid-19 fatality rate, that is, the proportion of reported cases that resulted in death, remained at values ​​close to 1%. Throughout 2021, they fluctuated between 2% and 3%.

At the beginning of 2022, they were reduced to 0.2% and, throughout March, they increased again to 1%. The slight increase in hospital lethality among adolescents aged 10 to 19 years is also highlighted by the researchers.

For them, the turning point of Covid-19 from a pandemic to an endemic one will involve a set of indicators, one of which is lethality, and the WHO (World Health Organization) should be the main reference for this definition.

On the 17th, the Minister of Health, Marcelo Queiroga, presented to the president of the STF (Federal Supreme Court), Luiz Fux, studies for the end of the health emergency situation in Brazil due to the Covid-19 pandemic, but, according to the government, this transition will not be made abruptly.