Ministry of Health made a Contingency Plan to deal with the new coronavirus pandemic; states also published similar planning
The federal government is preparing a series of measures to combat the spread of the Sars-Cov-2, the coronavirus responsible for the current pandemic declared by the World Health Organization (WHO).
For now, the government’s main concern is to prepare the country’s health system for a likely increase in the number of cases – including the release of extra money.
What are the main measures taken by the Brazilian government against Coronavirus so far?
On Friday night (13), about R$ 5 billion in extraordinary credit was released for this purpose via Provisional Measure (MP) (read more below).
Leaders of the Ministry of Health do not rule out, however, the adoption of harsher measures of social isolation, whose aim is to try to halt the spread of the disease. So far, the only decision at the federal level of this type is an ordinance published last Wednesday (11) determining the isolation, preferably at home, of people with suspected coronavirus.
Some states, however, have already taken more aggressive attitudes – such as the gradual suspension of classes in São Paulo.
The actions of the Ministry of Health are described in a Contingency Plan to be followed by the federal government. Each state has also published a similar plan.
The number of confirmed cases is being updated once a day by the Ministry. By the beginning of this Saturday (14), the number of confirmed cases throughout the country was 121.
According to the president of the Brazilian Society of Infectology (SBI), Clovis Arns da Cunha, the necessary precautions vary according to the city where each person lives – in São Paulo (SP), it makes sense to avoid agglomerations, which is not yet the case in Brasília (DF). Therefore, it is important to be aware of the evolution of the number of cases in your city or region.
“It is as if the epidemic were an ICU patient. Today he is fine, but you ask me tomorrow”, he says. “In Paraná, for example, closing schools and universities is still not an appropriate thing. But in São Paulo, yes,” he tells BBC News Brasil. The gradual suspension of classes was announced by the São Paulo government on Friday (13).
Arns – who participated in the Ministry of Health’s planning – says the country’s response so far has been adequate. The exception, he says, was the Federal District government’s decision to suspend classes in the capital last week, when the so-called community transmission of the disease had not yet occurred.
All cases in Brasília at that time were imported, Arns says, and the closing of schools should only be adopted when the virus is already circulating in a certain region.
According to Arns, the response to the coronavirus may even have a positive side for Brazil – the population’s education balance and the health system’s preparation may be beneficial to reduce the cases of common flu, which infect people and make victims every year.
But after all, what are the main government measures to combat the coronavirus so far? The list below brings initiatives that the Ministry of Health itself includes among the most relevant in combating the disease.
1. Recommendation to cancel events and tourist cruises
Cruise with more than 600 people on board was isolated in Recife after passenger showed symptoms of covid-19
In health jargon, attitudes such as these are called “non-pharmacological measures”: actions that seek to slow down the speed with which the virus spreads in a certain place by reducing social contact.
The objective is to avoid overloading health services and, according to the ministry, these attitudes can reduce the number of cases by up to a third.
The precautions are divided into three moments, according to the degree of spread of the disease.
They range from general measures, which have already been recommended by the Ministry of Health to the entire country since last Friday (13); to attitudes that should be taken when there is community transmission of the virus, recommended today for São Paulo and Rio.
At this moment, one of the main recommendations of the Ministry of Health for the whole country is to cancel or postpone any events that gather a large number of people: soccer matches, shows, demonstrations.
Tourist cruises (national and international) should also be cancelled – besides the risk of transmission among travelers, the care of patients at sea is more difficult.
“They are environments where people are confined, and many are international tourists (…),” explained Wanderson Kleber de Oliveira, the ministry’s health surveillance secretary.
There are also recommendations for places that receive large numbers of people: you need to expand places where people can wash their hands; offer alcohol gel with 70% concentration; and increase the frequency in cleaning the floor, handrails, doorknobs, etc.
In addition to the general recommendations, the briefcase has published guidelines for cities with local transmission of the virus, among them the restriction of social contact (trips, movies, shopping malls, etc.) for the elderly and chronically ill and vaccination against influenza in this group.
2. In SP and Rio, home office and suspension of classes
In places where the so-called community transmission of the virus already occurs, such as the cities of Rio de Janeiro (RJ) and São Paulo (SP), the recommendations become more severe. Unlike local transmission, in community transmission it is no longer possible to know who transmitted the disease to whom.
In these cities, the Ministry of Health has already recommended since last Friday that companies adopt teleworking (home office); that classes be interrupted; and that local managers monitor the entry and exit of patients with covid-19 in ICUs.
Residents of these cities are also encouraged to cancel trips and meetings that are not essential.
At present, there is still no recommendation for quarantine: this will only be indicated if the occupation rate of the ICU beds intended for covid-19 treatment reaches 80%.
Unlike isolation, quarantine is mandatory and involves the use of security forces to prevent the movement of people.
The ministry also discards control of passengers traveling within Brazil, including in these two cities.
Passengers of the subway in São Paulo; capital of São Paulo, as well as Fluminense, has community transmission of the coronavirus
3. Provisional Measure with at least R$ 5 billion additional
The presidency published on Friday (13) a provisional measure (MP) releasing about R$ 5 billion more for actions to combat the new coronavirus via the ministries of Health and Education. The MP went into effect when it was published in the Official Gazette, but needs to be approved by Congress within 120 days – or it loses its validity.
According to the executive secretary of the Ministry of Health, João Gabbardo dos Reis, the resources were already considered in the budget of the portfolio – but were part of the individual amendments of deputies and senators. Now, this money will be directed to actions to combat the new coronavirus.
“We already have guaranteed R$5 (billion). What Minister Paulo Guedes (Economy) said, is that it can reach R$10 (billion),” Gabardo said. “He said that for him, Paulo Guedes, it would be R$10 billion (US$6.5 billion). But so far, what has been agreed with Congress is the release of R$5 billion (US$5 billion)”.
Part of the money is expected to be given to about 40,000 basic health units nationwide. The money will also be used for health surveillance; for the leasing of hospital beds; and for the purchase of medicines and other materials.
A portion of the funds will also be used by university hospitals linked to the Ministry of Education (MEC).
4. Reinforcement at Mais Médicos
On Thursday (12), the Ministry of Health published an edict to hire an additional 5,800 doctors, with the purpose of strengthening health teams.
Will be admitted doctors trained in Brazil and abroad, provided their diplomas have been revalidated in the country – including Cuban doctors who are still in Brazilian territory. The remuneration of these professionals will be around R$ 12 thousand per month, and the contract will last one year.
The total cost of the measure is estimated at R$1.2 billion – which should come out of the R$5 billion of the provisional measure.
The professionals will be distributed in 1,864 Brazilian municipalities, and most of the vacancies (44.5%) are for the state capitals – where the difficulties are supposed to be greater.
5. Training of laboratories for Sars-Cov-2 tests
Employee holds samples to be tested for Sars-Cov-2 at Fiocruz, where laboratory technicians from various states are being trained
Since the beginning of last week, the Oswaldo Cruz Foundation (Fiocruz) and the Ministry of Health have been training technicians from public laboratories in the Brazilian states to be able to test patients with suspected new coronavirus infections.
Last week, technicians from eight states received training from Fiocruz, in Rio de Janeiro (RJ). The course includes recommendations on biosecurity and procedures for transporting samples, among other points.
The goal of Fiocruz is to have trained technicians from 26 Brazilian states (and the Federal District) by the end of this week.
Fiocruz is also producing the kits that will be used for testing. By the end of last week, 20 thousand of these kits were already ready.
Some private lab networks have also developed their own kits for testing the new coronavirus – and are already able to perform the test. The goal of the Ministry of Health now is that the tests done in the private network are notified more quickly – today, this integration depends on the health departments of each municipality.
6. More ICU beds and extended hours at health posts
Also on Thursday (12), the government announced the leasing of up to 2,000 extra beds in intensive care units (ICUs) – 1,000 beds had already been planned since the beginning of the crisis, but a new notice was announced at the end of last week.
The Ministry of Health expects that these additional beds will be paid with the R$ 5 billion released by the provisional measure.
At the other end, the ministry will try to expand the number of health posts that operate during extended hours, through a program called Health on the Spot. Of the country’s 42,000 health centers, only 1.5 thousand are part of the program today, which extends the units’ hours of operation until 10 pm.
Now, the idea is that at least another 5,200 posts will operate during extended hours. The folder has set aside about R$ 900 million for this initiative.
According to the folder, up to 90% of the cases of coronavirus can be treated in these health posts – the person can seek the service when he has symptoms of coivd-19, such as fever, cough and dyspnea.