Subway users pass through a disinfection zone when leaving a station in the city of Osasco, in the State of São Paulo.Sebastiao Moreira / EFE
After a long plateau that registered a daily average of more than a thousand deaths from coronavirus in Brazil, the curve has lowered in the last two weeks.
According to official data from the Ministry of Health, between August 23 and September 5 an average of between 800 and 900 deaths per day has been registered.
A study carried out by the press consortium with data from the state health secretariats also observes a downward trend in the average number of deaths from covid-19.
The figures may seem encouraging, but it is still too early to say that the country is controlling the pandemic, which has already killed more than 130,000 people in Brazil, a death toll only less than that of the United States.
Specialists warn that national data should be interpreted with caution, since the reduction in the national average may be due to the decrease in deaths in the populous states of São Paulo and Minas Gerais.
At the national level, the virus transmission rate will tend to be lower, but the phases of the epidemic continue to be very diverse in the different Brazilian regions.
“The impression is that the State of São Paulo is lowering the [national] average.
In some states it continues to rise, but the impact of São Paulo is strong, because it is very populated.
And other places no longer have the initial acceleration ”, observes Paulo Lotufo, epidemiologist and professor at the School of Medicine of the University of São Paulo.
Since the beginning of the health crisis due to covid-19, São Paulo has had the highest absolute numbers, both of infections and deaths, and the reduction of these figures for four weeks affects national statistics.
Lotufo explains that in the capital there were already fewer deaths, but in recent weeks this trend has been seen throughout the State.
“At the beginning of the crisis, several cities in the interior were quite reticent and interrupted activities.
But they reopened in a hurry, forcing them to close again.
This has led to the current reduction in deaths ”, says the epidemiologist.
The decline in the curve in São Paulo is quite pronounced in the graph presented by the Ministry of Health, although the document does not offer specific figures for the decline throughout the state.
The Covid-19 BR Observatory, which follows the pandemic data since the beginning of the crisis, agrees that the deaths registered in São Paulo have decreased, even with the statistical correction made due to the delay in the notification of new deaths .
“The possibility of reducing the number of deaths from covid-19 in Brazil exists, it is real.
But we still have to wait a bit to know if it is an effective reduction or if it is influenced by the delay in notifications ”, explains Rafael Lopes, member of the Observatory.
It also indicates that the weight of the reduction in São Paulo in the national data must be considered.
“When looking at Brazil as a whole, we have to consider the differences in the dynamics and timing of the epidemic in different regions.
A decrease in deaths in São Paulo will always weigh more in the national data than if it occurred in Ceará, because the size of the populations is very different ”, he explains.
The latest epidemiological bulletin from the Ministry of Health indicates that the states of São Paulo, Rio de Janeiro and Minas Gerais were where the most deaths occurred in the epidemiological week that runs from August 30 to September 5, but the figures for the three they were lower compared to the previous week.
The numbers from the State of Amazonas have increased considerably, but now include deaths that were still being investigated.
In the southern and central western states, where the few cases from the beginning of the crisis have multiplied in recent months, the number of deaths from covid-19 has also dropped.
To get an idea of the current moment of the epidemic, one must examine the data on deaths from severe acute respiratory syndrome - a complication derived from covid-19 and other flu - by the date of onset of symptoms.
The Ministry of Health also notes that there has been a decline.
"Excluding the last weeks [which should be disregarded due to the delay in notification], we see that there is a downward trend in the number of deaths," says Eduardo Macário, deputy secretary of Health Surveillance.
As for new infections, the ministry points out that there has been an increase of 5% this week, but that this variation represents a trend towards stability.
“The big message when looking at the epidemic numbers is that we have to be cautious.
The epidemic, at all levels - national, state or municipal - is always the result of human actions.
Even if people move more, they wear more masks and protect themselves more ”, says Rafael Lopes.
More and more Brazilian cities are relaxing quarantine, but the researcher points out that a less rigid social behavior than confinement cannot minimize the importance of security measures.
“There has been a reduction from a thousand to 800 deaths.
It is expressive, but it does not mean that things are okay.
It does not mean that we no longer have to protect ourselves, ”he adds.
Epidemiologists around the world warned months ago of the risk of a second wave of infections in countries that reached the peak and then showed relative control of the epidemic.
In Spain, for example, there have been new outbreaks, but the situation is far from being like that of the first wave.
In other European countries there have not been such serious outbreaks either.
The epidemiologist Paulo Lotufo avoids talking about a second wave when he analyzes an epidemic that did not exist eight months ago and whose seasonality is still unknown.
“This dispute over nomenclatures scares me, it doesn't help at all.
What is clear is that the virus has not disappeared, it is still there.
All care is little, "he says.
Lotufo says that even making a comparison between countries is complicated.
In Italy, the pandemic hit the Lombardy region hard, but the impacts in the south of the country were contained.
Brazil, a continental country, could have better controlled the epidemic in the southern region, according to the researcher: “Rio Grande do Sul and Minas Gerais, which had few cases at the beginning of the crisis, could have much better numbers if they had been more rigorous in isolation ”.
Lotufo believes that social distancing measures should be followed even when the pandemic shows the first signs of cooling.
“Society needs to discuss what is a priority.
Something that Brazil and the United States seem unable to do.
Is it a priority to open schools or shopping centers?
You have to have a general control of contagion.
If one thing opens, the possibility of reopening another will decrease ”, he says.
Lopes adds that the decline in the number of deaths in Brazil is far from representing the end of the pandemic.
For him, the reduction is not representative for the country to assume a safe level.
“Brazil cannot understand the epidemic.
We are in the same situation as four or five months ago.
We still do very little tests, which are used to confirm cases, but not to control the epidemic, ”he says.
The lack of tests, according to Lopes, is manifested in the high rate of positives: 35.9%, according to data from the Ministry of Health itself.
“The number of deaths seems to be improving, but it does not mean that the situation is under control.
Our strategy has never been to contain cases, but to manage severe cases and deaths.
Brazil still has a lot to do to get the pandemic under control ”, he says.