Why did deaths from other diseases lead to the epidemic as well?

Posted on 10/24/2021 03:08 PM

(Credit: Jair Amaral/EM/DAPress)

Fear of the coronavirus and the stifling of medical services by the pandemic meant that 51-year-old staff supervisor Alex Jose de Oliveira Ferreira, a resident of Itabrito, in the central region of Minas Gerais, had to wait weeks for an appointment. By private agreement.

While the delay exacerbated his hypertensive condition, despite taking care of himself with prescribed medications, he also stopped going to the emergency room when he felt unwell, to avoid the emergency care unit.

With only two days left before she could finally consult, this couple, who is a father of two daughters, had a heart attack.

In addition to the deaths of more than 55,000 people in Minas Gerais due to the new coronavirus (SARS-CoV-2), a weak health system and often the fear of leaving isolation kills thousands of patients from other diseases that can be controlled, as it happened. with Alex.

In Mushrif City alone, which has a population of 53,000 and is one of the richest cities in the region, the number of daily deaths not linked to covid-19 or from external causes, such as accidents and crimes, rose by 29% from January to September. 2021 compared to 2019 (the last year before the pandemic).

The data are from the Ministry of Health of the State of Minas Gerais (SES-MG), which was compiled by a report from the State of Minas.

The survey indicates that in 2020, 391 municipalities in Minas Gerais (46% of the total 853) recorded more daily non-coronavirus deaths than the previous year. In 2021, this amount was already 333 as of September (39%). The average increase in comparative deaths was 17% in 2020 and 20% in 2021.

The greatest number of deaths are related to cardiovascular disease, many of which require follow-up and prescribed medication.

Such was the case with Alex, according to his wife, administrative supervisor Mônica Lúcia dos Reis Ferreira, 48.

His appointment was scheduled for May 11, but days before he felt ill. From 7-8, I asked if we could go to a UPA in town, but he didn’t want to. He preferred to rest and get better, and believed that the date was near and would be safer than an emergency. But on the ninth day, he was very ill, and the firefighters took him to the UPA, but he did not resist. It was unexpected for us, because he looked so good and took care of himself,” said Monica.

Also in Itabrito, director Fabio Junior Ribeiro, 41, and his wife need specialized care, but have avoided attending medical services for fear of overcrowding and possible transmission of the novel coronavirus.

“She has to have a hysterectomy and I need her gallbladder removed, but we are afraid to go to the hospital or see us at the health centers. With the vaccination progress now, we will feel much safer,” says the official.

Housewife Margaret Silva, 57, lost her aunt Luzia Silva, 84, to cancer that had spread.

She had health monitoring, but after the coronavirus started spreading, she no longer left the house for anything. One day, he fell ill and did not receive further treatment,” he says. Bakery worker Cassia Maria da Silva, 45, lost her aunt Eraselda Silva, 60, who suffers from heart disease, who lives in the municipality of Moeda. She was afraid to consult. , to get to health centers full of people suspected of having COVID-19. The worst of it was they tried to bury her as if she had the disease, but we were able to reverse it and she could at least be buried in an open space, which many of them didn’t. Because COVID-19 forces the place to be closed,” he says.

Doctor Carlos Starling, an infectious disease specialist and a member of the Belo Horizonte City Council Committee to Combat COVID-19, sees this increase in deaths as an indirect result of an epidemic like the one we are facing today, with the need for social isolation and isolation. Precautions.

They are consequences of several factors in an epidemic, such as overcrowding in the system due to disease. Just as people needed to stay away, there was also a decrease in monitoring for other health conditions and postponement of surgeries and treatments. Certainly, it was very harmful for those already in a worsening health condition,” Starling notes.

“The overcrowding of the health system with one disease does not allow the treatment of other important diseases. In the epidemic, not only those infected and needing care were affected, but also those who lost the opportunity for treatment. The situation was not worse because many of the reference cities, such as Belo Horizonte, I knew how to adapt to these demands, including essential partnerships with the private health sector,” the infectious disease specialist considers.

Death rate from non-respiratory diseases increased by 43%

In Brazil, it is worth noting the increase in the daily death rate due to non-respiratory diseases, which increased by almost 43%, compared to 2019, the last year before the pandemic, with this year’s data, as of September 10 only.

In the Southeast region, the increase was 44.3% in the same daily comparison.

The increase in deaths on the national scene was noted in the Ministry of Health data sent to the report regarding patients who did not fight off non-respiratory diseases.

However, it may contain distortions, as it includes cases where doctors are still reporting deaths from the Covid-19 virus, such as “other unspecified infectious diseases”.

According to the figures, in Brazil, in 2019, 3,254 people died per day, on average, from non-respiratory causes (excluding accidents, crimes and other external factors).

The number rose in 2020, the first year of the epidemic, to 3,866 deaths per day, an increase of 19%, but in 2021 it suffered a jump of 43% compared to 2019, when the number of deaths reached 4,640 patients every 24 hours.

The regions with the highest increase in non-respiratory disease deaths per day in 2021, compared to 2019, were the Midwest (62%), the South (51%), the North (50%), the Southeast (44%), and the Northeast (28 %).

The diseases with the largest increase in deaths in 2021 were ischemic heart disease, with an average of 274 deaths per day. cerebral vasculature, which reaches 246 every 24 hours; and diabetes, with 184 daily deaths.

In Minas Gerais, cerebrovascular disease is the largest cause of death. Only in the Western, Eastern, and Southeastern Total Health Districts are there more deaths from ischemic heart disease.

Repercussions of suspending appointments and surgeries

SES-MG confirms that so many patients have been affected by the pandemic, even without covid-19 infection, that elective procedures, such as surgeries and consultations, have been suspended as a way to prevent potential overload in the public health network.

He added, “Also, direct, face-to-face care services have also been suspended, partially or completely, in outpatient clinics with the assistance of people in need of rehabilitation, hypertensive patients, diabetics and dentists (patients), among others.”

However, the file highlights that since the end of 2020 and throughout 2021, outpatient and elective hospital services have resumed “in a responsible and orderly manner, through the strategic action Cuida de Minas, a program that seeks to ensure inclusiveness and continuity of care for chronically ill and pre-existing SUS users.” Other health care needs assistance even during a pandemic. It is also worth noting that the emergency and urgency services have never stopped,” the Secretariat informed.

Currently, SES-MG is reporting a staffing assessment for health providers and a new hospital management plan for elective surgeries.

The Ministry of Health claims that it provides unrestricted support to local SUS managers (states and municipalities) to perform surgeries, and adds that it issued R$350 million in additional resources, transferred after the procedures were proven.

“As a result of distributing more than 300 million doses of covid-19 vaccine across the country, Brazil has crossed the mark of more than 100 million Brazilians fully vaccinated, surpassing 60% of the target audience vaccinated with two doses of the vaccine or a single-dose immune system. The result was The federal government’s efforts, along with states and municipalities, provide a cooler pandemic scenario, with fewer cases and deaths, and a less stressed public health system.”