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Brazil’s inability to produce reliable Covid-19 data an obstacle for policymaking
Brenno Grillo and Gustavo Ribeiro . Apr 05, 2020
Closed store at São Paulo Guarulhos Airport. Photo: Ricardo Stuckert/FP
Earlier this month, Brazil’s Health Minister Luiz Henrique Mandetta said that the coronavirus outbreak infection curve in Brazil would peak by late-April, early-May, as have some infectious disease experts. However, all projections might have one problem at their origin: they are based on data that is simply not that reliable. As Covid-19 cases grow, Brazil has proven to be unable to produce consistent — and detailed — data that would help experts and policymakers understand the virus’ path in the country and design action plans capable of lowering the infection curve as much as possible.
As we have reported on March 29,
<a href="https://brazilian.report/latin-america/2020/03/29/low-testing-casts-doubt-over-covid-19-reality-brazil/">no one knows exactly how many people have been infected in Brazil</a>, as testing rates have been extremely low. The São Paulo-based Adolfo Lutz Institute alone has a backlog of 14,000 tests to process — 500 of them of severe patients.</p>
<p>Meanwhile, we showed in our live Covid-19 blog that notary offices have <a href="https://brazilian.report/coronavirus-brazil-live-blog/2020/04/02/notaries-report-more-covid-19-deaths-than-hospitals/">registered more Covid-19-related deaths</a> than hospitals have, and that funeral parlors are preparing for a soaring demand in months to come. Meanwhile, many death certificates come with “suspicion of Covid-19” as the cause of death — something that goes against all international protocols.</p>
<p>On Thursday, the Health Ministry had said the virus may have reached Brazil as early as January, quoting the case of a 75-year-old woman who died on January 23 as the first instance of Covid-19 death in the country. Less than 24 hours later, however, the ministry announced it had made a mistake: the woman in question had died on March 25 — over two months later.</p>
<p>A <a href="https://abori.com.br/wp-content/uploads/2020/04/EMBARGADO-Transpar%C3%AAncia-Covid19.pdf">new study</a> by the Open Knowledge Foundation in Brazil (OKBR) offers a snapshot of how poor Covid-19 data collection has been in the country. The federal government and 90 percent of states have yet to publish data that is detailed enough to track the virus’ path. As the World Health Organization said in a 2017 bulletin, “analysis of big data is already proving critical in building accurate models of disease progression.”</p>
<h2>No Country for Big Data</h2>
<p>“Most states still don’t publish basic information with regard to content, detail, and format,” says Fernanda Campagnucci, OKBR’s executive director in Brazil. “Content issues relate to the disclosure of data on available test kits — and those which have already been performed. It is also hard to find data on <a href="https://brazilian.report/newsletters/brazil-daily/2020/03/27/brazil-to-pay-emergency-salary-to-informal-workers/">acute respiratory distress syndrome cases</a> — some states have published them, but with no standardization.”</p>
<p>Ms. Campagnucci explains that this data is important to help authorities understand the context of underreporting. She also mentions that state administrations fail to disclose intensive care bed occupancy rates — and how many confirmed patients are in intensive care units. In a country where the Health Ministry itself projects a <a href="https://brazilian.report/society/2020/03/15/brazil-healthcare-system-prepared-covid-19-pandemic/">collapse of the healthcare system</a> for later this month, this kind of data is of the utmost importance.</p>
<p>“It is also hard to know patients’ location, which would help us understand the dynamics of the spread,” says Ms. Campagnucci. The OKBR executive also criticizes the common practice of publishing data on text files, instead of downloadable spreadsheets, making data collection a very difficult ordeal. “The Health Ministry could disclose more accurate data, as they centralize the information.”</p>
<p>The Open Knowledge Foundation rated Brazil’s 27 states by the transparency of their Covid-19 data, from “opaque” to “high.” Only northeastern state Pernambuco made the top echelon.</p>
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<h2>Lack of transparency might be politically motivated</h2>
<p>The Covid-19 outbreak has been the backdrop of several political clashes between President Jair Bolsonaro and politicians who are likely to try replacing him in 2022, such as São Paulo Governor João Doria and Rio de Janeiro’s Wilson Witzel. These two states also concentrate Brazil’s two biggest metropolitan areas — and, quite naturally, the bulk of infections and deaths.</p>
<p>But a <a href="https://g1.globo.com/sp/sao-paulo/noticia/2020/03/27/secretaria-da-saude-de-sp-orienta-unidades-de-saude-a-notificarem-apenas-casos-graves-de-coronavirus.ghtml">report</a> by news website <em>G1</em> sheds light on what seems to be a tactic to hide <em>how bad</em> the outbreak has already become. Reporters Patrícia Figueiredo and Marina Pinhoni revealed a memo from state authorities with guidelines to 37 healthcare units to only report severe cases of coronavirus infections. The state administration responded that the move was “standard procedure,” to help policymakers focus on more severe cases.</p>
<p>While President Jair Bolsonaro has attempted to play down the pandemic entirely, fearing blame for the economic downturn caused by preventive measures, these revelations show that state governments may be attempting to shape their own narrative: obfuscating official figures and being celebrated for their apparently effective response to the crisis.
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