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Called out on its bullshit, Minas Gerais hides Covid-19 data

. May 16, 2020
minas gerais test covid-19 WHO head: 'Our key message is: test, test, test' "Test, test, test," says World Health Organization head Tedros Adhanom Ghebreyesus. Photo: Marcelo Soares/TBR

The state of Minas Gerais boasts that it is one of the most successful Brazilian states in tackling the coronavirus. Despite having the country’s second-largest population (21 million people), it has recorded only 4,196 infections (fewer than 20 per million people) and 146 deaths. However, as we showed last week, this is simply because the state is not testing suspected cases and has a backlog of over 100,000 untested suspected coronavirus patients. Called out on its bullshit, the state has come up with a simple solution: it simply stopped publishing data on suspected cases altogether.

</p> <p>All Brazilian states — or all countries, for that matter&nbsp;— have fewer confirmed cases than the real numbers. And while some underreporting is unavoidable, there is a dangerous trend occurring in places such as Minas Gerais. Many patients go to healthcare units presenting Covid-19-like symptoms. These cases are monitored —&nbsp;but most are never tested. In the first few weeks of the pandemic, the Health Minister&#8217;s guidelines <a href="https://brazilian.report/latin-america/2020/03/29/low-testing-casts-doubt-over-covid-19-reality-brazil/">reserved testing only for more severe cases</a>, as well as healthcare workers. Those guidelines have since changed in most states.</p> <p>Among the states which publish testing data, Minas Gerais has the second-lowest rate per million people. Researchers from the Federal University of Minas Gerais have analyzed patterns of hospital admittances for diseases that could be mistakenly diagnosed instead of Covid-19, including acute respiratory distress syndrome notifications, and have estimated that underreporting in Minas Gerais might be occurring at a rate <a href="https://ufmg.br/storage/9/f/3/e/9f3e7dadd7bc59c6d3f9339198dcbcaf_15893195534547_1310211378.pdf">four times higher than the national average</a>.</p> <p>Without testing, a healthcare system simply flies blind —&nbsp;as Nelson Teich, who resigned from the Health Ministry <a href="https://brazilian.report/coronavirus-brazil-live-blog/2020/04/29/health-minister-says-brazil-is-flying-blind-during-pandemic/">admitted</a> yesterday. For those who watched HBO&#8217;s hit show &#8220;Chernobyl,&#8221; it&nbsp; is something like the scene in which comrade Dyatlov considers the <a href="https://www.youtube.com/watch?v=Mg5HOnq7zD0">3.6-roentgen radiation</a> reading “not great, not terrible.” We later learn the real level is 15,000 roentgen or twice the radiation level of the Hiroshima atomic bomb — but the instruments at Chernobyl could only measure as high as 3.6.</p> <h2>&#8220;Myopic vision&#8221;</h2> <p>When questioned about the state’s lack of testing, State Health Secretary Carlos Eduardo Amaral claimed that it is not s a problem large enough to prevent the state from reopening its commerce. &#8220;Focusing on testing is a myopic way to look at the situation,&#8221; he <a href="https://www.em.com.br/app/noticia/gerais/2020/05/14/interna_gerais,1147263/focar-na-testagem-e-uma-visao-miope-diz-secretario-de-saude.shtml">said</a> —&nbsp;going against all World Health Organization recommendations.</p> <p>To avoid any further questions on the matter, the government — led by Romeu Zema, a member of the Novo party (which translates as the &#8220;New party&#8221;), resorted to the oldest trick in the book of untransparent rulers: it simply stopped counting suspected cases. &#8220;Following the definitions of cases put forward by the Health Ministry and the State Health Secretariat, cases that were being logged as &#8216;suspected&#8217; now go into our system as &#8216;not-specific flu syndrome&#8217; as they do not integrally meet all criteria for laboratory investigation,&#8221; declared the state government.</p> <p>Minas Gerais, however, was of the few states which published this piece of data — useful for identifying testing bottlenecks. Its importance could only be attested to in late April when the state began releasing microdata on patients who arrived at hospitals with Covid-19 symptoms.</p> <p>The database had 90,000 lines —&nbsp;one per patient&nbsp;— and brought together demographic data such as age, gender, and city of residence. However, it lacked data on symptoms and pre-existing conditions. In neighboring state Espírito Santo, for instance, 27 variables are measured.</p> <h2>Why data is crucial</h2> <p>A highly-detailed database allows scientists and analysts to use machine learning to identify patterns that are not initially apparent — this could offer precious information on the behavior of the virus. The UK&#8217;s National Health Service has compiled a detailed database of 17 million patients, allowing for a robust study on the <a href="https://opensafely.org/outputs/2020/05/covid-risk-factors/">main factors that lead to a patient&#8217;s death</a>.</p> <figure class="wp-block-embed-twitter wp-block-embed is-type-rich is-provider-twitter"><div class="wp-block-embed__wrapper"> <blockquote class="twitter-tweet" data-width="550" data-dnt="true"><p lang="en" dir="ltr">OUR NEW PAPER.<br><br>Factors associated with COVID-19-related hospital death in the linked electronic health records of 17 MILLION adult NHS patients.<br><br>Largest study of its kind ever, anywhere.<br><br>The power of UK / NHS data, realised.<a href="https://t.co/XeQj4IG8I8">https://t.co/XeQj4IG8I8</a><a href="https://t.co/SpglPKpJSk">https://t.co/SpglPKpJSk</a></p>&mdash; Ben StayAtHome Goldacre (@bengoldacre) <a href="https://twitter.com/bengoldacre/status/1258372975004389379?ref_src=twsrc%5Etfw">May 7, 2020</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> </div></figure> <p>When Minas Gerais began publishing microdata on 90,000-plus patients, it was praised by NGO Open Knowledge Brazil — which produces a weekly state-level transparency ranking on Covid-19 data. The study has created a healthy competition among governors and helped improve data collection in nearly all Brazilian regions.</p> <p>In the next ranking, expect Minas Gerais to fall off the charts.

 
Marcelo Soares

Marcelo Soares is a Brazilian journalist specializing in data journalism and reader engagement.

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