Objective: To estimate excess mortality by cause of death in Brazil and states in 2020. Methods: We estimated the expected number of deaths considering a linear trend analysis with the number of deaths between 2015 and 2019 for each group of causes and each federative unit. We calculated standardized mortality ratios (SMR) and 95% confidence intervals for each SMR assuming a Poisson distribution. We performed the analyses in the R program, version 4.1.3. Results: We observed a 19% excess in deaths in 2020 (SMR=1.19; 95%CI=1.18–1.20). The Infectious and Parasitic Diseases group stood out among the defined causes (SMR=4.80; 95%CI 4.78–4.82). The ill-defined causes showed great magnitude in this period (SMR=6.08; 95%CI 6.06–6.10). Some groups had lower-than-expected deaths: respiratory diseases (10% lower than expected) and external causes (4% lower than expected). In addition to the global analysis of the country, we identified significant heterogeneity among the federative units. States with the highest SMR are concentrated in the northern region, and those with the lowest SMR are concentrated in the southern and southeastern regions. Conclusion: Excess mortality occurs during the COVID-19 pandemic. This excess results not only from COVID-19 itself, but also from the social response and the management of the health system in responding to a myriad of causes that already had a trend pattern before it.

8th November 2022 • comment

Abstract The effectiveness of inactivated vaccines (VE) against symptomatic and severe COVID-19 caused by omicron is unknown. We conducted a nationwide, test-negative, case-control study to estimate VE for homologous and heterologous (BNT162b2) booster doses in adults who received two doses of CoronaVac in Brazil in the Omicron context. Analyzing 1,386,544 matched-pairs, VE against symptomatic disease was 8.6% (95% CI, 5.6–11.5) and 56.8% (95% CI, 56.3–57.3) in the period 8–59 days after receiving a homologous and heterologous booster, respectively. During the same interval, VE against severe Covid-19 was 73.6% (95% CI, 63.9–80.7) and 86.0% (95% CI, 84.5–87.4) after receiving a homologous and heterologous booster, respectively. Waning against severe Covid-19 after 120 days was only observed after a homologous booster. Heterologous booster might be preferable to individuals with completed primary series inactivated vaccine.

17th October 2022 • comment

Using national COVID-19 notification, hospitalisation, and vaccination datasets from Brazil, we did a testnegative, case-control study to assess the effectiveness of four vaccines (CoronaVac [Sinovac], ChAdOx1 nCoV-19 [AstraZeneca], Ad26.COV2.S [Janssen], and BNT162b2 [Pfizer-BioNtech]) for individuals with laboratory-confirmed previous SARS-CoV-2 infection. We matched cases with RT-PCR positive, symptomatic COVID-19 with up to ten controls with negative RT-PCR tests who presented with symptomatic illnesses, restricting both groups to tests done at least 90 days after an initial infection. We used multivariable conditional logistic regression to compare the odds of test positivity and the odds of hospitalisation or death due to COVID-19, according to vaccination status and time since first or second dose of vaccines.

16th May 2022 • comment

COVID-19, vaccine hesitancy and child vaccination: Challenges from Brazil

by Michelle Fernandez, Gustavo Matta, Ester Paiva

In the world, the governments' policy decisions in response to COVID-19 were very different. Many countries, including in the Americas, political polarisation in health policies has been used as a tool for ideological dispute, draining out the debate around the right to social protection and health. During 2021, these strategies were used in vaccination policies. The consequences of the dissemination of misinformation about COVID-19 vaccines overflows distrust and hesitation into an entire public health project.

12th April 2022 • comment

Inequitable access to the fruits of research during the COVID-19 pandemic highlights the urgency — and feasibility — of overhauling the R&D system.

8th March 2022 • comment

Español/English/Português Esta Hoja de ruta de investigación de las Naciones Unidas para la recuperación de COVID-19 proporciona un marco para aprovechar el potencial de la Ciencia en apoyo de una recuperación socioeconómica más afectiva, y un futuro más equitativo, resiliente y sostenible. Diseñado para complementar el Marco de la ONU para la respuesta socioeconómica inmediata ante COVID-19 (abril de 2020), esta Hoja de Ruta en Investigación se desarrolló rápidamente, en diez semanas, a través de un proceso participativo global que se basó en los conocimientos de investigadores/as, fuentes de financiación de investigación, legisladores/as gubernamentales, sociedad civil, y personas líderes y/o funcionarios/as de la ONU de todo el mundo. Vea el Diálogo abierto con el Secretario General Adjunto de la ONU sobre Ciencia para el Desarrollo en el contexto de COVID-11 (disponible en inglés). El diálogo fue copatrocinado por los Institutos Canadienses de Investigación en Salud y la Oficina de las Naciones Unidas para las Asociaciones de Colaboración. ¿Cómo puede la Ciencia contribuir a una recuperación más equitativa, resiliente y sostenible de la pandemia de COVID-19? Estrategias para mejorar la colaboración entre los organismos de financiación de la investigación, las instituciones de investigación y las Naciones Unidas del mundo.

4th March 2022 • comment

Both  vaccines  demonstrated  overall  effectiveness  against  severe  COVID-19  up  to  80  years  of age.  Our  results  suggest  that  individuals  aged  90  years or  older  may  benefit from  an expedited  third  booster  dose.  Ongoing  evaluations, including  any  additional  vaccines authorized,  are  crucial  to  monitoring  long-term vaccine  effectiveness.

26th January 2022 • comment

A complete regimen of CoronaVac in pregnant women was effective in preventing symptomatic Covid-19, and highly effective against severe illness in a setting that combines high disease burden and elevated Covid-19 related maternal deaths.

26th January 2022 • comment

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities.

26th January 2022 • comment

Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders.

14th December 2020 • comment

Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents’ poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim was to study nutritional modifications during COVID-19 confinement in adolescents aged 10 to 19 years, compare them with their usual diet and dietary guidelines, and identify variables that may have influenced changes. 

14th December 2020 • comment