The disruption of elective procedures due to COVID-19 in Brazil in 2020

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Abstract

Elective procedures were temporarily suspended several times over the course of the pandemic of COVID-19. Monthly data from the Unified Health System (SUS) were used for the period between January 2008 and December 2020 and the interrupted time series method was used to estimate the effect of the pandemic on the number of elective surgeries and elective procedures that were not performed. Considering a 9-month period, a reduction of 46% in the number of elective procedures carried out in the SUS could be attributed to COVID-19, corresponding to about 828,429 elective procedures cancelled, ranging from 549,921 to 1,106,936. To a full recovery of pre-pandemic performance, SUS would need to increase about 21,362 hospital beds, ranging from 12,370 to 36,392 hospital beds during a 6 month-period. This effort would represent an increase of 8.48% (ranging from 4.91 to 14.45%) in relation to the total number of SUS’s hospital beds in 2019. As a result, the pandemic will leave a large number of elective procedures to be carried out, which will require efforts by health agencies to meet this demand.

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Elective surgery cancellations due to the COVID ‐19 pandemic: global predictive modelling to inform surgical recovery plans

Dmitri Nepogodiev, Aneel Bhangu, Savino Spadaro … (2020)

Background The COVID‐19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID‐19. Methods A global expert‐response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian beta‐regression model was used to estimate 12‐week cancellation rates for 190 countries. Elective surgical case‐mix data, stratified by specialty and indication (cancer versus benign surgery), was determined. This case‐mix was applied to country‐level surgical volumes. The 12‐week cancellation rates were then applied to these figures to calculate total cancelled operations. Results The best estimate was that 28,404,603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID‐19 (2,367,050 operations per week). Most would be operations for benign disease (90.2%, 25,638,922/28,404,603). The overall 12‐week cancellation rate would be 72.3%. Globally, 81.7% (25,638,921/31,378,062) of benign surgery, 37.7% (2,324,069/6,162,311) of cancer surgery, and 25.4% (441,611/1,735,483) of elective Caesarean sections would be cancelled or postponed. If countries increase their normal surgical volume by 20% post‐pandemic, it would take a median 45 weeks to clear the backlog of operations resulting from COVID‐19 disruption. Conclusions A very large number of operations will be cancelled or postponed due to disruption caused by COVID‐19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to safely restore surgical activity. This article is protected by copyright. All rights reserved.

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Ranking the effectiveness of worldwide COVID-19 government interventions

Nils Haug, Lukas Geyrhofer, Alessandro Londei … (2021)

Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, Rt, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific 'what-if' scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions.

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Brazil's unified health system: the first 30 years and prospects for the future

Marcia Castro, Adriano Massuda, Gisele Detomazi Almeida … (2019)

In 1988, the Brazilian Constitution defined health as a universal right and a state responsibility. Progress towards universal health coverage in Brazil has been achieved through a unified health system (Sistema Único de Saúde [SUS]), created in 1990. With successes and setbacks in the implementation of health programmes and the organisation of its health system, Brazil has achieved nearly universal access to health-care services for the population. The trajectory of the development and expansion of the SUS offers valuable lessons on how to scale universal health coverage in a highly unequal country with relatively low resources allocated to health-care services by the government compared with that in middle-income and high-income countries. Analysis of the past 30 years since the inception of the SUS shows that innovations extend beyond the development of new models of care and highlights the importance of establishing political, legal, organisational, and management-related structures, with clearly defined roles for both the federal and local governments in the governance, planning, financing, and provision of health-care services. The expansion of the SUS has allowed Brazil to rapidly address the changing health needs of the population, with dramatic upscaling of health service coverage in just three decades. However, despite its successes, analysis of future scenarios suggests the urgent need to address lingering geographical inequalities, insufficient funding, and suboptimal private sector-public sector collaboration. Fiscal policies implemented in 2016 ushered in austerity measures that, alongside the new environmental, educational, and health policies of the Brazilian government, could reverse the hard-earned achievements of the SUS and threaten its sustainability and ability to fulfil its constitutional mandate of providing health care for all.

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Author and article information

Contributors

Letícia Xander Russo: leticiarusso@ufgd.edu.br

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 29 June 2022

Publication date PMC-release: 29 June 2022

Publication date Collection: 2022

Volume: 12

Electronic Location Identifier: 10942

Affiliations

[1 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Graduate Program in Collective Health, Faculty of Health Science, , University of Brasilia, ; Brasília, Brazil

[2 ]GRID grid.411965.e, ISNI 0000 0001 2296 8774, Catholic University of Pelotas, ; Pelotas, Brazil

[3 ]GRID grid.412335.2, ISNI 0000 0004 0388 2432, Department of Economics, , Federal University of Grande Dourados, ; Dourados, Brazil

[4 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Graduate Program in Medical Science, Faculty of Medicine, University Hospital of Brasília, , University of Brasilia, ; Brasília, Brazil

[5 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Graduate Program in Medical Science, Faculty of Medicine, , University of Brasilia, ; Brasília, Brazil

[6 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Graduate Program in Medical Science, Health Department of the Federal District (SES/DF), Faculty of Medicine, , University of Brasilia, ; Brasília, Brazil

[7 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Faculty of Medicine, University Hospital of Brasília, , University of Brasília, ; Brasília, Brazil

[8 ]GRID grid.5808.5, ISNI 0000 0001 1503 7226, Faculty of Medicine, Institute of Public Health (ISPUP), , University of Porto, ; Porto, Portugal

[9 ]GRID grid.7632.0, ISNI 0000 0001 2238 5157, Graduate Program in Collective Health, Faculty of Health Science, Faculty of Ceilândia, , University of Brasilia, ; Brasília, Brazil

Article

Publisher ID: 13746

DOI: 10.1038/s41598-022-13746-5

PMC ID: 9243075

PubMed ID: 35768482

SO-VID: a150cbd7-57a8-430a-b225-56b8e911d49d

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 28 September 2021

Date accepted : 27 May 2022

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ScienceOpen disciplines: Uncategorized

Keywords: health care,diseases

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ScienceOpen disciplines: Uncategorized

Keywords: health care, diseases

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The disruption of elective procedures due to COVID-19 in Brazil in 2020

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Novel Coronavirus Disease COVID-19

Most cited references 29

Elective surgery cancellations due to the COVID ‐19 pandemic: global predictive modelling to inform surgical recovery plans

Ranking the effectiveness of worldwide COVID-19 government interventions

Brazil's unified health system: the first 30 years and prospects for the future

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