portuguÊs situação atual...2020/10/22 · situação atual • os casos confirmados diariamente...

Brazil Model updates for October 22, 2020

covid.healthdata.org Institute for Health Metrics and Evaluation

PORTUGUÊS

Durante o mês de outubro, o número de casos positivos e mortes diárias continuou diminuindo. Os casos positivos permanecem abaixo de 30.000 por dia após um declínio gradual ao longo de vários meses. As mortes diárias, agora caindo para cerca de 500 por dia, continuaram a tendência de queda que tem sido evidente nas últimas semanas. O R efetivo médio permanece abaixo de 1 na maioria dos estados, embora tenha subido acima de 1 em vários locais, indicando que uma propagação adicional é possível. Projetamos que o Brasil terá um total de 180.000 mortes até 1 de fevereiro de 2021. No entanto, se o uso de máscaras se generalizar, quase 8.000 vidas serão salvas até 1 de fevereiro de 2021.

Situação atual

• Os casos confirmados diariamente mostram uma ligeira diminuição e são cerca de 25.000 nacionalmente em 20 de outubro (Figura 1).

• As mortes diárias continuam diminuindo e estão em 500 nacionalmente (Figura 2a). No entanto, apesar da redução na última semana, a COVID-19 continua sendo a principal causa de morte no país (Tabela 1).

• Estimativas de mortes cumulativas no Brasil por COVID-19 em 14 de outubro indicam que 56% delas ocorrem em pessoas entre 60 e 84 anos (Figura 2b).

• O R efetivo médio a partir de 1º de outubro - com base na análise combinada de casos, internações e óbitos - agora está abaixo de 1 em todos os estados, exceto Amazonas e Piauí, entre 1 e 1,1. Na Paraíba e Sergipe, os valores estão bem próximos de 1, entre 0,94 e 0,99 (Figura 3).

• Em 20 de outubro, 18 estados tinham mais de 19,5% da população infectada, com as maiores concentrações nos estados do centro-oeste e norte: São Paulo, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Piauí e Tocantins (19,5–24,4 %); Espírito Santo, Pará, Goiás, Ceará e Rondônia (24,5–28,9%); Amapá, Amazonas e Rio de Janeiro (29–33,9%); Distrito Federal, Mato Grosso e Sergipe (34–38,4%); e Roraima (> 48%).

• O número de casos positivos detectados nacionalmente representa 12% da população infectada (Figura 5). • A maioria dos estados tem taxas de mortalidade diárias abaixo de 4 por 1 milhão. A taxa de mortalidade é

ligeiramente mais alta em Mato Grosso e no Distrito Federal (4–4,9%). • Tendências nos principais fatores de transmissão (mobilidade, uso de máscara, teste e sazonalidade) • O Rio de Janeiro continua sendo o único estado que possui mandato de máscara (Tabela 2). Desde o início de

junho, quando o uso da máscara atingiu o pico de 76% nacionalmente, o uso da máscara diminuiu lentamente, para cerca de 64%. Países semelhantes na América Latina continuam a ter taxas constantemente altas de uso de máscara, em torno de 80% (Figura 9a).

• A mobilidade, embora abaixo da linha de base de janeiro de 2020 (-18%), está entre as mais altas da América Latina, perdendo apenas para a Colômbia (Figura 8a).

• Os testes continuam abaixo da média para a América Latina, com 30 testes por 100.000 habitantes (Figura 10a).

Projeções

• Projetamos um número cumulativo de mortes de 180.000 até 1º de fevereiro. Aumentar o uso de máscaras para 95% poderia salvar 8.000 vidas em comparação com o cenário de linha de base (Figura 12).

• De 20 de outubro a 1º de fevereiro, projetamos que mais 25.000 vidas serão perdidas (Figura 12).



• Projetamos que as mortes diárias diminuirão continuamente até outubro. Em 31 de outubro, esperamos que o número de mortes diárias seja 442, abaixo dos 484 de hoje. Em 1o de fevereiro, prevemos que as mortes diárias cheguem a um valor mínimo de 24 no melhor cenário, ou 92 no pior cenário (Figura 13).

• Não projetamos que algum estado ultrapasse uma taxa de mortalidade diária de 8 por milhão até 1o de fevereiro (Figura 15).

• Cerca de metade dos estados terão mais de 24,5% da população infectada até 1º de fevereiro: Amazonas, Roraima, Tocantins, Mato Grosso, Sergipe, Piauí, Amapá, Rondônia, Acre, Goiás, Distrito Federal, Ceará, Rio de Janeiro, e Espírito Santo (Figura 16).

• A taxa de mortalidade diária cairá para menos de 2 por milhão na maior parte do país até 1º de fevereiro; a maioria dos estados experimentará taxas de mortalidade abaixo de 1 por milhão.

• Oferecemos uma comparação de nossas previsões com outros modelos que fornecem atualizações periódicas e arquivam seus resultados. Ao comparar as previsões anteriores com o que aconteceu, nosso modelo tem o menor erro percentual médio para mortes cumulativas. Nos EUA, conforme mostrado na Figura 18, nossas previsões são bastante diferentes. Outros modelos importantes sugerem que a epidemia está chegando ao fim, com queda nas mortes diárias até o final do ano. Encontramos uma forte correlação estatística de R eficaz nos últimos seis meses com o padrão semanal de mortes por pneumonia visto em cada país ou estado. Essa variável de sazonalidade, combinada com nossa previsão de que os mandatos continuarão a diminuir durante o outono, é responsável por nossas previsões marcadamente diferentes.

Atualizações de modelo

• Não há grandes atualizações na estratégia de modelagem esta semana. Continuamos a examinar uma ampla gama de fontes de dados, incluindo taxas de mortalidade por infecção calculadas a partir de pesquisas de soroprevalência, taxas de mortalidade hospitalar e bancos de dados de registros hospitalares individuais para determinar se a taxa de mortalidade por infecção específica para idade diminuiu.

• Estamos elaborando nosso modelo para permitir a inclusão do impacto do aumento de escala da vacinação no primeiro e segundo trimestres de 2021.



ENGLISH

During the month of October, the numbers of positive cases and daily deaths have continued to decline. Positive cases remain under 30,000 per day after a gradual decline over several months. Daily deaths, now down to around 500 per day, continued the downward trend that has been evident over the past several weeks. The mean effective R remains below 1 in most states, though it has risen above 1 in several locations, indicating that further spread is possible. We project that Brazil will see a total of 180,000 deaths by February 1, 2021. However, if the use of face masks becomes widespread, nearly 8,000 lives would be saved by February 1, 2021.

Current situation

• Daily confirmed cases show a slight decrease and are around 25,000 nationally as of October 20 (Figure 1). • Daily deaths continue to decline and are at 500 nationally (Figure 2a). However, despite the decrease over the

past week, COVID-19 remains the leading cause of death in the nation (Table 1). • Estimates of cumulative deaths from COVID-19 in Brazil as of October 14 indicate that 56% of them occur in

people between the ages of 60 and 84 (Figure 2b). • The mean effective R as of October 1 – based on the combined analysis of cases, hospitalizations, and deaths – is

now below 1 in all states except for Amazonas and Piauí, where it is between 1 and 1.1. In Paraíba and Sergipe, the values are very close to 1, between 0.94 and 0.99 (Figure 3).

• As of October 20, 18 states had more than 19.5% of the population infected, with the highest concentrations in the central-west and northern states: São Paulo, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Piauí, and Tocantins (19.5–24.4%); Espírito Santo, Pará, Goiás, Ceará, and Rondônia (24.5–28.9%); Amapá, Amazonas, and Rio de Janeiro (29–33.9%); Federal District, Mato Grosso, and Sergipe (34–38.4%); and Roraima (>48%).

• The number of positive cases detected nationally represents 12% of the infected population (Figure 5). • Most states have daily mortality rates below 4 per 1 million. The death rate is slightly higher in Mato Grosso and

the Federal District (4–4.9%).

Trends in key drivers of transmission (mobility, mask use, testing, and seasonality)

• Rio de Janeiro remains the only state that has a mask mandate (Table 2). Since early June, when mask usage peaked at 76% nationally, mask usage has slowly declined to about 64%. Peer countries in Latin America continue to have steadily high rates of mask usage, around 80% (Figure 9a).

• Mobility, while below the January 2020 baseline (-18%), is among the highest for Latin America, second only to Colombia (Figure 8a).

• Testing in Brazil continues to be below average for Latin America, at 30 tests per 100,000 population (Figure 10a).

Projections

• We project a cumulative death toll of 180,000 by February 1. Increasing the use of masks to 95% could save 8,000 lives compared to the baseline scenario (Figure 12).

• From October 20 to February 1, we project that a total of 25,000 more lives will be lost (Figure 12). • We project that daily deaths will decline steadily through October. By October 31, we expect that the number of

daily deaths will be 442, down from 484 today. By February 1, we anticipate daily deaths to reach as low as 24 in the best-case scenario, or 92 in the worst-case scenario (Figure 13).

• We do not project that any state will surpass a daily mortality rate of 8 per million by February 1 (Figure 15).



• About half of the states will have more than 24.5% of the population infected by February 1: Amazonas, Roraima, Tocantins, Mato Grosso, Sergipe, Piauí, Amapá, Rondônia, Acre, Goiás, the Federal District, Ceará, Rio de Janeiro, and Espírito Santo (Figure 16).

• The daily mortality rate will fall below 2 per million for most of the country by February 1; most states will experience mortality rates below 1 per million.

• We offer a comparison of our forecasts with other models that provide periodic updates and archive their results. When comparing past forecasts with what has happened, our model has the lowest average percentage error for cumulative deaths. In the US, as shown in Figure 18, our forecasts are markedly different. Other important models suggest that the epidemic is coming to an end, with a decline in daily deaths through the end of the year. We found a strong statistical correlation of effective R in the last six months with the weekly pattern of pneumonia deaths seen in each country or state. This seasonality variable, combined with our prediction that mandates will continue to decline during the fall, accounts for our markedly different forecasts.

Model updates

• There are no major updates the modeling strategy this week. We continue to examine a wide range of data sources, including infection-fatality rates calculated from seroprevalence surveys, hospital-fatality rates, and select individual hospital record databases, to determine whether the age-specific infection-fatality rate has declined.

• We are elaborating our model to allow for including the impact of vaccination scale-up in the first and second quarters of 2021.

IHME wishes to warmly acknowledge the support of these and others who have made our COVID-19 estimation efforts possible. Thank you.

For all COVID-19 resources at IHME, visit http://www.healthdata.org/covid.

Questions? Requests? Feedback? Please contact us at https://www.healthdata.org/covid/contact-us.

Brazil SUMMARY OF FINDINGS

COVID-19 Results Briefing: BrazilInstitute for Health Metrics and Evaluation (IHME)October 22, 2020This briefing contains summary information on the latest projections from the IHME model on COVID-19 inBrazil. The model was run on October 20, 2020.

Model updatesUpdates to the model this week include additional data on deaths, cases, and updates on covariates.

Summary of findings

covid19.healthdata.org 1 Institute for Health Metrics and Evaluation

Brazil CURRENT SITUATION

Current situationFigure 1. Reported daily COVID-19 cases

0

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Table 1. Ranking of COVID-19 among the leading causes of mortality this week, assuming uniform deathsof non-COVID causes throughout the year

Cause name Weekly deaths RankingCOVID-19 3,527 1Ischemic heart disease 3,293 2Stroke 2,519 3Lower respiratory infections 1,705 4Chronic obstructive pulmonary disease 1,321 5Interpersonal violence 1,267 6Diabetes mellitus 1,257 7Alzheimer’s disease and other dementias 1,050 8Road injuries 856 9Chronic kidney disease 814 10

Figure 2a. Reported daily COVID-19 deaths.

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Figure 2b. Estimated cumulative deaths by age group

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Figure 4. Estimated percent of the population infected with COVID-19 on October 19, 2020

=48

Figure 5. Percent of COVID-19 infections detected. This is estimated as the ratio of reported COVID-19cases to estimated COVID-19 infections based on the SEIR disease transmission model.

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Argentina United States of America Colombia Mexico Brazil



Figure 6. Daily COVID-19 death rate per 1 million on October 19, 2020

=8


Brazil CRITICAL DRIVERS

Critical driversTable 2. Current mandate implementation

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Mandate in place No mandate



Figure 7. Total number of social distancing mandates (including mask use)

Tocantins

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Figure 8a. Trend in mobility as measured through smartphone app use compared to January 2020 baseline

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Figure 8b. Mobility level as measured through smartphone app use compared to January 2020 baseline(percent) on October 19, 2020

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Figure 9a. Trend in the proportion of the population reporting always wearing a mask when leaving home

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Figure 9b. Proportion of the population reporting always wearing a mask when leaving home on October19, 2020

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Figure 10a. Trend in COVID-19 diagnostic tests per 100,000 people

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Figure 10b. COVID-19 diagnostic tests per 100,000 people on October 19, 2020

=500



Figure 11. Increase in the risk of death due to pneumonia on February 1 compared to August 1

=80%


Brazil PROJECTIONS AND SCENARIOS

Projections and scenariosWe produce three scenarios when projecting COVID-19. The reference scenario is our forecast of what wethink is most likely to happen. We assume that if the daily mortality rate from COVID-19 reaches 8 permillion, social distancing (SD) mandates will be re-imposed. The mandate easing scenario is what wouldhappen if governments continue to ease social distancing mandates with no re-imposition. The universal maskmandate scenario is what would happen if mask use increased immediately to 95% and social distancingmandates were re-imposed at 8 deaths per million.

Figure 12. Cumulative COVID-19 deaths until February 01, 2021 for three scenarios.

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Fig 13. Daily COVID-19 deaths until February 01, 2021 for three scenarios.

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Fig 14. Daily COVID-19 infections until February 01, 2021 for three scenarios.

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Fig 15. Month of assumed mandate re-implementation. (Month when daily death rate passes 8 per million,when reference scenario model assumes mandates will be re-imposed.)

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JanuaryNo mandates before Feb 1



Figure 16. Forecasted percent infected with COVID-19 on February 01, 2021

=48

Figure 17. Daily COVID-19 deaths per million forecasted on February 01, 2021 in the reference scenario

=8



Figure 18. Comparison of reference model projections with other COVID modeling groups. For thiscomparison, we are including projections of daily COVID-19 deaths from other modeling groups when available:Delphi from the Massachussets Institute of Technology (Delphi; https://www.covidanalytics.io/home),Imperial College London (Imperial; https://www.covidsim.org), The Los Alamos National Laboratory(LANL; https://covid-19.bsvgateway.org/), the SI-KJalpha model from the University of Southern California(SIKJalpha; https://github.com/scc-usc/ReCOVER-COVID-19), and Youyang Gu (YYG; https://covid19-projections.com/). Daily deaths from other modeling groups are smoothed to remove inconsistencies withrounding. Regional values are aggregates from availble locations in that region.

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Imperial

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https://www.covidanalytics.io/homehttps://www.covidsim.orghttps://covid-19.bsvgateway.org/https://github.com/scc-usc/ReCOVER-COVID-19https://covid19-projections.com/https://covid19-projections.com/


Table 3. Ranking of COVID-19 among the leading causes of mortality in the full year 2020. Deaths fromCOVID-19 are projections of cumulative deaths on Jan 1, 2021 from the reference scenario. Deaths fromother causes are from the Global Burden of Disease study 2019 (rounded to the nearest 100).

Cause name Annual deaths RankingCOVID-19 176,956 1Ischemic heart disease 171,200 2Stroke 131,000 3Lower respiratory infections 88,600 4Chronic obstructive pulmonary disease 68,700 5Interpersonal violence 65,900 6Diabetes mellitus 65,400 7Alzheimer’s disease and other dementias 54,600 8Road injuries 44,500 9Chronic kidney disease 42,300 10

Mask data source: Premise; Facebook Global symptom survey (This research is based on survey resultsfrom University of Maryland Social Data Science Center) and the Facebook United States symptom survey(in collaboration with Carnegie Mellon University); Kaiser Family Foundation; YouGov COVID-19 BehaviourTracker survey.

A note of thanks:

We would like to extend a special thanks to the Pan American Health Organization (PAHO) for keydata sources; our partners and collaborators in Argentina, Brazil, Bolivia, Chile, Colombia, Cuba, theDominican Republic, Ecuador, Egypt, Honduras, Israel, Japan, Malaysia, Mexico, Moldova, Panama, Peru,the Philippines, Russia, Serbia, South Korea, Turkey, and Ukraine for their support and expert advice; andto the tireless data collection and collation efforts of individuals and institutions throughout the world.

In addition, we wish to express our gratitude for efforts to collect social distancing policy information inLatin America to University of Miami Institute for Advanced Study of the Americas (Felicia Knaul, MichaelTouchton), with data published here: http://observcovid.miami.edu/; Fundación Mexicana para la Salud(Héctor Arreola-Ornelas) with support from the GDS Services International: Tómatelo a Pecho A.C.; andCentro de Investigaciones en Ciencias de la Salud, Universidad Anáhuac (Héctor Arreola-Ornelas); Lab onResearch, Ethics, Aging and Community-Health at Tufts University (REACH Lab) and the University ofMiami Institute for Advanced Study of the Americas (Thalia Porteny).

Further, IHME is grateful to the Microsoft AI for Health program for their support in hosting our COVID-19data visualizations on the Azure Cloud. We would like to also extend a warm thank you to the many otherswho have made our COVID-19 estimation efforts possible.


http://observcovid.miami.edu/

COVID-19 Results Briefing: BrazilInstitute for Health Metrics and Evaluation (IHME)October 22, 2020

Model updatesSummary of findingsCurrent situationCritical driversProjections and scenarios

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