@Article{SilvaASTGCSVCCF:2020:AnDaGo,
author = "Silva, Lena Veiga e and Abi Harb, Maria da Penha de Andrade and
Santos, Aurea Milene Teixeira Barbosa dos and Teixeira, Carlos
Andr{\'e} de Mattos and Gomes, Vitor Hugo Macedo and Cardoso,
Evelin Helena Silva and Silva, Marcelino S. da and Vijaykumar,
Nandamudi Lankalapalli and Carvalho, Solon Ven{\^a}ncio de and
Carvalho, Andr{\'e} Ponce de Leon Ferreira de and Frances, Carlos
Renato Lisboa",
affiliation = "{Universidade Federal do Par{\'a} (UFPA)} and {Universidade
Federal do Par{\'a} (UFPA)} and {Universidade Federal do
Par{\'a} (UFPA)} and {Universidade Federal do Par{\'a} (UFPA)}
and {Universidade Federal do Par{\'a} (UFPA)} and {Universidade
Federal do Par{\'a} (UFPA)} and {Universidade Federal do
Par{\'a} (UFPA)} and {Instituto Nacional de Pesquisas Espaciais
(INPE)} and {Instituto Nacional de Pesquisas Espaciais (INPE)} and
{Universidade de S{\~a}o Paulo (USP)} and {Universidade Federal
do Par{\'a} (UFPA)}",
title = "COVID-19 mortality underreporting in Brazil: analysis of data from
government internet portals",
journal = "Journal of Medical Internet Research",
year = "2020",
volume = "22",
number = "8",
pages = "e21413",
month = "Aug.",
keywords = "Brazil, COVID-19, mortality, underreporting, respiratory system
diseases, public health, pandemic, time series, forecasting.",
abstract = "BACKGROUND: In Brazil, a substantial number of coronavirus disease
(COVID-19) cases and deaths have been reported. It has become the
second most affected country worldwide, as of June 9, 2020.
Official Brazilian government sources present contradictory data
on the impact of the disease; thus, it is possible that the actual
number of infected individuals and deaths in Brazil is far larger
than those officially reported. It is very likely that the actual
spread of the disease has been underestimated. OBJECTIVE: This
study investigates the underreporting of cases and deaths related
to COVID-19 in the most affected cities in Brazil, based on public
data available from official Brazilian government internet
portals, to identify the actual impact of the pandemic. METHODS:
We used data from historical deaths due to respiratory problems
and other natural causes from two public portals: DATASUS
(Department of Informatics of the Unified Healthcare System)
(2010-2018) and the Brazilian Transparency Portal of Civil
Registry (2019-2020). These data were used to build time-series
models (modular regressions) to predict the expected mortality
patterns for 2020. The forecasts were used to estimate the
possible number of deaths that were incorrectly registered during
the pandemic and posted on government internet portals in the most
affected cities in the country. RESULTS: Our model found a
significant difference between the real and expected values. The
number of deaths due to severe acute respiratory syndrome (SARS)
was considerably higher in all cities, with increases between 493%
and 5820%. This sudden increase may be associated with errors in
reporting. An average underreporting of 40.68% (range 25.9%-62.7%)
is estimated for COVID-19-related deaths. CONCLUSIONS: The
significant rates of underreporting of deaths analyzed in our
study demonstrate that officially released numbers are much lower
than actual numbers, making it impossible for the authorities to
implement a more effective pandemic response. Based on analyses
carried out using different fatality rates, it can be inferred
that Brazil's epidemic is worsening, and the actual number of
infectees could already be between 1 to 5.4 million.",
doi = "10.2196/21413",
url = "http://dx.doi.org/10.2196/21413",
issn = "1439-4456",
language = "en",
targetfile = "silva_covid.pdf",
urlaccessdate = "01 jun. 2024"
}