Released this Thursday (11/16), the new InfoGripe Bulletin, like the last update, points to a heterogeneous picture in the country of cases of Severe Acute Respiratory Syndrome (SARS) due to Covid-19, with some states showing an increase in new weekly occurrences – mainly in the older population – and others signaling stability. Based on data entered into the Influenza Epidemiological Surveillance Information System (Sivep-Gripe) until November 13th, the analysis refers to Epidemiological Week (SE) 45, period from November 5th to 11th.
At a national level, due to the variation in the Brazilian territory, the scenario translates into stability. The update observed stability or fluctuation in SARS cases also in children and adolescents, but a continued slow increase in the adult population, especially in the group over 65 years of age. The increase in SARS cases in this age group is a reflection of the growth in positive cases for Sars-CoV-2 (Covid-19), starting in September, especially in the southern half of the country (Central-West, Southeast and South) , and which, recently, has also manifested itself in the state of Bahia. However, the reversal of the scenario in some states contrasts with the beginning of growth in others, resulting in a decrease in the pace of growth in the national aggregate.
According to Report card, some states in the Southeast and South region have signs of an increase in new weekly cases of SARS due to Covid-19, such as Bahia, Rio Grande do Sul, Santa Catarina and Minas Gerais. “Minas, which was in a situation of stability, once again showed growth in hospitalizations associated with Covid-19. In the Northeast, only Bahia presents this scenario”, informs the researcher from the Scientific Computing Program (Procc/Fiocruz) and coordinator of the InfoGripe, Marcelo Gomes.
In the Southeast, the state of São Paulo, which has been growing for some time, is currently pointing towards stability, reflecting a clear sign of interruption in the growth of new weekly cases of SARS associated with Covid-19 in the capital. In the interior, however, some regions continue to maintain an increase.
The researcher clarifies that, on the other hand, in the state of Rio de Janeiro, which had been maintaining a decline, the current analysis observes “an early interruption of the decline” in cases associated with Covid-19. “Furthermore, in Espirito Santo we have a small sign of a recent increase in positive cases for Covid-19, without yet generating a significant increase in the adult population, but which deserves attention. Goiás, Mato Grosso do Sul, Paraná, in addition of the State of São Paulo, there are signs of growth interruption”, observed Gomes.
Age group: most significant incidence among children and the elderly
The study also highlights that, when observing the incidence and mortality from SARS in the population over the last eight weeks, there is a typical scenario of cases of respiratory infection, with a very significant incidence at both ends of the age groups analyzed. The incidence in young children has been influenced by different respiratory viruses during this period (rhinovirus, respiratory syncytial virus [VSR], Sars-CoV-2 and adenovirus). Among the elderly, it is largely dominated by Sars-CoV-2.
A similar picture is observed in relation to deaths. The average weekly incidence and mortality, in the last eight epidemiological weeks, maintains the typical scenario of greater impact at the extremes of the age groups analyzed. While the incidence of SARS has a higher impact on children up to two years of age, in terms of mortality the opposite is true, with the population over 65 years of age being the most impacted.
Deaths from SARS in the country
Regarding SARS cases in 2023, regardless of the presence of fever, 9,813 deaths have already been recorded in the country, 5,036 (51.3%) with a positive laboratory result for a respiratory virus, 4,092 (41.7%) negative and at least 174 (1.8%) awaiting laboratory results.
Among those positive this year, 9.8% are influenza A; 4.9% are influenza B; 7.2% are RSV; 71.1% are Sars-CoV-2 (Covid-19). In the last four epidemiological weeks, the prevalence among positive cases was 0% for influenza A; 0.6% for influenza B; 0.6% for RSV; and 82.5% for Sars-CoV-2 (Covid-19).
States and capitals
In this update, it is observed that nine of the 27 federative units show signs of growth in the long-term trend (last six weeks) up to SE 45: Alagoas, Amazonas, Bahia, Ceará, Distrito Federal, Maranhão, Minas Gerais, Rio Grande do Sul and Santa Catarina.
In Bahia, Minas Gerais, Rio Grande do Sul and Santa Catarina, growth is concentrated in the adult population and is due to the increase in positive cases for Sars-CoV-2 (Covid-19). In São Paulo, which until the previous bulletin was in this same group, shows signs of interruption in growth, mainly due to the scenario in the capital. In Rio de Janeiro, where there was a drop in the number of new SARS cases due to Covid-19 in the population over 65 years of age, in this update there is an indication of an early interruption of the decline, maintaining a plateau.
In Goiás, Minas Gerais and Paraná, SARS cases positive for Sars-CoV-2 maintain an interruption in growth, without this being reflected in a significant increase in the total number of SARS cases in the elderly population during this cycle. In Espírito Santo, although there is no increase in SARS cases in general, it is possible to observe a slight increase in those positive for Sars-CoV-2 in the population over 65 years of age.
In Amazonas, recent growth is modest and observed only in children, adolescents, and young adults. That is, outside the typical Covid-19 or RSV groups. There is still not enough laboratory information to infer which agent is responsible for the current scenario.
In Alagoas, Ceará, Distrito Federal and Maranhão, the sign is of smooth and concentrated growth in young children, compatible with oscillation.
In this update, it is observed that four of the 27 capitals show signs of growth in the long-term trend (last 6 weeks) up to SE 45: Belo Horizonte (MG), Curitiba (PR), Fortaleza (CE) and Vitória (ES ).
In Belo Horizonte and Curitiba. growth is observed mainly in the elderly population. In Salvador, although SARS cases in the general population have stabilized, among individuals aged 65 and over the sign of growth resulting from Covid-19 is still present. In São Paulo, this same scenario is already being interrupted, forming a plateau. In Fortaleza and Vitória, the signal is still compatible with oscillation.