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Brazil Covid-19 Report

Rossana Maria Seabra Sade Ph.D., Professor University State of São Paulo (UNESP), Brazil, 08/05/2020

"I am carrying out with my research group, we are developing the analysis of the actions of the service, user, and professionals because of the current panorama. We selected 24-hour health centers (CAPS III), in cities with populations over 500 thousand inhabitants, we have 28 municipalities across the country and the capitals. Through phone calls, we are asking some questions; how are home visits; the level of involvement of users and family members separately; how many users have presented Covid-19; crisis response strategies; how the teams are protected by equipment and psychological support and prevention strategy actions. We intend to analyze the data and publish it by May 30th."

Brazilian political situation: The President Jair Bolsonaro is the only world leader who keeps questioning the merits of the blockade measures to combat the COVID-19 pandemic, calling the virus a "simple flu",

 The epidemic in the country remains more concentrated in the states of São Paulo (39,928 cases and 3,206 deaths), Rio de Janeiro (14,156 cases and 1,394 deaths), Ceará (13,888 cases and 903 deaths), Pernambuco (10,824 cases and 845 deaths), and Amazonas (10,099 cases and 806 deaths).

Since the new coronavirus was first detected in Brazil in late February, the virus has spread rapidly across the country. On May 8, there were 138.087 confirmed cases in Brazil and 9.390 records of deaths. The tests are been limited which substantially alters the perception of the pandemic in the country, Deaths take, on average, between one and two weeks to be accounted.

 Brazil does not have a centralized health policy concerning COVID-19, in addition to the fact that the Brazilian health system over the last few years has been weakened by public policies that have not been focused on strengthening the Unified Health System (SUS).

 According to Abrasco (2020), the services of the Unified Health System (SUS), responsible for ensuring competent and humanitarian treatment to users of the system, begin to collapse, a situation that has already been observed in some Brazilian capitals.

As a result, mental health services have been greatly affected by the policies implemented. In 2017, the ordinance number 3588 changed the National Mental Health Policy, the document increases paid hospital stays in psychiatric hospitals, and increases the number of psychiatric beds in these units from 15% to 20%, among other changes. The ordinance directly interferes with the Psychosocial Care Network (RAPS), it was a major setback in the Brazilian mental health policy.

Currently, the Psychosocial Care Centers (CAPS), are operating only for emergency care to the mental health crisis, maintaining only extremely necessary cases. Services that offer night assistance should assess the user's clinical conditions, and the real need to remain in the service.

The professionals (CAPS) have a direct line 24 hours for emergency (on-line) service. As home visits are restricted, as well as support in therapeutic residences.

In the face of this given this situation, Covid-19's main preventive mechanism continues to be social isolation, associated with basic hygiene measures.

 We know that adherence to social isolation for an unpredictable time is not easy, Brazil has millions of unemployed informal workers, in addition to many who, despite maintaining formal employment relationships, are in increasingly precarious conditions and without guarantee of minimum income. There is a lack of effective public policies that guarantee the livelihood and life of people and their families with decency and dignity.

The Unified Health System (SUS) created an online health and mental health support network. The entire Brazilian scientific community, some governors with the support of the judicial system, decreed quarantine in almost all states and initiated the lockdown by court order in the state of Maranhão. A part of the society is mobilized with social and humanitarian actions. Media campaigns, aiming to raise awareness of the importance of care in the face of the pandemic, are daily, but the country's top authority deconstructs daily actions, promoting agglomerations and speeches contrary to WHO guidelines. We look forward to more serious measures to combat Covid-19 and greater awareness among the population that supports the President and follows his actions.

 People with psychological distress, users of mental health services are part of a vulnerable group, most live in precarious homes, without basic sanitation, low education, taking a great risk of contamination, and, in the event of a crisis, they will probably be admitted to the psychiatric hospital.

Conclusion I present an action that I am carrying out with my research group, we are developing the analysis of the actions of the service, user, and professionals because of the current panorama. We selected 24-hour health centers (CAPS III), in cities with populations over 500 thousand inhabitants, we have 28 municipalities across the country and the capitals. Through phone calls, we are asking some questions; how are home visits; the level of involvement of users and family members separately; how many users have presented Covid-19; crisis response strategies; how the teams are protected by equipment and psychological support and prevention strategy actions. We intend to analyze the data and publish it by May 30th.

Thank you.

Keep fine, and safe. Rossana Maria Seabra Sade 

Ph.D., Professor University State of São Paulo (UNESP)

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