Ana Valesca Fernandes Gilson Silva

Since its first identification in Brazil, the variant of concern (VOC) Gamma has been associated with increased infection and transmission rates, hospitalizations, and deaths. Minas Gerais (MG), the second-largest populated Brazilian state with more than 20 million inhabitants, observed a peak of cases and deaths in March–April 2021. We conducted a surveillance study in 1240 COVID-19-positive samples from 305 municipalities distributed across MG’s 28 Regional Health Units (RHU) between 1 March to 27 April 2021. The most common variant was the VOC Gamma (71.2%), followed by the variant of interest (VOI) zeta (12.4%) and VOC alpha (9.6%). Although the predominance of Gamma was found in most of the RHUs, clusters of Zeta and Alpha variants were observed. One Alpha-clustered RHU has a history of high human mobility from countries with Alpha predominance. Other less frequent lineages, such as P.4, P.5, and P.7, were also identified. With our genomic characterization approach, we estimated the introduction of Gamma on 7 January 2021, at RHU Belo Horizonte. Differences in mortality between the Zeta, Gamma and Alpha variants were not observed. We reinforce the importance of vaccination programs to prevent severe cases and deaths during transmission peaks.

The COVID-19 pandemic has created an unprecedented need for epidemiological monitoring using diverse strategies. We conducted a project combining prevalence, seroprevalence, and genomic surveillance approaches to describe the initial pandemic stages in Betim City, Brazil. We collected 3239 subjects in a population-based age-, sex- and neighborhood-stratified, household, prospective; cross-sectional study divided into three surveys 21 days apart sampling the same geographical area. In the first survey, overall prevalence (participants positive in serological or molecular tests) reached 0.46% (90% CI 0.12–0.80%), followed by 2.69% (90% CI 1.88–3.49%) in the second survey and 6.67% (90% CI 5.42–7.92%) in the third. The underreporting reached 11, 19.6, and 20.4 times in each survey. We observed increased odds to test positive in females compared to males (OR 1.88 95% CI 1.25–2.82), while the single best predictor for positivity was ageusia/anosmia (OR 8.12, 95% CI 4.72–13.98). Thirty-five SARS-CoV-2 genomes were sequenced, of which 18 were classified as lineage B.1.1.28, while 17 were B.1.1.33. Multiple independent viral introductions were observed. Integration of multiple epidemiological strategies was able to adequately describe COVID-19 dispersion in the city. Presented results have helped local government authorities to guide pandemic management.

The Covid-19 pandemic has created an unprecedented need for epidemiological monitoring using diverse strategies. We conducted a project combining prevalence, seroprevalence, and genomic surveillance approaches to describe the initial pandemic stages in Betim City, Brazil. We collected 3239 subjects in a population-based age-, sex- and neighbourhood-stratified, household, prospective; cross-sectional study divided into three surveys 21 days apart sampling the same geographical area. In the first survey, overall prevalence (participants positive in serological or molecular tests) reached 0.46% (90% CI 0.12% – 0.80%), followed by 2.69% (90% CI 1.88% – 3.49%) in the second survey and 6.67% (90% CI 5.42% - 7.92%) in the third. The underreporting reached 11, 19.6, and 20.4 times in each survey, respectively. We observed increased odds to test positive in females compared to males (OR 1.88 95% CI 1.25 – 2.82), while the single best predictor for positivity was ageusia/ anosmia (OR 8.12, 95% CI 4.72 – 13.98). Thirty-five SARS-CoV-2 genomes were sequenced, of which 18 were classified as lineage B.1.1.28, while 17 were B.1.1.33. Multiple independent viral introductions were observed. Integration of multiple epidemiological strategies was able to describe Covid-19 dispersion in the city adequately. Presented results have helped local government authorities to guide pandemic management.

This article aims to develop a reflective theoretical study with an emphasis on the actions, challenges and recommendations of practices for the prevention, control and monitoring of PHC disease. The COVID-19 pandemic has been demanding a remodeling of structures, not only in hospital care, but, especially in interventions in communities and their social, urban and structural problems. The article highlights the work process and new technical and dynamic incorporations for prevention, surveillance and monitoring imposed by SARS-CoV2 on primary health care, which must also guarantee access to essential care. As it allows thinking about the most feasible forms of action, this article recognizes the principles of action in the health system, offering to managers and health professionals, through the interlocution between related studies, several measures that can help in assistance of pandemic. The COVID-19 pandemic changed the course of some health policies in the world. Patient-centered care requires a change in perspective towards a concept of community-centered care. As the primary health care is the first level of contact for individuals, family and community in a health system, constituting the preferred gateway to the care process, it is expected that the reflections raised by this article will contribute to an analysis that answers the main public health issues from the perspective of primary health care, preserving its stability, avoiding the disintegration of its actions and maintaining its functionality with the strengthening of local and community actions.

O presente artigo avalia brevemente o papel central exercido pela Atenção Primária à Saúde no Combate da COVID-19 e aponta uma reflexão sobre as normativas dos atendimentos aos casos da COVID 19 e as condições das UBSs quanto a estrutura, profissionais, equipamentos e organização desses serviços.

Significando o risco sanitário: modos de atuação sobre o risco na vigilância sanitária