A new article published in The Lancet Regional Health - Americas estimates that more than 1 million elective and emergency surgeries were accumulated in Brazil in 2020 due to the Covid-19 pandemic. The work is a collaboration between Harvard Medical School's Global Surgery and Social Change Program and international researchers.
“Our publication represents the first in a Latin American country on the accumulation of surgeries caused by the pandemic”, says one of the authors of the article, Dr. Rodrigo Vaz Ferreira, Professor at the State University of Amazonas and a graduate student at the Faculdade de Medicina da Universidade de São Paulo (FMUSP). Besides him, Prof. Nivaldo Alonso, from the Surgery Department at FMUSP, is the coordinator of the Brazilian Global Surgery research group that integrates the publication.
As a methodology, the study used data from the public health service (DATASUS) on surgeries performed from 2016 to 2020. Using a statistical model, an expected surgical volume was estimated for the pandemic period, between March 2020 and December 2020. When comparing this value with the actual data provided by the states, there was an accumulation of more than 1,100,000 surgeries, with 928,758 procedures involving elective surgeries, those that are not considered urgent.
According to Ferreira, this pattern follows that of other countries with a large volume of surgical interventions. “On the one hand, this reduction is explained by the prioritization of more urgent procedures, the reallocation of resources and management of health professionals during the pandemic”, says the researcher.
Another aspect to be noted is that states with stricter government policies to contain the virus, such as closing schools, workplaces and travel bans, managed to maintain the level of operation of emergency surgeries, thanks to the preservation of resources and beds , despite the great delay in elective surgeries. “The delay of 1 million surgeries is very significant for Brazil, which already has a very overloaded health system”, says Dr. Fábio Botelho, Trauma and Pediatric Surgeon, researcher at McGill University, in Canada, and one of the co-authors of this study. “Unfortunately, we believe that it will be possible to observe an increase in the number of deaths and sequelae for patients who failed to obtain surgical care.”
The analysis of these data, however, can inform public policies that mitigate the effects of this accumulation, in addition to preventing future crises. “We have to be prepared, encourage the population to get vaccinated and respect local sanitary measures, as this contributes to the preservation of full surgical services,” says Botelho.