Covid is still one of the main causes of death in the country – 03/28/2023 – Health

Although mortality from Covid fell in 2022, the disease remains among the top five causes of death in Brazil, according to a survey carried out by DeltaFolha using data from the SIM (Mortality Information System) of the Ministry of Health.

In 2020, when the pandemic began, 194,976 people died from Covid. As a result, it has become the leading cause of death from all types (including external causes such as accidents and violent deaths). The picture was repeated in 2021, when 424,133 deaths were accounted for by Covid alone.

In the last two years, deaths from Covid have surpassed the two main types of causes of death in the country in the last decade: diseases of the circulatory system (including myocardial infarction and ischemic disease) and neoplasms (tumors). However, in February 2022, Covid ceased to be the main cause of death in the country, occupying second place, behind cardiovascular diseases (a varied set that includes different types of diseases).

And, in March, it finally reached the sixth position, behind ischemic heart disease, cerebrovascular diseases (CVA), other cardiovascular diseases and respiratory infections. The numbers for 2022, however, are still preliminary.

The most favorable scenario, according to experts, is mainly due to the advancement of vaccination, but it is still important to look at the impact of Covid on health.

“We’re certainly not seeing those high numbers of deaths [por Covid] like we had before”, says the demographer, professor at Harvard University and columnist for Sheet Marcia Castro. “To get that level back, just another pathogen or some variant that completely escapes antibodies.”

Castro also points out that, despite the improvement, it is not possible to predict what the annual level of deaths from the disease will be. “Following SARS hospitalizations [síndrome respiratória aguda grave] due to Covid we managed to estimate mortality according to the trend in recent months, but we still don’t have that number.”

The researcher also recalls that the different booster vaccine coverage in the population also enter into this account. “In a hypothetical scenario in which all people receive reinforcements, even so mortality will not be zero, there will always be a death rate, but there is a lot of vaccine delay.”

The percentage in the total number of annual deaths in the country from Covid has also dropped in recent months. If in April 2021, the month that recorded the most deaths from Covid, 41.85% of deaths in the country were from the coronavirus, it represented about 1.89% of deaths in September 2022, when the latest data were made available, percentage similar to that recorded for deaths by homicide (1.8%).

“We had two terrible peaks, which were in May 2020 and then in the first months of 2021, but after that mortality decreased, in such a way that today we are returning to our baseline level”, explains the epidemiologist and professor at the Faculty of Medicine at USP Paulo Lotufo.

The effects of Covid on other diseases, however, may still take a while to be noticed. “The excess mortality in the first two years and still in 2022 due to Covid was direct, but the pandemic may have caused a reduction in the survival of cancer patients who ended up dying before their time. Therefore, the effects on other causes of death are still under observation,” he says.

It is already known that Covid caused a reduction in global life expectancy of around 1.8 years, but in Brazil this difference reached 4.4 years, as indicated by a study conducted by Castro.

“Covid certainly had an impact on mortalities from other causes, but while in some it reduced [porque tiveram menos mortes por aquela causa], in others it increased, such as diabetes and kidney disease. She [Covid] it is not an independent cause of death”, says the demographer.

It is important to note that Covid is a single cause, while cardiovascular disease represents a cluster of diseases that includes multiple causes. Some types of causes of death will vary according to gender, age, social status or region of the country.

For the senior technical advisor at Vital Strategies and former director of the Department of Surveillance of Noncommunicable Diseases and Diseases and Health Promotion of the Ministry of Health, Fátima Marinho, the calculation of the impact that Covid had on other diseases depends on stratified data and which are often difficult to obtain nationally.

One example she cites is the calculation of excess mortality made in the United States by researchers from the CDC (Center for Disease Control and Prevention). In some places, such as NY, the excess mortality found was 60% caused by Covid (direct deaths from the coronavirus infection), while the rest were associated causes. “We know that Covid can be an associated cause when comparing groups of people with the previous health condition and who had or did not have Covid. These effects may last for a while until they are well defined”, she evaluates.

Marinho recalls that the disease that had the most deaths associated with Covid was diabetes. A study showed that 40% of diabetic patients hospitalized for Covid died from the disease, and the rate of people with diabetes has grown in the last two years.

“The cost of health will be even greater, because if before we had a total number of people each year who needed hospitalization and medical care, now it is much greater. And, unfortunately, we do not have well-defined criteria to assess the consequences of Covid” , it says.