Space-time risk clusters of COVID-19 in a tourism area in the northeastern Brazil: an epidemiological overview after two years of pandemic

The world is facing a serious viral infection caused by the new Severe Acute Respiratory Syndrome Coronavirus 2. We aimed to evaluate and map the high-risk clusters of COVID-19 in the State of Alagoas, a touristic area in northeastern Brazil, after two years of pandemic by a population-based ecological study, using COVID-19 cases reported in the State of Alagoas, between March, 2020 and April, 2022. We performed a descriptive and statistical analysis of epidemiological data. We then map high-risk areas for COVID-19, using spatial analysis, considering the incidence rate by municipality. 297,972 positive cases were registered;56.9% were female and 42.7% aged between 20 and 39 years old. Men (OR = 1.59) and older than 60 years old (OR = 29.64) had a higher risk of death, while the highest incidence rates of the disease occurred in the metropolitan region. Our data demonstrate the impact of COVID-19 in the State of Alagoas, through the two years of pandemic. Although the number of cases were greater among women and young adults, the chance of death was greater among men and older adults. High-risk clusters of the disease initially occur in metropolitan cities and tourist areas.

The family and the school in times of pandemic: guidelines to assist the studies of children at home

Covid-19 has made families search for ways to assist their children in their online studies, so their learning should not be interrupted. The present article aimed to identify the difficulties faced in the teaching-learning process from the homes. Symptoms such as depression and stress caused by the lack of social interaction could be identified. During the analysis of the results, three categories were conceived: apprehension regarding the students' health (physical and/or mental), concern about the child's learning, and how to motivate students in the remote teaching period. From the data generated, it was possible to obtain elements for the elaboration of an orientation guide with the intention of helping other families. The results obtained suggest possible ways to guide and motivate pupils and how it has become important during online teaching, as well as the support and welcoming of the educational institutions to which the students belong.

THE PUBLIC ADMINISTRATION OF TOURISM IN BRAZIL

The moment we are living in has demanded changes in the lives and routines of people all over the world. Currently, in the regions where tourism is developed, the crisis moment is recognized as a consequence of the pandemic caused by the new Coronavirus (COVID-19), whose security protocols are opposed to the characteristics of movement and rupture of isolation, which the phenomenon of tourism brings in its essence. This article presents a bibliographic and documental review, containing the historical evolution of public administration actions in the tourism sector in Brazil, which contributed to the economic, social and environmental preservation of tourist destinations. This study aims to present the National Tourism System, its institutions, laws, plans, programs and actions, highlighting the Ministry of Tourism, as the central institution, and the Brazilian Agency for International Tourism Promotion responsible for developing marketing and support the commercialization of products from the various segments related to the tourist activity in the country and abroad. Among public policies, the National Tourism Program stands out, proposing actions by the federal government, states and municipalities, improving communication between public entities in the three spheres of power. Copyright © 2021 by Naudé Scribante. Permission granted to IAMOT to publish and use.

Resolutive results with oral corticosteroids for patients with COVID-19 in pulmonary inflammatory phase. successful outpatient experience during the collapse of Belem do Para health system-Brazil

In the face of new diseases, medicine needs to reinvent itself in order to contain and control epidemics, such as the one we have recently faced, COVID-19, a disease with a wide spectrum of clinical severity. A new moment has been established, since the application of well-known, effective and safe medications for other diseases, has shown high success rates in the treatment of COVID-19. Thereunto, studies with early intervention are needed, which can change the unfavorable outcome of patients. In this article, we report the successful experience using an oral strategy during the collapse of Belem (Para, Brazil) Health System. Two hundred and ten patients were diagnosed with respiratory failure due to COVID-19, with no option of hospital treatment due to lack of beds and resources. These patients were then started on therapeutic regimen consisting of 40 mg prednisolone, 40 mg enoxaparin and macrolides (500 mg clarithromycin, 500 mg axetylcefuroxime) associated and followed in outpatient facilities. Two hundred and eight patients had an excellent therapeutic response and there were only two fatalities. These results push research boundaries, valuing outpatient treatment with early use of prednisolone in the initial pulmonary phase, preventing severe COVID-19 pneumonitis. Adoption of the proposed treatment intends to reduce the need for hospitalization, as well as lethality, with social robust benefits and incalculable economic savings since involves the use of accessible, safe and not expensive medications.

Risk clusters of COVID-19 transmission in northeastern Brazil: prospective space-time modelling.

This study aimed to analyse the trend and spatial-temporal clusters of risk of transmission of COVID-19 in northeastern Brazil. We conducted an ecological study using spatial and temporal trend analysis. All confirmed cases of COVID-19 in the Northeast region of Brazil were included, from 7 March to 22 May 2020. We used the segmented log-linear regression model to assess time trends, and the local empirical Bayesian estimator, the global and local Moran indexes for spatial analysis. The prospective space-time scan statistic was performed using the Poisson probability distribution model. There were 113 951 confirmed cases of COVID-19. The average incidence rate was 199.73 cases/100 000 inhabitants. We observed an increasing trend in the incidence rate in all states. Spatial autocorrelation was reported in metropolitan areas, and 178 municipalities were considered a priority, especially in the states of Ceará and Maranhão. We identified 11 spatiotemporal clusters of COVID-19 cases; the primary cluster included 70 municipalities from Ceará state. COVID-19 epidemic is increasing rapidly throughout the Northeast region of Brazil, with dispersion towards countryside. It was identified high risk clusters for COVID-19, especially in the coastal side.

Impact of the COVID-19 pandemic on the development of burnout syndrome in frontline physicians: prevalence and associated factors

OBJECTIVE: To evaluate the prevalence of burnout syndrome (BS) in physicians working during the COVID-19 pandemic in Paraiba and to investigate the association between BS and the sociodemographic and labor variables of these professionals. METHODS: This was a cross-sectional study including physicians who were active during the pandemic in Paraiba, whether they were on the front line (group 1) or not (group 2). Sociodemographic and labor variables were collected, and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied. RESULTS: A total of 126 physicians were included, including 82 who were on the front line. Among the professionals with results compatible with BS, 85.5% were in group 1, compared with 14.5% in group 2, and this difference was statistically significant. At the 5% level, the variables associated with BS were age (24-33 years), not having children, working on the front line, working in the COVID-19 ICU, being on duty, and having contracted COVID-19. CONCLUSIONS: This case series found a positive association between the development of BS and medical action on the front line of the COVID-19 pandemic in Paraiba.