Newborn in the Pediatric Emergency Department: A Reality During the COVID-19 Pandemic

Introduction: We aimed to characterize newborns admitted to the pediatric emergency department in the first months of the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a retrospective observational study regarding newborns who presented to the pediatric emergency department during the pandemic period in comparison with the same period of the previous year. Data gathered concerning the neonatal characteristics included the length of postpartum stay in the nursery, age at presentation to the pediatric emergency department, source of referral to the pediatric emergency department, presenting complaint, need for complementary exams, diagnosis, final destination, and hospital readmission. Results: The number of births was 591 in the pandemic period and 709 in the homologous period. We analyzed 72 pediatric emergency department admissions in the pandemic period and 123 pediatric emergency department admissions in the homologous period. During the pandemic period, there was a decreased rate of neonatal admissions to the pediatric emergency department, but not as pronounced as for the total number of children. We found an increased rate of patients visiting the pediatric emergency department and without disease during the first 2 weeks of life. There were higher referral rates to the pediatric emergency department and to an ambulatory pediatrics appointment. No differences were found concerning the presenting complaints, need for complementary exams, diagnoses, and admission rates. Discussion: Although there was a decreased rate of neonatal admissions during the pandemic period, it was not as pronounced as for the total number of children, denotating a greater need to attend to the pediatric emergency department compared to the other age categories. The reduced access to primary care during the pandemic period and the decreased time of parental education in the nursery might have contributed to these findings. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2022.

Impacts of the COVID-19 pandemic on the Brazilian hydrothermal system

Hydropower has been the predominant source of electrical energy supply in Brazil, with significant increasing participation share of thermal and wind power plants. From 2000 to 2012, on average, 91% of Brazilian effective electric generation was provided by hydropower, while the reservoir system operated, on average, at 68% of the active storage. From 2013 to 2020, 73% was supplied by hydropower plants, with only 39% of active storage. Demand increase, delays in expanding the system, and a series of moderate to severe droughts occurred in Brazil over the last eight years have contributed to bringing the power system to its current state of low storage levels and intense dispatch of the thermal plants. The COVID-19 pandemic in 2020 hit the country hard and brought an abrupt reduction in energy demand, with persistent impacts expected for the coming years. On average, 7.5 GW or 9.7% reduction is expected for the next three years in power demand. To deal with the reduction in demand, a well-planned adaptation strategy is urgently needed. It is important to plan how to efficiently combine reduction of dispatching the most expensive thermal plants and recover water levels of reservoir storage and productivity in the complex hydrosystem with over 150 reservoirs. To determine the tradeoff and adaptation strategy, we use the HIDROTERM model, a nonlinear programming optimization model previously developed for planning the operation of the Brazilian hydrothermal system for analysis by comparing results with demand forecasts before and during the pandemic and under different hydrological scenarios. © ASCE.