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Cien Saude Colet ; 27(11): 4125-4130, 2022 Nov.
Article in Portuguese, English | MEDLINE | ID: covidwho-20243160


In this interview, Sonia Guajajara, the executive coordinator of the Brazil's Indigenous Peoples Articulation (APIB), addresses the analyzis and strategies developed by the Indigenous movement to face the COVID-19 pandemic. Among other topics, she highlights some of the movement's strategies concerning communication, surveillance, and the monitoring of COVID-19, as well as its actions to support Indigenous territories, the initiatives carried out in the Legislative and Judiciary realms, the movement's international incidence, and its articulation with academia. Sonia shows the important role played by the Indigenous movement to control the health emergency and to defend the rights of the Indigenous peoples, in the framework of intense conflicts with the federal government and setbacks in public policies.

Nesta entrevista, Sonia Guajajara, coordenadora executiva da Articulação dos Povos Indígenas do Brasil (APIB), aborda as análises e estratégias desenvolvidas pelo movimento indígena para o enfrentamento da pandemia da COVID-19. Entre os pontos destacados, estão as estratégias de comunicação, vigilância e monitoramento da COVID-19, o apoio aos territórios indígenas, as iniciativas no Legislativo e no Judiciário, a incidência internacional e a articulação com a academia. Torna-se evidente o importante protagonismo do movimento indígena nas ações de contenção da emergência sanitária e na defesa dos direitos dos povos indígenas, em uma conjuntura de embate com o governo federal e de retrocessos nas políticas públicas.

COVID-19 , Indigenous Peoples , Female , Humans , Federal Government , Pandemics , Public Policy
Cien Saude Colet ; 28(5): 1277-1286, 2023 May.
Article in Portuguese, English | MEDLINE | ID: covidwho-2326627


The study aim is to analyze the performance of the Brazilian federal government (FG) in the COVID-19 pandemic, seeking to identify tensions and conflicts between actors and institutions of the three branches of the government and the FG with state governors. Data production included a review of articles, publications and documents that analyze the pandemic evolution and record announcements, decisions, actions, debates and controversies between these actors in the period of 2020 to 2021. The results include the characterization of the action style of the central Actor and the analysis of conflicts between the Presidency, the Ministry of Health, ANVISA, state governments, the House of Representatives and the Senate and the Federal Supreme Court, seeking to correlate them with the debate around the political projects for health in dispute under the current circumstances. It is concluded that the central actor largely used a communicative action aimed at his supporters and strategic action characterized by imposition, coercion and confrontation in the relationships he maintained with other institutional actors, especially when they diverged from his viewpoints about how to face the health crisis, consistently with his connection to the ultra-neoliberal and authoritarian political project of the FG, which includes the deconstruction of the Brazilian Unified Health System.

O objetivo é analisar a atuação do governo federal (GF) na pandemia de COVID-19 e identificar as tensões e conflitos entre atores e instituições dos três poderes e do GF com governadores estaduais. A produção de dados incluiu revisão de artigos, publicações e documentos que analisam a pandemia e registram pronunciamentos, decisões, ações, debates e controvérsias entre esses atores no período 2020-2021. Os resultados contemplam a análise do estilo de ação do ator central e dos conflitos entre a Presidência, Ministério da Saúde, Anvisa, governos estaduais, Câmara, Senado e Supremo Tribunal Federal, buscando correlacioná-los com os projetos políticos para a saúde em disputa na atual conjuntura. Conclui-se que o ator central utilizou largamente uma ação comunicativa dirigida a seus apoiadores e uma ação estratégica caracterizada pela imposição, coação e confronto nas relações que manteve com outros atores institucionais, sobretudo quando estes divergiram da sua visão acerca do enfrentamento da crise sanitária, coerentemente com sua vinculação ao projeto político ultra neoliberal e autoritário do GF, que inclui o desmonte do SUS.

COVID-19 , Humans , Pandemics , Federal Government , Brazil/epidemiology , Government
Rev Bras Enferm ; 75(2): e20200328, 2021.
Article in English, Portuguese | MEDLINE | ID: covidwho-2308062


OBJECTIVES: to reflect on the impacts of Brazil's response to the COVID-19 pandemic demands on the nursing labor market in light of the recovery of experiences in the USA during the World War II. METHODS: this is a discursive formulation, which discusses the nursing labor market, establishing analogies between historical events. RESULTS: measures implemented in the World War II by the USA are similar to those that the Brazilian Federal Government has adopted, and, as in the USA, such measures strongly affected both professional training and the nursing labor market. In Brazil, the measures can also deepen problems in the national nursing labor market, reverberating in precariousness. CONCLUSIONS: a better way to meet the demand for nursing workers can be with the existing supply of trained and available workers.

COVID-19 , Pandemics , Brazil , Federal Government , Humans , SARS-CoV-2
Salud Colect ; 19: e4280, 2023 03 16.
Article in Spanish | MEDLINE | ID: covidwho-2301707


With the arrival of coronavirus in Mexico, doctors' offices adjacent to private pharmacies (DAPPs) played a major role in the diagnosis, care, and prevention of Covid-19, providing treatment for 11.7% to 23% of people with Covid-19 symptoms according to national surveys. Therefore, this article seeks to identify the role of DAPPs as a private health system providing care for patients with Covid-19 symptoms in the city of Oaxaca, and to describe and analyze the factors that influenced their utilization. Using a qualitative methodology, twelve physicians were interviewed and 59 users responded to a questionnaire at doctors' offices adjacent to pharmacies in the municipality of Oaxaca de Juárez between September 2020 and August 2022. Secondary data were also collected. Among the findings, the function of these offices at the front line of care for Covid-19 and other health needs that emerged with the public health crisis is described, and the determining factors in care trajectories of users that sought care there are analyzed, such as the increase in perception of risk and mistrust towards public services or strategies implemented by the federal government.

Con la llegada del coronavirus a México, los consultorios adyacentes a farmacias desempeñaron un rol preponderante en el diagnóstico, atención y prevención del covid-19. De acuerdo a las encuestas nacionales, entre el 11,7% y el 23% de las personas con síntomas de covid-19 se atendieron en uno. Por ello, este artículo busca identificar el papel de los consultorios adyacentes a farmacias (CAF) como sistema de salud privado que atendió a personas con síntomas de covid-19 en la ciudad de Oaxaca y describir y analizar los factores que influyeron en su utilización. Desde una metodología cualitativa, entre septiembre de 2020 y agosto de 2022 se entrevistó a 12 médicos y médicas y se aplicó un cuestionario a 59 personas usuarias de los consultorios adyacentes a farmacias del municipio de Oaxaca de Juárez. Asimismo se hizo una recopilación y análisis de fuentes secundarias. Entre los hallazgos, se describen sus funciones como frente de atención al covid-19 y a otras necesidades de salud que emergieron con la crisis sanitaria y se analizan los factores determinantes en las trayectorias de atención de personas usuarias de estos consultorios, como son el incremento en la percepción del riesgo y la desconfianza hacia los servicios públicos o hacia las estrategias implementadas por el gobierno federal.

COVID-19 , Pharmacies , Humans , COVID-19/epidemiology , COVID-19/therapy , Pandemics , Federal Government , Mexico/epidemiology
Science ; 379(6639): 1277, 2023 03 31.
Article in English | MEDLINE | ID: covidwho-2261076


Societies generally have reacted to deadly epidemics by strengthening health systems, including laws. Under American federalism (the constitutional division of power between states and the federal government), individual states hold primary public health powers. State legislatures have historically granted health officials wide-ranging authority. After the anthrax attacks in the United States in 2001, the US Centers for Disease Control and Prevention (CDC) supported the Model State Emergency Health Powers Act, which granted public health officials even more expansive powers to declare a health emergency and respond swiftly. But all that ended with COVID-19, as state legislatures and courts gutted this authority. The next pandemic could be far deadlier than COVID-19, but when the public looks to federal and state governments to protect them, they may find that health officials have their hands tied behind their backs.

Public Health Administration , Public Health , State Government , Humans , COVID-19/prevention & control , Federal Government , Pandemics/prevention & control , Public Health/legislation & jurisprudence , United States , Public Health Administration/legislation & jurisprudence
JAMA ; 329(5): 365-366, 2023 02 07.
Article in English | MEDLINE | ID: covidwho-2267574


This Viewpoint discusses how some pulse oximeters can provide incorrect oxygen saturation data for dark-skinned patients compared with light-skinned patients, describes the reasons that biased oximeters remained in use, and highlights why a rule recently proposed by the US Department of Health and Human Services may bring about needed change in the use of pulse oximetry for patients with dark skin.

Human Rights , Oximetry , Social Discrimination , Oximetry/instrumentation , Oximetry/standards , Social Discrimination/legislation & jurisprudence , Social Discrimination/prevention & control , United States , Federal Government , Human Rights/legislation & jurisprudence , Human Rights/standards
Saúde Soc ; 31(4): e210523pt, 2022. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-2197560


Resumo A partir de um estudo de caso do Rio Grande do Norte, este artigo discute o papel dos estados na coordenação da saúde durante a pandemia do novo coronavírus. A ausência de coordenação federal no enfrentamento do surto pandêmico no Brasil tem sido compreendida por diversos analistas como algo inédito na federação brasileira, rompendo com um padrão recorrente de normatização e indução nacional por diferentes governos desde a Constituição de 1988. Nesse sentido, estados e municípios passaram a adotar iniciativas próprias para o enfrentamento da pandemia. A partir de uma pesquisa qualitativa baseada em dados documentais - mídia local, boletins epidemiológicos e regulamentações estaduais - e em entrevistas semiestruturadas com gestores estaduais e municipais, foi possível identificar mudanças na relação estado-municípios durante a pandemia no Rio Grande do Norte, caso marcado, historicamente, pela ausência de cooperação estadual. A pandemia, dessa forma, funcionou como um choque exógeno, que induziu uma mudança no padrão de atuação do governo estadual na saúde. Não está claro, porém, se essas alterações são pontuais ou permanentes, na medida em que o peso do autorreforço - especificação dos efeitos do legado histórico - atua como um mecanismo que produz dinâmicas inerciais de difícil rompimento com o passado.

Abstract From a case study of the State of Rio Grande do Norte, in Brazil, this article discusses the role of states in coordinating healthcare with its local governments in the context of the new coronavirus pandemic. The absence of federal government initiatives in responding to the pandemic in Brazil have been acknowledged by several specialists as an unprecedented event in the Brazilian federation, breaking with a recurrent pattern of national coordination and regulation by different governments since the 1988 Constitution. In this sense, states and municipalities had to adopt their own initiatives to respond to the pandemic. Qualitative research based on the collection of documents (local media, epidemiological reports, and state regulations) and in-depth interviews with state and municipal managers reveals significant changes in the state-municipal relationship throughout the pandemic period in Rio Grande do Norte, a state historically characterized by the lack of state coordination. The pandemic, thus, functioned as an exogenous shock, which induced changes in the pattern of state coordination in healthcare. It is unclear, however, whether these changes are one-off or permanent since the weight of increasing returns - a specification of a path dependency process - seem to work as a mechanism producing inertial dynamics of difficult disruption with the past.

Humans , Male , Female , State Government , Communicable Disease Control , Public Health , Federal Government , COVID-19 , Interinstitutional Relations , Local Government
Nat Hum Behav ; 6(8): 1035-1037, 2022 08.
Article in English | MEDLINE | ID: covidwho-2016715
Nature ; 609(7926): 219-220, 2022 09.
Article in English | MEDLINE | ID: covidwho-2016633
PLoS One ; 17(7): e0264293, 2022.
Article in English | MEDLINE | ID: covidwho-1933205


The COVID-19 pandemic was severely aggravated in Brazil due to its politicization by the country's federal government. However, the impact of diffuse political forces on the fatality of an epidemic is notoriously difficult to quantify. Here we introduce a method to measure this effect in the Brazilian case, based on the inhomogeneous distribution throughout the national territory of political support for the federal government. This political support is quantified by the voting rates in the last general election in Brazil. This data is correlated with the fatality rates by COVID-19 in each Brazilian state as the number of deaths grows over time. We show that the correlation between fatality rate and political support grows as the government's misinformation campaign is developed. This led to the dominance of such political factor for the pandemic impact in Brazil in 2021. Once this dominance is established, this correlation allows for an estimation of the total number of deaths due to political influence as 350±70 thousand up to the end of 2021, corresponding to (57±11)% of the total number of deaths.

COVID-19 , Brazil/epidemiology , COVID-19/epidemiology , Federal Government , Humans , Pandemics , Politics
Int J Environ Res Public Health ; 19(14)2022 07 08.
Article in English | MEDLINE | ID: covidwho-1928557


The COVID-19 pandemic caused by SARS-CoV-2 is still raging. Similar to other RNA viruses, SARS-COV-2 is constantly mutating, which leads to the production of many infectious and lethal strains. For instance, the omicron variant detected in November 2021 became the leading strain of infection in many countries around the world and sparked an intense public debate on social media. The aim of this study is to explore the Chinese public's perception of the omicron variants on social media. A total of 121,632 points of data relating to omicron on Sina Weibo from 0:00 27 November 2021 to 23:59:59 30 March 2022 (Beijing time) were collected and analyzed with LDA-based topic modeling and DLUT-Emotion ontology-based sentiment analysis. The results indicate that (1) the public discussion of omicron is based on five topics, including omicron's impact on the economy, the omicron infection situation in other countries/regions, the omicron infection situation in China, omicron and vaccines and pandemic prevention and control for omicron. (2) From the 3 sentiment orientations of 121,632 valid Weibo posts, 49,402 posts were judged as positive emotions, accounting for approximately 40.6%; 47,667 were negative emotions, accounting for nearly 39.2%; and 24,563 were neutral emotions, accounting for about 20.2%. (3) The result of the analysis of the temporal trend of the seven categories of emotion attribution showed that fear kept decreasing, whereas good kept increasing. This study provides more insights into public perceptions of and attitudes toward emerging SARS-CoV-2 variants. The results of this study may provide further recommendations for the Chinese government, public health authorities, and the media to promote knowledge about SARS-CoV-2 variant pandemic-resistant messages.

COVID-19 , Emotions , Latent Class Analysis , Public Opinion , SARS-CoV-2 , Sentiment Analysis , Social Media , Attitude , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , COVID-19 Vaccines , China/epidemiology , Federal Government , Health Education , Humans , Internationality , Pandemics/prevention & control , Pandemics/statistics & numerical data , Public Health