Increasing impact of COVID-19 on young adults: evidence from hospitalisations in Brazil.

OBJECTIVES: Concerns about the increasing impact of severe COVID-19 in younger individuals in Brazil came after a recent synchronised country-wide wave of cases in Brazil. This communication analyses how hospitalisations due to COVID-19 changed in the age groups 18-49 years and ≥70 years. STUDY DESIGN: Longitudinal study based on secondary data. METHODS: Data from SIVEP-Gripe, a public and open-access database of Severe Acute Respiratory Illness records (including COVID-19 notifications), were used in this study. Statistical control charts examined changes in the magnitude and variation of younger (18-49 years) and older (≥70 years) adults who were hospitalised between 15th March 2020 and 19th June 2021. RESULTS: During the few first weeks of the pandemic in Brazil, the number of COVID-19 hospitalisations increased in older adults but decreased in younger adults. Subsequently, hospitalisations reached statistical control zones in epidemiological weeks (EW) 19-48 of 2020 (EW 19-48/2020) and EW 03-05/2021 (18-49 y, mean = 26.1%; ≥70 y, mean = 32.8%). Between EW 49/2020 and EW 02/2021, the number of hospitalisations of younger adults dropped to levels below the lower control limit. In contrast, the number of hospitalisations of older adults surpassed the upper limit of the corresponding statistical control zones. However, from EW 06/2021, numbers of hospitalisations changed from statistical control zones, with hospitalisations of younger adults increasing and reaching 44.9% in EW 24/2021 and hospitalisations of older adults decreasing until EW 19/2021 (14.1%) and reaching 17.3% in EW 24/2021. CONCLUSIONS: An increasing number of COVID-19 hospitalisations were observed in younger adults from EW 06/2021. This could be a result of the successful vaccination programme in older adults, who were initially prioritised, and possibly an increased exposure to highly transmissible variants of COVID-19 in younger adults who had to go to work in the absence of social protection (i.e. government financial support). Potential consequences of COVID-19 hospitalisations in younger adults could include a reduced life expectancy of the population and an increased number of people unable to perform daily activities due to post-COVID-19 conditions.

Chemical safety and governance in Brazil.

Chemical safety is recognized in Agenda 21(UNCED--Rio 92), as one of the most serious problems to be faced worldwide being a problem not just of governability, restricted more to the role of states and governments, but of governance at the national and international levels. It poses greater challenges for countries like Brazil where the issues of democracy, security, sustainability and equity, which are fundamental to governance, are merely incipient and still far from solved. Taking as references the analysis of four cases in the Brazilian context, we illustrate the situation from less densely populated areas (as in the cases of mercury use by gold miners in the Amazon and pesticides in agricultural producing areas), through medium-sized towns (as in the accident with cesium 137 in Goiânia), to the major urban and industrial centers (as in the cases of lead from battery renovators and benzene in the oil and steel industries and oil refineries). What can be seen is a situation where problems connected with chemical safety have grown in intensity and extent far more than the capacity to deal with them. In industrializing countries, the formulation of chemical safety policies must take into account not only the complexity and uncertainties involved in understanding the problems, but also the aspects relating to the different modes and levels of vulnerability. This is necessary in order to attempt to build better contextualized and more participatory knowledge and decision-making processes at the local and global levels, which we take as basic prerequisites for governance.

[The Institutional Program for Health and Environment in the development process of the Oswaldo Cruz foundation]. / O Programa Institucional sobre Saúde e Ambiente no Processo de Desenvolvimento da Fundação Oswaldo Cruz.

The objective of this paper is to show the development program about health and environment in an institution of academic research and teaching, technological development and services. We analyse data from the register of projects in health and environment in the development process as the thematic axis for this program. We show the sectors which the projects are related, the key words of research and teaching, the construction of thematic axis that should guide and the different approach of interdisciplinary. At the end we show the challenges and perspectives for an interdisciplinar work about health and environment in an academic research and teaching institution.

Host specificity of Amblyomma cajennense (Fabricius, 1787) (Acari: Ixodidae) with comments on the drop-off rhythm.

The parasitic specificity of larval, nymph and adult Amblyomma cajennense on six different host species: Oryctolagus cuniculus, Rattus norvegicus, Gallus gallus domesticus, Anas platyrhynchus, Coturnix coturnix and Streptopelia decorata is described. In terms of the numbers of larvae and nymphs recovered, O. cuniculus was the best host species. The modal day for drop-off of larvae and nymphs was day three for the mammal hosts, but variable in the birds. We conclude that adult A. cajennense have a strong degree of specificity due to the fact that the tick failed to complete its life cycle on any of the evaluated hosts. The immature stages, on the other hand, showed a low level of specificity, most especially in the larval stage, indicating the existence of secondary hosts which probably serve as dispersers in the wild. The results also indicated a variable drop-off rhythm for larvae and nymphs in two periods, diurnal (6-18 hr) and nocturnal (18-6 hr), which differed depending upon the host.

Major chemical accidents in industrializing countries: the socio-political amplification of risk.

Accidents in the chemical industry, such as those that took place in Seveso (1976) and Bhopal (1984), may kill or injure thousands of people, cause serious health hazards and irreversible environmental damage. The aim of this paper is to examine the ever-increasing risk of similar accidents becoming a frequent ocurrence in the so-called industrializing countries. Using figures from some of the worst chemical accidents in the last decades, data on the Bhopal disaster, and Brazil's social and institutional characteristics, we put forward the hypothesis that present social, political and economic structures in industrializing countries make these countries much more vulnerable to such accidents and create the type of setting where--if and when these accidents occur--they will have even more catastrophic consequences. The authors argue that only the transformation of local structures, and stronger technical cooperation between international organizations, industrialized and industrializing countries could reduce this vulnerability.

[Amplified chemical disasters: a challenge for public health]. / Acidentes químicos ampliados: um desafio para a saúde pública.

Chemical accidents involving explosions, large fires and leakages of hazardous substances occurring during transport, storage and industrial production of chemicals constitute a real challenge to health, environmental and industrial safety professionals. The aim of this article is to discuss the main questions that this kind of accident provokes, in terms of public health, particularly in developing countries such as Brazil. The paper defines and characterises these accidents and the various health risk they involve excluding the leakages of hazardous substances during "normal" production in industry--through the combination of quantitative and qualitative information drawn from the international literature on the subject. From some examples of chemical accidents such as occurred in Bhopal (India), Vila Socó (Brazil), São Paulo (México) and data of the World Health Organization (WHO), the authors seek to show that these events present a worsening, in terms of immediate deaths and injuries, in developing countries. The statistics of chemical accidents which occurred during the last ten years (1984 to 1993) in the State of Rio de Janeiro are used taken as a frame reference for the purpose of bringing to light the great number of occurrences made with no registration of basic information regarding assessment or surveillance. The complexity of causes and consequences, together with the structural problems of developing countries, present public health professionals and institutions, with some important tasks especially those of health risk assessment and the formulation of strategies to prevent and control future major chemical accidents.