COVID-19 Mortality Underreporting in Brazil: Analysis of Data From Government Internet Portals
COVID-19 Mortality Underreporting in Brazil: Analysis of Data From Government Internet Portals
复制标题
DOI：
10.2196/21413
复制
发表时间：
2020-08-18
影响因子：
7.4
通讯作者：
Frances, Carlos Renato Lisboa
中科院分区：
文献类型：
--
作者：
Veiga e Silva, Lena;Harb, Maria Da Penha de Andrade Abi;Frances, Carlos Renato Lisboa
背景：在巴西，报告了大量冠状病毒病(新冠肺炎)病例和死亡。截至2020年6月9日，中国已成为全球第二大受影响国家。巴西政府的官方消息来源提供了关于该疾病影响的相互矛盾的数据；因此，巴西的实际感染人数和死亡人数可能远远超过官方报告的人数。很有可能疾病的实际传播被低估了。目的：本研究基于巴西政府官方门户网站提供的公开数据，调查巴西受影响最严重的城市与新冠肺炎相关的病例和死亡被漏报的情况，以确定大流行的实际影响。方法：我们使用了两个公共门户网站的历史死亡数据：统一医疗保健系统信息学部门(2010年-2018年)和巴西民事登记透明门户网站(2019-2020年)。这些数据被用来建立时间序列模型(模块回归)，以预测2020年的预期死亡率模式。这些预测被用来估计在疫情期间被错误登记并发布在全国受影响最严重的城市的政府门户网站上的可能死亡人数。结果：我们的模型发现实际值和预期值之间存在显著差异。所有城市死于严重急性呼吸综合征(SARS)的人数都要高得多，增幅在493%到5820%之间。这一突然增加可能与报告中的错误有关。新冠肺炎相关死亡的平均漏报比例估计为40.68%(范围为25.9%-62.7%)。结论：我们研究中分析的显著漏报死亡人数表明，官方公布的数字远低于实际数字，因此当局无法实施更有效的疫情应对措施。根据使用不同死亡率进行的分析，可以推断巴西的疫情正在恶化，实际感染人数可能已经在100万到540万之间。
Background: In Brazil, a substantial number of coronavirus disease (COVID-19) cases and deaths have been reported. It has become the second most affected country worldwide, as of June 9, 2020. Official Brazilian government sources present contradictory data on the impact of the disease; thus, it is possible that the actual number of infected individuals and deaths in Brazil is far larger than those officially reported. It is very likely that the actual spread of the disease has been underestimated.Objective: This study investigates the underreporting of cases and deaths related to COVID-19 in the most affected cities in Brazil, based on public data available from official Brazilian government internet portals, to identify the actual impact of the pandemic.Methods: We used data from historical deaths due to respiratory problems and other natural causes from two public portals: DATASUS (Department of Informatics of the Unified Healthcare System) (2010-2018) and the Brazilian Transparency Portal of Civil Registry (2019-2020). These data were used to build time-series models (modular regressions) to predict the expected mortality patterns for 2020. The forecasts were used to estimate the possible number of deaths that were incorrectly registered during the pandemic and posted on government internet portals in the most affected cities in the country.Results: Our model found a significant difference between the real and expected values. The number of deaths due to severe acute respiratory syndrome (SARS) was considerably higher in all cities, with increases between 493% and 5820%. This sudden increase may be associated with errors in reporting. An average underreporting of 40.68% (range 25.9%-62.7%) is estimated for COVID-19-related deaths.Conclusions: The significant rates of underreporting of deaths analyzed in our study demonstrate that officially released numbers are much lower than actual numbers, making it impossible for the authorities to implement a more effective pandemic response. Based on analyses carried out using different fatality rates, it can be inferred that Brazil's epidemic is worsening, and the actual number of infectees could already be between 1 to 5.4 million.