A partisan pandemic: State government public health policies to combat COVID-19 in Brazil

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dc.contributor.authorTouchton M.
dc.contributor.authorKnaul F.M.
dc.contributor.authorArreola-Ornelas H.
dc.contributor.authorPorteny T.
dc.contributor.authorMéndez O.
dc.contributor.authorKnaul F.M.
dc.contributor.authorEdelson V.
dc.contributor.authorArreola-Ornelas H.
dc.contributor.authorMéndez O.
dc.contributor.authorPorteny T.
dc.contributor.authorSánchez M.
dc.contributor.authorFaganello M.
dc.contributor.authorGygi B.
dc.contributor.authorHummel C.
dc.contributor.authorOtero S.
dc.contributor.authorInsua J.
dc.contributor.authorUndurraga, Eduardo A.
dc.contributor.authorRosado J.A.
dc.date.accessioned2024-01-10T13:10:10Z
dc.date.available2024-01-10T13:10:10Z
dc.date.issued2021
dc.description.abstract© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Introduction To present an analysis of the Brazilian health system and subnational (state) variation in response to the COVID-19 pandemic, based on 10 non-pharmaceutical interventions (NPIs). Materials and methods We collected daily information on implementation of 10 NPI designed to inform the public of health risks and promote distancing and mask use at the national level for eight countries across the Americas. We then analyse the adoption of the 10 policies across Brazil's 27 states over time, individually and using a composite index. We draw on this index to assess the timeliness and rigour of NPI implementation across the country, from the date of the first case, 26 February 2020. We also compile Google data on population mobility by state to describe changes in mobility throughout the COVID-19 pandemic. Results Brazil's national NPI response was the least stringent among countries analysed. In the absence of a unified federal response to the pandemic, Brazilian state policy implementation was neither homogenous nor synchronised. The median NPI was no stay-at-home order, a recommendation to wear masks in public space but not a requirement, a full school closure and partial restrictions on businesses, public transportation, intrastate travel, interstate travel and international travel. These restrictions were implemented 45 days after the first case in each state, on average. Rondônia implemented the earliest and most rigorous policies, with school closures, business closures, information campaigns and restrictions on movement 24 days after the first case; Mato Grosso do Sul had the fewest, least stringent restrictions on movement, business operations and no mask recommendation. Conclusions The study identifies wide variation in national-level NPI responses to the COVID-19 pandemic. Our focus on Brazil identifies subsequent variability in how and when states implemented NPI to contain COVID-19. States' NPIs and their scores on the composite policy index both align with the governors' political affiliations: opposition governors implemented earlier, more stringent sanitary measures than those supporting the Bolsonaro administration. A strong, unified national response to a pandemic is essential for keeping the population safe and disease-free, both at the outset of an outbreak and as communities begin to reopen. This national response should be aligned with state and municipal implementation of NPI, which we show is not the case in Brazil.
dc.fechaingreso.objetodigital2024-05-06
dc.fuente.origenScopus
dc.identifier.doi10.1136/bmjgh-2021-005223
dc.identifier.eissn20597908
dc.identifier.issn20597908
dc.identifier.scopusidSCOPUS_ID:85107660199
dc.identifier.urihttps://doi.org/10.1136/bmjgh-2021-005223
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/77793
dc.identifier.wosidWOS:000764169100006
dc.information.autorucInterdisciplinarias; Undurraga Fourcade, Eduardo Andres; S/I; 12868
dc.issue.numeroe005223
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherBMJ Publishing Group
dc.revistaBMJ Global Health
dc.rightsacceso abierto
dc.subjectCOVID-19
dc.subjectdescriptive study
dc.subjecthealth policy
dc.subjectqualitative study
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleA partisan pandemic: State government public health policies to combat COVID-19 in Brazil
dc.typeartículo
dc.volumen6
sipa.codpersvinculados12868
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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