Underreporting is "gigantic," say states and municipalities.

247 - Primary care teams in several cities and states across Brazil say there has been a significant underreporting of coronavirus cases to the Ministry of Health. Currently, the country has 6,9 cases and 245 deaths caused by the disease, according to official records. 

According to the Brazilian Society of Family and Community Medicine (SBMFC), which represents 6.000 doctors working in 47,7 primary care teams throughout Brazil, many patients are not included in the statistics due to a lack of testing kits and the absence of a specific ordinance from the Ministry of Health to determine which cases should be considered confirmed or suspected. 

Underreporting occurs even after Minister Luiz Henrique Mandetta requested, on March 20th, that all suspected cases, regardless of severity, be reported by states and municipalities.

“The result is that we are in the dark regarding what to actually report and the real number of cases,” says Denize Ornellas, Communications Director of SBMFC. The reports were published in Report by Fernando Canzian, in the Folha de S.Paulo newspaper..

In the Federal District, for example, all cases of ILI (Influenza-like Illness) – which include fever and at least one other symptom, such as a cough – are now being reported.

“Based on the old guidelines, I only reported one case last week. After the new technical note, there were three on Monday alone,” says Rodrigo Lima, a doctor at a clinic in the satellite city of Samambaia, in the Federal District, where approximately 25 people are treated.

According to him, there are no coronavirus test kits in the region and underreporting is “immense.” “Even the guidance from the new technical note was sent via WhatsApp, and colleagues didn’t see it,” he continues.

In Recife, family doctor Bruno Pessoa estimates that formal notifications are based on 1 out of nearly 40 suspected cases. He attends to approximately 4.000 people at a basic health unit.

Unlike the Federal District, the capital of Pernambuco limited the requirement to cases of Severe Acute Respiratory Syndrome. "The change occurred on the day that community transmission was established." 

In Minas Gerais, physician Natália Madureira, who cares for approximately 5.000 people in a primary care unit, states that the lack of testing kits and specific health guidelines has increased the number of underreported cases. "Each state has been handling the notifications differently," says Natália.

In the state of São Paulo, the Health Department published a resolution in the Official Gazette on March 17th, advising that non-serious cases should not be reported.