Analysis of COVID-19 under-reporting in Brazil
Authors: Marcelo F. Prado, Bianca B. P. Antunes, Leonardo S. L. Bastos, Igor T. Peres, Amanda A. B. Silva, Leila F. Dantas, Fernanda A. Baião, Paula M. Maçaira, Silvio Hamacher, Fernando A. Bozza
Published at: RBTI, 2020
ABSTRACT
OBJECTIVE
To estimate the reporting rates of coronavirus disease 2019 (COVID-19) cases for Brazil as a whole and states.
METHODS
We estimated the actual number of COVID-19 cases using the reported number of deaths in Brazil and each state, and the expected case-fatality ratio from the World Health Organization. Brazil’s expected case-fatality ratio was also adjusted by the population’s age pyramid. Therefore, the notification rate can be defined as the number of confirmed cases (notified by the Ministry of Health) divided by the number of expected cases (estimated from the number of deaths).
RESULTS
The reporting rate for COVID-19 in Brazil was estimated at 9.2% (95%CI 8.8% - 9.5%), with all the states presenting rates below 30%. São Paulo and Rio de Janeiro, the most populated states in Brazil, showed small reporting rates (8.9% and 7.2%, respectively). The highest reporting rate occurred in Roraima (31.7%) and the lowest in Paraiba (3.4%).
CONCLUSION
The results indicated that the reporting of confirmed cases in Brazil is much lower as compared to other countries we analyzed. Therefore, decision-makers, including the government, fail to know the actual dimension of the pandemic, which may interfere with the determination of control measures.
