![]() ![]() SUS is maintained by public power, with supplementary participation of private initiatives, which guarantees free health care for all citizens, which is based primarily on equity, universality, and integrality ( 7, 8). ![]() Brazil is the only country with a population of more than 200 million people to have a universal health care system, where almost 75% of the population rely on the service ( 7). The Unified Health System (Sistema Único de Saúde, SUS) of Brazil is the Brazil Health System. The lack of funds to support the public health system has led to a deterioration of health capacity among smaller municipalities and exacerbating inequalities ( 6). In addition, the Brazilian government has faced several challenges while seeking the funds for the public Unified Health System (SUS) over the last decade ( 6). Resource constraints, including a lack of intensive care, inequitable distribution of hospital beds, and inadequate numbers of ventilators, compromise the capacity of the health system to care for patients with COVID-19 ( 5). To provide necessary health system resources to adequately overcome COVID-19, a strong coordinated emergency response with adequate facilities, personnel, and equipment is required ( 4). This case burden put the Brazilian health service at risk of total collapse ( 3). However, Brazil, where the virus reached much later than other countries, is one of the most affected countries with 19.1 million confirmed cases and 533,000 deaths reported so far ( 2). As of July 6, 2021, COVID-19 infected more than 183 million people and resulted in almost 4 million deaths globally ( 2). The WHO declared COVID-19 a pandemic disease by the end of January 2020 ( 1). In December 2019, the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was identified as the causative agent of coronavirus 2019 (COVID-19) ( 1). In addition, the ineffectiveness of public measures of the municipal and federal administrations aggravated the pandemic in Brazil. The inequitable distribution of health facilities, equipment, and human resources led to inadequate preparedness to manage the COVID-19 pandemic. ![]() ![]() The north region has the lowest accessibility to ICUs.Ĭonclusions: The Brazilian Health Care System is unevenly distributed across the country. The South and Southeast regions have the highest rates of professionals and infrastructure to attend patients with COVID-19 compared with the northern region. In addition, 17,240 new ICU beds were created in June 2020. Results: As of February 2020, Brazil had 35,682 ICU beds, 426,388 hospital beds, and 65,411 ventilators. A spatial analysis using Getis-Ord Gi * was performed to identify areas lacking access to high-complexity centers (HCC). A health service accessibility index was created using a two-step floating catchment area (2SFCA). Beds per health professionals and ventilators per population rates were assessed. The numbers of intensive care (ICU) and hospital beds, general or intensivist physicians, nurses, nursing technicians, physiotherapists, and ventilators from each health region were extracted. Methods: A retrospective and ecological study was performed with data retrieved from the Brazilian Information Technology Department of the Public Health Care System. As the national emergency care capacity is a crucial part of the COVID-19 response, we evaluated the Brazilian Health Care System response preparedness against the COVID-19 pandemic.
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