The city of Rio de Janeiro presented again a high number of deaths in households, as well as a large excess of deaths in relation to previous years. These are two strong indicators that the city may be facing a serious situation of general lack of care in the municipal healthcare system - which is not restricted to hospitals, but focuses mainly on the primary care network and the health surveillance system.

According to data from the Health Department of Rio, in the months of April to September alone there were about 27,000 more deaths than expected - based on previous years - 13,000 of them directly caused by Covid-19. Another 1,000 people died within their households - i.e., outside any hospital or other healthcare facility, and probably without medical assistance. In addition, the data indicate that, from March to September, there were 1,800 more deaths than the expected, classified as “poorly-defined causes”, without diagnosis, another possible indicator of lack of health care. 

“The data show that, even among the Covid-19 cases that were admitted to hospitals, most of the deaths occurred outside the ICUs. The set of these indicators strongly points to the inability of the municipal healthcare system to attend serious cases of the disease. They also indicate that we may be close to a new collapse of the system, as the new cases, which will generate greater demand for care, are increasing rapidly, in a very worrying way”, comments Christovam Barcellos, public healthcare researcher and vice-director of the Institute of Communication and Information in Health (Icict / Fiocruz).

According to Technical Note from Monitora Covid-19, from Icict, entitled Deaths in excess, inside and outside hospitals, show signs of lack of health care in the city of Rio de Janeiro; the capital of Rio de Janeiro surpassed the city of São Paulo in the last two weeks: 500, against 400 average daily deaths. Rio had been registering a “slight downward trend” in the number of deaths, however irregularly, with occasional increases since August, which would be a sign of the “city’s vulnerability to new outbreaks or even the resumption of transmission patterns at the beginning of the year”.