Hospital contingency in coping with COVID-19 in Brazil: governmental problems and alternatives

• Published in: Ciência & saude coletiva Vol. 26; no. 4; pp. 1407 - 1418
• Main Authors: Santos, Thadeu Borges Souza, Andrade, Laise Rezende de, Vieira, Silvana Lima, Duarte, Joseane Aparecida, Martins, Juliete Sales, Rosado, Lilian Barbosa, Oliveira, Juliana Dos Santos, Pinto, Isabela Cardoso de Matos
• Format: Journal Article
• Language: English; Portuguese; Spanish
• Published: Brazil Associacao Brasileira de Pos-Graduacao em Saude Coletiva - ABRASCO 01-04-2021; Associação Brasileira de Saúde Coletiva
• Subjects: Brazil; Contingency; Contingency planning; Contingency plans; Convergence; Coronaviruses; COVID-19; Decision theory; Delivery of Health Care - standards; Government; Hospitals; Human resources; Humans; Public policy; Brazil; Brasil; China
• ISSN: 1413-8123; 1678-4561
• DOI: 10.1590/1413-81232021264.43472020

This paper analyzes the government's strategic agenda for coping with COVID-19 in Brazil, focusing on hospital care. Twenty-eight Contingency Plans were analyzed in full, one national, 26 at state level, and one from the Federal District. The Public Policy Cycle's theoretical framework was used, specifically governmental pre-decision and decision to face the pandemic. The evidence revealed convergences between the national and state levels concerning proposals for reorienting care flow, detecting cases, and indicating referral hospitals. However, the state agendas revealed weaknesses in acquiring mechanical ventilation devices, sizing human resources, and regionalizing hospital care. Moreover, few states have established a method for calculating back-end beds, mainly regarding the outlook of opening hospitals of reference or contracting additional ICU beds. We can conclude that the heterogeneous actions explained in the plans show the complex process of coping with COVID-19 in Brazil with its regional inequalities, weaknesses in the state health systems, and reduced coordination by the Ministry of Health.