'We Are Blind': Brazilian Health Officials Have Big Data Gaps Amid Rise in COVID and Flu

Brazilian health officials have big data gaps amid a rise in COVID brought on by the Omicron variant and the flu, eliciting public health researcher Marcelo Gomes to tell the Associated Press, "We are blind."

Researchers say Brazil's Health Ministry data is incomplete and difficult to access. Municipalities and states are reporting issues uploading information to the ministry's platforms and web pages supposed to be available to the public have been often shut down. Health Ministry officials are attempting to recover from hacker attacks on its system that occurred between Dec. 10 and Dec. 13.

Gomes, of Fiocruz, a major state-run research institution, told AP that "You need a scenario of an entire municipality, an entire state, to be able to identify the situation adequately."

Fiocruz depends on the Health's Ministry database to use the Infogripe bulletins to track severe respiratory illness in Brazil.

The press offices of nine states' health secretaries, including Sao Paolo, told AP they are still having trouble transmitting data to the federal government.

"Accesses to the systems have been normalized, but it's still possible to observe that the data suffer impacts from the hacker attack," wrote the national council of health secretariats to AP in an emailed statement.

While COVID cases are also surging, there is also an outbreak of influenza that has similar symptoms. This has caused confusion among people, creating lines at pharmacies for tests and reportedly long waits at health clinics.

Brazil, Reporting Issues, COVID Information, Influenza Outbreak
Health Ministry officials are attempting to recover from hacker attacks on its system that occurred between Dec. 10 and Dec. 13. In this photo, a woman gets a COVID swab test at the urban bus station, in downtown Brasília, Brazil, on Jan. 7, 2022. Sergio Lima/AFP via Getty Images

While the Health Ministry reported 53,292 cases of COVID-19 in the week of Dec. 27 to Jan. 2, a national pharmacy association said its 8,500 branches alone registered 94,540 positive tests in its network over the same period — a 33 percent jump from the previous week.

It said cases were expanding especially quickly in the big states of São Paulo and Rio de Janeiro, where pharmacy-confirmed cases of COVID-19 grew by almost 50 percent in the same period.

A large private diagnostics company, Diagnosticos America, told the AP that it was seeing a sharp increase in the percentage of positive versus negative tests — often a sign that the virus is becoming more widespread. It said the positivity rate went to 40 percent on Jan. 5 from about 19 percent on Dec. 29.

Despite the increase in cases, no state so far has reported its hospital system to be overburdened. Some have seen hospitalization rates rise significantly, like Minas Gerais, Piaui and Amazonas. Rio de Janeiro's rate has barely budged from its lowest level since the pandemic began.

Federal police are investigating the hack of the Health Ministry's system and the ministry told the AP that it has already restored its systems.

Digital law expert Luiza Leite said the data breach suffered by the Health Ministry required the government to back up all its information, reintroduce it into the system and then carry out a series of vulnerability tests against further hacking — even as new data was pouring in.

"The simple fact that an attack has occurred demonstrates a lack of a well-structured information security policy," she said.

Health researchers had already been critical of the country's data collection and reporting during the pandemic. "In addition to underreporting, absence of testing and creative accounting, we now have this lack of transparency," said Miguel Lago, executive director of the Institute for Health Policy Studies, which advises Brazilian public health officials.

"Data are important for public policy planning, but in health they are fundamental, even more so in the context of a pandemic," he said.

Gomes, the researcher at Fiocruz, said that fuller information would have helped people make decisions on travel and gatherings over the Christmas and New Year's holidays.

"The transmission of the virus depends on our individual and collective behavior," Gomes said. He added that sequencing data he has reviewed found most recent cases to be of the Omicron variant, but cautioned that laboratory samples aren't necessarily representative of the general public.

As of Thursday, the ministry had identified 265 cases of Omicron and another 520 were under observation. The first confirmed death from the variant occurred this week.

Even with an absence of reliable data to guide decisions, many state and city officials have moved to again restrict activities in the hopes of limiting transmission, including canceling street parties for the upcoming Carnival celebrations.

Brazil also suffered a blackout of official COVID data in June 2020, when the government took information offline after President Jair Bolsonaro, who has persistently downplayed the seriousness of the disease, complained that the figures were "not representative." The Supreme Court soon ordered the pages restored.

At that time, the coronavirus had claimed about 34,000 lives. As of this week, Health Ministry data show nearly 620,000 COVID-19 deaths — the world's second-highest total.

The Associated Press contributed to this report.