Conclusions
By analysing the evolution of the COVID-19 epidemic in Minas Gerais,
Brazil, we showed the importance of considering sub-notification not
only of deaths but also of infection cases. It was shown that the
largely used criteria of a historical all-deaths series did not work in
this case, where most of the deaths are associated with causes that
should decrease under social distancing and reduction of economic
activities. Other criteria for better estimating deaths, infected cases,
and high mortality rate during the pandemic in Minas Gerais, discussing
possible contributions and their implications were then presented. It is
shown that the excess deaths and
infected cases are related to the strong increase of SARS deaths and
cases reported in 2020 compared to 2019. A new methodology to estimate
excess deaths and cases was developed. A quite simple and intuitive
model based on the Gompertz
function was also used to well fit the data and to predict the evolution
of the epidemic. Based on these analyses an excess of 21.638 deaths and
557.216 infected cases is predicted until the end of 2020, with an upper
bound of the case fatality rate of around 2.4 % and a prevalence of 2.6
%. The importance of ethnic and geographical distribution of cases and
deaths is demonstrated, and the
discrepancies between cases and
deaths in black and white patients are discussed. Government and private
organizations need to work together to increase public awareness,
stimulate social distancing, and keep a surface disinfection routine to
curb the viral infection, especially in critical places. Particular
attention should be given to people under social vulnerability, living
in underdeveloped regions.