Clinics (Sao Paulo). 2020;75:e2166.

Epidemiologic Surveillance in an academic hospital during the COVID-19 pandemic in Sao Paulo, Brazil: the key role of epidemiologic engagement in operational processes

Izabel Marcilio , Anna Miethke-Morais , Leila Harima, Amanda C. Montal, Beatriz Perondi, Jose Ricardo de Carvalho Mesquita Ayres, Nelson Gouveia, Eloisa Bonfa, Hillegonda Maria Dutilh Novaes

DOI: 10.6061/clinics/2020/e2166

On January 30, 2020, the Director-General of the World Health Organization (WHO) declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak a public health emergency of international concern under the International Health Regulations (2005) (). As an immediate response effort, Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP) mobilized its Crisis Management Committee (CMC) to deal with the outbreak by assisting with strategic planning. As stipulated in the CMC’s organogram for outbreak incidents (), the Epidemiologic Surveillance Center (Núcleo de Vigilância Epidemiológica (NUVE)) was engaged from the beginning in planning, assisting the incident commander by providing event-specific advice during the coronavirus disease (COVID-19) pandemic.

HCFMUSP is a tertiary teaching hospital in Sao Paulo, Brazil, usually dedicated to treating high-complexity cases, and it comprises eight specialized institutes accounting for approximately 2,200 beds and 20,000 healthcare personnel. Its main building operates with about 900 beds and 33 different medical specialties and includes an Emergency Room and an 84-bed intensive care unit (ICU). Beginning in March 2020, the number of severe COVID-19 cases in Sao Paulo started to rise rapidly, and the demand for ICU beds outnumbered the then available resources in the Metropolitan Region of Sao Paulo. In an attempt to meet this demand, the CMC decided to isolate its Central Institute, transferring all non-COVID cases to other institutes or to the Emergency Room. This strategy increased the number of ICU beds devoted exclusively to COVID-19 patients by about 4-fold, to a total of 300 beds. As expected, this unprecedented but necessary transformation affected all sectors within the hospital, including the Epidemiologic Surveillance Center. For instance, while in the past an average of 3200 cases per year were reported to the central level of epidemiologic surveillance, during the pandemic NUVE reported 3300 cases in May 2020 alone.

[…]