Research reveals pessimism among doctors about spike in coronavirus cases

While officials discuss the easing of quarantine, doctors who attend cases of Covid-19 are not at all optimistic about the evolution of the pandemic in the country. According to a study by the São Paulo Association of Medicine, conducted with physicians from public and private health networks, 84.5% consider that we have not yet crossed the worst wave of the new coronavirus. The study was released on Monday, amid studies and dissemination of measures to resume activities in several cities in the country. The topic concerns doctors and specialists. Brazil has already surpassed 500,000 cases of the disease, and records more than 30,000 deaths due to Covid-19, according to a bulletin from the Ministry of Health. "Pessimism could not be different," says José Luiz Gomes do Amaral, president of the São Paulo Medical Association. "We have seen in the work environments the number of patients multiply, and the intensive care inpatient beds are still full, recruiting doctors from different specialties. There is no indication that we are arriving in a stable situation, or even a cooling of the disease." For the physician, considering the underreporting in the official numbers, the scenario seems far from a solution. And the pessimism among the interviewed physicians only reinforces the concern about a flexibilization of quarantine in Brazilian cities. "Imagine, you come back from the hospital after an on-call, exhausted, lie down and wake up the next day with people discussing flexibility. You wonder how many patients will show up in two weeks at the hospital. This certainly does not contribute to the reduction of anxiety," says Amaral, who advocates isolation, increased testing and solidarity as ways to try to stop the expansion of the new coronavirus. The survey heard more than 2,800 doctors from public and private networks across the country. The majority (68.6%) says that colleagues and collaborators are "apprehensive" when asked about the climate of the work environment. The perception of lack of adequate inputs and safety is still cited by health professionals, but fell in relation to a previous survey of the association. "We must praise a certain effort in making these items available. On the other hand, the lack of tests for all symptomatics is a failure to be considered, and should be treated with attention. At least 40% of respondents say they can't get tests for all patients," says the president of the São Paulo Medical Association. The study also showed that 58.5% of the interviewees had witnessed or heard of cases of violence against physicians and other health professionals due to the Covid-19 pandemic. The most cited actions are verbal aggressions (53%), in addition to psychological aggressions (29%). Physical aggressions were cited by 17% of the interviewees who reported having known or witnessed scenes of violence. "Violence in the health system is chronic. Or endemic, to use the jargon of epidemiology. The impatience and dissatisfaction with the queues in the health system, which have long been part of the daily life of hospitals, are linked to the excess of demand and misinformation with the tension with the cases of coronavirus", says Amaral. The president of the APM states that the authorities have a fundamental role to clarify the population about a situation in which everyone is afraid, and to discuss aspects of the disease, prevention actions and care for health professionals themselves. "The information attenuates panic. As cases go on, managers need to learn and act," says Amaral, who calls for the training of health professionals. "There was a displacement of health professionals to care for Covid-19. But many are not able to attend infectious diseases, and start practicing in an unknown environment. There is a need to increase the concern to empower them, especially in the public system, because we are reaching a record of infected professionals."