Going back to school may represent an extra risk for more than 9.3 million Brazilians (4.4% of the overall population) who are elderly or adults (18 years and up) with chronic health conditions and at risk for Covid-19 infection. This is due to the fact that they live in the same household as children and teenagers of school age (3 to 17 years old). The number of people that will be exposed to the new coronavirus was calculated through a Fiocruz analysis according to the National Health Survey (PNS 2013), carried out by the Brazilian Institute of Geography and Statistics (IBGE) in a partnership with the Health Information Laboratory (LIS) of Fiocruz.
São Paulo is the state with the higher absolute number of people in this situation: about 2.1 million adults and elderly people belonging to risk groups, with children at home, followed by Minas Gerais (1 million), Rio de Janeiro (600 thousand), and Bahia (570 thousand). Rio Grande do Norte is the state with the higher percentage of population in these groups: 6.1% of the total.
Researchers of the Institute of Scientific and Technological Communication and Information in Health (Icict/Fiocruz) analyzed data from the PNS 2013 regarding two population groups in the so-called risk groups for Covid-19: adults between 18 and 59 years of age with diabetes, heart condition, or pulmonary condition, and the elderly (60 years old and up). They then crossed the figures to check how many of these two groups reside in households with at least one person between 3 and 17 years of age (i.e. school age).
The result brought up some worrying numbers. Almost 3.9 million adults (1.8% of the country’s population) between 18 and 59 years of age with diabetes, heart condition, or pulmonary condition reside in a household with at least one minor at school age (between 3 and 17 years old). The elderly population (60 years and up) that lives with at least one minor at school age amounts to almost 5.4 million people (2.6% of the population).
According to the study, going back to school, something that has gradually been announced by various states and municipalities, puts students at potential contagion situations. Even if schools and universities adopt safety measures (and assuming they will be strictly followed), public transportation and the absence of any control on the behavior of children and teenagers who walk around by themselves away from home represent potential situations of contagion by Covid-19 for these students. The problem is that, if they do get contaminated, these young people may carry the SARS-CoV-2 virus to their homes, infecting relatives of all ages who have chronic diseases and other vulnerability conditions. This is a potential breach of the social isolation these people have been maintaining until now.
Made public through the technical note Populations at risk and return to school: Ending social distancing, of the MonitoraCovid-19 platform, the study draws attention to the fact that “the discussion on whether to resume the school year in the country is not following a moment in which the reduction of cases and deaths are dropping, and presents another worsening factor: the de-mobilization of health resources and the dismantling of some field hospitals”.
An epidemiologist for Icict/Fiocruz, Diego Xavier, who was part of the study, highlights that so far most of these millions of Brazilians at risk and who have a student living with them had been practicing social distancing. “But going back to school may represent a dangerous breach in this distancing. In the study, we estimate that if only 10% of this population of adults with risk factors and elderly people living with children of school age come to need intensive care, this will mean 800 thousand people in the waiting list for intensive care units. To make things worse, if we apply the lethality rate in Brazil to this scenario, we’ll be talking about 35 thousand new deaths, among these groups at risk only”, says Xavier.
Christovam Barcellos, public health specialist and vice-director of Icict/Fiocruz, believes that states and municipalities should offer parents the necessary information for the measures they must adopt in their own homes. “If this isn’t done, many parents will feel unsafe when facing the decision of whether to send their children back to school. With the expansion of the population exposed to the virus, it would also be necessary to intensify epidemiological surveillance actions for these vulnerable groups, through testing and permanent clinical follow-up”, he states.
The data on the populations at risk can be consulted on the MonitoraCovid-19 system developed by the Icict/Fiocruz team and are available here.