Public Policy professors at UFRN analyze, in an article, State actions in the fight against Covid-19

By Sandra Gomes and Anderson Cristopher dos Santos
According to epidemiological bulletins from the Ministry of Health, the growth rates of incidence and deaths from Covid-19 in the state of Rio Grande do Norte (RN) have grown at a slower rate than in the rest of the country. Another example of this would be the low occupancy of ICU beds reserved for patients with Covid-19: around 33%. Apparently, the state has been successful in flattening the infection curve, even though it is known that contagion data is certainly underreported.
In fact, the government of RN took a series of rapid and progressively more comprehensive measures throughout March and April, taking on the role of coordinator of actions in the state and inducing its municipalities, state bodies and even public and private institutions, to issue rules in line with the decisions of the state Executive. The vast majority of these measures — through decrees by the state governor, Fátima Bezerra, from the PT — were taken before the contagion worsened.
The World Health Organization's declaration of an international pandemic and the confirmation of the first case in RN led the state government to issue a series of decrees — between March 12 and 24 — that were progressively more comprehensive. Some examples can be cited: closing of shopping malls, restaurants, bars and similar; prohibition of collective events (public or private), including churches; suspension of classes both in public networks (state and municipal schools) and in private ones and for all levels and types of education (including higher education); decree of a state of public calamity (opening space for extraordinary health expenses), among several other actions that were followed by other public and private bodies and institutions in the state. On April 1st, the quarantine decree in RN reached the peak of control decisions. Recently, however, the government of Rio Grande do Norte issued a decree that makes some service activities aimed at personal hygiene more flexible, such as hairdressers, barbershops, manicure shops, as well as civil construction and other activities that were previously not permitted.
The first case of covid-19 in RN was confirmed in Natal, on March 12. Initially, the concentration of cases reached the most upscale neighborhoods of the capital. The same happened in Mossoró, which, however, quickly started to have the highest mortality rate in the state. A possible reason is the proximity of Mossoró to the state of Ceará, which presents a more severe situation of contagion by the new coronavirus. Currently, the internalization and peripheralization of Covid-19 cases is observed. RN has 167 municipalities and 64 of them have confirmed cases. Some of them registered deaths before positive cases, suggesting that underreporting is more severe in the interior of the state.
The biggest risk, at the moment, is precisely this change in the places of highest incidence and mortality from covid-19 associated with what appears to be a decrease in the adherence of the population of Rio Grande do Norte to social isolation.
IF IT IS FAR FROM HAVING AN ACCURATE OVERVIEW OF THE SPREAD OF THE VIRUS IN THE STATE WITH THE STILL DEFICIENT TESTING CAPACITY
If, at the beginning of the epidemic, those mainly affected were residents of upper middle class neighborhoods, in recent days there are indications that this pattern is moving to the outskirts of cities. In these places, there is a set of situations that can make the infection greater, faster and more lethal: high population and housing density; a situation of social vulnerability that makes it difficult for these populations to voluntarily withdraw from the job market; greater precarious access to public health services, etc. In other words, the flattening of the curve currently observed could be quickly reversed if specific actions for these areas of the city with precarious housing, urban and social conditions are not initiated immediately.
With the internalization and peripheralization of Covid-19 cases, concerns are growing about disobedience to distancing measures. In some regions of the state and in areas of the largest cities, popular support appears to be low. Data from Lais-UFRN (Laboratory of Technological Innovation in Health at the Federal University of Rio Grande do Norte) show that there was a greater movement of people precisely in the last week, which coincides with the validity of the decree with greater flexibility. Long lines at banks to receive emergency aid from the