Early Stages of the Coronavirus Disease (COVID-19) Pandemic in Brazil: National and Regional Contexts

The first case of COVID-19 in Brazil occurred in February 2020, affecting mainly the country's large urban centers. The initial strategy to suppress the transmission of the virus was based on social isolation and the suspension of economic activities to flatten the incidence curve and allow health services to prepare for the expected increase in hospital admissions. However, there was no coordinated strategy between the federal government, states and municipalities to adopt effective control measures and to carry out epidemiological surveillance of the disease and/or contact tracing, favouring the rapid increase in the number of new COVID-19 cases. The spread of the disease occurred in a non-homogeneous manner throughout the territory, reaching small and medium-sized cities in the country and overloading local health services, which in many places reached their maximum capacity. There is still no clear trend toward stabilization of the epidemic curve, since the data available to estimate the behaviour of infection in the country are lagged by the low testing rate.