Brazil’s northeastern state of Piauí has responded to the novel coronavirus with a remarkably efficient operation. In more than 190 cities, the health workers that are part of Piauí’s “Active Search” program use an app and phone calls to monitor symptoms of suspected and confirmed COVID-19 patients in their homes and then make house visits to take oxygen levels and test family members. Although several public hospitals across two bordering states have reached full ICU capacity in recent weeks, around 35 percent of Piauí’s respirator-equipped beds in public hospitals were available as of last Tuesday.
Piauí’s response owes its strength to that of Brazil’s universal public health system, called the SUS (Sistema Único de Saúde). The SUS belongs to the whole of the country, but only a handful of cities and states have mobilized it effectively during the pandemic. The vast differentials across Brazil show that a public health system alone is not enough. Such a system’s success depends on good management—something the country has sorely lacked.
