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This article is published in Open Access under the Creative Commons Attribution license, which allows use, distribution, and reproduction in any medium, without restrictions, as long as the original work is correctly cited. The COVID-19 pandemic, caused by the novel coronavirus (SARS-CoV-2), has emerged as one of this century’s major global health challenges. In the middle of April, just a few months after the epidemic erupted in China in late 2019, there had been more than a 2 millions cases and 120,000 deaths from COVID-19 worldwide. Many more cases and deaths are predicted in the coming months. In Brazil, to date, there have been some 21,000 confirmed cases and 1,200 deaths from COVID-19. Insufficient scientific knowledge on the novel coronavirus, the fast pace of its spread, and its capacity to cause deaths in vulnerable groups have generated uncertainties on the best strategies for confronting the epidemic in different parts of the world. The challenges are even greater in Brazil, since little is known about the characteristics of COVID-19 transmission in a context of huge social inequality, with communities exposed to precarious housing and sanitation conditions, without systematic access to running water, and with widespread crowding. In a schematic, simplified approach, the response to the COVID-19 pandemic can be divided into four stages: containment, mitigation, suppression, and recovery. The first stage, containment, begins before cases are reported in a country or region. It mainly involves active tracing of inbound international passengers and their contacts, aimed at avoiding or postponing community transmission. In the current pandemic, an exemplary containment stage was essential for decreasing the pandemic’s initial impact in Taiwan, Singapore, and Hong Kong, despite their proximity to China. Previous experience with the first major epidemic of severe acute respiratory syndrome (SARS) caused by coronavirus in this century (2003) may, at least partially, explain the successful containment of COVID-19 in these countries. The second stage, mitigation, begins when there is already sustained transmission of the infection in the country. The goal is to decrease the levels of disease transmission in groups with the highest risk of clinical severity, besides, of course, isolation of positive cases. These measures, called “vertical isolation”, are generally accompanied by some degree of reduction of social contact. The approach generally begins with the cancellation of large events, followed gradually by suspension of school activities, a ban on smaller events, The COVID-19 pandemic in Brazil: chronicle of a health crisis foretold

A pandemia de COVID-19 no Brasil: crônica de uma crise sanitária anunciada