{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:10:11Z","timestamp":1774573811474,"version":"3.50.1"},"reference-count":52,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ci\u00eanc. sa\u00fade coletiva"],"abstract":"<jats:p>Resumo Mesmo no per\u00edodo em que a pandemia de Covid-19 encontrava-se em crescimento no Nordeste do Brasil, iniciou-se a ado\u00e7\u00e3o de medidas de flexibiliza\u00e7\u00e3o do distanciamento social. O objetivo do estudo \u00e9 o de avaliar a pertin\u00eancia das propostas de flexibiliza\u00e7\u00e3o, tomando-se em conta a situa\u00e7\u00e3o da pandemia em cada local e o momento em que foram adotadas. Tendo como refer\u00eancia as diretrizes da OMS, foram constru\u00eddos e analisados indicadores operacionais para cada diretriz, no contexto da regi\u00e3o Nordeste. Para an\u00e1lise do comportamento da epidemia, conforme indicadores selecionados, foram usadas t\u00e9cnicas de Joinpoint Trend Analysis, mapas de calor, raz\u00e3o de taxas e compara\u00e7\u00e3o da tend\u00eancia temporal entre capitais e interior dos estados. O pico do crescimento semanal ocorreu em maio-julho\/2020 (semanas epidemiol\u00f3gicas 19 a 31). Na maioria das capitais n\u00e3o se observou tend\u00eancia decrescente simult\u00e2nea do n\u00famero de casos e \u00f3bitos nos 14 dias pr\u00e9vios \u00e0 flexibiliza\u00e7\u00e3o. Em todos os estados o quantitativo de testes realizados foi insuficiente. Na semana epidemiol\u00f3gica 24 os percentuais estaduais de ocupa\u00e7\u00e3o de leitos de UTI\/Covid-19 foram pr\u00f3ximos ou superiores 70%. A situa\u00e7\u00e3o epidemiol\u00f3gica das nove capitais dos estados do Nordeste, no momento em que a decis\u00e3o de flexibiliza\u00e7\u00e3o foi tomada, mostra que nenhuma delas atendia aos crit\u00e9rios e par\u00e2metros recomendados pela OMS.<\/jats:p>","DOI":"10.1590\/1413-81232021264.39422020","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T14:47:27Z","timestamp":1618843647000},"page":"1441-1456","source":"Crossref","is-referenced-by-count":23,"title":["Covid-19 no nordeste do Brasil: entre o lockdown e o relaxamento das medidas de distanciamento social"],"prefix":"10.1590","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9951-8840","authenticated-orcid":false,"given":"Ricardo Arraes de Alencar","family":"Ximenes","sequence":"first","affiliation":[{"name":"Universidade Federal de Pernambuco,  Brazil; Universidade de Pernambuco,  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Quick Rebound of COVID-19: Predictions From a Monte Carlo Stochastic Model","volume":"8","author":"Girona T","year":"2020","journal-title":"Front Phys"},{"key":"ref36","series-title":"Coronav\u00edrus. Fran\u00e7a bate novo recorde e sinaliza 'segunda onda' do coronav\u00edrus na Europa","year":"2020"},{"key":"ref37","series-title":"See How All 50 States Are Reopening (and Closing Again)","year":"2020"},{"key":"ref38","series-title":"Live Coronavirus Updates: Here's the Latest","year":"2020"},{"issue":"39","key":"ref39","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.15585\/mmwr.mm6939e4","article-title":"Recent Increase in COVID-19 Cases Reported Among Adults Aged 18-22 Years - United States, May 31 - September 5, 2020","volume":"69","author":"Salvatore PP","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref40","series-title":"S\u00edntese de Indicadores Sociais: uma an\u00e1lise das condi\u00e7\u00f5es de vida da popula\u00e7\u00e3o brasileira","year":"2019"},{"key":"ref41","series-title":"Inqu\u00e9rito soropreval\u00eancia coronav\u00edrus em Fortaleza","year":"2020"},{"issue":"5","key":"ref42","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S1473-3099(20)30303-0","article-title":"COVID-19 in Latin America","volume":"20","author":"Burki T","year":"2020","journal-title":"Lancet Infect Dis"},{"issue":"2","key":"ref43","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.immuni.2020.04.012","article-title":"Herd Immunity: Understanding COVID-19","volume":"52","author":"Randolph HE","year":"2020","journal-title":"Immunity"},{"key":"ref44","article-title":"Herd immunity thresholds for SARS-CoV-2 estimated from unfolding epidemics","author":"Aguas R","year":"2020","journal-title":"medRxiv"},{"issue":"6505","key":"ref45","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1126\/science.abc6810","article-title":"A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2","volume":"369","author":"Britton T","year":"2020","journal-title":"Science"},{"key":"ref46","article-title":"Local protection bubbles: an interpretation of the decrease in the velocity of coronavirus's spread in the city of S\u00e3o Paulo","author":"Pinto JPG","year":"2020","journal-title":"medRxiv"},{"key":"ref47","first-page":"293","article-title":"To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic","volume":"5","author":"Eikenberry SE","year":"2020","journal-title":"Infect Dis Model"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"20200376","DOI":"10.1098\/rspa.2020.0376","article-title":"A modelling framework to assess the likely effectiveness of facemasks in combination with 'lock-down'in managing the COVID-19 pandemic","volume":"A476","author":"Stutt RO","year":"2020","journal-title":"Proc R Soc"},{"issue":"18","key":"ref49","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMp2026913","article-title":"Facial Masking for Covid-19 - Potential for \"Variolation\" as We Await a Vaccine","volume":"383","author":"Gandhi M","year":"2020","journal-title":"N Engl J Med"},{"issue":"1","key":"ref50","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13362-020-00083-3","article-title":"Quantifying the role of social distancing, personal protection and case detection in mitigating COVID-19 outbreak in Ontario, Canada","volume":"10","author":"Wu J","year":"2020","journal-title":"J Math Ind"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"101692","DOI":"10.1016\/j.tmaid.2020.101692","article-title":"COVID-19 social distancing in the Kingdom of Saudi Arabia: Bold measures in the face of political, economic, social and religious challenges","volume":"37","author":"Yezli S","year":"2020","journal-title":"Travel Med Infect Dis"},{"key":"ref52","series-title":"Ethiopia's unconventional COVID-19 response","author":"Oqubay A","year":"2020"}],"container-title":["Ci\u00eancia &amp; Sa\u00fade Coletiva"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/csc\/v26n4\/1413-8123-csc-26-04-1441.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T14:47:52Z","timestamp":1618843672000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1413-81232021000401441&tlng=pt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":52,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["S1413-81232021000401441"],"URL":"https:\/\/doi.org\/10.1590\/1413-81232021264.39422020","relation":{},"ISSN":["1678-4561","1413-8123"],"issn-type":[{"value":"1678-4561","type":"electronic"},{"value":"1413-8123","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}