The γ (gamma) variant was dominant at the time, representing up to 90% of the sequenced samples in Brazil. It is the referral facility for tertiary care for an area comprising >500,000 inhabitants in inner São Paulo State, Brazil (22✥3’09”S, 48✢6’42”W). Our hospital has 500 beds in wards, including 53 in intensive care units and an emergency room (ER). In March 2021, we implemented a clinical and laboratory screening strategy in the emergency unit and hospital wards of the Clinical Hospital of Botucatu Medical School. 4 Policies for identifying COVID-19 among those admitted for other reasons is of utmost importance for preventing outbreaks. Few hospitals have reported healthcare-associated coronavirus disease 2019 (COVID-19) cases to the Brazilian Healthcare-Associated Infections Program, with rates varying from 0.23% to 2.5% of all admissions. The incidence of transmission of SARS-CoV-2 within hospital settings is unknown. Reference Abbas, Robalo Nunes and Martischang3 In February 2022 in Brazil, official data from the Ministry of Health estimated >24,000,000 confirmed cases of COVID-19, with >620,000 deaths. Reference Shitrit, Zuckerman and Mor1, Reference Lim, Tan and Htun2 Given the estimated basic reproduction number of the virus, the transmission through respiratory droplets, the possibility of transmission of asymptomatic and oligosymptomatic individuals, and the high occupancy rate of the health services, the hospital environment has become a risk scenario, especially susceptible to outbreaks and compromising patients with potential for unfavorable clinical outcomes. To the Editor-The greater spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) variants of concern (VOCs) determines the occurrence of community outbreaks and quickly poses a potential risk for nosocomial outbreaks.
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