Restructuring of emergency services to COVID-19 in Brazil: a space-time analysis from February to August 2020.

Objective: To explore the reorganization of the health system in response to the COVID-19 pandemic.

Methods: We conducted an ecological, descriptive-exploratory study with analysis of spatio-temporal clusters by epidemiological week in Brazilian municipalities. Secondary data sources were used, from the National Health Establishment Registry (April 2020) and on COVID-19 cases, February to August 2020. Intensive Care Units (ICU) availability was overlaid on incidence and mortality hot spots in order to assess expanded access in critical regions.

Results: Of the 5,570 municipalities analyzed, 54% were identified as incidence hot spots and 31% as mortality hot spots. Of the municipalities in incidence hot spots and with scarce access, 28% were covered by ICU expansion, while with regard to mortality 14% were covered.

Conclusion: The opening of new beds was not able to provide broad coverage for critical regions and could be optimized with the use of spatial analysis techniques.