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Abstract
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We appreciate Volpe and Lacerda's valuable feedback on our published manuscript. Our study analysed annual rates of suicide and self-harm, considering the estimated Brazilian yearly population. Reanalyses could offer further insights into the topic. For instance, to assess short-term events, particularly the impact of the COVID-19 pandemic, we recognise the importance of absolute monthly numbers of occurrences, as Volpe and Lacerda did. However, our primary objective was to evaluate temporal trends for three different outcomes over time, extending beyond the scope of the COVID-19 pandemic.
Previous research has demonstrated the increasing trend of suicide rates in Brazil, with specific moments, such as periods of austerity, impacting these rates. Our results indicated a pre-existing upward trend in suicide and self-harm rates in Brazil that persisted post-pandemic onset. Utilising the joint point methodology enabled us to identify overall inflection points, that characterise periods with different levels of trend increase, making it possible to hypothesize on potential drivers of these different trends.
Volpe and Lacerda's visual analysis reinforced these findings, providing a closer look at a decline in self-harm notifications during the pandemic's onset, as already observed in our data. However, it is important to highlight that this reduction in notifications did not occur for death outcomes as shown in our paper, suggesting possible artefacts in the healthcare system. A decrease in notifications of infectious diseases, as well as in hospital surveillance services, has also been demonstrated. This decrease suggests that the Brazilian healthcare system, especially high-complexity services, may have been overwhelmed by the demands of the pandemic, along with the population's fear of contracting SARS-CoV-2 and difficulty accessing healthcare services during the pandemic. Additionally, challenges in maintaining active epidemiological surveillance, leading to reduced surveillance and reporting of other health issues, contributed to the observed reduction in notifications of self-harm patients.
Language: en |