Challenges in establishing telehealth care during the COVID-19 pandemic in a neglected HTLV-1-infected population in northeastern Brazil

In an attempt to contain the SARS-CoV-2 epidemic, the Brazilian Health Ministry recognized the epidemic as a public health emergency of national importance on February 2, and the Brazilian senate approved legislation (law no. 13,97916, Lei da Quarentena) on March 6, allowing states and municipalities to implement discretionary social isolation and distancing measures [5]. The decentralized efforts implemented by state and municipal governments, ranging from voluntary social isolation to partial lockdowns, has allowed for a flexible approach in accordance with regional conditions, in coordination with public healthcare services provided by the country’s National Health System (Sistema Único de Saúde [SUS]) [8]. In Brazil, prior to the COVID-19 pandemic, the implementation of telehealth faced resistance from healthcare professionals, as well as national and state medical boards and healthcare councils. [...]complex legal and technological requirements hindered the widespread adoption of telehealth services. Despite the fact that no reports have indicated that COVID-19 may be more severe in patients infected with HTLV-1, special care recommendations have been published for this group, since this infection predominantly affects older individuals for whom comorbidities such as diabetes, systemic arterial hypertension, and overweight are frequent [16]. [...]it has been reported that HTLV-1-infected individuals may present some degree of immunosuppression, since several infectious diseases, such as tuberculosis, strongyloidiasis, and scabies, are more frequent or more severe in these individuals [9].