The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil

Autor(es)

Nicolelis, Miguel A. L. ^{[1, 2, 3, 4, 5, 6]} ; Raimundo, Rafael L. G. ^{[7, 8]} ; Peixoto, Pedro S. ^[9] ; Andreazzi, Cecilia S. ^[10]

Afiliação do(s) autor(es)

^[1] Duke Univ, Dept Biomed Engn, Durham, NC 27706 - USA

^[2] Duke Univ Med Ctr, Dept Neurobiol, Box 103905, Durham, NC 27710 - USA

^[3] Duke Univ, Dept Neurol, Durham, NC - USA

^[4] Duke Univ, Dept Neurosurg, Durham, NC - USA

^[5] Duke Univ, Dept Psychol & Neurosci, Durham, NC - USA

^[6] Edmond & Lily Safra Int Inst Neurosci, Natal, RN - Brazil

^[7] Fed Univ Paraiba Campus IV, Dept Engn & Environm, Rio Tinto, Paraiba - Brazil

^[8] Fed Univ Paraiba Campus IV, Postgrad Program Ecol & Environm Monitoring PPGEM, Ctr Appl Sci & Educ, Rio Tinto, Paraiba - Brazil

^[9] Univ Sao Paulo, Inst Math & Stat, Dept Appl Math, Sao Paulo - Brazil

^[10] Fundacao Oswaldo Cruz, Lab Biol & Parasitol Wild Reservoir Mammals, IOC, Rio De Janeiro - Brazil

• Tipo de documento: Artigo Científico
• Fonte: SCIENTIFIC REPORTS; v. 11, n. 1 JUN 21 2021.
• Citações Web of Science: 4

Resumo

Although international airports served as main entry points for SARS-CoV-2, the factors driving the uneven geographic spread of COVID-19 cases and deaths in Brazil remain mostly unknown. Here we show that three major factors influenced the early macro-geographical dynamics of COVID-19 in Brazil. Mathematical modeling revealed that the ``super-spreading city{''} of SAo Paulo initially accounted for more than 85% of the case spread in the entire country. By adding only 16 other spreading cities, we accounted for 98-99% of the cases reported during the first 3 months of the pandemic in Brazil. Moreover, 26 federal highways accounted for about 30% of SARS-CoV-2's case spread. As cases increased in the Brazilian interior, the distribution of COVID-19 deaths began to correlate with the allocation of the country's intensive care units (ICUs), which is heavily weighted towards state capitals. Thus, severely ill patients living in the countryside had to be transported to state capitals to access ICU beds, creating a ``boomerang effect{''} that contributed to skew the distribution of COVID-19 deaths. Therefore, if (i) a lockdown had been imposed earlier on in spreader-capitals, (ii) mandatory road traffic restrictions had been enforced, and (iii) a more equitable geographic distribution of ICU beds existed, the impact of COVID-19 in Brazil would be significantly lower. (AU)

• Processo FAPESP: 16/18445-7 - Métodos numéricos para a nova geração de modelos de previsão de tempo e clima
• Beneficiário: Pedro da Silva Peixoto
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores