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Open accessJournal ArticleDOI: 10.1038/S41597-021-00859-1

Dataset on SARS-CoV-2 non-pharmaceutical interventions in Brazilian municipalities.

04 Mar 2021-Scientific Data (Nature Publishing Group)-Vol. 8, Iss: 1, pp 73-73
Abstract: Brazil has one of the fastest-growing COVID-19 epidemics worldwide. Non-pharmaceutical interventions (NPIs) have been adopted at the municipal level with asynchronous actions taken across 5,568 municipalities and the Federal District. This paper systematises the fragmented information on NPIs reporting on a novel dataset with survey responses from 4,027 mayors, covering 72.3% of all municipalities in the country. This dataset responds to the urgency to track and share findings on fragmented policies during the COVID-19 pandemic. Quantifying NPIs can help to assess the role of interventions in reducing transmission. We offer spatial and temporal details for a range of measures aimed at implementing social distancing and the dates when these measures were relaxed by local governments.

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Open accessJournal ArticleDOI: 10.1136/BMJGH-2021-004959
01 Apr 2021-BMJ Global Health
Abstract: Introduction Little evidence exists on the differential health effects of COVID-19 on disadvantaged population groups. Here we characterise the differential risk of hospitalisation and death in Sao Paulo state, Brazil, and show how vulnerability to COVID-19 is shaped by socioeconomic inequalities. Methods We conducted a cross-sectional study using hospitalised severe acute respiratory infections notified from March to August 2020 in the Sistema de Monitoramento Inteligente de Sao Paulo database. We examined the risk of hospitalisation and death by race and socioeconomic status using multiple data sets for individual-level and spatiotemporal analyses. We explained these inequalities according to differences in daily mobility from mobile phone data, teleworking behaviour and comorbidities. Results Throughout the study period, patients living in the 40% poorest areas were more likely to die when compared with patients living in the 5% wealthiest areas (OR: 1.60, 95% CI 1.48 to 1.74) and were more likely to be hospitalised between April and July 2020 (OR: 1.08, 95% CI 1.04 to 1.12). Black and Pardo individuals were more likely to be hospitalised when compared with White individuals (OR: 1.41, 95% CI 1.37 to 1.46; OR: 1.26, 95% CI 1.23 to 1.28, respectively), and were more likely to die (OR: 1.13, 95% CI 1.07 to 1.19; 1.07, 95% CI 1.04 to 1.10, respectively) between April and July 2020. Once hospitalised, patients treated in public hospitals were more likely to die than patients in private hospitals (OR: 1.40%, 95% CI 1.34% to 1.46%). Black individuals and those with low education attainment were more likely to have one or more comorbidities, respectively (OR: 1.29, 95% CI 1.19 to 1.39; 1.36, 95% CI 1.27 to 1.45). Conclusions Low-income and Black and Pardo communities are more likely to die with COVID-19. This is associated with differential access to quality healthcare, ability to self-isolate and the higher prevalence of comorbidities.

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11 Citations


Open accessPosted ContentDOI: 10.1101/2020.12.09.20246207
13 Dec 2020-medRxiv
Abstract: Background: Little evidence exists on the differential health effects of COVID-19 on disadvantaged population groups. Here we characterise the differential risk of hospitalisation and death in Sao Paulo state, Brazil and show how vulnerability to COVID-19 is shaped by socioeconomic inequalities. Methods: We conducted a cross-sectional study using hospitalised severe acute respiratory infections (SARI) notified from March to August 2020, in the Sistema de Monitoramento Inteligente de Sao Paulo (SIMI-SP) database. We examined the risk of hospitalisation and death by race and socioeconomic status using multiple datasets for individual-level and spatio-temporal analyses. We explained these inequalities according to differences in daily mobility from mobile phone data, teleworking behaviour, and comorbidities. Findings: Throughout the study period, patients living in the 40% poorest areas were more likely to die when compared to patients living in the 5% wealthiest areas (OR: 1.60, 95% CI: 1.48 - 1.74) and were more likely to be hospitalised between April and July, 2020 (OR: 1.08, 95% CI: 1.04 - 1.12). Black and Pardo individuals were more likely to be hospitalised when compared to White individuals (OR: 1.37, 95% CI: 1.32 - 1.41; OR: 1.23, 95% CI: 1.21 - 1.25, respectively), and were more likely to die (OR: 1.14, 95% CI: 1.07 - 1.21; 1.09, 95% CI: 1.05 - 1.13, respectively). Interpretation: Low-income and Black and Pardo communities are more likely to die with COVID-19. This is associated with differential access to healthcare, adherence to social distancing, and the higher prevalence of comorbidities.

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4 Citations


Open accessPosted ContentDOI: 10.1101/2021.07.01.21259404
06 Jul 2021-medRxiv
Abstract: The emergence and widespread circulation of SARS-CoV-2 variants of concern (VOC) or interest (VOI) imposes an enhanced threat to global public health. In Brazil, one of the countries most severely impacted throughout the pandemic, a complex dynamics involving variants co-circulation and turnover events has been recorded with the emergence and spread of VOC Gamma in Manaus in late 2020. In this context, we present a genomic epidemiology investigation based on samples collected between December 2020 and May 2021 in the second major Brazilian metropolis, Rio de Janeiro. By sequencing 244 novel genomes through all epidemiological weeks in this period, we were able to document the introduction and rapid dissemination of VOC Gamma in the city, driving the rise of the third local epidemic wave. Molecular clock analysis indicates this variant has circulated locally since the first weeks of 2021 and only seven weeks were necessary for it to achieve a frequency above 70%, consistent with rates of growth observed in Manaus and other states. Moreover, a Bayesian phylogeographic reconstruction indicates VOC Gamma spread throughout Brazil between December 2020 and January 2021, and that it was introduced in Rio de Janeiro through at least 13 events coming from nearly all regions of the country. Comparative analysis of RT-qPCR cycle threshold (Ct) values provide further evidence that VOC Gamma induces higher viral loads (N1 target; mean reduction of Ct: 2.7, 95% CI = 2.0 - 3.4). This analysis corroborates the previously proposed mechanistic basis for this variant enhanced transmissibility and distinguished epidemiological behavior. Our results document the evolution of VOC Gamma and provide independent assessment of scenarios previously studied in Manaus, therefore contributing to the better understanding of the epidemiological dynamics currently being surveyed in other Brazilian regions.

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2 Citations


Open accessJournal ArticleDOI: 10.1016/J.CHAOS.2021.111150
Abstract: In this paper, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) or COVID-19 is researched by employing mathematical analysis under modern calculus. In this context, the dynamical behavior of an arbitrary order p and fractal dimensional q problem of COVID-19 under Atangana Bleanu Capute (ABC) operator for the three cities, namely, Santos, Campinas, and Sao Paulo of Brazil are investigated as a case-study. The considered problem is analyzed for at least one solution and unique solution by the applications of the theorems of fixed point and non-linear functional analysis. The Ulam-Hyres stability condition via nonlinear functional analysis for the given system is derived. In order to perform the numerical simulation, a two-step fractional type, Lagrange plynomial (Adams Bashforth technique) is utilized for the present system. MATLAB simulation tools have been used for testing different fractal fractional orders considering the data of aforementioned three regions. The analysis of the results finally infer that, for all these three regions, the smaller order values provide better constraints than the larger order values.

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Topics: Nonlinear functional analysis (55%), Fractal (54%), Linear multistep method (53%) ... show more

2 Citations


Open accessPosted Content
Abstract: The Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), or Covid-19, burst into a pandemic in the beginning of 2020. An unprecedented worldwide effort involving academic institutions, regulatory agencies and industry is facing the challenges imposed by the rapidly spreading disease. Emergency use authorization for vaccines were granted in the beginning of December 2020 in Europe and nine days later in the United States. The urge for vaccination started a race, forcing governs and health care agencies to take decisions on the fly regarding the vaccination strategy and logistics. So far, the vaccination strategies and non-pharmaceutical interventions, such as social distancing and the use of face masks, are the only efficient actions to stop the pandemic. In this context, it is of fundamental importance to understand the dynamical behavior of the Covid-19 spread along with possible vaccination strategies. In this work a Susceptible - Infected - Removed - Sick with vaccination (SIRSi-Vaccine) model is proposed. In addtion, the SIRSi-Vaccine model also accounts for unreported, or asymptomatic, cases and the possibility of temporary immunity, either after infection or vaccination. Disease free and endemic equilibrium points existence conditions are determined in the (! ? ?) vaccine-effort and social distancing parameter space. The model is adjusted to the data from Sao Paulo, Santos and Campinas, three major cities in the State of Sao Paulo, Brazil.

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Topics: Pandemic (53%), Vaccination (51%)

1 Citations


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Open accessJournal ArticleDOI: 10.1126/SCIENCE.ABB6105
Huaiyu Tian1, Yonghong Liu1, Yidan Li1, Chieh-Hsi Wu2  +19 moreInstitutions (12)
31 Mar 2020-Science
Abstract: Responding to an outbreak of a novel coronavirus [agent of coronavirus disease 2019 (COVID-19)] in December 2019, China banned travel to and from Wuhan city on 23 January 2020 and implemented a national emergency response. We investigated the spread and control of COVID-19 using a data set that included case reports, human movement, and public health interventions. The Wuhan shutdown was associated with the delayed arrival of COVID-19 in other cities by 2.91 days. Cities that implemented control measures preemptively reported fewer cases on average (13.0) in the first week of their outbreaks compared with cities that started control later (20.6). Suspending intracity public transport, closing entertainment venues, and banning public gatherings were associated with reductions in case incidence. The national emergency response appears to have delayed the growth and limited the size of the COVID-19 epidemic in China, averting hundreds of thousands of cases by 19 February (day 50).

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1,053 Citations


Open accessJournal ArticleDOI: 10.1126/SCIENCE.ABD2161
23 Jul 2020-Science
Abstract: Brazil currently has one of the fastest-growing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics in the world. Because of limited available data, assessments of the impact of nonpharmaceutical interventions (NPIs) on this virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1 to 1.6 in Sao Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February and 11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average traveled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and provides evidence that current interventions remain insufficient to keep virus transmission under control in this country.

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286 Citations


Open accessJournal ArticleDOI: 10.1038/S41562-020-0928-4
Abstract: The first case of COVID-19 was detected in Brazil on 25 February 2020. We report and contextualize epidemiological, demographic and clinical findings for COVID-19 cases during the first 3 months of the epidemic. By 31 May 2020, 514,200 COVID-19 cases, including 29,314 deaths, had been reported in 75.3% (4,196 of 5,570) of municipalities across all five administrative regions of Brazil. The R0 value for Brazil was estimated at 3.1 (95% Bayesian credible interval = 2.4-5.5), with a higher median but overlapping credible intervals compared with some other seriously affected countries. A positive association between higher per-capita income and COVID-19 diagnosis was identified. Furthermore, the severe acute respiratory infection cases with unknown aetiology were associated with lower per-capita income. Co-circulation of six respiratory viruses was detected but at very low levels. These findings provide a comprehensive description of the ongoing COVID-19 epidemic in Brazil and may help to guide subsequent measures to control virus transmission.

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157 Citations


Open accessJournal ArticleDOI: 10.1126/SCIENCE.ABC5096
18 Sep 2020-Science
Abstract: As rates of new coronavirus disease 2019 (COVID-19) cases decline across Europe owing to nonpharmaceutical interventions such as social distancing policies and lockdown measures, countries require guidance on how to ease restrictions while minimizing the risk of resurgent outbreaks. We use mobility and case data to quantify how coordinated exit strategies could delay continental resurgence and limit community transmission of COVID-19. We find that a resurgent continental epidemic could occur as many as 5 weeks earlier when well-connected countries with stringent existing interventions end their interventions prematurely. Further, we find that appropriate coordination can greatly improve the likelihood of eliminating community transmission throughout Europe. In particular, synchronizing intermittent lockdowns across Europe means that half as many lockdown periods would be required to end continent-wide community transmission.

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123 Citations


Open accessJournal ArticleDOI: 10.1093/JTM/TAAA042
Abstract: The global outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been declared a pandemic by the World Health Organization. As the number of imported SARS-CoV-2 cases is on the rise in Brazil, we use incidence and historical air travel data to estimate the most important routes of importation into the country.

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99 Citations


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