| Author | Nicolelis, Miguel A. L. | |
| Author | Raimundo, Rafael L. G. | |
| Author | Peixoto, Pedro S. | |
| Author | Andreazzi, Cecilia S. | |
| Access date | 2021-07-30T13:26:12Z | |
| Available date | 2021-07-30T13:26:12Z | |
| Document date | 2021 | |
| Citation | NICOLELIS, Miguel A. L. et al. The impact of super‑spreader cities, highways, and intensive care availability in the early stages of the COVID‑19 epidemic in Brazil. Scientific Reports, v. 11, n. 13001, p. 1-12, 2021. | pt_BR |
| ISSN | 2045-2322 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/48423 | |
| Language | eng | pt_BR |
| Publisher | Nature | pt_BR |
| Rights | open access | |
| Subject in Portuguese | COVID-19 | pt_BR |
| Subject in Portuguese | Impacto | pt_BR |
| Subject in Portuguese | Espalhador | pt_BR |
| Subject in Portuguese | Cidades | pt_BR |
| Subject in Portuguese | Rodovias | pt_BR |
| Subject in Portuguese | Estágios iniciais | pt_BR |
| Subject in Portuguese | Epidemia | pt_BR |
| Subject in Portuguese | Brasil | pt_BR |
| Title | The impact of super‑spreader cities, highways, and intensive care availability in the early stages of the COVID‑19 epidemic in Brazil | pt_BR |
| Type | Article | |
| DOI | 10.1038/s41598-021-92263-3 | |
| Abstract | 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 infuenced the early macro-geographical dynamics of COVID-19
in Brazil. Mathematical modeling revealed that the “super-spreading city” of São 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 frst 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 efect” 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 trafc restrictions had been enforced, and (iii) a more equitable
geographic distribution of ICU beds existed, the impact of COVID-19 in Brazil would be signifcantly
lower. | pt_BR |
| Affilliation | Department of Neurobiology, Duke University Medical Center, Box 103905, Durham, NC 27710, USA / Department of Biomedical Engineering, Duke University, Durham, NC, USA / Department of Neurology, Duke University, Durham, NC, USA / Department of Neurosurgery, Duke University, Durham, NC, USA / Department of Psychology and Neuroscience, Duke University, Durham, NC, USA / Edmond and Lily Safra International Institute of Neurosciences, Natal, RN, Brasil. | pt_BR |
| Affilliation | Universidade Federal da Paraíba. Centro de Ciências Aplicadas e Educação. Departamento de Engenharia e Meio Ambiente e Programa de Pós-Graduação em Ecologia e Monitoramento Ambiental. Campus IV, Rio Tinto, PB, Brasil. | pt_BR |
| Affilliation | Universidade de São Paulo. Instituto de Matemática e Estatística. Departamento de Matemática Aplicada. São Paulo, SP, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Subject | COVID-19 | pt_BR |
| Subject | Epidemic | pt_BR |
| Subject | Super‑spreader | pt_BR |
| Subject | Intensive care availability | pt_BR |
| Subject | Brazil | pt_BR |
| Subject | Cities | pt_BR |
| Subject | Highways | pt_BR |
| Subject | Early stages | pt_BR |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
