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

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 influenced the early macro-geographical dynamics of COVID-19 in Br...

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Autores principales:	Miguel A. L. Nicolelis, Rafael L. G. Raimundo, Pedro S. Peixoto, Cecilia S. Andreazzi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a290779e35174146912e996eedd7a293
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spelling	oai:doaj.org-article:a290779e35174146912e996eedd7a2932021-12-02T16:05:54ZThe impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil10.1038/s41598-021-92263-32045-2322https://doaj.org/article/a290779e35174146912e996eedd7a2932021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92263-3https://doaj.org/toc/2045-2322Abstract 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 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 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.Miguel A. L. NicolelisRafael L. G. RaimundoPedro S. PeixotoCecilia S. AndreazziNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Miguel A. L. Nicolelis Rafael L. G. Raimundo Pedro S. Peixoto Cecilia S. Andreazzi The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
description	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 influenced 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 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.
format	article
author	Miguel A. L. Nicolelis Rafael L. G. Raimundo Pedro S. Peixoto Cecilia S. Andreazzi
author_facet	Miguel A. L. Nicolelis Rafael L. G. Raimundo Pedro S. Peixoto Cecilia S. Andreazzi
author_sort	Miguel A. L. Nicolelis
title	The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
title_short	The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
title_full	The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
title_fullStr	The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
title_full_unstemmed	The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil
title_sort	impact of super-spreader cities, highways, and intensive care availability in the early stages of the covid-19 epidemic in brazil
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a290779e35174146912e996eedd7a293
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The impact of super-spreader cities, highways, and intensive care availability in the early stages of the COVID-19 epidemic in Brazil

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