scholarly journals The use of health geography modeling to understand early dispersion of COVID-19 in São Paulo, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245051
Author(s):  
Carlos Magno Castelo Branco Fortaleza ◽  
Raul Borges Guimarães ◽  
Rafael de Castro Catão ◽  
Cláudia Pio Ferreira ◽  
Gabriel Berg de Almeida ◽  
...  
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Sao Paulo ◽  
São Paulo ◽  
Population Mobility ◽  
Long Distance ◽  
Urban Hierarchy ◽  
Use Of Resources ◽  
Disease Impact ◽  
Public Health Strategies

Public health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In São Paulo, the most populous state in Brazil (45 million inhabitants), most COVID-19 cases up to April 18th were reported in the Capital and metropolitan area. However, the inner municipalities, where 20 million people live, are also at risk. As governmental authorities discuss the loosening of measures for restricting population mobility, it is urgent to analyze the routes of dispersion of COVID-19 in São Paulo territory. We hypothesize that urban hierarchy is the main responsible for the disease spreading, and we identify the hotspots and the main routes of virus movement from the metropolis to the inner state. In this ecological study, we use geographic models of population mobility to check for patterns for the spread of SARS-CoV-2 infection. We identify two patterns based on surveillance data: one by contiguous diffusion from the capital metropolitan area, and the other hierarchical with long-distance spread through major highways that connects São Paulo city with cities of regional relevance. This knowledge can provide real-time responses to support public health strategies, optimizing the use of resources in order to minimize disease impact on population and economy.

scholarly journals Elementary spatial structures and dispersion of COVID-19: health geography directing responses to public health emergency in São Paulo State, Brazil

2020 ◽  
Author(s):  
Carlos Magno Castelo Branco Fortaleza ◽  
Raul Borges Guimarães ◽  
Rafael de Castro Catão ◽  
Cláudia Pio Ferreira ◽  
Gabriel Berg de Almeida ◽  
...  
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Sao Paulo ◽  
São Paulo ◽  
Population Mobility ◽  
Long Distance ◽  
Public Health Policies ◽  
Social Distancing ◽  
Public Health Strategies ◽  
The Impact

AbstractPublic health policies to contain the spread of COVID-19 rely mainly on non-pharmacological measures. Those measures, especially social distancing, are a challenge for developing countries, such as Brazil. In São Paulo, the most populous state in Brazil (45 million inhabitants), most COVID-19 cases up to April 18th were reported in the Capital and metropolitan area. However, the inner municipalities, where 20 million people live, are also at risk. As governmental authorities discuss the loosening of measures for restricting population mobility, it is urgent to analyze the routes of dispersion of COVID-19 in those municipalities. In this ecological study, we use geographical models of population mobility as patterns for spread of SARS-Cov-2 infection. Based on surveillance data, we identify two patterns: one by contiguous diffusion from the capital metropolitan area and other that is hierarchical, with long-distance spread through major highways to cities of regional relevance. We also modelled the impact of social distancing strategies in the most relevant cities, and estimated a beneficial effect in each and every setting studied. This acknowledgement can provide real-time responses to support public health strategies.

scholarly journals Expected impact of COVID-19 outbreak in a major metropolitan area in Brazil

2020 ◽  
Author(s):  
Tarcísio M. Rocha Filho ◽  
Fabiana Sherine Ganem dos Santos ◽  
Victor Bertollo Gomes ◽  
Thiago Augusto Hernandes Rocha ◽  
Julio Henrique Rosa Croda ◽  
...  
Keyword(s):  
Public Health ◽  
Older People ◽  
Metropolitan Area ◽  
Sao Paulo ◽  
World Health ◽  
São Paulo ◽  
The World ◽  
Health Organization ◽  
The Impact ◽  
The City

AbstractIn January 2020 China reported to the World Health Organization an outbreak of pneumonia of undetermined origin in the city of Wuhan, Hubei. In January 30, 2020, the World Health Organization declared the outbreak of COVID-19 as a Public Health Emergency of International Interest (PHEI).ObjectivesThe aim of this study is to assess the impact of a COVID-19 epidemic in the metropolitan region of São Paulo, Brazil.MethodsWe used a generalized SEIR (Susceptibles, Exposed, Infectious, Recovered) model, with additional Hospitalized variables (SEIHR model) and age-stratified structure to analyze the expected time evolution during the onset of the epidemic in the metropolitan area of São Paulo. The model allows to determine the evolution of the number of cases, the number of patients admitted to hospitals and deaths caused by COVID-19. In order to investigate the sensibility of our results with respect to parameter estimation errors we performed Monte Carlo analysis with 100 000 simulations by sampling parameter values from an uniform distribution in the confidence interval.ResultsWe estimate 1 368 (IQR: 880, 2 407) cases, 301 (22%) in older people (≥60 years), 81 (50, 143) hospitalizations, and 14 (9, 26) deaths in the first 30 days, and 38 583 (IQR: 16 698, 113, 163) cases, 8 427 (21.8%) in older people (≥60 years), 2181 (914, 6392) hospitalizations, and 397(166, 1205) deaths in the first 60 days.LimitationsWe supposed a constant transmission probability Pc among different age-groups, and that every severe and critic case will be hospitalized, as well as that the detection capacity in all the primary healthcare services does not change during the outbreak.ConclusionSupposing the reported parameters in the literature apply in the city of São Paulo, our study shows that it is expected that the impact of a COVID-19 outbreak will be important, requiring special planning from the authorities. This is the first study for a major metropolitan center in the south hemisphere, and we believe it can provide policy makers with a prognosis of the burden of the pandemic not only in Brazil, but also in other tropical zones, allowing to estimate total cases, hospitalization and deaths, in support to the management of the public health emergence caused by COVID-19.

scholarly journals Estimating the effects of reopening of schools on the course of the epidemic of COVID-19

2021 ◽  
Vol 149 ◽  
Author(s):  
Eduardo Massad ◽  
Marcos Amaku ◽  
Dimas Tadeu Covas ◽  
Luis Fernandes Lopez ◽  
Francisco Antonio Bezerra Coutinho
Keyword(s):  
Public Health ◽  
Sao Paulo ◽  
The State ◽  
School Staff ◽  
São Paulo ◽  
Low Level ◽  
Entire Country ◽  
Degree Of Confidence ◽  
The Right ◽  
Public Health Strategies

Abstract In this paper, we present a method to estimate the risk of reopening of schools illustrated with the case of the State of São Paulo, Brazil. The model showed that, although no death of children would result from the reopening of the schools in the three cities analysed, the risk of asymptomatic and symptomatic cases and secondary cases among teachers, school staff and relatives of the children is not negligible. Although the epidemic hit different regions with different intensities, our model shows that, for regions where the incidence profile is similar to the cities analysed, the risk of reopening of schools is still too high. This in spite of the fact that incidences in these cities were declining in the period of the time considered. Therefore, although we cannot extend the result to the entire country, the overall conclusion is valid for regions with a declining incidence and it is even more valid for regions where incidence is increasing. We assumed a very conservative level of infection transmissibility of children of just 10% as that of adults. In spite of the very low level of transmissibility is assumed, the number of secondary cases caused by infected children among teachers, school staff and relatives varied from 2 to 85. It is, therefore, too soon to have any degree of confidence that reopening of schools before the advent of a vaccine is the right decision to take. The purpose of our model and simulations is to provide a method to estimate the risk of school reopening, although we are sure it could be applied as a guide to public health strategies.

Evaluation of atmospheric aerosols in the metropolitan area of São Paulo simulated by the regional EURAD-IM model on high-resolution

2020 ◽  
Author(s):  
Ediclê De Souza Fernandes Duarte ◽  
Philipp Franke ◽  
Anne Caroline Lange ◽  
Elmar Friese ◽  
Fábio Juliano da Silva Lopes ◽  
...  
Keyword(s):  
High Resolution ◽  
Metropolitan Area ◽  
Atmospheric Aerosols ◽  
Sao Paulo ◽  
São Paulo ◽  
Im Model

Environmental and public health effects of vehicle emissions in a large metropolis: Case study of a truck driver strike in Sao Paulo, Brazil

2020 ◽  
Vol 11 (6) ◽  
pp. 24-31 ◽  
Author(s):  
Luciana Ferreira Leite Leirião ◽  
Daniela Debone ◽  
Theotonio Pauliquevis ◽  
Nilton Manuel Évora do Rosário ◽  
Simone Georges El Khouri Miraglia
Keyword(s):  
Public Health ◽  
Health Effects ◽  
Vehicle Emissions ◽  
Sao Paulo ◽  
Truck Driver ◽  
São Paulo

scholarly journals Characterization of Air-Quality Degradation Episodes of PM10 in the Metropolitan Area of São Paulo and Their Relationship with Meteorological Conditions

2020 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Maria C. Q. D. Oliveira ◽  
Luciana V. Rizzo ◽  
Anita Drumond
Keyword(s):  
Air Quality ◽  
Metropolitan Area ◽  
Sao Paulo ◽  
Meteorological Conditions ◽  
Pollutant Emissions ◽  
Maximum Temperature ◽  
São Paulo ◽  
Urban Centers ◽  
Duration Distribution ◽  
Air Quality Monitoring Stations

Air pollution is one of the main environmental problems in large urban centers, affecting people’s health and impacting quality of life. The Metropolitan Area of São Paulo (MASP) presents frequent exceedances of air-quality standards in inhalable particulate matter (PM10), a consequence of pollutant emissions modulated by meteorological conditions. This study aims to identify and characterize PM10persistent exceedance events (PEE) inthe MASP between 2005 and 2017, relating them to meteorological conditions. The criteria used to select the events were: (i) events that occurred in at least 50% of the air-quality monitoring stations chosen for this study and, (ii) among the events that met the first criterion, those with a duration equal to or greater than five days, which correspond to the 80% percentile of the event duration distribution. A total 71 persistent episodes of exceedance were selected. The results show that the exceedance of PM10 lasted up to 14 consecutive days and was predominant in the austral winter, accompanied by an increase in maximum temperature (T), a decrease in wind speed (WS) and relative humidity (RH), and a wind direction predominantly from the northwest during the peak concentration of the pollutant. On average, a concentration increase of 60% was observed at the peak of the PEE.

scholarly journals Impact of vehicular emissions on the formation of fine particles in the Sao Paulo Metropolitan Area: a numerical study with the WRF-Chem model

2016 ◽  
Vol 16 (2) ◽  
pp. 777-797 ◽  
Author(s):  
A Vara-Vela ◽  
M. F. Andrade ◽  
P. Kumar ◽  
R. Y. Ynoue ◽  
A. G. Muñoz
Keyword(s):  
Size Distribution ◽  
Metropolitan Area ◽  
Atmospheric Aerosols ◽  
Fine Particles ◽  
Sao Paulo ◽  
Vehicular Emissions ◽  
São Paulo ◽  
Mass Size Distribution ◽  
Mass Size ◽  
The Impact

Abstract. The objective of this work is to evaluate the impact of vehicular emissions on the formation of fine particles (PM2.5;  ≤  2.5 µm in diameter) in the Sao Paulo Metropolitan Area (SPMA) in Brazil, where ethanol is used intensively as a fuel in road vehicles. The Weather Research and Forecasting with Chemistry (WRF-Chem) model, which simulates feedbacks between meteorological variables and chemical species, is used as a photochemical modelling tool to describe the physico-chemical processes leading to the evolution of number and mass size distribution of particles through gas-to-particle conversion. A vehicular emission model based on statistical information of vehicular activity is applied to simulate vehicular emissions over the studied area. The simulation has been performed for a 1-month period (7 August–6 September 2012) to cover the availability of experimental data from the NUANCE-SPS (Narrowing the Uncertainties on Aerosol and Climate Changes in Sao Paulo State) project that aims to characterize emissions of atmospheric aerosols in the SPMA. The availability of experimental measurements of atmospheric aerosols and the application of the WRF-Chem model made it possible to represent some of the most important properties of fine particles in the SPMA such as the mass size distribution and chemical composition, besides allowing us to evaluate its formation potential through the gas-to-particle conversion processes. Results show that the emission of primary gases, mostly from vehicles, led to a production of secondary particles between 20 and 30 % in relation to the total mass concentration of PM2.5 in the downtown SPMA. Each of PM2.5 and primary natural aerosol (dust and sea salt) contributed with 40–50 % of the total PM10 (i.e. those  ≤  10 µm in diameter) concentration. Over 40 % of the formation of fine particles, by mass, was due to the emission of hydrocarbons, mainly aromatics. Furthermore, an increase in the number of small particles impaired the ultraviolet radiation and induced a decrease in ozone formation. The ground-level O3 concentration decreased by about 2 % when the aerosol-radiation feedback is taken into account.

scholarly journals Mental disorders and employment status in the São Paulo Metropolitan Area, Brazil: gender differences and use of health services

2017 ◽  
Vol 33 (9) ◽  
Author(s):  
Mariane Henriques França ◽  
Sandhi Maria Barreto ◽  
Flavia Garcia Pereira ◽  
Laura Helena Silveira Guerra de Andrade ◽  
Maria Cristina Alochio de Paiva ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Health Services ◽  
Metropolitan Area ◽  
Employment Status ◽  
Health Care Services ◽  
Multinomial Logistic Regression ◽  
Composite International Diagnostic Interview ◽  
Sao Paulo ◽  
São Paulo ◽  
Use Of Health Services

Abstract: Mental disorders are associated with employment status as significant predictors and as consequences of unemployment and early retirement. This study describes the estimates and associations of 12-month DSM-IV prevalence rates of mental disorders and use of health services with employment status by gender in the São Paulo Metropolitan Area, Brazil. Data from the São Paulo Megacity Mental Health Survey was analyzed (n = 5,037). This is a population-based study assessing the prevalence and determinants of mental disorders among adults, using the Composite International Diagnostic Interview. The associations were estimated by odds ratios obtained through binomial and multinomial logistic regression. This study demonstrates that having mental disorders, especially mood disorders, is associated with being inactive or unemployed among men and inactive among women, but only having a substance use disorder is associated with being unemployed among women. Among those with mental disorders, seeking health care services is less frequent within unemployed.

scholarly journals Evolution of bacterial meningitis diagnosis in Sao Paulo State-Brazil and future challenges

2013 ◽  
Vol 71 (9B) ◽  
pp. 672-676 ◽  
Author(s):  
Maristela Marques Salgado ◽  
Maria Gisele Goncalves ◽  
Lucila Okuyama Fukasawa ◽  
Fabio Takenori Higa ◽  
Juliana Thalita Paulino ◽  
...  
Keyword(s):  
Public Health ◽  
Bacterial Meningitis ◽  
Public Health Problem ◽  
Sao Paulo ◽  
Immunological Methods ◽  
Haemophilus Influenzae Type ◽  
Molecular Technique ◽  
São Paulo ◽  
Paulo State ◽  
São Paulo State

Bacterial meningitis (BM) is a severe disease and still represents a serious public health problem with high rates of morbidity and mortality. The most common cases of BM around the world, mainly in Brazil, have been caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b. Bacterial culture is the gold-standard technique for BM confirmation, but approximately 50% of suspected cases are not culture-confirmed, due to problems related to improper transportation and seeding or previous antibiotic treatment. Immunological methods present low sensitivity and have possibility of cross-reactions. Real time PCR (qPCR) is a molecular technique and has been successful used for BM diagnosis at Instituto Adolfo Lutz in São Paulo State, Brazil, since 2007. The incorporation of qPCR in the Public Health surveillance routine in our state resulted in diminishing 50% of undetermined BM cases. Our efforts are focused on qPCR implementation in the BM diagnostic routine throughout Brazil.

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