Open AccessThe use of health geography modeling to understand early dispersion of COVID-19 in São Paulo, Brazil
Author(s) -
Carlos Magno Castelo Branco Fortaleza,
Raúl Borges Guimarães,
Rafael de Castro Catão,
Cláudia Pio Ferreira,
Gabriel Berg de Almeida,
Thomas N. Vilches,
Edmur Azevedo Pugliesi
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0245051
Subject(s) - urban hierarchy , metropolitan area , geography , social distance , geographic mobility , population , public health , socioeconomics , covid-19 , environmental health , regional science , economic geography , disease , medicine , infectious disease (medical specialty) , sociology , nursing , archaeology , pathology
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.