Journal Article
28 May 2021
Gonçalves, Diego Assis, Ribeiro, Victória, Gualberto, Ana, Peres, Fernanda, Luconi, Michaela, Gameiro, Jacy
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1. IntroductionThe COVID-19 (coronavirus disease 2019) has been declared as a pandemic in March 2020 by the World Health Organization [1]. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which belongs to the Coronaviridae family. To date, more than 70 million people worldwide have been confirmed to be infected, with 1,599,704 deaths [2–4]. Currently, Brazil is the country with the second highest number of fatalities and third highest total cases, 180,437 and 6,836,227, respectively [2, 5]. More than 50,000 new cases keep on being reported per day in the country [5], and a high number of adults are considered at risk for severe COVID-19 in Brazil [6].Since the beginning of the pandemic, studies have shown that the number of patients requiring intensive care, as well as the number of deaths, is greater among individuals over 60 years of age....
Journal Article
18 May 2021
Dias-Godói, Isabella Piassi, Tadeu Rocha Sarmento, Túlio, Afonso Reis, Edna, Peres Gargano, Ludmila, Godman, Brian, de Assis Acurcio, Francisco, Alvares-Teodoro, Juliana, Guerra Júnior, Augusto Afonso, Mariano Ruas, Cristina
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The new coronavirus pandemic has appreciably impacted morbidity and mortality, as well as having an economic impact worldwide. New vaccines are a potential way forward to reduce transmission rates and subsequent infection. In Brazil, vaccines are being distributed via the public sector; however, in the future, they will be available in the private market. Information about consumers’ willingness to pay (WTP) for a hypothetical vaccine against SARS CoV-2 can help future price setting discussions. A cross-sectional study was conducted with consumers in the five regions of Brazil regarding the WTP for a hypothetical vaccine against SARS CoV-2 with a 50% efficacy. A total of 1402 individuals over 18 years of age who declared not having COVID-19 at the time of the survey were interviewed. The acceptability for this hypothetical vaccine was 80.7%. In addition, the amount of WTP by...
Preprint
13 May 2021
Nash, Beatrice,Badea, Anthony,Reddy, Ankita,Bosch, Miguel,Salcedo, Nol,Gomez, Adam R,Versiani, Alice,Silva, Gislaine Celestino Dutra,Santos, Thayza Maria Izabel Lopes Dos,Milhim, Bruno H G A,Moraes, Marilia M,Campos, Guilherme Rodrigues Fernandes,Quieroz, Flavia,Reis, Andreia Francesli Negri,Nogueira, Mauricio L,Naumova, Elena N,Bosch, Irene,Herrera, Bobby Brooke
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High frequency screening of populations has been proposed as a strategy in facilitating control of the COVID-19 pandemic. We use computational modeling, coupled with clinical data from rapid antigen tests, to predict the impact of frequent viral antigen rapid testing on COVID-19 spread and outcomes. Using patient nasal or nasopharyngeal swab specimens, we demonstrate that the sensitivity/specificity of two rapid antigen tests compared to quantitative real-time polymerase chain reaction (qRT-PCR) are 82.0%/100% and 84.7%/85.7%, respectively; moreover, sensitivity correlates directly with viral load. Based on COVID-19 data from three regions in the United States and São José do Rio Preto, Brazil, we show that high frequency, strategic population-wide rapid testing, even at varied accuracy levels, diminishes COVID-19 infections, hospitalizations, and deaths at a fraction of the...
Journal Article
12 May 2021
Malta, Monica,Vettore, Mario Vianna,da Silva, Cosme Marcelo Furtado Passos,Silva, Angelica Baptista,Strathdee, Steffanie A
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Brazil represents a tragic example of how lack of appropriate policies and pandemic denial impact public health. The country of 212 million inhabitants (3% of the world population) recorded around 1/3 of all daily COVID-19 deaths worldwide in late March 2021 [1]. Brazil’s brutal surge in COVID-19 deaths in the first months of 2021 has been climbing steadily, reaching over 4000 fatalities/day in early April, as a consequence of the widespread of the new variants overwhelming hospitals. In spite of the alarming scenario, the federal government is not yet adopting evidence-based and reliable public health measures, such as use of masks and social distancing.Brazil’s public health system provides healthcare for 78% of the population. Its free, publicly funded national vaccination program has an excellent track record: 96% of the population is vaccinated against TB, diphtheria, polio...
Editorial
6 May 2021
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Last week, Brazil’s total death toll from COVID-19 passed 400,000. In India, the pandemic is taking around 3,500 lives every day and has prompted a global response, with offers of oxygen, ventilators, intensive-care beds and more. Although these two countries are thousands of miles apart, the crises in both are the result of political failings: their leaders have either failed or been slow to act on researchers’ advice. This has contributed to an unconscionable loss of life.
Editorial
27 April 2021
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Dear editor,Currently, Brazil is going through a difficult crisis with its health system, which befall the country and has led to a trail of lives being cut short by COVID-19. Brazil has reached, by April 1st 2021, the mark of 12.748.747 cases and 321.515 lost lives caused by COVID-19 [1] and this numbers keeping on rising, as the situation is turn chaotic [2].Hospitals are at full capacity, some with even more than 100% occupancy and a crescent line of patients waiting for a bed for hospitalization. There is a lack of breathing equipment, oxygen cylinders and the health workers are operating at their physical and mental limits. In Brazil, it was declared on February 3rd, 2020, the Public Health Emergency of National Importance (ESPIN), as a direct result of the human infection by the coronavirus (2019-nCoV), considering it a complex event and the demand for a joint effort of the...
Working Paper
9 April 2021
Luan Borelli, Geraldo Sandoval Góes
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We apply the SIR-macro model proposed by Eichenbaum et al. (2020) in its complete version to comparatively study the interaction between economic decisions and COVID-19 epidemics in five different Brazilian states: São Paulo (SP), Amazonas (AM), Ceará (CE), Rio de Janeiro (RJ) and Pernambuco (PE). Our objective is to analyze qualitatively how the main intrinsic differences of each of these states can affect the epidemic dynamics and its consequences. For this purpose, we compute and compare the model for each of the states, both in competitive equilibrium and under optimal containment policy adoption, and analyze the implications of optimal policy adoption. We conclude that the intrinsic characteristics of the five different states imply relevant differences in the general dynamics of the epidemic, in the optimal containment policies, in the effect of the adoption of these policies...
Working Paper
9 April 2021
Nora Lustig, Valentina Martinez Pabon, Federico Sanz, Stephen D. Younger
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We use microsimulation to estimate the distributional consequences of covid-19-induced lockdown policies in Argentina, Brazil, Colombia and Mexico. Our estimates of the poverty consequences are worse than many others’ projections because we do not assume that the income losses are proportionally equal across the income distribution. We also simulate the effects of most of the expanded social assistance governments have introduced in response to the crisis. This has a large offsetting effect in Brazil and Argentina, much less in Colombia. In Mexico, there has been no such expansion. Contrary to prior expectations, we find that the worst effects are not on the poorest, but those (roughly) in the middle of the ex ante income distribution. In Brazil we find that poverty among the afrodescendants and indigenous populations increases by more than for whites, but the offsetting effects of...
Journal Article
4 March 2021
Ribeiro, Karina Braga,Ribeiro, Ana Freitas,de Sousa Mascena Veras, Maria Amélia,de Castro, Marcia Caldas
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Heterogeneity in COVID-19 morbidity and mortality is often associated with a country’s health-services structure and social inequality. This study aimed to characterize social inequalities in COVID-19 mortality in São Paulo, the most populous city in Brazil and Latin America. We conducted a population-based study, including COVID-19 deaths among São Paulo residents from March to September 2020. Age-standardized mortality rates and unadjusted rate ratios (RRs) [with corresponding 95% confidence intervals (CIs)] were estimated by race, sex, age group, district of residence, household crowding, educational attainment, income level and percentage of households in subnormal areas in each district. Time trends in mortality were assessed using the Joinpoint model. Males presented an 84% increase in COVID-19 mortality compared with females (RR = 1.84, 95% CI 1.79-1.90). Higher mortality...
Journal Article
18 February 2021
Gori Maia, Alexandre,Marteleto, Leticia,Rodrigues, Cristina Guimarães,Sereno, Luiz Gustavo
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We analyze the trade-offs between health and the economy during the period of social distancing in São Paulo, the state hardest hit by the COVID-19 pandemic in Brazil. We use longitudinal data with municipal-level information and check the robustness of our estimates to several sources of bias, including spatial dependence, reverse causality, and time-variant omitted variables. We use exogenous climate shocks as instruments for social distancing since people are more likely to stay home in wetter and colder periods. Our findings suggest that the health benefits of social distancing differ by levels of municipal development and may have vanished if the COVID-19 spread was not controlled in neighboring municipalities. In turn, we did not find evidence that municipalities with tougher social distancing performed worse economically. Our results also highlight that estimates that do not...