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Report 21: Estimating COVID-19 cases and reproduction number in Brazil

2020; Cold Spring Harbor Laboratory Press; Linguagem: Inglês

10.25561/78872

Thomas A. Mellan, Henrique Hoeltgebaum, Swapnil Mishra, Charles Whittaker, Ricardo Parolin Schnekenberg, Axel Gandy, H. Juliette T. Unwin, Michaela Vollmer, Helen Coupland, Iwona Hawryluk, Nuno R. Faria, Juan F. Vesga, Harrison Zhu, Michael Hutchinson, Oliver Ratmann, Mélodie Monod, Kylie E. C. Ainslie, Marc Baguelin, Sangeeta Bhatia, Adhiratha Boonyasiri, Nicholas F. Brazeau, Giovanni Charles, Laura Cooper, Zulma M. Cucunubá, Gina Cuomo-Dannenburg, Amy Dighe, A Djaafara, Jeffrey W. Eaton, Sabine van Elsland, Richard G. FitzJohn, Keith Fraser, Katy A. M. Gaythorpe, W Green, Sarah Hayes, Natsuko Imai, Benjamin Jeffrey, Edward Knock, Daniel J. Laydon, John A. Lees, Tara D. Mangal, Andria Mousa, G Nedjati Gilani, Pierre Nouvellet, Daniela Olivera Mesa, Kris V. Parag, Michael Pickles, Hayley A Thompson, Robert Verity, Caroline E. Walters, Haowei Wang, Yijia Wang, Oliver J. Watson, Lilith K. Whittles, Xin Xi, Lucy Okell, Ilaria Dorigatti, Patrick Walker, Azra C. Ghani, Steven Riley, Neil M. Ferguson, Christl A. Donnelly, Seth Flaxman, Samir Bhatt,

COVID-19 Pandemic Impacts

Summary Brazil is an epicentre for COVID-19 in Latin America. In this report we describe the Brazilian epidemic using three epidemiological measures: the number of infections, the number of deaths and the reproduction number. Our modelling framework requires sufficient death data to estimate trends, and we therefore limit our analysis to 16 states that have experienced a total of more than fifty deaths. The distribution of deaths among states is highly heterogeneous, with 5 states—Sao Paulo, Rio de Janeiro, Ceara, Pernambuco and Amazonas—accounting for 81% of deaths reported to date. In these states, we estimate that the percentage of people that have been infected with SARS-CoV-2 ranges from 3.3% (95% CI: 2.8%-3.7%) in Sao Paulo to 10.6% (95% CI: 8.8%-12.1%) in Amazonas. The reproduction number (a measure of transmission intensity) at the start of the epidemic meant that an infected individual would infect three or four others on average. Following non-pharmaceutical interventions such as school closures and decreases in population mobility, we show that the reproduction number has dropped substantially in each state. However, for all 16 states we study, we estimate with high confidence that the reproduction number remains above 1. A reproduction number above 1 means that the epidemic is not yet controlled and will continue to grow. These trends are in stark contrast to other major COVID-19 epidemics in Europe and Asia where enforced lockdowns have successfully driven the reproduction number below 1. While the Brazilian epidemic is still relatively nascent on a national scale, our results suggest that further action is needed to limit spread and prevent health system overload.