Background The determinants of access to immunizers are still poorly understood, leading to questions about which criteria were considered in this distribution. Given the above, the present study aimed to analyze the determinants of access to the SARS-CoV-2 vaccine by different countries. Methods The study covered 189 countries using data from different public databases, and collected until February 19, 2021. We used eight explanatory variables: gross domestic product (GDP), extreme poverty, human development index (HDI), life expectancy, median age, coronavirus disease 2019 (COVID-19) cases, COVID-19 tests, and COVID-19 deaths. The endogenous variables were total vaccine doses, vaccine doses per thousand, and days of vaccination. The structural equation modeling (SEM) technique was applied to establish the causal relationship between the country's COVID-19 impact, socioeconomic variables, and vaccine access. To support SEM, we used confirmatory factor analysis, t-test, and Pearson's correlation. Results We collected the sample on February 19, and to date, 80 countries (42.1%) had already received a batch of immunizers against COVID-19. The countries with first access to the vaccine (e.g., number of days elapsed since they took the first dose) were the United Kingdom (68), China (68), Russia (66), and Israel (62). The countries receiving the highest doses were the United States, China, India, and Israel. The countries with extreme poverty had lower access to vaccines and the richer countries gained priority access. Countries most affected by COVID (deaths and cases) also received immunizers earlier and in greater volumes. Unfortunately, similar to other vaccines, indicators, such as income, poverty, and human development, influence vaccines' access. Thus affecting the population of vulnerable and less protected countries. Therefore, global initiatives for the equitable distribution of COVID need to be discussed and encouraged. Conclusions Determinants of vaccine distribution consider the impact of the disease in the country and are also affected by favorable socioeconomic indicators. The COVID-19 vaccines need to be accessible to all affected countries, regardless of their social hands.

The coronavirus disease (COVID-19) pandemic has overwhelmed health care systems in many countries and bed availability has become a concern. In this context, the present study aimed to analyze the hospitalization and intensive care unit (ICU) times in patients diagnosed with COVID-19. The study covered 55,563 ICU admissions and 238,075 hospitalizations in Brazilian Health System units from February 22, 2020, to June 7, 2021. All the patients had a positive COVID-19 diagnosis. The symptoms analyzed included: fever, dyspnea, low oxygen saturation (SpO2 < 95%), cough, respiratory distress, fatigue, sore throat, diarrhea, vomiting, loss of taste, loss of smell, and abdominal pain. We performed Cox regression in two models (ICU and hospitalization times). Hazard ratios (HRs) and survival curves were calculated by age group. The average stay was 14.4 days for hospitalized patients and 12.4 days for ICU patients. For hospitalized cases, the highest hazard mean values, with a positive correlation, were for symptoms of dyspnea (HR = 1.249; 95% confidence interval [CI], 1.225–1.273) and low oxygen saturation (HR = 1.157; 95% CI 1.137–1.178). In the ICU, the highest hazard mean values were for respiratory discomfort (HR = 1.194; 95% CI 1.161–1.227) and abdominal pain (HR = 1.100; 95% CI 1.047–1.156). Survival decreased by an average of 2.27% per day for hospitalization and 3.27% per day for ICU stay. Survival by age group curves indicated that younger patients were more resistant to prolonged hospital stay than older patients. Hospitalization was also lower in younger patients. The mortality rate was higher in males than females. Symptoms related to the respiratory tract were associated with longer hospital stay. This is the first study carried out with a sample of 238,000 COVID-19 positive participants, covering the main symptoms and evaluating the hospitalization and ICU times.

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The present study aimed to identify the factors associated with the distribution of the first doses of the COVID-19 vaccine. In this study, we used 9 variables: human development index (HDI), gross domestic product (GDP per capita), Gini index, population density, extreme poverty, life expectancy, COVID cases, COVID deaths, and reproduction rate. The time period was until February 1, 2021. The variable of interest was the sum of the days after the vaccine arrived in the countries. Pearson’s correlation coefficients were calculated, and t-test was performed between the groups that received and did not receive the immunizer, and finally, a stepwise linear regression model was used. 58 (30.4%) of the 191 countries received the SARS-CoV-2 vaccine. The countries that received the most doses were the United States, China, the United Kingdom, and Israel. Vaccine access in days showed a positive Pearson correlation HDI, GDP, life expectancy, COVID-19 cases, deaths, and reproduction rate. Human development level, COVID-19 deaths, GDP per capita, and population density are able to explain almost 50% of the speed of access to immunizers. Countries with higher HDI and per capita income obtained priority access.

Este artigo buscou compreender as relações entre as dimensões do processo estratégico: pensamento, formação e mudança e as estratégias genéricas e funcionais em MPEs situadas no Vale do São Francisco. A amostra considera 271 respondentes e os resultados evidenciam que os dirigentes tendem a utilizar mais o pensamento lógico do que intuitivo, a formar a estratégia de maneira mais emergente do que deliberada e promover mudanças mais evolutivas do que revolucionárias. Ressalta-se ainda que não houve relação significativa entre o processo estratégico e as estratégicas genéricas e funcionais efetivamente adotadas pelas firmas.