COVID-19: Local/regional inequalities and impacts over critical healthcare infrastructure in Brazil

Abstract

This article addresses regional inequalities about critical healthcare infrastructure for coping with the COVID-19, based on geospatial analysis and compartmental modeling (SEIR). The study sites were the São Paulo Macro Metropolis (MMP) and the Metropolitan Region of Vale do Paraíba/Litoral Norte (RMVPLN). The results indicated the absence of ICU beds in more than 2/3 of the municipalities, in addition to the concentration in regional hubs, for which the migration of COVID-19 cases from neighboring municipalities should be considered. The analysis with the SEIR model, performed for scenarios with and without social isolation, showed that the isolation adopted in the regions was able to postpone the collapse of the health infrastructure, reducing the reproduction rate of the disease. The simulations indicated a reproduction rate of 0.95 in order to avoid collapse in the health infrastructure for RMVPLN in the analyzed period. In addition, for future resilience, it is essential to address inequalities in terms of health infrastructure available for public and private access.

Incorporating Social Determinants of Health into Modelling of COVID-19 and other Infectious Diseases: A Baseline Socio-economic Compartmental Model

“…Discussions around these issues have largely concentrated on the health systems of high-income countries. It is essential to note, however, that health systems in much of the rest of the world have significantly less capacity than developed countries ( Murthy et al 2015 ; Martinez-Alvarez et al 2020 ; Sousa et al 2020 ). These intra-country inequalities in health systems directly bear on the ability of states to provide effective treatment support for hospitalised COVID-19 patients (for example, through adequate access to drugs or ICU capacity).…”

COVID-19 magnifies the vulnerabilities: The Brazilian case

“…In addition, regional inequalities impact the resilience of the local services, for example deficiencies about critical healthcare infrastructure for coping with the pandemic (De Sousa Júnior et al, 2020) are aggravated in the poorer regions. States in the North of the country tend to be more affected, as it is the case of Amazonas, in relation to the other states with more economic competitiveness in the Southeast of Brazil (Veiga e Silva et al, 2020).…”

O Paradoxo Do Isolamento Na Pandemia Segundo O Povo Indígena Sateré-Mawé/Am

“…A variável "desigualdade social" tem sido ponderação associada a altas taxas de espalhamento do SARS-CoV-2 no Brasil (Jacobi, 2020;Sousa et al, 2020;Travassos et. al., 2020).…”

“…A desigualdade social está atrelada diretamente à adesão ao isolamento, definindo quem pode e quem não pode ter esse direito, instaurando um dilema insolúvel entre a adesão ao isolamento pelo medo da morte por contaminação e a recusa pelo medo da fome que ele ocasiona. Sem contar a covariância entre desigualdades sociais, política de produção de ignorância e biopolítica do governo federal para povos vulneráveis (Jacobi, 2020;Sousa, Gonçalves, & Cruz, 2020, Travassos et al, 2020.…”