Social distancing in São Paulo State: demonstrating the reduction in cases using time series analysis of deaths due to COVID-19

Abstract

<jats:p>ABSTRACT: Introduction: Demonstrating the results of Social Distancing Strategies (SDS) became a relevant factor to obtain support by the population in São Paulo State and in Brazil. The delay in the processing of PCR tests and the small number of tests available limits the ability of sanitary authorities to make meaningful data available as to the number of cases or the number of deaths due to COVID-19. Methodology: We use a time series analysis of deaths due to COVID-19 referenced to the date of deaths (as opposed to the date in which the test results were obtained). Results: We demonstrate that the SDS adopted in São Paulo City and State clearly brought meaningful results to delay the growth of COVID-19 cases. We also show that by using this type of time series it is possible to identify different trends for regions, allowing for targeted approaches. Additionally, by using a time series which is death-oriented makes it possible to identify, for São Paulo City, the effects of the SDS with the Social Isolation Index (SII) adopted in the state and to make a gross estimate for the SII, which prevents the growth of the disease. Conclusion: The use of a time series of deaths due to COVID-19 referenced to the date of the event allows a better understanding of the effects of the SDS on the progression of the COVID-19 epidemic in São Paulo State, Brazil.</jats:p>

Considerations for diagnostic COVID-19 tests

“…In other developing regions, similar initiatives were promoted by regional and international health surveillance institutes. In South-East Asia this was pushed, for instance, by the Vietnam National Steering Committee 106 , whereas, for instance in South America, the state of São Paulo in Brazil actively supported the use of diagnostics in maintaining social distancing guidelines 107 . Still, and despite this type of support, suboptimal and delayed diagnostics in many developing regions and consequent problems in the efficacy of disease suppression were expected 108 – 110 .…”

Excesso de mortes durante a pandemia de COVID-19: subnotificação e desigualdades regionais no Brasil

“…Em São Paulo, verificou-se excesso de mortes significativo nos diferentes períodos, mas com percentuais crescentes e inferiores a 48%. Esse cenário pode estar relacionado com o padrão local de resposta à epidemia ao longo do tempo 21 e, pelo menos em parte, com o eventual efeito sazonal, já que nos meses de maio e junho espera-se maior circulação de vírus respiratórios que costumam impactar o perfil de adoecimento e morte da população 22,23 . Cabe ressaltar que, em 2019, a microrregião de saúde à qual São Paulo pertence, apresentava maior oferta de leitos gerais, de Unidades de Terapia Intensiva e aparelhos de ventilação mecânica por 10 mil habitantes, quando comparada com as demais cidades avaliadas 24 .…”

Medidas de distanciamento social para o enfrentamento da COVID-19 no Brasil: caracterização e análise epidemiológica por estado

“…In Brazil, a time series study of COVID-19 deaths in the state of São Paulo showed that social distancing strategies implemented from March 16 to 22, 2020, resulted in a substantial reduction in the number of infections, with the most evident reduction in the city of São Paulo from April 5 to 20. The author explains that the time between the measures' implementation and the reduction in the number of deaths was about 17 days, equivalent to the onset of symptoms and death from COVID-19 36 . These findings corroborate those reported in another study that assessed the impact of nonpharmacological interventions in the cities of São Paulo and Rio de Janeiro, using mobility-oriented transmission models, and found that the reproduction rate (Rt) for SARS-CoV-2 over time in these cities dropped below Cad.…”