The pandemic of poverty, vulnerability, and COVID-19: Evidence from a fuzzy multidimensional analysis of deprivations in Brazil

Tavares, Fernando Flores; Betti, Gianni

doi:10.1016/j.worlddev.2020.105307

Cited by 97 publications

(79 citation statements)

References 20 publications

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“…In other countries, higher in-hospital mortality for blacks in comparison to whites has also been observed [17][18][19][20]. In Brazil, such findings may be more a reflection of socioeconomic vulnerabilities to which blacks, browns and native Brazilians are exposed, which influence living conditions, lifestyles, access to healthcare, and ultimately have implications for their health, including COVID-19 outcomes [21]. In other countries, such as England and the United States, sociodemographic inequalities are also correlated with higher mortality among blacks and Hispanics when compared to whites [19,22].…”

Section: Discussionmentioning

confidence: 94%

Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020

et al. 2021

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Background Almost 200,000 deaths from COVID-19 were reported in Brazil in 2020. The case fatality rate of a new infectious disease can vary by different risk factors and over time. We analysed the trends and associated factors of COVID-19 case fatality rates in Brazilian public hospital admissions during the first wave of the pandemic. Methods A retrospective cohort of all COVID-19-related admissions between epidemiological weeks 10–40 in the Brazilian Public Health System (SUS) was delimited from available reimbursement records. Smoothing time series and survival analyses were conducted to evaluate the trends of hospital case fatality rates (CFR) and the probability of death according to factors such as sex, age, ethnicity, comorbidities, length of stay and ICU use. Results With 398,063 admissions and 86,452 (21.7%) deaths, the overall age-standardized hospital CFR trend decreased throughout the period, varying from 31.8% (95%CI: 31.2 to 32.5%) in week 10 to 18.2% (95%CI: 17.6 to 18.8%) in week 40. This decreasing trend was observed in all sex, age, ethnic groups, length of stay and ICU admissions. Consistently, later admission (from July to September) was an independent protective factor. Patients 80+ year old had a hazard ratio of 8.18 (95% CI: 7.51 to 8.91). Ethnicity, comorbidities, and ICU need were also associated with the death risk. Although also decreasing, the CFR was always around 40–50% in people who needed an ICU admission. Conclusions The overall hospital CFR of COVID-19 has decreased in Brazilian public hospitals during the first wave of the pandemic in 2020. Nevertheless, during the entire period, the CFR was still very high, suggesting the need for improving COVID-19 hospital care in Brazil.

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Section: Discussionmentioning

confidence: 94%

Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020

et al. 2021

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“…The Brazilian northern region poses the highest rate of SARS-CoV-2 infection vulnerability. By late March 2021, Amazonas state concentrated the most deaths per million people 16 . As such, the effectiveness of pandemic response management demands a better comprehension on the impact of social asymmetries in relation to SARS-CoV-2 exposure risk within different population groups, especially amid ethnic minorities living in poverty, such as the indigenous populations of this region.…”

Section: Discussionmentioning

confidence: 99%

Increased vulnerability to SARS-CoV-2 infection among indigenous people living in the urban area of Manaus

Pontes

Silva

Pinheiro-Silva

et al. 2021

Sci Rep

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The COVID-19 pandemic threatens indigenous peoples living in suburban areas of large Brazilian cities and has thus far intensified their pre-existing socio-economic inequalities. We evaluated the epidemiological situation of SARS-CoV-2 infection among residents of the biggest urban multiethnic indigenous community of the Amazonas state, Brazil. Blood samples of 280 indigenous people living in the surrounding area of Manaus were tested for the presence of anti-SARS-CoV-2 IgA or IgG antibodies. The risk factors and sociodemographic information were assessed through an epidemiological questionnaire. We found a total positivity rate of 64.64% (95% CI 59.01–70.28) for SARS-CoV-2 infection. IgA and IgG were detected in 55.71% (95% CI 49.89–61.54) and 60.71% (95% CI 54.98–66.45) of the individuals, respectively. Over 80% of positive individuals were positive for both IgA and IgG.No significant difference in positivity rates between genders or age groups was observed. Moreover, the age group ≥ 60 years old showed the highest antibody ratios (IgA mean ratio = 3.080 ± 1.623; IgG mean ratio = 4.221 ± 1.832), while the age groups 13–19 and 20–29 showed the lowest IgA (mean ratio = 2.268 ± 0.919) and IgG ratios (mean ratio = 2.207 ± 1.246), respectively. Individuals leaving the home more frequently were at higher risk of infection (Odds ratio (OD) 2.61; 95% CI 1.00–1.49; p = 0.048). Five or more individuals per household increased fivefold the risk of virus transmission (OR 2.56; 95% CI 1.09–6.01; p = 0.019). The disproportionate dissemination of SARS-CoV-2 infection observed among the study population might be driven by typical cultural behavior and socioeconomic inequalities. Despite the pandemic threat, this population is not being targeted by public policies and appears to be chronically invisible to the Brazilian authorities.

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“…Brazil should implement measures to deal with the pandemic considering the vulnerability groups related to COVID-19 being the Indigenous peoples the most vulnerable to infection with SARS-CoV-2 and the most impoverished monetarily [35]. Furthermore, Brown and Black people are more vulnerable to infection with SARS-CoV-2 than White and Asian groups, and the states with greatest vulnerability deserve more attention to control the pandemic [35].…”

Section: How the Sars-cov-2 Spread Among Indigenous Peoples Could Have Been Preventedmentioning

confidence: 99%

COVID-19 pandemic evolution in the Brazilian Indigenous population

Mendes

Pereira

Lima

et al. 2021

J. Racial and Ethnic Health Disparities

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Introduction The COVID-19 pandemic has affected several neglected populations such as the Indigenous peoples, which have suffered a high impact from the pandemic. Objectives To analyze the impact on the health and disease process according to the COVID-19 evolution in the Brazilian Indigenous population. Methods Data was collected from press releases by the Health Ministry and a descriptive analysis of the numbers of Indigenous individuals infected with the SARS-CoV-2 in Brazil was carried out. Results In February 2021, there were 41,855 confirmed cases of Indigenous individuals infected by the SARS-CoV-2, including 4,387 active cases, 36,809 recovered cases, and 549 deaths. The Brazilian Indigenous population is distributed in over 300 ethnic groups and, due to the high number of deaths by the COVID-19, many of these groups are endangered. The elderly are the most affected age group, and they play a fundamental role among the Indigenous population for transmitting their customs mainly orally. Indigenous populations do not have proper access to transport to specialized health centers, since many areas are inaccessible and other cases require air or river transportation, which many times results in late assistance. When managing the COVID-19, it is important to emphasize the need for social isolation to prevent the virus from spreading among the Indigenous groups, mainly due to their contact with other ethnic groups represented by missionaries, hunters, and wood explorers, among others. Conclusion The adoption of practices that can reduce the virus transmission among the Indigenous population and provide them with better access to treatment, mainly for the elderly, must be prioritized in Brazil.

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The pandemic of poverty, vulnerability, and COVID-19: Evidence from a fuzzy multidimensional analysis of deprivations in Brazil

Cited by 97 publications

References 20 publications

Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020

Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020

Increased vulnerability to SARS-CoV-2 infection among indigenous people living in the urban area of Manaus

COVID-19 pandemic evolution in the Brazilian Indigenous population

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