Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Political Science, University of São Paulo (USP), Sao Paulo, SP, Brazil.
Science. 2021 May 21;372(6544):821-826. doi: 10.1126/science.abh1558. Epub 2021 Apr 14.
Brazil has been severely hit by COVID-19, with rapid spatial spread of both cases and deaths. We used daily data on reported cases and deaths to understand, measure, and compare the spatiotemporal pattern of the spread across municipalities. Indicators of clustering, trajectories, speed, and intensity of the movement of COVID-19 to interior areas, combined with indices of policy measures, show that although no single narrative explains the diversity in the spread, an overall failure of implementing prompt, coordinated, and equitable responses in a context of stark local inequalities fueled disease spread. This resulted in high and unequal infection and mortality burdens. With a current surge in cases and deaths and several variants of concern in circulation, failure to mitigate the spread could further aggravate the burden.
巴西受到了 COVID-19 的严重打击,病例和死亡人数迅速在空间上扩散。我们使用了每日报告病例和死亡数据,以了解、衡量和比较各市镇之间传播的时空模式。聚集、轨迹、速度和 COVID-19 向内陆地区移动的强度等指标,以及政策措施指标表明,尽管没有单一的说法可以解释传播的多样性,但在地方不平等明显的情况下,未能迅速、协调和公平地采取应对措施,导致疾病传播。这导致了高且不平等的感染和死亡负担。由于当前病例和死亡人数的激增,以及几种令人担忧的变异株的传播,如果不能减轻传播,负担可能会进一步加重。