Expected impact of COVID-19 outbreak in a major metropolitan area in Brazil

Descrição do produto

In January 2020 China reported to the World Health Organization an outbreak of pneumonia of
undetermined origin in the city of Wuhan, Hubei. In January 30, 2020, the World Health
Organization declared the outbreak of COVID-19 as a Public Health Emergency of International
Interest (PHEI). Objectives: The aim of this study is to assess the impact of a COVID-19
epidemic in the metropolitan region of São Paulo, Brazil. Methods: We used a generalized
SEIR (Susceptibles, Exposed, Infectious, Recovered) model, with additional Hospitalized
variables (SEIHR model) and age-stratified structure to analyze the expected time evolution
during the onset of the epidemic in the metropolitan area of São Paulo. The model allows to
determine the evolution of the number of cases, the number of patients admitted to hospitals and
deaths caused by COVID-19. In order to investigate the sensibility of our results with respect to
parameter estimation errors we performed Monte Carlo analysis with 100 000 simulations by
sampling parameter values from an uniform distribution in the confidence interval. Results: We
estimate 1 368 (IQR: 880, 2 407) cases, 301 (22%) in older people (60 years), 81 (50, 143)
hospitalizations, and 14 (9, 26) deaths in the first 30 days, and 38 583 (IQR: 16 698, 113, 163)
cases, 8 427 (21.8%) in older people (60 years), 2181 (914, 6392) hospitalizations, and
397(166, 1205) deaths in the first 60 days. Limitations: We supposed a constant transmission
probability Pc among different age-groups, and that every severe and critic case will be
hospitalized, as well as that the detection capacity in all the primary healthcare services does not
change during the outbreak. Conclusion: Supposing the reported parameters in the literature
apply in the city of São Paulo, our study shows that it is expected that the impact of a COVID-19
outbreak will be important, requiring special planning from the authorities. This is the first study
for a major metropolitan center in the south hemisphere, and we believe it can provide policy
makers with a prognosis of the burden of the pandemic not only in Brazil, but also in other
tropical zones, allowing to estimate total cases, hospitalization and deaths, in support to the
management of the public health emergence caused by COVID-19.