Report 21: Estimating COVID-19 cases and reproduction number in Brazil
File(s)2020-05-08 COVID19 Report 21.pdf (5.32 MB)
Published version
Author(s)
Type
Report
Abstract
Brazil is an epicentre for COVID-19 in Latin America. In this report we describe the Brazilian epidemic
using three epidemiological measures: the number of infections, the number of deaths and the reproduction number. Our modelling framework requires sufficient death data to estimate trends, and we
therefore limit our analysis to 16 states that have experienced a total of more than fifty deaths. The
distribution of deaths among states is highly heterogeneous, with 5 states—São Paulo, Rio de Janeiro,
Ceará, Pernambuco and Amazonas—accounting for 81% of deaths reported to date. In these states, we
estimate that the percentage of people that have been infected with SARS-CoV-2 ranges from 3.3% (95%
CI: 2.8%-3.7%) in São Paulo to 10.6% (95% CI: 8.8%-12.1%) in Amazonas. The reproduction number (a
measure of transmission intensity) at the start of the epidemic meant that an infected individual would
infect three or four others on average. Following non-pharmaceutical interventions such as school closures and decreases in population mobility, we show that the reproduction number has dropped substantially in each state. However, for all 16 states we study, we estimate with high confidence that the
reproduction number remains above 1. A reproduction number above 1 means that the epidemic is
not yet controlled and will continue to grow. These trends are in stark contrast to other major COVID19 epidemics in Europe and Asia where enforced lockdowns have successfully driven the reproduction
number below 1. While the Brazilian epidemic is still relatively nascent on a national scale, our results
suggest that further action is needed to limit spread and prevent health system overload.
using three epidemiological measures: the number of infections, the number of deaths and the reproduction number. Our modelling framework requires sufficient death data to estimate trends, and we
therefore limit our analysis to 16 states that have experienced a total of more than fifty deaths. The
distribution of deaths among states is highly heterogeneous, with 5 states—São Paulo, Rio de Janeiro,
Ceará, Pernambuco and Amazonas—accounting for 81% of deaths reported to date. In these states, we
estimate that the percentage of people that have been infected with SARS-CoV-2 ranges from 3.3% (95%
CI: 2.8%-3.7%) in São Paulo to 10.6% (95% CI: 8.8%-12.1%) in Amazonas. The reproduction number (a
measure of transmission intensity) at the start of the epidemic meant that an infected individual would
infect three or four others on average. Following non-pharmaceutical interventions such as school closures and decreases in population mobility, we show that the reproduction number has dropped substantially in each state. However, for all 16 states we study, we estimate with high confidence that the
reproduction number remains above 1. A reproduction number above 1 means that the epidemic is
not yet controlled and will continue to grow. These trends are in stark contrast to other major COVID19 epidemics in Europe and Asia where enforced lockdowns have successfully driven the reproduction
number below 1. While the Brazilian epidemic is still relatively nascent on a national scale, our results
suggest that further action is needed to limit spread and prevent health system overload.
Date Issued
2020-05-08
Citation
2020, pp.1-24
Start Page
1
End Page
24
Sponsor
Medical Research Council (MRC)
Identifier
https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-05-08-COVID19-Report-21.pdf
Grant Number
MR/R015600/1
Subjects
COVID-19
COVID19
Coronavirus
Brazil
Publication Status
Published