key: cord-320785-42p8292o
authors: Lobo, Andréa de Paula; Cardoso-dos-Santos, Augusto César; Rocha, Marli Souza; Pinheiro, Rejane Sobrino; Bremm, João Matheus; Macário, Eduardo Marques; Oliveira, Wanderson Klébler de; França, Giovanny Vinícius Araújo de
title: COVID-19 epidemic in Brazil: where we at?
date: 2020-06-16
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2020.06.044
sha: 
doc_id: 320785
cord_uid: 42p8292o

Abstract Objetive to analyze the trends of COVID-19 in Brazil in 2020 by Federal Units (FU). Method ecological time-series based on cumulative confirmed cases of COVID-19 from March 11 to May 12. Joinpoint regression models were applied to identify points of inflection in COVID-19 trends, considering the days since the 50th confirmed case as time unit. Results Brazil reached the 50th confirmed case of COVID-19 in 11 March 2020 and, 63 days after that, on May 12, 177,589 cases had been confirmed. The trends for all regions and FU are upward. In the last segment, from the 31st to the 63rd day, Brazil presented a DPC of 7.3% (95%CI= 7.2;7.5). For the country the ADPC was 14.2% (95%CI: 13.8;14.5). The highest ADPC values were found in the North, Northeast and Southeast regions. Conclusions In summary, our results show that all FUs in Brazil present upward trends of COVID-19. In some FUs, the slowdown in DPC in the last segment must be considered carefully. Each FUs is at a different stage of the pandemic and, therefore, non-pharmacological measures must be applied accordingly.

J o u r n a l P r e -p r o o f 4 of the epidemic (around 45-50 days after the 50 th case), compared other states, such as Rondônia, Sergipe and Tocantins. Some FUs, such as Pará, Pernambuco, São Paulo, Paraná, and Goiás showed a reduction in DPC in last segment in comparison with the previous one (Table 1) .

Discussion: Although all FUs presented upward trends in the number of cumulative cases of COVID-19, 18 out of 27 FUs showed a reduction in the pace of the trend in the last segment. This may be related to the non-pharmacological measures adopted. 3, 4 Despite the recent slowdown, 25 FUs still present significant upward trends.

Some of them, such as Amazonas, Rio Grande do South[AdPL7], Mato Grosso, Mato Grosso do South [AdPL8]and Distrito Federal even showed an increase in the DPC in the last segment. We highlight that the FUs are at different stages of the epidemic, which can also explain those differences.

Even though the FUs from the Southeast region presented most of the confirmed cases, the highest ADPC values were found in the Northeast and North regions. This is particularly troublesome because these regions present the lowest human development indices, and the highest proportion of poverty and low education rates in

Some factors may have affected the inflections of the curves, such as the availability of diagnostic tests and the sensitivity of the epidemiological and laboratory surveillance system. 4,6 As we used publicly available data, analyses were performed using the notification date rather than the symptoms onset date, as well as the cumulative cases instead of incident cases.

In future analyzes, other information will be added to investigate the inflections in the curve of a given territory, such as the validity of municipal or state decrees (lock-down 

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

This work was developed with secondary data and approval by an ethics committee is not necessary. (36.9;58.8) 3-11 13.8*(12.7;14.9) 11-20 8.1*(7.2;9.0 • All of Federative Units in Brazil shows a upward in accumulated cases of COVID-19.

• The highest increment were find in the North, Northeast and Southeast regions.

• Each Federative Unit in Brazil is at a different stage of the COVID-19 pandemic. 

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