key: cord-336064-8b5cvll7
authors: Bolaño-Ortiz, Tomás R.; Camargo-Caicedo, Yiniva; Puliafito, Salvador Enrique; Ruggeri, María Florencia; Bolaño-Diaz, Sindy; Pascual-Flores, Romina; Saturno, Jorge; Ibarra-Espinosa, Sergio; Mayol-Bracero, Olga L.; Torres-Delgado, Elvis; Cereceda-Balic, Francisco
title: Spread of SARS-CoV-2 through Latin America and the Caribbean region: a look from its economic conditions, climate and air pollution indicators
date: 2020-07-15
journal: Environ Res
DOI: 10.1016/j.envres.2020.109938
sha: 
doc_id: 336064
cord_uid: 8b5cvll7

We have evaluated the spread of SARS-CoV-2 through Latin America and the Caribbean (LAC) region by means of a correlation between climate and air pollution indicators, namely, average temperature, minimum temperature, maximum temperature, rainfall, average relative humidity, wind speed, and air pollution indicators PM(10), PM(2.5), and NO(2) with the COVID-19 daily new cases and deaths. The study focuses in the following LAC cities: Mexico City (Mexico), Santo Domingo (Dominican Republic), San Juan (Puerto Rico), Bogotá (Colombia), Guayaquil (Ecuador), Manaus (Brazil), Lima (Perú), Santiago (Chile), São Paulo (Brazil) and Buenos Aires (Argentina). The results show that average temperature, minimum temperature, and air quality were significantly associated with the spread of COVID-19 in LAC. Additionally, humidity, wind speed and rainfall showed a significant relationship with daily cases, total cases and mortality for various cities. Income inequality and poverty levels were also considered as a variable for qualitative analysis. Our findings suggest that and income inequality and poverty levels in the cities analyzed were related to the spread of COVID-19 positive and negative, respectively. These results might help decision-makers to design future strategies to tackle the spread of COVID-19 in LAC and around the world.

The outbreak of the new Coronavirus Disease 2019 , caused by the Severe Acute Respiratory Syndrome -Corona Virus 2 (SARS-CoV-2) likely started in the city of Wuhan, China, at the end of 2019. The virus spread rapidly, becoming an epidemic event in almost all countries and, on March 11, 2020, the World Health Organization (WHO) declared it a pandemic (WHO, 2020) . By May 31, 2020, there were 5,934,936 confirmed cases of COVID-19 and 367,166 deaths reported globally (WHO, 2020) . COVID-19 is an acute respiratory disease, some of its most frequent manifestations are pneumonia that includes fever, cough and dyspnea (Jiang et al., 2020) . In addition, some studies show that it has an approximate mortality rate of 2 to 3% (Rodriguez-Morales et al., 2020) .

In Latin America and the Caribbean (LAC), the first confirmed case of COVID-19 was reported in São Paulo (Brazil) on February 25, 2020, and other hotspots of the disease were identified later throughout different LAC countries. Argentina reported the first death on March 7, 2020. By the end of May 2020, LAC was recognized as the new focus of the led by Brazil (465, 166) , Perú (148, 285) and Chile (94, 858) with the highest number of confirmed cases. Across the LAC region, there are 932,807 confirmed cases and 48,936 deaths (WHO, 2020). Dalziel et al. (2018) found that climatic conditions are the main predictors of coronavirus diseases. Beelen et at. (2014) showed how important the continuing effects of air pollution are on people's health. Other studies show that air pollution increases hospitalizations for respiratory virus bronchiolitis (Carugno et al., 2018; Nenna et al., 2017) , damages the immune system of people (Liao et al., 2011) and increases asthma incidence (Glencross et al., 2020) . Yuan et al. (2006) showed that wind speed, humidity and temperature are relevant in the transmission of infectious diseases. In addition, the increase in the mortality rate from pneumonia is highly correlated with climatic changes (Bull, 1980) . Recently, several studies demonstrate significant relationships between COVID-19 spread with temperature, humidity, rainfall, and wind speed (Bashir et al., 2020b; Coccia, 2020a; Tosepu et al., 2020; Xie and Zhu, 2020) . COVID-19 pandemic lockdowns generates have generated improvements in air quality (Collivignarelli et al., 2020; Dantas et al., 2020; Mahato et al., 2020; Nakada and Urban, 2020; Sharma et al., 2020; Zambrano-Monserrate et al., 2020) . Nevertheless, air quality is also important in the control of COVID-19. Fattorini et al (2020) provides evidence on the possible influence of air quality, particularly in terms of chronicity of exposure to disseminated viral infection in Italian regions. Studies conducted in Italy show that accelerated transmission dynamics of COVID-19 is mainly due to the mechanism of air pollution-tohuman transmission, rather than human-to-human transmission (Coccia, 2020b) . found a significant relationship and positive associations of NO 2 , PM 10 , PM 2.5 , CO, and O 3 with COVID-19 confirmed cases in China. While showed that airborne concentration of PM 2.5 is associated with an increase in the COVID-19 death rate in the United States. High atmospheric concentrations of NO 2 indicate that long-term exposure to this pollutant may be one of the most important contributors to mortality caused by the COVID-19 virus in several countries in Europe (Ogen, 2020) . Although several studies have found viral material in suspended aerosol particles, the viability of infectious virus embedded on airborne particles is still under debate (Lewis, 2020) .

Socioeconomic conditions also demonstrate to play a role in the spread of infectious viral diseases such as COVID-19. Social distancing and emergency shutdown measures due to the COVID-19 pandemic lead to other impacts, such as job loss, sudden fall into extreme poverty, economic crisis, hunger and inability to face social hatred (Shammi et al., 2020) . Furthermore, Sarmadi et at. (2020) analyzed the global correlation of COVID-19 cases and deaths with the gross domestic product (GDP) per capita. Their results showed a significant correlation in GDP per capita with cases and deaths due to COVID-19. Previous studies exposed that, in many LAC countries, mortality from respiratory disease gradually fell between 1998 and 2008. Nevertheless, this downward trend came to a halt in 2009, probably as a result of the 2009 global H1N1 influenza virus pandemic (WHO, 2013) . COVID-19 is spreading throughout LAC and worldwide, in addition, a second wave of COVID-19 seems possible (Leung et al., 2020; Price et al., 2019) . Several studies display that many regional and local factors could mark the rapid spread of COVID-19 (Y. Wu et al., 2020a; Yuan et al., 2006) . Recent studies have shown that climate and air pollution indicators are correlated with the spread of COVID-19 in Oslo, Norway, Jakarta, Indonesia, New York City, and California in the United States (Bashir et al., 2020b (Bashir et al., , 2020a Menebo, 2020; Tosepu et al., 2020) . On the other hand, Bontempi et al. (2020) found that detailed COVID-19 data should be taken in to account, at least at the regional level, considering that there is inequality and heterogeneity in international trade relations. Thus, it is important to analyze the relationship between climate and air pollution indicators with the spread of COVID-19, to expand knowledge and predict the possible scenarios in the next weeks and months. Here we present a study of the correlation of average temperature, minimum temperature, maximum temperature, rainfall, average relative humidity, wind speed, and air quality (PM 10 , PM 2.5 , and NO 2 ) with the new cases, total cases, and new deaths from COVID-19 in 10 cities located in LAC. In addition, we also analyzed the relationship of COVID-19 cases with various socioeconomic indicators. Our study focuses on statistical analyzes of the association between COVID-19 cases and deaths with climatic, air quality, and socioeconomic indicators. Particularly, this study can explain, some of the factors that control the acceleration of infection and mortality of the COVIC-19 pandemic in specific regions of LAC, and guide policymakers to prevent future epidemics similar to COVID-19 (Coccia, 2020b; Cooper et al., 2006; Kucharski et al., 2015) . This study delivers results to design a strategy to tackle the current COVID-19 pandemic and prevent future epidemics similar to COVID-19, that generate health and socioeconomic problems for nations and the world (Coccia, 2020b; EIU, 2020) .

LAC comprises more than 20 million km 2 of surface ( Fig. 1 . Location of cities under study in the Latin America and the Caribbean (LAC) region. Number of COVID-19 confirmed cases as of 31 May 2020 are indicated by color scale.), which corresponds to approximately 13.5% of the emerging surface of the planet. It has a population, based on projections, of more than 650 million inhabitants (ECLA, 2020) distributed in several countries linked by historical, cultural and economic ties.

According to the World Bank (WBG, 2020), its largest cities are Mexico City, São Paulo, and Buenos Aires. The economy of LAC, assuming market prices (purchasing power parity), is the third largest in the world. Also, LAC has great diversity and geographical extension (32.5° N -55.3° S).

The data for COVID-19 were collected from April 1 to May 31, 2020 (N=61), using available data (see Table 1 . Population, Population density, Human Development Index of cities analyzed and Gini index by LAC countries. The dates of the first case and the start of activities or measures implemented to prevent the spread of COVID-1) for the different LAC cities as shown in Fig. 1 and other related institutions of each country. Data for climate indicators included average temperature, minimum temperature, maximum temperature, rainfall, average relative humidity, wind speed, and urban air quality (PM 10 , PM 2.5 , and NO 2 ). In addition, COVID-19 data included the number of new cases, total cases, and mortality. The dataset of COVID-19 infections and their deaths, were reported by the date of diagnosis (day 0), so to assume that the infection was on previous days, it was also correlated with climate and pollution indicators of 5, 6 and 14 days prior.

The data for the economic analysis used the Gini index from the United Nations Development Program in Latin America and the Caribbean, and poverty levels from the Economic Commission for Latin America (ECLAC), as one of the five regional commissions of the United Nations (ECLAC, 2020a, 2020b).

The Spearman rank correlation tests were used to examine the correlation between climate indicators and COVID-19 variables (daily cases and deaths), because the dataset had a non-normal distribution. This was verified previously by the Shapiro-Wilk normality test. Finally, the spread of COVID-19 is related to the economic characteristics observed in LAC. 

During the studied period, we analyzed the daily behavior of total cases and deaths from COVID-19

in the 10 LAC cities (Fig. 2 . Cases of COVID-19 in several cities of Latin America and the Caribbean. Green and blue lines indicate the total confirmed cases and total deaths, respectively).

The climate indicator data analyzed (shown in Table 2 ), consisted of minimum temperature (°C), maximum temperature (°C), average temperature (°C), humidity (%), rainfall (mm/day) and wind speed (m/s). In addition, air quality indicators such as PM 10 (μg/m 3 ), PM 2.5 (μg/m 3 ), and NO 2 mixing ratio (ppb) from the cities that had these data available, were used. The statistical correlation was done by using Spearman rank correlation tests between these variables and new cases of COVID-19 (Table 3 . Empirical results of the Spearman rank correlation tests for new cases on every city analyzed), total cases of COVID-19 (Table 4) , and new deaths of COVID-19 (Table 5) . Moreover, the infection rate by COVID-19 in each city (per 100,000 inhabitants) was related to socioeconomic indicators, such as the Gini index and the levels of poverty in the countries analyzed in LAC.

As of May 31, 2020, a total of 316,358 confirmed cumulative cases and 12,005 cumulative deaths were documented in the 10 LAC cities analyzed, being Lima, Santiago, São Paulo and Mexico City the cities with more cases of infections and deaths in LAC (WHO, 2020). All cities showed an accelerated increase in cases and deaths, except Guayaquil, which began to flatten the curve of cases and deaths since the beginning of May. Santiago and Lima were the two cities with the highest daily increase in infections ( Fig. 2 Table 2 ). Some of the cities studied are in the extratropical zone and present seasonal variations. On April and May 2020, such as, it is spring on Mexico City and autumn on Santiago. For this reason, a decrease in temperature was observed in Lima, Santiago, São Paulo and Buenos Aires (shown in Suppl. Mat. Fig. S1 ). This explains their temperatures, that are related to the seasonal changes (Poole, 2020) .

correlation with daily cases in Mexico City, Santo Domingo, San Juan, Guayaquil, Lima, São Paulo, Santiago and Buenos Aires (Table 3 ). Significant correlations were also found between those parameters and the total cases in Mexico City, Santo Domingo, San Juan, Guayaquil, Lima, São

Paulo, Santiago and Buenos Aires (Table 4 ). Mortality also showed correlation with the temperature in Mexico City, Guayaquil, Lima, Santiago and Buenos Aires ( Table 5 ). The cities located in the tropical zone (Santo Domingo, San Juan and Guayaquil) showed a significant positive correlation with temperature. These results coincide with previous research, that exposes the correlation between climate transmission and respiration of some viruses (Bashir et al., 2020b; Tan et al., 2005; Tosepu et al., 2020) . Meanwhile, contagion cases show significant negative correlation with temperature in Mexico City, Lima, São Paulo, Santiago and Buenos Aires. Particularly, for number of the new and total cases, Lima, São Paulo, Santiago and Buenos Aires were the cities with the highest negative correlation (<-0.6; p <0.01), these cities were entering their winter season, so temperatures were decreasing. Thus, these correlations suggest that COVID-19 cases increase with the temperature decrease observed (Suppl. Mat. Fig. S1 ). This is consistent with other studies that have examined the association between the circulation of the respiratory virus and climatic factors, showing that the epidemiology related to these viral diseases has a peak incidence in the winter months (Dowell et al., 2003; Kim et al., 1996; Talbot et al., 2005) . Moreover, other recent studies showed that temperature was negatively related to the daily new cases and daily new deaths of COVID-19 (Coccia, 2020b; Y. Wu et al., 2020b) . However, new cases showed that they had no relationship with temperature in Bogotá and Manaus, nor did mortality with temperature in Santo Domingo and Lima (Table 3 and Table 4 ). These findings were steady with other studies (Yao et al., 2020a) Several of the cities in LAC showed significant correlations between humidity, wind speed and rainfall with new cases (Table 3) , total cases (Table 4) , and mortality of COVID-19, which are shown on Table 5 . In the case of Santo Domingo, San Juan, and São Paulo, a negative correlation was found between total cases and humidity. Furthermore, previous studies (Dalziel et al., 2018; Tosepu et al., 2020; Y. Wu et al., 2020a; Yuan et al., 2006) showed that humidity is negatively correlated with new cases and daily new deaths. These results are consistent with our findings in Santo Domingo, San Juan, and São Paulo. Regarding the amount of rainfall, Buenos Aires presented the highest precipitation during this study with 41.9 mm (Table 2 ) and presented a negative correlation with new cases. This suggests that precipitation had a significant effect in stopping infections, which was also observed in Hong Kong, associated more rainfall with fewer coronavirus-like viruses (Wang et al., 2018) . Although México City, Bogotá, Guayaquil, and São Paulo showed a positive correlation, this is related to the increase of respiratory illness caused by virus during the rainy season (Fares, 2013; Fisman, 2012) . This study also found that wind speed presented significant correlations with new cases, total cases and mortality, for various cities. Santiago was the city that showed, on lag day -14, the highest negative correlations for new cases (-0.72; p < 0.01), total cases (-0.76; p < 0.01), and mortality (-0.60; p < 0.01). This is in line with previous studies (Ellwanger and Chies, 2018) . Furthermore, the investigation by Coccia (2020b Coccia ( , 2020a shown a higher number of infected individuals than coastal cities (Coccia, 2020b) . In this direction, our study showed similar results. For instance, Santiago and Buenos Aires, both cities are located at mid latitude in South America. However, Santiago (inland) showed maximum values of PM 10 (108 μg/m 3 ), while Buenos Aires (coastal city) showed maximum values in 38.82 μg/m 3 of PM 10 , and a low contagion rate (269 per 100,000 inhabitants). In fact, our results also suggest that wind speed cleanses the air of contaminants associated with possible transmission dynamics of viral infectivity (Coccia, 2020a (Coccia, , 2020b Xu et al., 2020) .

The air quality data, including PM 2.5 , PM 10 and NO 2 mixing ratios was only available for six of the cities under study: México City, San Juan, Bogotá, Santiago, São Paulo, and Buenos Aires. The air quality in terms of PM 10 and PM 2.5 has improved during COVID-19 pandemic lockdown in LAC (shown in Suppl. Mat. Fig. S2 and Fig. S3 ). In general, significant correlations were found in these cities, for the number of new cases (Table 3) , total cases (Table 4 ) and mortality (Table 5) York city and California in the United States (Bashir et al., 2020b (Bashir et al., , 2020a . On the contrary, São

Paulo, Santiago and Buenos Aires showed a significant positive correlation between deaths from COVID-19 and the analyzed air pollution indicators (Table 5 ). These correlations are in the same direction as recent research. Research conducted in China, that found COVID-19 had higher mortality rates with increasing concentration of PM 2.5 and PM 10 levels on the spatial scale . Similarly, in the United States, a 15% increase in the COVID-19 death rate related to increases that only 1 μg/m 3 in PM 2.5 was observed . In addition to this, other studies found similar results (Yao et al., 2020b) .

In this direction, the lockdown is also important because it reduces the generation of pollution and reduces social contact. Recent studies showed reductions in atmospheric emissions due to comprehensive lockdown measures in Europe and China (Collivignarelli et al., 2020; Muhammad et al., 2020) . It is important to note that the correlation between air pollutant indicators and COVID-19

cases and mortality, can be misleading given the diversity of mobility restriction measures in the different cities. A recent study conducted in Italy showed that the role of airborne PM 10 for the SARS-CoV-2 virus diffusion is not evident (E Bontempi, 2020). Our findings supported that, in most of the analyzed cities, the fine particulate matter (PM 2.5 ) is better correlated with the SARS-CoV-2 virus than PM 10 . Other studies (Ogen, 2020) Development Bank (IDB) has projected LAC regional GDP growth of 1.6% during 2020, however, now estimates a drop of between 1.8% and 5.5% due to the COVID-19 pandemic (IDB, 2020).

America showed that economic growth and trade openness are associated with lower poverty (Huang et al., 2010) . Establishing new businesses in cities is often proposed as an alternative to reduce their poverty levels (Bartik, 2005 Mexico City Table 4 . Empirical results of the Spearman rank correlation tests for total cases on every city analyzed. The colors indicate stands for 1%, 5%, and 10% level of significance, respectively. The middle hyphen (-) indicates the data was not available. Table 5 . Empirical results of the Spearman rank correlation tests for mortality on every city analyzed. The colors indicate stands for 1%, 5%, and 10% level of significance, respectively. The middle hyphen (-) indicates the data was not available.

Our findings, if confirmed by future studies, provide strong evidence regarding the association of COVID-19 spread with various socioeconomic, pollutants and climate indicators in the LAC region.

However, it presents limitations. COVID-19 is an infectious disease that is related to additional variables that must be considered in a comprehensive study. Also, in future research, it would be interesting to study relations between air pollutants such as SO 2 , black carbon and SARS-CoV-2 embedded in PM 2.5 particles. In addition, socio-economic aspects such as measures of social distancing, full and partial shutdown, personal hygiene, among others, should also be explored.

This study was an exploratory approach to correlate climatic indicators like average temperature, minimum temperature, maximum temperature, humidity, rain, wind speed, and air quality indicators for PM 10 , PM 2.5 , and NO 2 with the incidence of COVID-19 daily cases and the mortality rate in different cities in the LAC region. We have found that the incidence rate of COVID-19 cases shows a negative correlation with wind speed, whereas with air pollution indicators, there was a positive correlation in several LAC cities. One could hypothesize that low wind speed generates less ventilation, therefore, a higher concentration of pollutants or air contaminated with the SARS- • The low wind speed generates less ventilation, then a higher concentration of pollutants or air contaminated with the SARS-CoV-2 virus can be inhaled in various cities of Latin America and the Caribbean.

• The climate and pollution indicators are one of the factors that triggered the spread of Covid-19 through Latin America and the Caribbean.

• The COVID-19 spread is significantly correlated with PM 10 , PM 2.5 and NO 2 in several cities of Latin America and the Caribbean.

• The income inequality and poverty levels of the cities analyzed in Latin America and the Caribbean are related to the spread of COVID-19.

While the cities with the lowest infection rate by COVID-19 were San Juan, Bogotá and Santo Domingo with 43

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We thank Adrian Covaci and Xavier Querol for their review and comments to improve our paper.Also, the authors are thankful to the Latin America Early Career Earth System Scientist Network (LAECESS) for encouraging collaborative scientific work among researchers in LAC.

On behalf of all author, the corresponding author states that there is no conflict of interest. 

☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: