Detecting space-time clusters of COVID-19 in Brazil: mortality, inequality, socioeconomic vulnerability, and the relative risk of the disease in Brazilian municipalities

Martines, Marcos Roberto; Ferreira, Ricardo Vicente; Toppa, Rogerio H; Assuncao, Luiza; Desjardins, Michael Richard; Delmelle, Eric M

The first case of COVID-19 in South America occurred in Brazil on February 25th, 2020. By June 7th, 2020, there were 691,758 confirmed cases, 36,455 confirmed deaths, and a mortality rate of 5.3%. To assist with the establishment of measures for the strategic planning to combat the COVID-19 pandemic in Brazil, we present the first Brazilian geographic study with the aims to examine active hand emerging space-time clusters of COVID-19. We examine the associations between clusters and mortality rate, vulnerability, and social inequality. We used the prospective space-time scan statistic to detect daily COVID-19 clusters and examine the relative risk from February 25th-June 7th, 2020 in 5,570 Brazilian municipalities. We apply a Spearman statistic to measure correlation between the relative risk of each cluster and mortality rate, GINI index, and social inequality. We detected 11 emerging space-time clusters of COVID-19 occurring in all Brazilian regions, with seven of them with a relative risk greater than one, and the highest in the Amapa state in the northern region of Brazil. We observed a positive and significant correlation between the relative risk and mortality rate, Brazilian Social Vulnerability Index, and GINI Index. The results can be utilized to improve COVID-19 response and planning in all Brazilian states.