Association between COVID-19, mobility and environment in Sao Paulo, Brazil

Ibarra-Espinosa, S.; Dias de Freitas, E.; Ropkins, K.; Dominici, F.; Rehbein, A.

Background Brazil, the country most impacted by the coronavirus disease 2019 (COVID-19) on the southern hemisphere, uses mobility indices to monitor quarantines. In this study, we quantified the associations between residential mobility index (RMI), air pollution, meteorology, and daily cases and deaths of COVID-19 in Sao Paulo, Brazil Objectives To acquire time-series data to estimate the associations between daily residential mobility index (RMI), air pollution, and meteorology, and daily cases and deaths for COVID-19 in Sao Paulo, Brazil. Methods We applied a semiparametric generalized additive model (GAM) to estimate: 1) the association between residential mobility index and cases and deaths due to COVID-19, accounting for ambient particulate matter (PM2.5), ozone (O3), relative humidity, temperature and delayed exposure between 3-21 days and 2) the association between exposure to for ambient particulate matter (PM2.5), ozone (O3), accounting for relative humidity, temperature and mobility. Results We found an RMI of 45.28% results in 1,212 cases (95% CI: 1,189 to 1,235) and 44 deaths (95% CI: 40 to 47). Reducing mobility 5% would avoid 438 cases and 21 deaths. Also, we found that an increment of 10 g m-3 of PM2.5 risk of 1.140 (95% CI: 1.021 to 1.274) for cases and of 1.086 (95% CI: 1.008 to 1.170 for deaths, while O3 produces a relative risk of 1.075 (95% CI: 1.006 to 1.150) for cases and 1.063 (95% CI: 1.006 to 1.124) for deaths, respectively. Discussion We compared our results with observations and literature review, finding well agreement. These results implicate that authorities and policymakers can use such mobility indices as tools to support social distance activities and assess their effectiveness in the coming weeks and months. Small increments of air pollution pose a risk of COVID-19 cases. Conclusion Spatial distancing is a determinant factor to control cases and deaths for COVID-19. Small increments of air pollution result in a high number of COVID-19 cases and deaths. PM2.5 has higher relative risks for COVID-19 than O3.