Severe airport sanitarian control could slow down the spreading of COVID-19 pandemics in Brazil

Servio Pontes Ribeiro; Wesley Dattilo; Alcides Castro e Silva; Alexandre Barbosa Reis; Aristoteles Goes-Neto; Luiz Alcantara; Marta Giovanetti; Wendel Coura-vital; Geraldo Wilson Fernandes; Vasco Ariston Azevedo

The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/2020.03.26.20044370 doi: medRxiv preprint 234 network of Brazil, which is also key for the whole Latin America, if not properly 235 monitored and controlled, may cause a window of opportunity for the virus to spread 236 over the entire continent. 237 The consequences of this uncontrolled SARS-Cov-2 spreading is particularly 238 serious if one takes into consideration the chances of a mutant virulent strain appearing 239 and spreading into poorer and little monitored places of the world. Specifically, for the 240 Amazon region, the lack of any control will make the city of Manaus a very sensitive 241 cluster for public health, due to predominantly poor and indigenous-dominated cities in 242 the region, which are connected to Manaus and will be rapidly infected. Reaching 243 isolated regions means reaching indigenous or traditional communities, whose 244 individuals are classically more susceptible to new pathogens than western-influenced 245 or mixed urban populations. Therefore, a way to prevent such spreading, if still there is 246 time, would be to deal with airports as entrances that need severe infection barriers. The eventual lesson to take is that inflexible, severe, and easy to repeat 250 controlling protocols must be applied to all the cities with airports. Likewise, the follow-251 up monitoring of suspicious individuals and their living network should be reinforced as 252 a national strategy to prevent a large territory to be taken over by a pandemic in a short 253 period of time. In other words, internationally accepted procedures must be taken and 254 even be reviewed to adjust to complex national flight networks of any country. Such 255 procedures must be considered as a priority for national remote airports too, in order to 256 keep poorer and worse equipped cities away from a rapid spread of a pandemic 257 disease. 258 It is clear at this point that a fast spread of the SARS-CoV-2 is a reality in Brazil, 259 and across most of the country. We proposed this model in order to emphasize the 260 fragility of Brazilian surveillance in the airport network, in an attempt to cause some 261 policy change in time to preserve at least the most remote regions, which are also the 262 most vulnerable, with a weaker health service. Moreover, most of the Eastern part of the 263 country must stay in social isolation in order to prevent a health public collapse by mid-264 April, as the Ministry of Health predicted. In addition, we also could consider the 265 generalized poverty of Brazil as a further problem our model did not deal with. The 266 chances to produce home-to-home isolation, even legally imposed, is impossible for 267 these poor communities. Nonetheless, considering the few main entrances of most of 268 the Brazilian shanty towns and communities, a similar to airport entrance severe control 269 must be considered to protect a larger but closely connected set of people, eventually 270 following the protocols used for control of Ebola during the last epidemic in Africa (Lau 271 et al. 2017 ). 272 All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.