Aplicação de modelos matemáticos em pandemias: um estudo de comportamento epidemiológico a partir da Covid-19.
Carregando...
Data
2022-03-22
Autores
Almeida, Gabriel Berg de
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Modelos matemáticos, estatísticos e computacionais são extensamente utilizados para o estudo das doenças infecciosas, sua dispersão e seus fatores de risco. A identificação do SARS-CoV-2 e da doença causada por ele, a Covid-19, culminou em esforços globais para o entendimento da dinâmica de transmissão e dispersão em uma situação pandêmica. O presente estudo é fruto de um processo contínuo de pesquisa epidemiológica em saúde. Foi proposto um modelo matemático para o estudo da dinâmica de transmissibilidade do SARS-CoV-2 em pequenas e médias cidades no interior do Brasil, e o possível efeito de intervenções em saúde pública. Também foram propostos modelos geográficos, a partir de análise exploratória de dados secundários e visualização cartográfica: estudamos a evolução da epidemia no interior do Estado de São Paulo, relacionando o grau de conectividade entre municípios e as estruturas elementares espaciais que influenciam a dispersão da doença; e a distribuição espacial precoce da incidência de Covid-19 no Brasil, em conjunto com o aumento da capacidade laboratorial brasileira para o diagnóstico molecular da doença. Por fim, apresentamos um estudo de acompanhamento dos duzentos primeiros dias de epidemia em São Paulo, através de estimativas do número de reprodução (Rt) do SARS-CoV-2 e sua relação com as intervenções em saúde pública adotadas pelo governo do Estado. Nossos resultados em modelagem matemática demonstram que intervenções não-farmacológicas são necessárias para o controle de epidemia e que cada município deve ser estudado individualmente, levando-se em consideração fatores bióticos e abióticos que podem influenciar na transmissão de doença. O modelo geográfico confirma a hipótese de que o SARS CoV-2 se dissemina por contiguidade da metrópole para suas cidades vizinhas mais próximas e que também é observado um espalhamento à distância, um processo de dispersão hierárquica, na qual os municípios maiores se relacionam com a metrópole, através de rodovias, hidrovias, pontes aéreas e do fluxo de pessoas e comércio. Além disso, fica claro que a incidência precoce da Covid-19 foi mais importante em grandes metrópoles brasileiras, e avançou no sentido do interior em todas as regiões, acompanhado do importante aumento da capacidade de diagnóstico por laboratórios públicos credenciados. Por fim, demonstramos os resultados do acompanhamento do Rt ao longo dos duzentos dias subsequentes à ocorrência do primeiro caso de Covid 19 em São Paulo e como a variação em suas estimativas consegue ser relacionada às diferentes medidas restritivas vigentes no momento. Todos os estudos apresentados são complementares, buscando uma compreensão ecológica e, através de evidência científica, auxiliar as tomadas de decisão em gestão de saúde pública e, consequentemente, o enfrentamento racional à epidemia.
Mathematical, statistical and computational models are widely used to study infectious diseases, their spread and their risk factors. Identifying SARS-CoV-2 and the disease it causes, Covid-19, has culminated in global efforts to understand the dynamics of transmission and dispersion in a pandemic situation. The present study results from a continuous process of epidemiological health research. A mathematical model was proposed to study the dynamics of SARS-CoV-2 transmissibility in small and mediumsized cities in the interior of Brazil and the possible effect of public health interventions. Geographical models were also proposed, based on exploratory secondary data analysis and cartographic visualization. We studied the evolution of the epidemic in the inner State of São Paulo, relating the degree of connectivity between municipalities and the elementary spatial structures that influence the spread of the disease; And the early spatial distribution of the incidence of Covid-19 in Brazil, together with the increase in Brazilian laboratory capacity for the molecular diagnosis of the disease. Finally, we present a follow-up study of the first two hundred days of the epidemic in São Paulo through estimates of the reproduction number (Rt) of SARS-CoV-2 and its relationship with public health interventions adopted by the state government. Our results in mathematical modelling demonstrate that non-pharmacological interventions are necessary for epidemic control and that each municipality should be studied individually, taking into account biotic and abiotic factors that can influence disease transmission. The geographic model confirms the hypothesis that SARS-CoV-2 spreads by contiguity from the metropolis to its closest neighbouring cities and that a 9 distant spread is also observed, a process of hierarchical dispersion, in which the largest municipalities relate to other cities, the metropolis, through highways, waterways, air bridges and the flow of people and commerce. In addition, it is clear that the early incidence of Covid-19 was more important in large Brazilian metropolises and advanced towards the interior in all regions, accompanied by a significant increase in diagnostic capacity by accredited public laboratories. Finally, we demonstrate the results of monitoring the Rt over the two hundred days following the first case of Covid19 in São Paulo and how the variation in its estimates can be related to the different restrictive measures in force at the time. All the studies presented are complementary, seeking an ecological understanding and, through scientific evidence, helping decision-making in public health management and, consequently, the rational confrontation of the epidemic
Mathematical, statistical and computational models are widely used to study infectious diseases, their spread and their risk factors. Identifying SARS-CoV-2 and the disease it causes, Covid-19, has culminated in global efforts to understand the dynamics of transmission and dispersion in a pandemic situation. The present study results from a continuous process of epidemiological health research. A mathematical model was proposed to study the dynamics of SARS-CoV-2 transmissibility in small and mediumsized cities in the interior of Brazil and the possible effect of public health interventions. Geographical models were also proposed, based on exploratory secondary data analysis and cartographic visualization. We studied the evolution of the epidemic in the inner State of São Paulo, relating the degree of connectivity between municipalities and the elementary spatial structures that influence the spread of the disease; And the early spatial distribution of the incidence of Covid-19 in Brazil, together with the increase in Brazilian laboratory capacity for the molecular diagnosis of the disease. Finally, we present a follow-up study of the first two hundred days of the epidemic in São Paulo through estimates of the reproduction number (Rt) of SARS-CoV-2 and its relationship with public health interventions adopted by the state government. Our results in mathematical modelling demonstrate that non-pharmacological interventions are necessary for epidemic control and that each municipality should be studied individually, taking into account biotic and abiotic factors that can influence disease transmission. The geographic model confirms the hypothesis that SARS-CoV-2 spreads by contiguity from the metropolis to its closest neighbouring cities and that a 9 distant spread is also observed, a process of hierarchical dispersion, in which the largest municipalities relate to other cities, the metropolis, through highways, waterways, air bridges and the flow of people and commerce. In addition, it is clear that the early incidence of Covid-19 was more important in large Brazilian metropolises and advanced towards the interior in all regions, accompanied by a significant increase in diagnostic capacity by accredited public laboratories. Finally, we demonstrate the results of monitoring the Rt over the two hundred days following the first case of Covid19 in São Paulo and how the variation in its estimates can be related to the different restrictive measures in force at the time. All the studies presented are complementary, seeking an ecological understanding and, through scientific evidence, helping decision-making in public health management and, consequently, the rational confrontation of the epidemic
Descrição
Palavras-chave
Covid-19, Epidemiologia, Modelos matemáticos