COVID-19 and zoonoses in Brazil: Environmental scan of one health preparedness and response.

The emergence of the COVID-19 pandemic reinforced the central role of the One Health (OH) approach, as a multisectoral and multidisciplinary perspective, to tackle health threats at the human-animal-environment interface. This study assessed Brazilian preparedness and response to COVID-19 and zoonoses with a focus on the OH approach and equity dimensions. We conducted an environmental scan using a protocol developed as part of a multi-country study. The article selection process resulted in 45 documents: 79 files and 112 references on OH; 41 files and 81 references on equity. The OH and equity aspects are poorly represented in the official documents regarding the COVID-19 response, either at the federal and state levels. Brazil has a governance infrastructure that allows for the response to infectious diseases, including zoonoses, as well as the fight against antimicrobial resistance through the OH approach. However, the response to the pandemic did not fully utilize the resources of the Brazilian state, due to the lack of central coordination and articulation among the sectors involved. Brazil is considered an area of high risk for emergence of zoonoses mainly due to climate change, large-scale deforestation and urbanization, high wildlife biodiversity, wide dry frontier, and poor control of wild animals' traffic. Therefore, encouraging existing mechanisms for collaboration across sectors and disciplines, with the inclusion of vulnerable populations, is required for making a multisectoral OH approach successful in the country.

Were the socio-economic determinants of municipalities relevant to the increment of COVID-19 related deaths in Brazil in 2020?

BACKGROUND: The COVID-19 pandemic in Brazil has been showing a pattern of distribution of related deaths associated with individual socioeconomic status (SES). However, little is known about the role of SES in the distribution of the mortality rate in different population, from an ecological perspective. OBJECTIVE: The objective of this study was to evaluate the role of socioeconomic factors in the distribution of the COVID-19-related mortality rate among Brazilian municipalities in 2020. METHODS: We conducted a retrospective, cross-sectional, observational, population-wide, and ecological study, using data of COVID-19-related deaths from the Influenza Epidemiological Surveillance Information System database (SIVEP-Gripe) and SES from the Social Vulnerability Index (SVI), the Human Development Index (HDI), the Geographic Index of the Socioeconomic Context and Social Studies (GeoSES), and 2010 Demographic Census (IBGE/Brazil). We computed crude, age- and sex-standardized, and the latter offset by the time of exposure to the epidemic mortality rates. To determine socioeconomic factors associated with mortality rates we used log-linear models with state codes as a random effect and Haversine variance-covariance matrix. RESULTS: 191,528 deaths were related to COVID-19 and distributed in 4,928 (88.55%) Brazilian municipalities. Whatever the socioeconomic indexes used, the R2 were very small to explain SMRT. Consistent across all socioeconomic indexes used, high-income, more educated, and well infrastructure municipalities generally had higher mortality rates. CONCLUSION: Excluding the effect of demographic structure and pandemic timing from mortality rates, the contribution of SES to explain differences in COVID-19-related mortality rates among municipalities in Brazil became very low. The impact of SES on COVID-19-related mortality may vary across levels of aggregation. Urban infrastructure, which includes mobility structures, more complex economic activities and connections, may have influenced the average municipal death rate.