ABSTRACT
The presence of SARS-CoV-2 RNA in wastewaters was demonstrated early into the COVID-19 pandemic. Data on the presence of SARS-CoV-2 in urban wastewater can be exploited for different aims, including: i) description of outbreaks trends, ii) early warning system for new COVID-19 outbreaks or for the spread of the virus in new territories, iii) study of SARS-Co V-2 genetic diversity and detection of its variants, and iv) estimating the prevalence of COVID-19 infections. Therefore, wastewater surveillance (known as Wastewater Based Epidemiology, WBE) can be a powerful tool to support the decision-making process on public health measures. Italy was among the first EU countries investigating the occurrence and concentration of SARS-Co V-2 RNA in urban wastewaters, virus detection being accomplished at an early phase of the epidemic, between February and May 2020 in north and central Italy. The present study reports on the methodological issues, related to sample data collection and management, encountered in establishing the systematic, wastewater-based SARS-CoV-2 surveillance, and describes the results of the first six months of surveillance. © 2022 IEEE.
ABSTRACT
OBJECTIVE: To explore the reorganization of the health system in response to the COVID-19 pandemic. METHODS: We conducted an ecological, descriptive-exploratory study with analysis of spatio-temporal clusters by epidemiological week in Brazilian municipalities. Secondary data sources were used, from the National Health Establishment Registry (April 2020) and on COVID-19 cases, February to August 2020. Intensive Care Units (ICU) availability was overlaid on incidence and mortality hot spots in order to assess expanded access in critical regions. RESULTS: Of the 5,570 municipalities analyzed, 54% were identified as incidence hot spots and 31% as mortality hot spots. Of the municipalities in incidence hot spots and with scarce access, 28% were covered by ICU expansion, while with regard to mortality 14% were covered. CONCLUSION: The opening of new beds was not able to provide broad coverage for critical regions and could be optimized with the use of spatial analysis techniques.