Association of urban inequality and income segregation with COVID-19 mortality in Brazil.

Socioeconomic factors have exacerbated the impact of COVID-19 worldwide. Brazil, already marked by significant economic inequalities, is one of the most affected countries, with one of the highest mortality rates. Understanding how inequality and income segregation contribute to excess mortality by COVID-19 in Brazilian cities is essential for designing public health policies to mitigate the impact of the disease. This paper aims to fill in this gap by analyzing the effect of income inequality and income segregation on COVID-19 mortality in large urban centers in Brazil. We compiled weekly COVID-19 mortality rates from March 2020 to February 2021 in a longitudinal ecological design, aggregating data at the city level for 152 Brazilian cities. Mortality rates from COVID-19 were compared across weeks, cities and states using mixed linear models. We estimated the associations between COVID-19 mortality rates with income inequality and income segregation using mixed negative binomial models including city and week-level random intercepts. We measured income inequality using the Gini index and income segregation using the dissimilarity index using data from the 2010 Brazilian demographic census. We found that 88.2% of COVID-19 mortality rates variability was between weeks, 8.5% between cities, and 3.3% between states. Higher-income inequality and higher-income segregation values were associated with higher COVID-19 mortality rates before and after accounting for all adjustment factors. In our main adjusted model, rate ratios (RR) per 1 SD increases in income inequality and income segregation were associated with 17% (95% CI 9% to 26%) and 11% (95% CI 4% to 19%) higher mortality. Income inequality and income segregation are long-standing hallmarks of large Brazilian cities. Risk factors related to the socioeconomic context affected the course of the pandemic in the country and contributed to high mortality rates. Pre-existing social vulnerabilities were critical factors in the aggravation of COVID-19, as supported by the observed associations in this study.

Investigation and Development of Transparent Online Assessment: A Case Study at DPU

The unprecedented COVID-19 incident created many challenges for higher education institutions. This case brought online examinations and E-learning to the spotlight after many universities refuged to e-assessment and online teaching. However, one of the main obstacles with online teaching and learning is the e-assessments transparency especially in Iraq universities and Kurdistan Region universities. Thus, the aim of the paper is to understand the experiences of students and lecturers in Duhok Polytechnic University (DPU) situated at KRG Iraq with online assessment. The paper investigates via questionnaire designed for this purpose the DPU participants with online assessments to show how are they are familiar with online exams, determine the most important problems that appeared during online examinations. The results from the questionnaire are analyzed and assessed determine factors affecting the quality of online learning and e-assessment transparency. Finally, solutions suggestions with best measures to assure the transparency and quality of online examination are recommended. © 2022 IEEE.

Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil.

COVID-19 is now identified in almost all countries in the world, with poorer regions being particularly more disadvantaged to efficiently mitigate the impacts of the pandemic. In the absence of efficient therapeutics or large-scale vaccination, control strategies are currently based on non-pharmaceutical interventions, comprising changes in population behavior and governmental interventions, among which the prohibition of mass gatherings, closure of non-essential establishments, quarantine and movement restrictions. In this work we analyzed the effects of 707 governmental interventions published up to May 22, 2020, and population adherence thereof, on the dynamics of COVID-19 cases across all 27 Brazilian states, with emphasis on state capitals and remaining inland cities. A generalized SEIR (Susceptible, Exposed, Infected and Removed) model with a time-varying transmission rate (TR), that considers transmission by asymptomatic individuals, is presented. We analyze the effect of both the extent of enforced measures across Brazilian states and population movement on the changes in the TR and effective reproduction number. The social mobility reduction index, a measure of population movement, together with the stringency index, adapted to incorporate the degree of restrictions imposed by governmental regulations, were used in conjunction to quantify and compare the effects of varying degrees of policy strictness across Brazilian states. Our results show that population adherence to social distance recommendations plays an important role for the effectiveness of interventions and represents a major challenge to the control of COVID-19 in low- and middle-income countries.

Covid-19 in Latin America countries: Course of the pandemic and the different responses towards control (preprint)

Background: The emergence of COVID-19 in Latin America occurred within a troubled political, economic and social context, with growing trends of poverty and social inequality challenging already overburdened and underfinanced local healthcare systems. In the absence of a vaccine or of any treatment for COVID-19, public health measures such as social distancing had to be adopted. The objective of this paper is to describe the course of the COVID-19 pandemic in Latin American countries and to summarize the social distancing measures implemented in each one of these countries, discussing the changes that took place in the social mobility of the populations and their potential effects on the course of the epidemic up to June 2020. Results: Brazil has the highest cumulative number of cases and deaths; however, cumulative incidence rates are higher in Peru and Chile, while the highest cumulative mortality rates are in Ecuador, Peru and Brazil. Some countries implemented social distancing measures before the first case was registered, culminating in lockdown in eight countries before detection of the 100th case. The measures that appear to have had the greatest impact in reducing mobility include, in addition to lockdown, the closure of schools and prohibition of events. In general, the countries that implemented social distancing measures earlier and where the reduction in social mobility was greatest also recorded lower incidence and mortality rates. Brazil and Mexico failed to adopt lockdown and the number of cases of the disease continues to grow. Conclusions: As occurred in other continents, control of the COVID-19 pandemic was better in countries that were faster in adopting more restrictive measures. Nevertheless, this equation does not appear to guarantee a positive outcome in all settings, possibly due to the considerable social inequalities and chronic deficiencies of the healthcare systems, with the scenario being even more complex in view of the recurring political crises and the negationist view of some national leaders. The COVID-19 pandemic continues to spread in Latin America and exposes these contradictions. Further studies are required to gain a greater understanding and generate lessons on how to manage such a complex crisis.

Assessing the nationwide impact of COVID-19 mitigation policies on the transmission rate of SARS-CoV-2 in Brazil (preprint)

COVID-19 is now identified in almost all countries in the world, with poorer regions being particularly more disadvantaged to efficiently mitigate the impacts of the pandemic. In the absence of efficient therapeutics or vaccines, control strategies are currently based on non-pharmaceutical interventions, comprising changes in population behavior and governmental interventions, among which the prohibition of mass gatherings, closure of non-essential establishments, quarantine and movement restrictions. In this work we analyzed the effects of 547 published governmental interventions, and population adherence thereof, on the dynamics of COVID-19 cases across all 27 Brazilian states, with emphasis on state capitals and remaining inland cities. A generalized SEIR model with a time-varying transmission rate (TR), that considers transmission by asymptomatic individuals, is presented. Confirmed COVID-19 cases were used to calibrate the model parameters using non-linear least squares methods. We analyze the changes on the TR and effective reproduction number as a function of both the extent of enforced measures across Brazilian states as well as population movement. The social mobility reduction index, a measure of population movement, together with the stringency index, adapted to incorporate the degree of restrictions imposed by governmental regulations, were used in conjunction to quantify and compare the effects of varying degrees of policy strictness across Brazilian states. Our results show that population adherence to social distance recommendations plays an important role for the effectiveness of interventions, and represents a major challenge to the control of COVID-19 in low- and middle-income countries.