ABSTRACT
Background: COVID-19 has exacerbated health inequalities worldwide. Yet, such a perspective has not been investigated in specific healthcare workers and their resulting inclusion as a priority group for vaccination have been an important focus of political and social discussion. This study aimed at investigating whether SARS-CoV-2-seropositivity in healthcare workers in a public hospital in Rio de Janeiro, Brazil, was influenced by social determinants of health and the social vulnerability in subgroups of workers. Methods: A serological survey was conducted in 1,154 healthcare workers in June and July 2020. The association between the serological test results for detection of IgG antibodies to SARS-CoV-2 and socioeconomic, occupational characteristics and transportation used by the workers to commute was assessed using the Pearson´s chi-square test and Carmer’s V. Findings: Overall, the serum prevalence for the virus in the healthcare workers was 30%. Non-white workers with lower income and schooling, as well as users of the mass transportation system showed the highest infection rates. Importantly they mostly corresponded to hospital support workers, in particular the cleaning personnel. Accordingly, income, schooling and work modality appeared as negative predictors, as ascertained by forest plot analysis. Interpretations: The data clearly illustrate the inequality in SARS-CoV-2 infection in the Brazilian population, comprising even healthcare workers of the Brazilian unified health system.Funding Information: This study was financed by Fiocruz, CNPq, Faperj, Capes, FOCEM/Mercosur and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.Declaration of Interests: The authors declare no competing financial interests.Ethics Approval Statement: “Clinical and immunological characteristics of children, adolescents, and adults with COVID-19 diagnosis: COVID-19 Kids Project” was submitted to the Institutional Review Board of IFF (CEP/IFF) under identification number 30487120.2.0000.0008 and approved under review number 4.100.148. There was no discrimination in the selection of research subjects or exposure to unnecessary risks.
Subject(s)
Porphyria, Erythropoietic , COVID-19 , Gerstmann SyndromeABSTRACT
The aim of this study was to develop a realistic network model to predict the relationship between lockdown duration and coverage in controlling the progression of the incidence curve of an epidemic with the characteristics of COVID-19 in two scenarios (1) a closed and non-immune population, and (2) a real scenario from State of Rio de Janeiro from May 6th 2020. Effects of lockdown time and rate on the progression of an epidemic incidence curve in a virtual population of 10 thousand subjects. Predictor variables were reproductive values established in the most recent literature (R0 =2.7 and 5.7, and Re = 1.28 from Rio de Janeiro State at May 6th), without lockdown and with coverages of 25%, 50%, and 90% for 21, 35, 70, and 140 days in up to 13 different scenarios for each R0/Re, where individuals remained infected and transmitters for 14 days. We estimated model validity in theoretical and real scenarios respectively by applying an exponential model on the incidence curve with no lockdown with growth rate coefficient observed in realistic scenarios, and (2) fitting real data series from RJ upon simulated data, respectively. For R0=5.7, the flattening of the curve occurs only with long lockdown periods (70 and 140 days) with a 90% coverage. For R0=2.7, coverages of 25 and 50% also result in curve flattening and reduction of total cases, provided they occur for a long period (70 days or more). For realistic scenario in Rio de Janeiro, lockdowns +25% or more from May 6th during 140 days showed expressive flattening and number of COVID cases two to five times lower. If a more intense coverage lockdown (about +25 to +50% as much as the current one) will be implemented until June 6th during at least 70 days, it is still possible reduce nearly 40-50% the impact of pandemy in state of Rio de Janeiro. These data corroborate the importance of lockdown duration regardless of virus transmission and sometimes of intensity of coverage, either in realistic or theoretical scenarios of COVID-10 epidemics. Even later, the improvement of lockdown coverage can be effective to minimize the impact of epidemic.