Fernando de Noronha: how an island controlled the community transmission of COVID-19 in Brazil

  1. Mozart Júlio Tabosa Sales
  2. Ligia Regina Franco Sansigolo Kerr
  3. Regina Vianna Brizolara
  4. Ivana Cristina de Holanda Cunha Barreto
  5. Rosa Lívia Freitas de Almeida
  6. Paulo Savio Angeiras de Goes
  7. Luiz Odorico Monteiro de Andrade
  8. Leuridan Cavalcante Torres
  9. Flávia Kelly Alvarenga Pinto
  10. Francisco Marto Leal Pinheiro Júnior
  11. Rebeca Valentim Leite
  12. Aline Priscila Rego de Carvalho
  13. Amanda Carolina Felix Cavalcanti de Abreu
  14. Rebecca Lucena Theophilo
  15. Fernando Rodrigues Magalhães
  16. Susane Lindinalva da Silva
  17. Carl Kendall

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Introduction

Fernando Noronha (FNA) is a small Brazilian archipelago in the Atlantic, part of the state of Pernambuco that COVID-19 has decimated. Anticipating the worst from the pandemic, Island and state authorities implemented a series of public health actions to contain the epidemic. This paper, reporting the results of the first wave of a cohort study, documents the measures and their effects through a cohort study.

Methods

Measures were documented at the time of implementation. A random sample of 904 residents were selected from the health register, interviewed and tested for COVID-19 (RT-PCR and serology). The survey explored socioeconomic variables and adherence to prevention behaviors.

Results

Flights were reduced from 38 to once a week, FNA was closed to tourism, schools were closed, and testing and tracing contacts was mandated along with social distancing and use of masks. A household lockdown was briefly imposed for residents. A prevalence of 5.1% was found, and a total of 158 cases of COVID-19 was estimated, although only 28 had been reported in routine surveillance. Half of the population reported food insecurity and applied for government COVID-19 benefits. Adherence to control measures was high, except for intrahousehold mask use with family and friends.

Conclusion

Despite high levels of COVID-19 in Pernambuco, continued exposure through the provision of essential services from the mainland, and lack of direction from national authorities, FNA was able to implement a series of prevention measures unique in Brazil that contained the epidemic on the island.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.10.22.20216010: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: In the case of minors (<18), parent or guardian provided consent.
    RandomizationResidents were excluded if not found at home after a second visit and replaced with another randomly selected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.10.22.20216010 on medRxiv