Mitigation of COVID-19 using social distancing of the elderly in Brazil: The vertical quarantine effects in hospitalizations and deaths

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Abstract

Governments and epidemiologists have been proposing several mitigation strategies based on non-pharmaceutical interventions to reduce COVID-19 cases, hospitalizations, and deaths. In this work, we quantitatively compare the effects of elderly population (60 years old or more) selective isolation with a no isolation scenario using an adapted Susceptible - Exposed - Infectious - Removed (SEIR) compartmental model. For these simulated scenarios, we estimate the number of hospitalizations and deaths for different Brazilian cities, including those due to the lack of hospital beds. Our simulations show that, for São Paulo City, the isolation of the elderly would reduce demand for hospital beds by 9% and deaths by 16% compared to the no intervention scenario. Other Brazilian cities follow the same pattern, with median reductions of deaths ranging from 12-18%. We conclude that the social distancing of the elderly would be marginally effective and would not avoid health system collapse in several Brazilian cities.

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  1. SciScore for 10.1101/2021.01.12.21249495: (What is this?)

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

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study limitations: In our model, we considered only the age to distinguish risk groups. More sophisticated models could add more factors e.g., considering those with heart or respiratory diseases. By increasing the number of people isolated by the vertical quarantine strategy, it would be probable more effective, reducing death as well as hospitalization numbers. However, using a broader inclusion criterion for the risk group is likely to include the economically active population in the isolation group, which could have considerably different economic and social impacts. Our model assumes a homogeneous distribution of the citizens within each age group and no contacts between individuals from different cities. It does not consider the spatial dynamics, seasonality, effects of treatments or vaccine, healthcare system networks and heterogeneous mixture of the population, except those determined by the age contact patterns. Such phenomena could alter the dissemination dynamics within the population. Our model assumes a standard population pyramid based on the Brazilian population pyramid for all simulated cities. However, the population pyramid for the simulated cities can vary significantly, changing the expected number of deaths for each city, since there is a strong positive relationship between age and COVID-19 infection fatality ratio [33]. Further studies should address this issue by using different population pyramids accordingly to each city.

    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.

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