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Evolución y propagación epidémica del SARS-CoV-2 en Brasil
Darlan S Candido1,2, Ingra M Claro2,3, Jaqueline G de Jesus2,3
1Department of Zoology, University of Oxford, Oxford, UK.
Science (New York, N.Y.)
|July 25, 2020
Resumen
Las intervenciones no farmacéuticas (IPN) redujeron la transmisión del coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) en Brasil, pero las intervenciones siguen siendo insuficientes. El virus se propagó ampliamente a través de introducciones internacionales y viajes domésticos, lo que pone de relieve los desafíos en curso en el control de la epidemia.
Área de la Ciencia:
- Epidemiología
- La genómica
- Modelado matemático
Sus antecedentes:
- Brasil se enfrenta a una epidemia de aumento rápido del síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2).
- Los datos limitados complican la evaluación de la efectividad de las intervenciones no farmacéuticas (IPN) contra la propagación del SARS-CoV-2.
- Comprender la dinámica de transmisión del virus y las trayectorias evolutivas es crucial para la respuesta de salud pública de Brasil.
Objetivo del estudio:
- Evaluar el impacto de las IPN en la transmisión del SARS-CoV-2 en Brasil.
- Investigar los orígenes y la propagación de los linajes de SARS-CoV-2 dentro de Brasil.
- Evaluar la suficiencia de las intervenciones actuales para controlar la epidemia.
Principales métodos:
- Se utilizó un modelo de transmisión basado en la movilidad para estimar el efecto de las NPI en el número de reproducciones.
- Secuenciaron 427 nuevos genomas de SARS-CoV-2 y analizaron un conjunto de datos genómicos geográficamente representativos.
- Se analizaron las introducciones de virus, la distribución de clado y los patrones de propagación espacial.
Principales resultados:
- Los NPI redujeron el número de reproducción (R0) de más de 3 a 11,6 en São Paulo y Río de Janeiro.
- Se identificaron más de 100 introducciones internacionales de SARS-CoV-2, con el 76% de las cepas brasileñas originadas en tres clado europeos.
- La propagación temprana fue local, pero las exportaciones posteriores de los centros urbanos aumentaron con los viajes nacionales.
Conclusiones:
- Los NPI demostraron un impacto medible en la reducción de las tasas de transmisión del SARS-CoV-2.
- Las múltiples introducciones internacionales y la posterior propagación doméstica alimentaron la epidemia en Brasil.
- Las intervenciones actuales son insuficientes para controlar eficazmente la transmisión del SARS-CoV-2 en el país.
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