Vulnerabilidade estrutural dos hospitais e cemitérios e crematórios da cidade de São Paulo à COVID-19

Marilia Palumbo Gaiarsa; Flávia Maria D. Marquitti; Paula Lemos-Costa; Gustavo Burin; Lucas P. Medeiros; Viviana Márquez Velásquez; Pamela C. Santana; Erika Marques Santana; Kate P. Maia; Danilo Muniz; Leandro G. Cosmo; Ana Paula A. Assis; Irina Birskis-Barros; Mauricio Cantor; Carine Emer; Cecilia Siliansky de Andreazzi; Mathias M. Pires; Marina C. Côrtes; Diogo Melo; Wesley F. Dáttilo da Cruz; Rafael Luís G. Raimundo; Eduardo X. F. G. Migon; Paulo R. Guimarães Jr

doi:10.1590/SciELOPreprints.381

##article.authors##

Marilia Palumbo Gaiarsa UC Riverside, UC Merced, USA https://orcid.org/0000-0003-4414-472X
Flávia Maria D. Marquitti Instituto de Física, UNICAMP https://orcid.org/0000-0003-0510-3992
Paula Lemos-Costa Departament of Ecology and Evolution, University of Chicago, USA https://orcid.org/0000-0001-6983-2022
Gustavo Burin Departamento de Ecologia, Instituto de Biociências, USP https://orcid.org/0000-0001-7851-0666
Lucas P. Medeiros Department of Civil and Environmental Engineering, MIT, USA https://orcid.org/0000-0002-0320-5058
Viviana Márquez Velásquez Doutoranda do Centro de Ciências Exatas e da Natureza, UFPB https://orcid.org/0000-0002-1205-7720
Pamela C. Santana Departamento de Ecologia, Instituto de Biociências, USP
Erika Marques Santana Departamento de Ecologia, Instituto de Biociências, USP https://orcid.org/0000-0001-5883-4284
Kate P. Maia Departamento de Ecologia, Instituto de Biociências, USP
Danilo Muniz Departamento de Ecologia, Instituto de Biociências, USP
Leandro G. Cosmo Departamento de Ecologia, Instituto de Biociências, USP https://orcid.org/0000-0003-2541-2645
Ana Paula A. Assis Departamento de Ecologia, Instituto de Biociências, USP
Irina Birskis-Barros School of Natural Sciences, University of California, Merced, USA
Mauricio Cantor Department for the Ecology of Animal Societies, Max Planck Institute of Animal Behaviour, Konstanz, Alemanha; Professor colaborador do Departamento de Ecologia e Zoologia, UFSC, e do Centro de Estudos do Mar, UFPR. https://orcid.org/0000-0002-0019-5106
Carine Emer Centro Nacional de Pesquisa e Conservação de Aves Silvestres - CEMAVE https://orcid.org/0000-0002-1258-2816
Cecilia Siliansky de Andreazzi Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz
Mathias M. Pires Departamento de Biologia Animal, Instituto de Biologia, UNICAMP
Marina C. Côrtes Departamento de Biodiversidade, Instituto de Biociências, UNESP Rio Claro
Diogo Melo Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, USP https://orcid.org/0000-0002-7603-0092
Wesley F. Dáttilo da Cruz Departamento de Eco-etologia, Instituto de Ecología, A.C. México
Rafael Luís G. Raimundo Departamento de Engenharia e Meio Ambiente, Centro de Ciências Aplicadas e Educação, Universidade Federal da Paraíba, Campus IV
Eduardo X. F. G. Migon Laboratório de Estudos de Defesa, Escola de Comando e Estado-Maior do Exército (LED/ECEME)
Paulo R. Guimarães Jr Departamento de Ecologia, Instituto de Biociências, USP

DOI:

https://doi.org/10.1590/SciELOPreprints.381

Keywords:

networks, policy, Brazil, Optimization, Mortuary system, overload

Abstract

This is the first report by the COVID19 Observatory - Group: Contagion Networks analyzing mortality data from the city of São Paulo. In this report, we integrated mortality data for the city of São Paulo between 04/02/2020 and 04/28/2020, with information on the flow of victims between hospitals and cemeteries/crematoriums. We included in our analyzes both confirmed and suspected deaths from COVID-19. The main objectives of this report were: (1) to describe the structure of the flow of victims between locations and (2) to suggest changes in the current flow based on geographical distances in order to avoid a potential overload of the mortuary system. We suggest that the city of São Paulo should plan for a potential overload of the mortuary system (that is, the number of burials), based on the presented results. Thus, our results reinforce the need to adopt specific planning for the management of the extraordinary number of victims of this pandemic. Our predictions are based on the structural analysis of the COVID-19 victim flow network, which shows several hotspots with high vulnerability to system overload. These hotspots concentrate with either the greatest number of deaths (hospital) or of burials (cemetery or crematorium), and therefore have high potential to become overwhelmed by receiving many bodies due to the increase in victims of the pandemic. We recommend special attention to be given to localities on the east side of São Paulo, which has both the most vulnerable hospitals in the city, and also houses cemeteries and crematoriums that have a central role in the network and / or are vulnerable. Based on our optimization analysis, we suggest logistical changes in the current flow of bodies from hospitals to cemeteries/crematoriums so as not to overload the funeral system and minimize transportation costs. In this sense, our results are potentially useful for improving the operational planning of the Municipality of São Paulo, ratifying or rectifying actions underway at the municipal level.