Structural vulnerability of hospitals, cemeteries, and crematoriums of the city of São Paulo to COVID-19
Keywords:networks, policy, Brazil, Optimization, Mortuary system, overload
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.
Copyright (c) 2020 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, Paulo R. Guimarães Jr
This work is licensed under a Creative Commons Attribution 4.0 International License.