Covid-19 in a Metropolitan Region: public polices and social vulnerability within a context of inequality

vulnerabilidad social y políticas públicas en contextos de desigualdad.

Abstract

Covid-19 dramatically impacted socially vulnerable regions at the outskirts of large Brazilian cities. Besides, low testing capacity resulted in the lack of proper control measures due to inconsistent information on the disease’s behavior. This study aimed to estimate prevalence of SARS-CoV-2 antibodies among the Baixada Santista Metropolitan Region (RMBS) population and the impacts of social vulnerability and public policies implemented within an environment of inequality. A quantitative, cross sectional study, through a serial serological survey and the application of a questionnaire in stratified population sampling and home drew, in nine municipalities of RMBS. Seroprevalence was 1.4% in the first and 2.2% in the second phase, allowing to estimate 15 infected people for each case notified in the first phase, and 10 in the following. Lethality was recalculated to 0.40% and 0.48% in each phase, approaching the international rates. Socially vulnerable people were the most affected by the pandemic. Informal work, low income, self reported skin color as black or brown, and ambivalent information regarding prevention should be considered as risk factors. Our results reinforce the relevance of social isolation and the adoption of protective economic and social measures, especially for socially vulnerable populations.