Relationship between COVID-19, sanitation and municipal indicators of the state of Ceará

Abstract

Covid-19, characterized as a pandemic disease by the World Health Organization (WHO), has become a health challenge around the world. Studies related to social and environmental indicators can help the health and government authorities to manage the resources for coping with specific Covid-19 hotspot outbreaks. Therefore, this study aimed to correlate confirmed Covid-19 cases with sanitation and social indicators of 152 municipalities in the Ceará state, Brazil. Specific correlations were obtained by descriptive, histogram, scatter diagram and Spearman correlation coefficient, and multivariate, Principal Component Analysis – PCA, statistical methods. The results showed that the Fortaleza Metropolitan mesoregion was classified in the range of intermediate to very high for the number of confirmed Covid-19 cases, around 45.4%. Fortaleza city, epicenter of the disease, accounted for almost 33% of the cases in the mesoregion. The mesoregions in the interior of the state: Northwest Cearense, North Cearense, South Cearense, Center-South Cearense, Jaguaribe and Sertões Cearenses showed a moderate or low scale for the incidence of the Covid-19. According to the PCA results, the variables demographic density, population with water and sewage collection access were associated with confirmed Covid-19 cases. Spearman's correlation analysis showed a strong and significant positive relationship (p<0.05) between confirmed Covid-19 and the population with water and sewage collection and the human development index (HDI), as well as the relationship moderate among those confirmed with Covid-19 with gross domestic product (GDP) per capita and HDI.  Based on the results it was concluded that demographic density and the local economy were more associated with the transmission of SARS-CoV-2 than basic sanitation indicators.

Keywords: Municipal indicators; Basic sanitation; SARS-CoV-2; Statistical methods; Correlation.