COVID-19: Local/regional inequalities and impacts over critical healthcare infrastructure in Brazil

Abstract This article addresses regional inequalities about critical healthcare infrastructure for coping with the COVID-19, based on geospatial analysis and compartmental modeling (SEIR) The study sites were the Sao Paulo Macro Metropolis (MMP) and the Metropolitan Region of Vale do Paraiba/Litoral Norte (RMVPLN) The results indicated the absence of ICU beds in more than 2/3 of the municipalities, in addition to the concentration in regional hubs, for which the migration of COVID-19 cases from neighboring municipalities should be considered The analysis with the SEIR model, performed for scenarios with and without social isolation, showed that the isolation adopted in the regions was able to postpone the collapse of the health infrastructure, reducing the reproduction rate of the disease The simulations indicated a reproduction rate of 0 95 in order to avoid collapse in the health infrastructure for RMVPLN in the analyzed period In addition, for future resilience, it is essential to address inequalities in terms of health infrastructure available for public and private access