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Comparisons between the Neighboring States of Amazonas and Pará in Brazil in the Second Wave of COVID-19 Outbreak and a Possible Role of Early Ambulatory Treatment

Emmerich et al., Int. J. Environ. Res. Public Health, doi:10.3390/ijerph18073371
Mar 2021  
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Comparison between the two largest neighboring states in Brazil, Amazonas and Pará, showing more than 5 times lower mortality in Pará during the second wave when the Pará government supported early treatment and Amazonas did not, compared to similar results in the first wave when treatment protocols were similar.
Emmerich et al., 21 Mar 2021, preprint, 1 author.
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Comparisons between the Neighboring States of Amazonas and Pará in Brazil in the Second Wave of COVID-19 Outbreak and a Possible Role of Early Ambulatory Treatment
Francisco G Emmerich
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18073371
Brazil and many countries are now experiencing a second wave of the COVID-19 outbreak. The objective of this study is to compare results with statistical samples involving millions of people in the two largest neighboring states in Brazil, Amazonas and Pará, which in the first wave were similar but now show significant different results in combating COVID-19. During the first wave, in May 2020, the maximums of the 7-day average daily deaths per population of Amazonas and Pará were similar: 15.7 and 17.1 deaths per day per million people, respectively, which means a ratio 15.7/17.1 = 0.92 ≈ 1. Now, in the second wave of COVID-19 outbreak, Amazonas has entered a serious situation; meanwhile, Pará has presented a much smaller growth in the mortality. The accumulated mortality per population from 11 November 2020 to 15 March 2021 of Amazonas and Pará are 1645 and 296 deaths per million people, respectively. As 1645/296 = 5.55, Amazonas is presenting an accumulated mortality per population more than five times that of Pará. Future in-depth research can provide a grounded answer to explain this significant difference, nonetheless the explicit support of the Pará state government, after 21 May 2020, to early ambulatory treatment may have played some role on this result.
Supplementary Materials: The following are available online at, File S1: provides the daily deaths and other statistical data of COVID-19 in Brazil from 25 February 2020 to 15 March 2021. File S2: contains the primary data, the determination of useful parameters, and the data used to make the graphs. File S3: provides the graphs of the country and of the federation units of Brazil. Funding: This research received no external funding. Conflicts of Interest: The author declares no conflict of interest. Disclaimer: The views expressed in this manuscript are those of the author, and they do not necessarily reflect the position or the policy of the Federal University of Espirito Santo. As the complete CSV File S1 is exceedingly long, mainly because it involves daily data of 5570 municipalities, it is convenient to use a TXT file editor to separate the suitable part of the data that is the focus of the analysis, before opening this part in a spreadsheet editor. As the present work involves only the country, the states and the federal district, and not the municipalities, it was sufficient to take the first 10,783 lines. The primary data contained in the above lines were exported to the Excel File S2 of three tabs in the tab "CO-VIDBR_15mar2021-data-calc". The primary data is spread over an area of 17 columns and 10,781 rows kept intact (from column A to Q). Two rows (306 and 327) of the original spreadsheet were removed, because..
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